THE EFFECT OF EXERCISE ON PHYSICAL FITNESS IN INDIVIDUALS WITH INTELLECTUAL DISABILITY: A SYSTEMATIC REVIEW

Öz

Intellectual disability is a multifaceted and complex condition characterized by significant deficits in both mental functioning and adaptive behavior, including daily social and practical skills, and significant limitations in adaptive behavior. Individuals with intellectual disabilities may be inadequate in terms of physical, cognitive and social development compared to their other peers. To systematically review the scientific evidence for the effects of exercise programs designed to improve physical fitness in adults with intellectual disabilities. This study is a systematic review and was carried out by searching English indexes from Pubmed, Web of Science and EBSCOhost databases between January 2010-May 2020. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) provided a guide for guiding the research and writing the research report. A total of 8 studies were included in the study. When the physical fitness results related to health are examined, it is seen that there are no significant effects on body composition data; It has been reported that there are significant changes in cardiovascular and cardiorespiratory fitness, motor skills and metabolic fitness. Physical activity and combined (strength and aerobic) exercise designed for healthy living are the most frequently recommended programs. There is scientific evidence of beneficial effects on cardiovascular, cardiorespiratory fitness and motor skills in adults with mild to moderate intellectual disability. However, there is a need for more studies focusing on the effect of exercise practices on the body composition of this population and increasing the commitment to exercise by making exercise enjoyable as well as alternative applications.

Anahtar Kelimeler

• Mental disability
• exercise
• exercise program
• physical fitness

ZİHİNSEL ENGELLİ BİREYLERDE EGZERSİZİN FİZİKSEL UYGUNLUĞA ETKİSİ: SİSTEMATİK BİR DERLEME

Öz

Zihinsel engellilik, günlük sosyal ve pratik beceriler de dahil olmak üzere hem zihinsel işlevlerde hem de uyum sağlayıcı davranışlarda önemli eksiklerle karakterize edilen çok yönlü ve karmaşık bir durumdur. Zihinsel engelli bireyler diğer akranlarına kıyasla fiziksel, bilişsel ve sosyal gelişim bakımından yetersiz olabilmektedir. Bu derlemenin amacı zihinsel engelli olan yetişkin bireylerde fiziksel uygunluğu geliştirmek için tasarlanan egzersiz programlarının etkilerine ilişkin bilimsel kanıtları sistematik olarak gözden geçirmektir. Bu çalışma sistematik derleme niteliğindedir ve Ocak 2010–Mayıs 2020 tarihleri arasında Pubmed, Web of Science ve EBSCOhost veri tabanlarından İngilizce dizinler taranarak gerçekleştirilmiştir. Sistematik Derlemeler ve Meta-Analiz Protokolleri için Tercih Edilen Raporlama Öğeleri (The Preferred Reporting Items for Systematic Reviews and MetaAnalyses - PRISMA) araştırmanın yönlendirilmesinde ve araştırma raporunun yazımında bir kılavuz oluşturmuştur. Araştırmaya toplam 8 çalışma dahil edilmiştir. Sağlıkla ilgili fiziksel uygunluk sonuçları incelendiğinde vücut kompozisyonu verilerinde önemli etkilerin olmadığı görülürken; kardiyovasküler ve kardiyoresperatuar uygunluk, motor beceriler ile metabolik uygunluk üzerinde önemli değişiklikler olduğu bildirilmiştir. Sağlıklı yaşam için tasarlanmış fiziksel aktivite ve kombine (kuvvet ve aerobik) egzersiz en sık önerilen programlardır. Hafif ve orta düzey zihinsel engelli olan yetişkin bireylerde kardiyovasküler ve kardiyorespiratuar uygunluk ve motor beceriler üzerindeki yararlı etkilerine dair bilimsel kanıtlar mevcuttur. Fakat egzersiz uygulamalarının bu popülasyonun vücut kompozisyonu üzerindeki etkisine odaklanan ve alternatif uygulamaların yanı sıra egzersizin eğlenceli hali getirilerek egzersize olan bağlılığın arttırıldığı daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Zihinsel engelli
• egzersiz
• egzersiz programı

