physical fitness and activity in persons with severe ... filehanzen) active ageing of persons with...
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Physical fitness and activity in persons
with
severe/profound intellectual and
visual disabilities
Dr. A (Aly) Waninge
Physical therapist and Lector Participation and health in persons
with severe/profound intellectual and visual disabilities
Koninklijke Visio & Hanzehogeschool Groningen
De Brink Applied Science in Health Care
and Nursing
Content
Definition and features ID
Target population ID
Overview research
Target population ID and visual disability (4)
Adapted tests physical fitness
GMFCS
Tests and measures (3)
Questions
Results (5)
In practice (2)
Lectoraat Transparante
Zorgverlening22-3-
2015
Definition and featuresIntellectual Disability
(ID))
Inleiding Mensen met een
verstandelijke beperking.
Significant limitations in intellectualfunctioning and adaptive behavior
Social and practical skills
Ability to make choices
Inclusion* Schalock et al, 2002
IQ<70
>2 (adaptive) behavior problems
Handicap discovered before 18 years old
Prevalence: Europe 1 %, NL 160.000* Ras et al, 2010
Lectoraat Transparante
Zorgverlening22-3-
2015
Target populationID 1
Inleiding Mensen met een
verstandelijke beperking.
Four levels IQ
- Mild ID 50-69
- Moderate ID 35-49
- Severe ID 20-35
- Profound ID <20
Lectoraat Transparante
Zorgverlening22-3-
2015
Foto´s Doelgroep Verstandelijke Beperking
(VB)
Inleiding Mensen met een
verstandelijke beperking.
11-12-2014 Lectoraat Transparante
Zorgverlening
Overview research
Health Participation
Healthproblems in persons withProfound Intellectual and Multiple Disabilities (Dinette vanTimmeren)
Concept participation in persons with severe/profound intellectualand visual disability (GinekeHanzen)
Active Ageing of persons withIntellectual Disabilities (Rianne Steenbergen, Marie José Ahlers)
ADL independence, strength andbalance in persons withsevere/profound intellectual andvisual disability (Annemarie Dijkhuizen)
Care for Participation: Rehabilitation in persons withsevere/profound intellectual andvisual disability (Gineke Hanzen)
Target population
1
Persons with Intellectual disabilities Visual impairments
Opportunities for compensation decrease
Disabilities increase(Kiestra, 2005)
IQ < 35; 75% loco motor disabilities(Nakken & Vlaskamp, 2007)
Target population
2
Prevalence visual impairment
(according to WHO)
In persons with intellectual disabilities
- 19% (Splunder et al, 2003)
In persons with severe intellectual disability
- 67% (Nagtzaam/Evenhuis, 2002)
In persons with severe or profound intellectual
disability - 92% (Van den Broek, 2004)
People
With
SIVD
Target population
3
Target population
4Motor disabilities
Slower
Less coordination
Less variation
Less explorative
Adapted tests
Physical Fitness 1
http://www.visio.org/nl-nl/bewegen-is-
gezond
Related to demands set by his or her
environment
Components related to sports, speed,
reaction time..
In case of poor motor skills…
Adaptation tests cardio respiratory fitness
Practice (with heart rate monitor)
Environment and structure
Professional guidance
Parcource
Contra-indications
Validity less, if feasibility is insufficient?
Difficulties in determining validity of tests and measures?
Adapted tests
Physical Fitness 2
GMFCS
(Palisano et al,1997; Gorter, 2001 NL)
*Gross Motor Functioning Classification System
I Walking without disabilities
II Walking with little support; walking outside
III Walking with support, distance decreases
IV Active moving
V Hardly active moving
Measuring
physical fitness
Body composition: BMI, waist circumference
Cardiorespiratory fitness:
- 6 Minutes Walking Distance (6 MWD)
- adapted Shuttleruntest (aSRT)
Balance:
- modified Berg Balance Scale
Muscle tonus:
- Modified Ashworth Scale
Muscle strength
- No feasible tests available
[Waninge et al, 2010]
Questions?
?
Question 1
What is true for persons with severe/profound
intellectual and visual disabilities?
1. Less overweight than in persons without
disabilities
2. More overweight than in persons with mild or
moderate intellectual disabilities.
3. More overweight than in persons without
disabilities
Results 1BMI 2007-2010!
p>0.05
p>0.05
n=45
Question 2
What is true for persons with severe/profound
intellectual and visual disabilities?
1. Cardiorespiratory fitness similar to healthy
elderly
2. Cardiorespiratory fitness worse than healthy
elderly
3. Cardiorespiratory fitness better than persons
with heart failure
0
100
200
300
400
500
600
700
Heart failure ChronicPulmonalDisease
Healthy Elderly Persons withSIVD
Dis
tan
ce in
met
ers
Results 26 Minutes Walking Distance
Results 3
6 MWT
Results 4
aSRT
P=0.135
22-3-2015 Titel presentatie aanpassen 22 Research and
Innovation Group in
Health Care and
0
5
10
15
20
25
30
35
40
2008 2011
p
o
i
n
t
s
mBBS niv 1 n=15
mBBS niv 2 n=11
p < 0.05
p = 0.168
Results 5modified Berg Balance Scale
Right/wrong?
People with intellectual disabilities perform
sufficient healthy physical activity
Influence direct support persons on life style
is important
Physical fitness of all persons with intellectual
disabilities can be reliably and validly
measured
Lectoraat Transparante Zorgverlening
In practice
1
Measurements weight monthly; Body
height once a year
Tests once a year
- Follow up individuals
- A movement plan voor every one,
integrated in daily program;
- Attention for healthy diet
In practice
2
New ways to move
Special weeks to promote physical activity,
sports and healthy diet
Motivation of clients and caregivers
increases
Moving is fun!
Thanks for your attention!