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How physically active are youth with disabilities compared to youth without disabilities?
Thursday 1 November Papers / Journal of Science and Medicine in Sport 15 (2013) S34–S126
181 Impact of health behaviors during adolescence on health complaints in adulthood R. Smith ∗ , E. Haug University of Bergen Introduction: We aimed to identify the prospective associations between health behaviors at age 13 on health complaints at age 30. Methods: We used data from The Norwegian Longitudinal Health Behavior Study (NLHB), in which participants were followed from the age of 13 to 30. Linear regression analysis was employed to examine the impact of smoking, alcohol use, diet, and physical activity at age 13 on the level of health complaints at age 30. Results: Alcohol use (b = .15, p = .01) and physical activity (b = .15, p = .005) at age 13 were associated with health complaints at age 30. A near significant association was found for healthy dietary behavior (b = -.10, p = .06). After controlling for health complaints at age 13, only physical activity (b = -.14, p = .008) remained a significant correlate of health complaints at age 30. Discussion: Health behaviors during early adolescence constituted potential risk factors for the development of health complaints in adulthood. This knowledge should be considered by policy makers, preventative services, and health-care professionals. http://dx.doi.org/10.1016/j.jsams.2012.11.184 182 Parental perception of children’s physical activity and cardiovascular health outcomes C. Ice 1 , E. Elliott 2,∗ , L. Cottrell 1 , J. Leary 1 , W. Neal 1 1
West Virginia University, School of Medicine, Department of Pediatrics 2 West Virginia University, College of Physical Activity and Sports Sciences
Introduction: Children’s physical activity levels and body mass index (BMI) percentiles are related to various cardiovascular health outcomes, including cholesterol levels. From the literature, we know parents routinely overestimate their child’s physical activity and underestimate their child’s weight. However, we do not know if these parental estimates of child’s physical activity and weight are related to their child’s cardiovascular health outcomes. Methods: The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project is a US school-based surveillance project that screens public-school children in all counties of an Appalachian state. For 5th grade students, this screening includes checking the child’s BMI percentile, blood pressure, Acanthosis Nigricans and conducting a fasting lipid profile. This study connects these screening results to a follow-up survey sent to participating 5th grade parents in 8 counties during the 2010–2011 school year (N = 74 children with valid lipid values). Parents were asked whether their child was more, less, or equally physically active when compared to other children of the same age and gender. One-way ANOVAs with Bonferroni post-hoc pairwise comparisons compared these parental perceptions with the child’s BMI percentile and cholesterol levels. All screening and survey procedures were approved by the University Institutional Review Board (IRB). Results: Only 9 parents perceived their child as less active, whereas 24 parents perceived the child as equally active and 41 as more active than other children the same age and gender. Parents who perceived their child as less active had children on average
S77
with significantly higher non-HDL cholesterol (123.78 versus 103.5 and 104.34; p = 0.042), BMI percentile (80.93%ile versus 73.36 and 50.64; p = 0.001), and log-transformed triglycerides (p = 0.003). HDL cholesterol approached significance (p = 0.054). Discussion: These results demonstrate that while parents might not accurately classify their child’s activity, there is a relationship between parental perception of child physical activity and their child’s cardiovascular health outcomes. The relationship between higher average cholesterol levels and BMI percentile with the parents’ perception of physical activity indicates that parental perceptions may be more accurate than previously anticipated and should be taken into account when designing interventions aimed at increasing children’s physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.185 183 How physically active are youth with disabilities compared to youth without disabilities? K. Lobenius Palmér 1,2,∗ , B. Sjöqvist Nätterlund 1 , L. Lundqvist 1 , A. Hurtig Wennlöf 2 1 2
Centre for Rehabilitation Research, Örebro County Council, Sweden School of Health and Medical Sciences, Örebro University, Sweden
