Conventional exercise interventions for adults with intellectual disabilities: A systematic review and meta-analysis
Corresponding Author
Lucia Cugusi
Department of Biomedical Sciences, University of Sassari, Italy
Correspondence
Lucia Cugusi, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100, Sassari (SS), Italy.
Email: [email protected]
Search for more papers by this authorMauro Giovanni Carta
Department of Medical Sciences and Public Health, University of Cagliari, Italy
Search for more papers by this authorCorresponding Author
Lucia Cugusi
Department of Biomedical Sciences, University of Sassari, Italy
Correspondence
Lucia Cugusi, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100, Sassari (SS), Italy.
Email: [email protected]
Search for more papers by this authorMauro Giovanni Carta
Department of Medical Sciences and Public Health, University of Cagliari, Italy
Search for more papers by this authorReview registration: PROSPERO registration number CRD42020138972
Abstract
Exercise is a well-established therapeutic component in the management of a wide range of intellectual disabilities (IDs). Our aim was to appraise the effects of conventional forms of exercise on anthropometric, cardiovascular, and motor-functional profiles of adults with IDs. Four databases (PubMed/Scopus/PEDro/Cochrane) were searched to detect any randomized controlled trial (RCT) pertinent to conventional exercise trainings for adults with ID. Meta-analyses were being performed for studies reported results on the same outcome measures employing RevMan 5.3. Thirteen RCTs involving 556 participants (56.7% men) entered the qualitative synthesis and eleven the meta-analyses. The effect of exercise was superior to controls (no exercise prescription) on several cardiovascular variables (peak oxygen uptake, MD 2.89, 95%CI 0.35;5.42, I2 = 69%; heart rate peak, MD 4.64, 95%CI 2.15;7.14, I2 = 7%; maximal exercise capacity, SMD 0.55, 95%CI 0.03;1.08, I2 = 67%; systolic blood pressure, MD −9.62, 95%CI −17.07;-2.18, I2 = 40%), without differences in diastolic blood pressure and total cholesterol. None of the anthropometric and body composition variables, six-minute walking test distance and handgrip strength values revealed significant changes at the follow-up. In adults with IDs, conventional exercise training substantially improves cardiovascular fitness and exercise capacity, while it seems of limited effectiveness on anthropometric and body composition variables.
CONFLICT OF INTEREST
The authors report no relationships that could be construed as a conflict of interest.
Supporting Information
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REFERENCES
- 1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington,VAAmerican Psychiatric Publishing; 2013.
10.1176/appi.books.9780890425596 Google Scholar
- 2https://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/news/news/2010/15/childrens-right-to-family-life/definition-intellectual-disability. Accessed March 15, 2020.
- 3Hilgenkamp TIM, van Wijck R, Evenhuis HM. Low physical fitness levels in older adults with ID: results of the HA-ID study. Res Dev Disabil. 2012; 33: 1048-1058.
- 4Temple VA, Walkley JW. Physical activity of adults with intellectual disability. J Intellectual Develop Disability. 2003; 28: 342-353.
- 5Emerson E. Underweight, obesity and exercise among adults with intellectual disabilities in supported accommodation in Northern England. J Intellect Disabil Res. 2005; 49: 134-143.
- 6Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43: 1334-1359.
- 7Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major noncommunicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet. 2012; 380(9838): 219-229.
- 8Hassan NM, Landorf KB, Shields N, Munteanu SE. Effectiveness of interventions to increase physical activity in individuals with intellectual disabilities: a systematic review of randomised controlled trials. J Intellect Disabil Res. 2019; 63(2): 168-191.
- 9 World Health Organization. (WHO). Global recommendations on physical activity for health. Geneva, SwitzerlandAuthor; 2010.
- 10Draheim CC, Williams DP, McCubbin JA. Prevalence of physical inactivity and recommended physical activity in community-based adults with mental retardation. Ment Retard. 2002; 40: 436-444.
- 11Bossink LW, van der Putten AA, Waninge A, Vlaskamp C. A power-assisted exercise intervention in people with profound intellectual and multiple disabilities living in a residential facility: a pilot randomised controlled trial. Clin Rehabil. 2017; 31(9): 1168-1178.
- 12https://www.specialolympics.org/. Accessed June 29, 2019.
- 13Heller T, McCubbin JA, Drum C, Peterson J. Physical activity and nutrition health promotion interventions: what is working for people with intellectual disabilities? Intellect Dev Disabil. 2011; 49(1): 26-36.
- 14Bartlo P, Klein PJ. Physical activity benefits and needs in adults with intellectual disabilities: systematic review of the literature. Am J Intellect Dev Disabil. 2011; 116(3): 220-232.
- 15Dodd KJ, Shields N. A systematic review of the outcomes of cardiovascular exercise programs for people with Down syndrome. Arch Phys Med Rehabil. 2005; 86(10): 2051-2058.
- 16Andriolo RB, El Dib RP, Ramos L, Atallah AN, da Silva EM. Aerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome. Cochrane Database Syst Rev. 2010;(5): CD005176.
- 17Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Sur. 2010; 8(5): 336-341.
- 18Moher D, Pham B, Klassen TP, et al. What contributions do languages other than English make on the results of meta-analyses? J Clin Epidemiol. 2000; 53(9): 964-972.