Kaynakça

1. Adolfsson, P., Sydner, Y. M., Fjellstrom, C., Lewin, B., Andersson, A. (2008). Observed dietary intake in adults with intellectual disability living in the community.Journal of Food and Nutrition Research.52.
2. American College of Sports Medicine (2018). ACSM's guidelines for exercise testing and prescription, (10th ed.). Philadelphia, PA: Wolters Kluwer.
3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington (VA): American Psychiatric Publishing.
4. Anneken, V., Hanssen-Doose, A., Hirschfeld, S., Scheuer, T., Thietje, R. (2010). Influence of physical exercise on quality of life in individuals with spinal cord injury. Spinal Cord, 48(5), 393–9.
5. Barnes, T.L., Howie, E.K., McDermott, S., Mann, J.R. (2013). Physical activity in a large sample of adults with intellectual disabilities. J Phys Act Health, 10(7), 1048-56.
6. Barwick, R.B., Tillman, M.D., Stopka, C.B., Dipnarine, K., Delisle, A., Sayedul, H.M. (2012). Physical capacity and functional abilities improve in young adults with intellectual disabilities after functional training. Journal of Strength and Conditioning Research, 26(6), 1638–1643.
7. Bayazıt B. (2007). Eğitilebilir, zihinsel engelli çocuklarda eğlenceli atletizm antrenman programının psikomotor özelliklere etkisi. Spormetre Beden Eğitimi ve Spor Bilimleri Dergisi, 5(4), 173-176.
8. Bergström, H., Hangström, M., Hagberg, J., Elinder, L.S. (2013). A multi-component universal intervention to improve dietand physical activity among adults with intellectualdisabilities in community residences: A cluster randomisedcontrolled trial. Research in Developmental Disabilities, 34, 3847–3857.