Introduction: To reach health benefits the recommendations for youth are to accumulate ≥60 minutes of physical activity (PA) per day of at least moderate-to-vigorous intensity (MVPA). Previous studies have suggested that youth with disabilities (YWD) reach recommendations to a lower extent and are generally less physically active than youth without disabilities (YWOD), but studies have used different methods and results are inconclusive. The aim of the present study was to assess habitual PA in YWD with an objective method (accelerometer) and to compare that to YWOD. Method: Habitual PA was assessed with an ActiGraph® GT1 M accelerometer in 29 boys and 18 girls, 8–10 and 14–16 years old with physical disabilities as cerebral palsy and spina bifida, autism spectrum disorder, hearing impairment/deafness and intellectual disability. Outcome variables were: total PA (mean counts/minute [cpm]), time spent sedentary (minutes in < 100 cpm/day) and time spent in MVPA (min/day). For comparisons with YWOD, accelerometer assessments of 445 girls and 357 boys from the Swedish part of the European Youth Heart Study, in the same age groups as YWD, were used. Results: YWD were significantly less physically active (lower cpm, less MVPA) and more sedentary than YWOD in all four age and sex groups, except in boys 14–16 years, where no significant difference was seen for cpm or MVPA, but for sedentary, with YWD being more sedentary. Fewer girls of YWD than of YWOD met recommendations in the age groups 8–10 years (YWD = 80% and YWOD = 100%) and 14–16 years (YWD = 23% and YWOD = 59%). For boys, there were no significant difference between YWD and YWOD in the age groups 8–10 years (YWD = 100% and YWOD = 98%) or 14–16 years (YWD = 47% and YWOD = 70%). Discussion: YWD were generally less physically active than YWOD. This result is in line with most previous accelerometer studies. YWD were also more sedentary than YWOD, which have, to the authours knowledge, not been shown previously with accelerometer. Furthermore, the proportion of girls and older boys in YWD meeting recommendations is low. The low PA in YWD is of concern, since apart from general health benefits of PA, engaging in PA gives important additional health benefits for YWD, such as prevented functional decline and increased social inclusion. Further studies using objective measures as accelerometer examining PA
S78
Thursday 1 November Papers / Journal of Science and Medicine in Sport 15 (2013) S34–S126
level and factors influencing PA level in different groups of YWD are warranted as well as interventions aiming to increase PA in YWD, especially in girls. http://dx.doi.org/10.1016/j.jsams.2012.11.186
185 Habits of life of people with Down Syndrome in Brazil A. Marques ∗ , A. Marques, R. Real, M. Azevedo, F. Siqueira Universidade Federal De Pelotas
184 People with traumatic brain injury are physically inactive and have reduced cardiorespiratory fitness L. Hassett 1,∗ , H. van der Ploeg 2 , A. Moseley 3 , A. Harmer 4 1
Brain Injury Rehabilitation Unit, Liverpool Hospital Cluster for Physical Activity and Health, The University of Sydney 3 Musculoskeletal Division, The George Institute for Global Health 4 Faculty of Health Sciences, The University of Sydney 2
Introduction: Traumatic brain injury (TBI) is the leading cause of disability in young adults, and subjective measurement of physical activity would indicate that they are more physically inactive than the general population. However the reliability and validity of subjective measurement of physical activity in this cognitively impaired population has not been determined. In addition, physical activity has not been objectively measured. Aims: 1) To determine the reliability of a subjective measure of physical activity (questionnaire) and to determine its validity with an objective measure of physical activity (accelerometer) in adults with TBI; 2) To objectively measure physical activity and cardiorespiratory fitness in adults with TBI; 3) To determine the relationship between physical activity and cardiorespiratory fitness in adults with TBI. Methods: A descriptive prospective study recruited a convenience sample of 30 ambulant community-dwelling adults with severe TBI. Participants completed the Physical Activity Scale for Individuals with a Physical Disability (PASIPD) on two occasions one week apart, and wore an accelerometer (Actigraph GT3XE) for the 7 days between completing the PASIPD. They also completed a peak cardiorespiratory fitness test with gas analysis to measure peak oxygen uptake (VO2 peak). Results: Participants were predominantly males (67%) in their early thirties approximately three years post injury. The PASIPD test-retest reliability was excellent (Intraclass Correlation Coefficient = 0.85) and the correlation with the accelerometer was weak, but similar to other able-bodied and patient populations (activity counts R = 0.298). From subjective measurement of physical activity (PASIPD), levels of physical activity were low (mean (SD) PASIPD 12.5 (8.8) MET hours/day), and all participants reported activity in more than one domain of physical activity. From objective measurement of physical activity (accelerometer) and cardiorespiratory fitness, two participants met the national physical activity guidelines and participants were on average well below average fitness compared to age-matched able-bodied data (mean (SD) peak VO2 peak 30.4 (7.6) ml/kg/min). There was a moderate relationship between objective measurement of physical activity and cardiorespiratory fitness (R = 0.660), indicating that the fitter participants were more likely to be physically active. Discussion: These findings support the use of an accelerometer to objectively measure the amount of physical activity and the PASIPD to subjectively measure the domains of physical activity in adults with TBI. Adults with severe TBI are generally physically inactive and very unfit. Due to this increased risk of morbidity and mortality, interventions to increase physical activity and cardiorespiratory fitness need to be investigated. http://dx.doi.org/10.1016/j.jsams.2012.11.187