- 19Heneghan C, Badenoch D. Evidence-based medicine toolkit. LondonBMJ Books; 2002.
- 20Elkins MR, Herbert RD, Moseley AM, et al. Rating the quality of trials in systematic reviews of physical therapy interventions. Cardiopulm Phys Ther J. 2010; 21(3): 20-26.
- 21Ryan R, Hill S. How to GRADE the quality of the evidence. Cochrane Consumers and Communication Group, 2016. https://cc.cochrane.org/sites/cc.cochrane.org/files/public/uploads/how_to_grade.pdf
- 22Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011; 343: d4002.
- 23 Review Manager software, The Cochrane Collaboration; 2014.
- 24Higgins JPT, Green S. (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011. www.handbook.cochrane.org.
- 25Suomi R, Surburg PR, Lecius P. Effects of hydraulic resistance strength training on isokinetic measures of leg strength in men with mental retardation. Adapted Physical Activity Quarterly. 1995; 12(4): 377-387.
- 26Varela AM, Sardinha LB, Pitetti KH. Effects of an aerobic rowing training regimen in young adults with Down syndrome. Am J Ment Retard. 2001; 106(2): 135-144.
- 27Carmeli E, Kessel S, Coleman R, Ayalon M. Effects of a treadmill walking program on muscle strength and balance in elderly people with Down syndrome. J Gerontol A Biol Sci Med Sci. 2002; 57(2): M106-M110.
- 28Rimmer JH, Heller T, Wang E, Valerio I. Improvements in physical fitness in adults with Down syndrome. Am J Ment Retard. 2004; 109(2): 165-174.
- 29Shields N, Taylor NF, Dodd KJ. Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2008; 89(7): 1215-1220.
- 30Calders P, Elmahgoub S, Roman de Mettelinge T, et al. Effect of combined exercise training on physical and metabolic fitness in adults with intellectual disability: a controlled trial. Clin Rehabil. 2011; 25(12): 1097-1108.
- 31Rosety-Rodriguez M, Camacho A, Rosety I, et al. Resistance circuit training reduced inflammatory cytokines in a cohort of male adults with Down syndrome. Med Sci Monit. 2013; 19: 949-953.
- 32Ordonez FJ, Rosety MA, Camacho A, et al. Aerobic training improved low-grade inflammation in obese women with intellectual disability. J Intellect Disabil Res. 2014; 58(6): 583-590.
- 33Melville CA, Mitchell F, Stalker K, et al. Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial. Int J Behav Nutr Phys Act. 2015; 12: 125.
- 34Shields N, Taylor NF. The feasibility of a physical activity program for young adults with Down syndrome: A phase II randomised controlled trial. J Intellectual Develop Disability. 2015; 40(2): 115-125.
- 35Boer PH, Moss SJ. Effect of continuous aerobic vs. interval training on selected anthropometrical, physiological and functional parameters of adults with Down syndrome. J Intellect Disabil Res. 2016; 60(4): 322-334.
- 36van Schijndel-Speet M, Evenhuis HM, van Wijck R, van Montfort KC, Echteld MA. A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial. J Intellect Disabil Res. 2017; 61(1): 16-29.
- 37Kim SS. Effects of endurance exercise and half-bath on body composition, cardiorespiratory system, and arterial pulse wave velocity in men with intellectual disabilities. J Phys Ther Sci. 2017; 29(7): 1216-1218.
- 38Draheim CC. Cardiovascular disease prevalence and risk factors of persons with mental retardation. Ment Retard Dev Disabil Res Rev. 2006; 12(1): 3-12.
- 39Bouchard C, Depres J, Tremblay A. Exercise and obesity. Obes Res. 1993; 1: 133-147.
- 40Bergström H, Hagströmer M, Hagberg J, Elinder LS. A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial. Res Dev Disabil. 2013; 34(11): 3847-3857.
- 41Mann J, Zhou H, McDermott S, Poston MB. Healthy behavior change of adults with mental retardation: Attendance in a health promotion program. Am J Ment Retard. 2006; 111: 62-73.
- 42Rubenstein E, DuBois L, Sadowsky M, et al. Evaluating the potential of Special Olympics fitness models as a health intervention for adults with intellectual disabilities. Disabil Health J. 2020; 13(2): 100850.
- 43Hardoy MC, Seruis ML, Floris F, et al. Benefits of exercise with mini tennis in intellectual disabilities: effects on body image and psychopathology. Clin Pract Epidemiol Ment Health. 2011; 7: 157-160.
- 44Cugusi L, Manca A, Bergamin M, et al. Aquatic exercise improves motor impairments in people with Parkinson's disease, with similar or greater benefits than land-based exercise: a systematic review. J Physiother. 2019; 65(2): 65-74.
- 45Cugusi L, Manca A, Yeo TJ, Bassareo PP, Mercuro G, Kaski JC. Nordic walking for individuals with cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2017; 24(18): 1938-1955.
- 46Bullo V, Gobbo S, Vendramin B, et al. Nordic Walking Can Be Incorporated in the Exercise Prescription to Increase Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis. Rejuvenation Res. 2018; 21(2): 141-161.
- 47Cugusi L, Manca A, Dragone D, et al. Nordic Walking for the Management of People With Parkinson Disease: A Systematic Review. PM&R. 2017; 9(11): 1157-1166.