9. Bhaumik, S., Watson, J. M., Thorp, C. F., Tyrer, F., McGrother, C. W. (2008). Body mass index in adults with intellectual disability: Distribution, associations andservice implications: A population-based prevalence study. Journal of Intellectual Disability Research, 52, 287–298.
10. Calders, P., Elmahgoub, S., Mettelinge, T.R., Vandenbroeck, C., Dewandele, I., Rombaut, L., Vandevelde, A., Cambier, D. (2011). Effect of combined exercise training on physical and metabolic fitness in adults with intellectual disability: a controlled trial. Clinical Rehabilitation, 25(12), 1097–1108.
11. Casey, A, Boyd, C., MacKenzie, S., et al. (2012). Dual-Energy X-Ray Absorptiometry to measure the effects of a thirteen-week moderate to vigorous aquatic exercise and nutritional education intervention on percent body fat in adults with intellectual disabilities from group home settings. J Hum Kinet., 32, 221–229.
12. Casey, A. F., & Rasmussen, R. (2013). Reduction measures and percent body fat in individuals with intellectual disabilities: A scoping review. Disability & HealthJournal, 6, 2-7.
13. Caspersen, C.J., Powell, K.E., Christenson, G.M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health‐related research. Public Health Rep., 100(2), 126‐131.
14. Cortes-Amador, S., Juan, J., Sempere-Rubio, C., Igual-Camacho, N., Luis, C., Villaplana-Torres, A., Perez-Alenda, A. (2018). Effects of a vestibular physiotherapy protocol on adults with intellectual disability in the prevention of falls: A multi-centre clinical trial. J Appl Res Intellect Disabil., 32, 359–367.
15. Reuben D.B., Siu, A.L., Kimpau, S. (1992). The predictive validity of self-report and performance-based measures of function and health. Journal of Gerontology, 47(4), 106-110.
16. Draheim, C. C., Stanish, H. I., Williams, D. P., McCubbin, J. A. (2007). Dietary intake of adults with mental retardation who reside in community settings. American Journal of Mental Retardation, 112, 392–400.
17. Emerson E, Baines S, Allerton L, Welch V. (2011). Health inequalities & people with learning disabilities in the UK: 2011. Improving Health and Lives: Learning Disability Observatory.
18. Emerson, E., Hatton, C. (2008). Socioeconomic disadvantage, social participation and networks and the self-rated health of English men and women with mild and moderate intellectual disabilities: cross sectional survey. Eur J Public Health; 18(1), 31-7.
19. Emerson, E. (2005). Underweight, obesity and exercise among adults with intellectual disabilities in supported accommodation in Northern England. Journal of Intellectual Disability Research, 49, 134–143.
20. Finlayson, J., Jackson, A., Cooper, S.A, Morrison, J., Melville, C.A., Smiley, E., et al. (2009). Understanding Predictors of Low Physical Activity in Adults with Intellectual Disabilities. J Appl Res Intellect Disabil., 22, 236–47.
21. Finlayson, J., Jackson, A., Cooper, S.A., Morrison, J., Melville, C.A., Smiley, E, Allan L, Mantry D. (2009). Understanding predictors of low physical activity in adults with intellectual disabilities. J Appl Res Intellect Disabil., 22:236–247.
22. Oviedo, G.R., Guerra-Balic, M., Baynard, T., Javierre, C. (2014). Effects of aerobic, resistance and balance training in adults with intellectual disabilities. Research in Developmental Disabilities. 35:2624–2634.
23. Golubovic, S., Maksimovic, J., Golubovic, B., Glumbic, N. (2012). Effects of exercise on physical fitness in children with intellectual disability. Research in Developmental Disabilities, 33(2), 608–614.
24. Hakim, R.M., Michael, D., Ross, W.R., & Michael, T. K. (2017). A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability. Journal of Exercise Rehabilitation, 13(1), 89-94.
25. Hamilton, S., Hankey, C. R., Miller, S., Boyle, S., Meville, C. A. (2007). A review of weight loss interventions for adults with intellectual disabilities. Obesity Reviews, 8, 339–345.
26. Heller, T., McCubbin, J. A., Drim, C., Peterson, J. (2011). Physical activity and nutrition health promotion interventions: What is working for people withintellectual disabilities. Intellectual & Developmental Disabilities, 49, 26–36.
27. Hilgenkamp, T.I., Wijck, R., Evenhuis, H. M. (2011). (Instrumental) activities of daily living in older adults with intellectual disabilities. Research in Developmental Disabilities, 32(5), 1977-1987.
28. Hilgenkamp, T. I., Wijck, R., Evenhuis, H. M. (2012). Low physical fitness levels in older adults with ID: Results of the HA-ID study. Research in Developmental Disabilities, 33(4), 1048–1058.
29. Hillman, C.H., Pontifex, M.B., Raine, L.B., Castelli, D.M., Hall, E.E., Kramer, A.F. (2009). The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Neuroscience, 159(3), 1044–54.
30. Hove, O. (2004). Weight survey on adult persons with mental retardation living in the community. Research in Developmental Disabilities, 25, 9–17.
31. Janicki, M.P., Jacobson J.W. (1986). Generational trends in sensory, physical, and behavioral abilities among older mentally retarded persons. American Journal of Mental Deficiency, 90(5), 490-500.
32. Jinks, A., Cotton, A., Rylance, R. (2011). Obesity interventions for people with a learning disability: An integrative literature review. Journal of Advanced Nursing, 67, 460–471.