In education perspective for an active lifestyle, the adherence to physical activity practice is considered an important health behavior for the comprehension of phenomena related with the implementation of health promotion programs for people with Down Syndrome (DS). This study has objective to describe the characteristics, life habits of the population with DS aged seven years-old or more in the South region of Brazil. This research is characterized as a cross-sectional epidemiologic study. A total of 2187 individuals were studied (54.7% men), with ages between seven, 64 years. It was observed that 39% (n = 852) of the individuals related some associated illness. It was verified that 12.5% (n = 242) of the individuals are able to read, write. It was observed good autonomy in the accomplishment of the activities of daily life (ADL), around 90%, whereas the instrumental activities of daily life (IADL) are carried out with more difficulty. In relation to leisure activities, 45.3% (n = 908) have preference for watching television. It was observed that 13.5% (n = 296) use computers. In terms of physical activity practice, 65.8% (n = 1482) are physically inactive. In the physical fitness, somatic evaluation, 1249 children, youth with DS of ages between 10, 20 years were studied (53.6% males). In terms of BMI, it was verified that 56.9% are in the overweight or obesity categories, with more risk in girls. Preventive actions will help handling the relative factors for activities, social programs, that can facilitate, promote the acquisition of healthy habits, stimulating, associative, happy life, that includes recreation, physical, cultural activities. http://dx.doi.org/10.1016/j.jsams.2012.11.188 186 Aerobic fitness, functional exercise capacity and muscle strength of adults with intellectual disability K. Lante 1,∗ , G. Davis 1 , R. Stancliffe 1 , A. Bauman 1 , S. Jan 2 , H. van der Ploeg 1 1 2
The University of Sydney The George Institute for Global Health
Introduction: Public health campaigns focus on decreasing sedentary behavior and increasing health-related physical activity. However, scant direct information is available on the aerobic fitness, functional exercise capacity and muscle strength of people with intellectual disability. In part, this may be due to them being a difficult-to-test population because of comprehension and acquiescence with standard strength and fitness assessments. To aid health-related campaigns targeted towards people with intellectual disability it is important to identify accessible assessment methods to gain accurate knowledge on the aerobic fitness and muscle strength of this population. The purpose of this trial is twofold; to establish accessible assessment methods and to collect descriptive data. Methods: Preliminary data has been collected on 29 adults with intellectual disability (45% with Down Syndrome) between 27 and 53 years of age. Participants undertook a series of physical assessments, selected to be accessible to adults with intellectual disability. A submaximal exercise aerobic fitness (cycle) test was used to determine aerobic fitness, a six-minute walk test assessed functional exercise capacity and muscle strength was assessed using handgrip force, squat strength, elbow flexion and extension.
181 Impact of health behaviors during adolescence on health complaints in adulthood R. Smith ∗ , E. Haug University of Bergen Introduction: We aimed to identify the prospective associations between health behaviors at age 13 on health complaints at age 30. Methods: We used data from The Norwegian Longitudinal Health Behavior Study (NLHB), in which participants were followed from the age of 13 to 30. Linear regression analysis was employed to examine the impact of smoking, alcohol use, diet, and physical activity at age 13 on the level of health complaints at age 30. Results: Alcohol use (b = .15, p = .01) and physical activity (b = .15, p = .005) at age 13 were associated with health complaints at age 30. A near significant association was found for healthy dietary behavior (b = -.10, p = .06). After controlling for health complaints at age 13, only physical activity (b = -.14, p = .008) remained a significant correlate of health complaints at age 30. Discussion: Health behaviors during early adolescence constituted potential risk factors for the development of health complaints in adulthood. This knowledge should be considered by policy makers, preventative services, and health-care professionals. http://dx.doi.org/10.1016/j.jsams.2012.11.184 182 Parental perception of children’s physical activity and cardiovascular health outcomes C. Ice 1 , E. Elliott 2,∗ , L. Cottrell 1 , J. Leary 1 , W. Neal 1 1
West Virginia University, School of Medicine, Department of Pediatrics 2 West Virginia University, College of Physical Activity and Sports Sciences
