Measuring physical fitness in Persons with Severe/Profound ...

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this study was to evaluate the feasibility and reliability of the modified Berg Balance Scale (mBBS)in persons with intellectual and visual disabilities classified Gross Motor Function ClassificationSystem (GMFCS) grade I and II.MethodsParticipantsParticipants were recruited from a residential care facility for the profound or severe intellectuallyand visually disabled in the Netherlands. Of the residents of this facility, 65% also suffers frommotor disabilities. The participants were classified according to their motor skills using the GrossMotor Function Classification System (GMFCS) [30], a five-level system used to classify the motorabilities of the physically disabled. Participants with a “Level I” classification can generally walkwithout restrictions but tend to have limitations in more advanced motor skills. Participants witha “Level II” classification can walk with slight restrictions and do not spontaneously increase theirspeed during walking. The locomotor skills of those assigned GMFCS levels III to V are very limitedand they were therefore excluded from performing the balance test.Written consent was requested from the representatives of 92 candidates and obtained from80. After informed consent was obtained, the subjects were screened based on an examinationby both a special needs physician and a behavioral scholar. The screening itself excluded sevensubjects. Another eight participants were excluded, as they did not live at the centre where thetests were to be performed. Eight other participants were excluded as they could not attend allfive practice sessions. Another 18 participants were excluded as they exhibited one or more of theexclusion criteria at the time of measurement (Fig. 1). These exclusion criteria were: psychoses,depression or other severe psychological problems; somatic diseases, which were defined aschronic diseases and/or diseases that do not resolve in the short term (e.g., osteoarthritis,osteoporosis, pneumonia, etc); general illness or fever; taking antibiotics; worsening of asthma,epilepsy (recent insult or epileptic fits), fresh wound(s)/bruise(s) or other factors causing painduring movement; and finally stress due to the participant’s behavior shortly prior to the date ofmeasurement.Chapter 6 | 93
92 participants12 participants lacked permission from representatives80 participants7 participants excluded for medical or behavioral reasons73 participants8 participants did not live at the examination centre65 participants8 participants did not practice five times57 participants18 participants were excluded for exhibiting exclusion criteria atthe time of the test39 participantsFigure 1. Inclusion steps.Out of the remaining 39 participants in this study 28 were male and 11 were female. Themean (SD) age was 38 (11) years for the men and 44 (10) years for their female counterpart.Twenty-three participants were classified GMFCS level I and 16 participants GMFCS level II.According to the classification scheme of the ICD-10 (WHO, 1992), 92% (n=36) had severeintellectual disabilities, and 8% (n=3) suffered from profound intellectual disabilities. Accordingto the WHO guidelines [31], all participants suffered from impaired vision: 44% (n=17) of theparticipants was severely partially sighted, 38% (n=15) was partially sighted and 18% (n=7)was slightly limited in sight. Most participants had impaired motor abilities: 67% (n=26) hadorthopedic defects and 5% (n=2) had severe motor handicap of neurological origin. In addition,23% (n=9) of the participants had slight hearing problems, 2% (n=1) had loss of hearing, and 5%(n=2) had either severe hearing loss or was completely deaf.DesignThe participants performed the mBBS twice, with a one-week interval between test and retest.Both tests were performed at the same time of day, under the same circumstances and under thesupervision of the same personal caretaker and observer.Ethical StatementThe study was performed in agreement with the guidelines of the Helsinki Declaration as revisedin 1975. Permission was obtained from the institutional ethics committee. Informed consent was94 | Chapter 6
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Measuring physical fitnessin person
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Rijksuniversiteit GroningenMeasurin
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Chapter 1IntroductionChapter 1 | 9
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overweight [15]. This prevalence is
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Theoretical framework of the studyI
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Components of physical fitnessThe a
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Therefore, a study is put forward w
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2002;40:436-444.19 Temple VA, Frey
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Chapter 2Feasibility and reliabilit