33. Kovacic, T., M. Kovacic., R. Ovsenik., J. Zurc. (2020). The impact of multicomponent programmes on balance and fall reduction in adults with intellectual disabilities: a randomised trial. Journal of Intellectual Disability Research, 64(5), 381–394.
34. Krahn, G.L., Hammond, L., Turner, A. (2006). A cascade of disparities: health and health care access for people with intellectual disabilities. Ment Retard Dev Disabil Res Rev., 12(1), 70-82.
35. Lahtinen, U., Rintala, P., Malin, A. (2007). Physical performance of individuals with intellectual disability: A 30 year follow up. Adapted Physical Activity Quarterly, 24(2), 125–143.
36. Schijndel-Speet, M., Evenhuis, H.M., Wijck, R., Montfort K. C. A. G. M., Echteld M. A. (2017). A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial. Journal of Intellectual Disability Research. 61(1), 16–29.
37. Maaskant, M.A., Akker, M., Kessels, A.G., Haveman, M.J., Schrojenstein Lantman-de Valk, H.M., Urlings H.F. (1996). Care dependence and activities of daily living in relation to ageing: Results of a longitudinal study. Journal of Intellectual Disability Research, 40(6), 535-543.
38. Maulik, P.K., Mascarenhas, M.N., Mathers, C.D., Dua, T., Saxena, S. (2011). Prevalence of intellectual disability: a meta-analysis of population-based studies. Res Dev Disabil., 32(2), 419-36.
39. Moher, D., Shamseer, L., Clarke, M., et al. (2015). Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev., 4, 1.
40. Moran, R., Drane, W., McDermott, S., Dasari, S., Scurry, J. B., Platt, T. (2005). Obesity among people with and without mental retardation across adulthood. Obesity Research, 13, 342–349.
41. National Institute for Health and Care Excellence. (2014). Identification, assessment and management of overweight and obesity in children, young people and adults. Clinical Guideline 189.
42. National Institutes of Health, (NIH). NIH consensus development panel on physical activity and cardiovascular health: physical activity and cardiovascular health. JAMA, 276, 241–6.
43. Oppewal, A., Thessa, I.M., Hilgenkamp, T.I., Wijck, R., Schoufour, J.D., Evenhuis, H.M. (2014). Physical fitness is predictive for a decline in daily functioningin older adults with intellectual disabilities: Results of theHA-ID study. Research in Developmental Disabilities, 35, 2299–2315.
44. Oppewal, A., Hilgenkamp, T. I., Wijck, R., Evenhuis, H. M. (2013). Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities. Research in Developmental Disabilities, 34(9), 2743–2752.
45. Pate, R.R., Pratt, M., Blair, S.N., Haskell, W.L., Macera, C.A., Bouchard, C., et al. (1995). Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA, 273, 402–7.
46. Reppermund, S., Trollor, J. N. (2016). Successful ageing for people with an intellectual disability. Current Opinion in Psychiatry, 29(2), 149–154.
47. Resolution WHA57.17. (2004). Global strategy on diet, physical activity and health g. fifty‐seventh world health assembly, World Health Organisation. Resolutions and decisions, annexes, Geneva.
48. Reuben, D.B., Rubenstein, L.V., Hirsch, S.H., Hays, R.D. (1992). Valueof functional status as a predictor of mortality: Results of a prospective study. The American Journal of Medicine, 93(6), 663-669.
49. Robertson, J., Emerson, E., Gregory, N., Hatto, C., Turner, S., Kessissoglou, S., et al. (2000). Lifestyle related risk factors for poor health in residential settings forpeople with intellectual disabilities. Research in Developmental Disabilities, 21, 469–486.
50. Rotatori, A., Switzky, H. N., Fox, R. (1981). Behavioral weight reduction procedures for obese mentally retarded individuals: A review. Mental Retardation, 19, 157–161.
51. Salaun, L., Berthouze‐Aranda, S. E. (2012). Physical fitness and fatness in adolescents with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 25(3), 231–239.
52. Schneider, S., Askew, C.D., Diehl, J., Mierau, A., Kleinert, J., Abel, T., et al. (2009). EEG activity and mood in health orientated runners after different exercise intensities. Physiol Behav., 96(4–5), 709–16.
53. Spanos, D., Melville, C. A., Hankey, C. R. (2013). Weight management interventions in adults with intellectual disabilities and obesity: A systematic review of theevidence. Nutrition Journal, 12, 132.
54. TC Sağlık Bakanlığı. (2014). Türkiye fiziksel aktivite rehberi. Türkiye Halk Sağlığı Kurumu, Ankara.
55. Temple, V.A., Stanish, H.I. (2008). Physical activity and persons with intellectual disability: some considerations for Latin America. Salud Publica Mex Suppl., 50(2), 185–93.
56. Tveter, A.T., Dagfinrud, H., Moseng, T., et al. (2014). Health-related physical fitness measures: reference values and reference equations for use in clinical practice. Arch Phys Med Rehabil. 95, 1366–1373.
57. U.S. Department of Health and Human Services (2008). Physical activity guidelines advisory committee report. Retrieved from Washington, DC.
58. United States Department of Health and Human Services. (1996). Physical activity and health: a report of the Surgeon General. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.
59. Wu, C.L., Lin, J.D., Hu, J., et al. (2010). The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution. Res Dev Disabil. 31, 713–717.
60. Zorba E. (2001). Fiziksel Uygunluk. Gazi Kitabevi. Ankara, 2-58.