Introduction: Children’s physical activity levels and body mass index (BMI) percentiles are related to various cardiovascular health outcomes, including cholesterol levels. From the literature, we know parents routinely overestimate their child’s physical activity and underestimate their child’s weight. However, we do not know if these parental estimates of child’s physical activity and weight are related to their child’s cardiovascular health outcomes. Methods: The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project is a US school-based surveillance project that screens public-school children in all counties of an Appalachian state. For 5th grade students, this screening includes checking the child’s BMI percentile, blood pressure, Acanthosis Nigricans and conducting a fasting lipid profile. This study connects these screening results to a follow-up survey sent to participating 5th grade parents in 8 counties during the 2010–2011 school year (N = 74 children with valid lipid values). Parents were asked whether their child was more, less, or equally physically active when compared to other children of the same age and gender. One-way ANOVAs with Bonferroni post-hoc pairwise comparisons compared these parental perceptions with the child’s BMI percentile and cholesterol levels. All screening and survey procedures were approved by the University Institutional Review Board (IRB). Results: Only 9 parents perceived their child as less active, whereas 24 parents perceived the child as equally active and 41 as more active than other children the same age and gender. Parents who perceived their child as less active had children on average
S77
with significantly higher non-HDL cholesterol (123.78 versus 103.5 and 104.34; p = 0.042), BMI percentile (80.93%ile versus 73.36 and 50.64; p = 0.001), and log-transformed triglycerides (p = 0.003). HDL cholesterol approached significance (p = 0.054). Discussion: These results demonstrate that while parents might not accurately classify their child’s activity, there is a relationship between parental perception of child physical activity and their child’s cardiovascular health outcomes. The relationship between higher average cholesterol levels and BMI percentile with the parents’ perception of physical activity indicates that parental perceptions may be more accurate than previously anticipated and should be taken into account when designing interventions aimed at increasing children’s physical activity. http://dx.doi.org/10.1016/j.jsams.2012.11.185 183 How physically active are youth with disabilities compared to youth without disabilities? K. Lobenius Palmér 1,2,∗ , B. Sjöqvist Nätterlund 1 , L. Lundqvist 1 , A. Hurtig Wennlöf 2 1 2
Centre for Rehabilitation Research, Örebro County Council, Sweden School of Health and Medical Sciences, Örebro University, Sweden
Introduction: To reach health benefits the recommendations for youth are to accumulate ≥60 minutes of physical activity (PA) per day of at least moderate-to-vigorous intensity (MVPA). Previous studies have suggested that youth with disabilities (YWD) reach recommendations to a lower extent and are generally less physically active than youth without disabilities (YWOD), but studies have used different methods and results are inconclusive. The aim of the present study was to assess habitual PA in YWD with an objective method (accelerometer) and to compare that to YWOD. Method: Habitual PA was assessed with an ActiGraph® GT1 M accelerometer in 29 boys and 18 girls, 8–10 and 14–16 years old with physical disabilities as cerebral palsy and spina bifida, autism spectrum disorder, hearing impairment/deafness and intellectual disability. Outcome variables were: total PA (mean counts/minute [cpm]), time spent sedentary (minutes in < 100 cpm/day) and time spent in MVPA (min/day). For comparisons with YWOD, accelerometer assessments of 445 girls and 357 boys from the Swedish part of the European Youth Heart Study, in the same age groups as YWD, were used. Results: YWD were significantly less physically active (lower cpm, less MVPA) and more sedentary than YWOD in all four age and sex groups, except in boys 14–16 years, where no significant difference was seen for cpm or MVPA, but for sedentary, with YWD being more sedentary. Fewer girls of YWD than of YWOD met recommendations in the age groups 8–10 years (YWD = 80% and YWOD = 100%) and 14–16 years (YWD = 23% and YWOD = 59%). For boys, there were no significant difference between YWD and YWOD in the age groups 8–10 years (YWD = 100% and YWOD = 98%) or 14–16 years (YWD = 47% and YWOD = 70%). Discussion: YWD were generally less physically active than YWOD. This result is in line with most previous accelerometer studies. YWD were also more sedentary than YWOD, which have, to the authours knowledge, not been shown previously with accelerometer. Furthermore, the proportion of girls and older boys in YWD meeting recommendations is low. The low PA in YWD is of concern, since apart from general health benefits of PA, engaging in PA gives important additional health benefits for YWD, such as prevented functional decline and increased social inclusion. Further studies using objective measures as accelerometer examining PA
S78
Thursday 1 November Papers / Journal of Science and Medicine in Sport 15 (2013) S34–S126
level and factors influencing PA level in different groups of YWD are warranted as well as interventions aiming to increase PA in YWD, especially in girls. http://dx.doi.org/10.1016/j.jsams.2012.11.186
185 Habits of life of people with Down Syndrome in Brazil A. Marques ∗ , A. Marques, R. Real, M. Azevedo, F. Siqueira Universidade Federal De Pelotas