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IntroductionPhysical fitness and he
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GMFCS was presented to the investig
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Body weightTo determine the body we
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Table 1 Results of Wilcoxon rank te
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Calculation of heightThe mean (SD)
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DiscussionThe results of our study
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References1 Bouchard C, Shepard RJ,
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37 Rimmer J, Kelly LE, Rosentswieg
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Chapter 3Measuring waist circumfere
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IntroductionChildren and adults wit
Page 44 and 45: participants. These calculations as
Page 46 and 47: Data analysisThe data were analyzed
Page 48: Table 2. Simple regression analysis
Page 54 and 55: Chapter 4Feasibility and reliabilit
Page 56 and 57: IntroductionPeople with intellectua
Page 58 and 59: Eighty representatives gave permiss
Page 60 and 61: 3) The measurement procedure: The m
Page 62 and 63: and whether motivation influenced t
Page 64 and 65: Table 3. Mean peak heart rate achie
Page 66 and 67: AcknowledgementsThis research was f
Page 68 and 69: 21 Hopkins WG, Gaeta H, Thomas AC,
Page 70 and 71: Chapter 5Psychometric quality of a
Page 72 and 73: IntroductionIntellectual disability
Page 74 and 75: Exclusion criteria were mental or p
Page 76 and 77: participant had fulfilled the task.
Page 78 and 79: Table 2. Descriptive results peak h
Page 80 and 81: Table 3. Test-retest reliability of
Page 82 and 83: Table 4. Correlation scored motivat
Page 84 and 85: preceding GXT results on HR peak. G
Page 86 and 87: References1 Schalock R, Brown I, Br
Page 88 and 89: 37 Stanish HI, Temple VA, Frey GC.
Page 90 and 91: Chapter 6Feasibility and reliabilit
Page 92 and 93: IntroductionLocomotor skills in peo
Page 96 and 97: obtained from the legal representat
Page 98 and 99: Modified Berg Balance Scale scoresI
Page 100 and 101: Modified Berg Balance Scale scoresT
Page 102 and 103: References1 Van Erkelens-Zwets JHJ
Page 104 and 105: 39 Dorai-Raj S. Binomial Confidence
Page 106 and 107: Chapter 7Feasibility, test-retest r
Page 108 and 109: IntroductionPersons with profound i
Page 110 and 111: DesignThe muscle tone and spasticit
Page 112 and 113: Interrater reliabilityFirstly, to d
Page 114 and 115: Table 3. Summary of the statistical
Page 116 and 117: Table 6. Summary of the statistical
Page 118 and 119: RecommendationsThe feasibility of c
Page 120 and 121: 18 Gielen EJJM. Is spasticiteit te
Page 122 and 123: Chapter 8Heart Rate Pattern as an I
Page 124 and 125: IntroductionIt is important to gain
Page 126 and 127: 48 persons18 persons lacked permiss
Page 128 and 129: Furthermore, the mean and the range
Page 130 and 131: Table 3. Day-to-day outline of the
Page 132 and 133: Relation between heart rate pattern
Page 134 and 135: patterns in this study we can concl
Page 136 and 137: References1 Emerson E. Underweight,
Page 138 and 139: 38 Multilevel Models Project (2004)
Page 140 and 141: Chapter 9General DiscussionChapter
Page 142 and 143: on this. To sum up, testing in pers
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for future research it is recommend
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studies. Randomized Controlled Tria
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of these individuals require more?
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19 Lahtinen U, Rintala P, Malin A.
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SummarySummary | 151
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problems in both locomotor skills a
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subjects are to be applied to perso
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may be an indicator of activity lev
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SamenvattingSamenvatting | 159
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InleidingVoldoende bewegen en fithe
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verstandelijk niveau en bepaalde mo
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Hieruit bleek, dat de motivatie van
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Verder is duidelijk geworden dat me
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DankwoordDankwoord | 169
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De leden van de leescommissie, prof
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Judith van der Boom, dank je wel vo
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Dankwoord | 175
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Curriculum vitaeCurriculum vitae |
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Curriculum vitae | 179
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