184 People with traumatic brain injury are physically inactive and have reduced cardiorespiratory fitness L. Hassett 1,∗ , H. van der Ploeg 2 , A. Moseley 3 , A. Harmer 4 1
Brain Injury Rehabilitation Unit, Liverpool Hospital Cluster for Physical Activity and Health, The University of Sydney 3 Musculoskeletal Division, The George Institute for Global Health 4 Faculty of Health Sciences, The University of Sydney 2
Introduction: Traumatic brain injury (TBI) is the leading cause of disability in young adults, and subjective measurement of physical activity would indicate that they are more physically inactive than the general population. However the reliability and validity of subjective measurement of physical activity in this cognitively impaired population has not been determined. In addition, physical activity has not been objectively measured. Aims: 1) To determine the reliability of a subjective measure of physical activity (questionnaire) and to determine its validity with an objective measure of physical activity (accelerometer) in adults with TBI; 2) To objectively measure physical activity and cardiorespiratory fitness in adults with TBI; 3) To determine the relationship between physical activity and cardiorespiratory fitness in adults with TBI. Methods: A descriptive prospective study recruited a convenience sample of 30 ambulant community-dwelling adults with severe TBI. Participants completed the Physical Activity Scale for Individuals with a Physical Disability (PASIPD) on two occasions one week apart, and wore an accelerometer (Actigraph GT3XE) for the 7 days between completing the PASIPD. They also completed a peak cardiorespiratory fitness test with gas analysis to measure peak oxygen uptake (VO2 peak). Results: Participants were predominantly males (67%) in their early thirties approximately three years post injury. The PASIPD test-retest reliability was excellent (Intraclass Correlation Coefficient = 0.85) and the correlation with the accelerometer was weak, but similar to other able-bodied and patient populations (activity counts R = 0.298). From subjective measurement of physical activity (PASIPD), levels of physical activity were low (mean (SD) PASIPD 12.5 (8.8) MET hours/day), and all participants reported activity in more than one domain of physical activity. From objective measurement of physical activity (accelerometer) and cardiorespiratory fitness, two participants met the national physical activity guidelines and participants were on average well below average fitness compared to age-matched able-bodied data (mean (SD) peak VO2 peak 30.4 (7.6) ml/kg/min). There was a moderate relationship between objective measurement of physical activity and cardiorespiratory fitness (R = 0.660), indicating that the fitter participants were more likely to be physically active. Discussion: These findings support the use of an accelerometer to objectively measure the amount of physical activity and the PASIPD to subjectively measure the domains of physical activity in adults with TBI. Adults with severe TBI are generally physically inactive and very unfit. Due to this increased risk of morbidity and mortality, interventions to increase physical activity and cardiorespiratory fitness need to be investigated. http://dx.doi.org/10.1016/j.jsams.2012.11.187
In education perspective for an active lifestyle, the adherence to physical activity practice is considered an important health behavior for the comprehension of phenomena related with the implementation of health promotion programs for people with Down Syndrome (DS). This study has objective to describe the characteristics, life habits of the population with DS aged seven years-old or more in the South region of Brazil. This research is characterized as a cross-sectional epidemiologic study. A total of 2187 individuals were studied (54.7% men), with ages between seven, 64 years. It was observed that 39% (n = 852) of the individuals related some associated illness. It was verified that 12.5% (n = 242) of the individuals are able to read, write. It was observed good autonomy in the accomplishment of the activities of daily life (ADL), around 90%, whereas the instrumental activities of daily life (IADL) are carried out with more difficulty. In relation to leisure activities, 45.3% (n = 908) have preference for watching television. It was observed that 13.5% (n = 296) use computers. In terms of physical activity practice, 65.8% (n = 1482) are physically inactive. In the physical fitness, somatic evaluation, 1249 children, youth with DS of ages between 10, 20 years were studied (53.6% males). In terms of BMI, it was verified that 56.9% are in the overweight or obesity categories, with more risk in girls. Preventive actions will help handling the relative factors for activities, social programs, that can facilitate, promote the acquisition of healthy habits, stimulating, associative, happy life, that includes recreation, physical, cultural activities. http://dx.doi.org/10.1016/j.jsams.2012.11.188 186 Aerobic fitness, functional exercise capacity and muscle strength of adults with intellectual disability K. Lante 1,∗ , G. Davis 1 , R. Stancliffe 1 , A. Bauman 1 , S. Jan 2 , H. van der Ploeg 1 1 2
The University of Sydney The George Institute for Global Health
Introduction: Public health campaigns focus on decreasing sedentary behavior and increasing health-related physical activity. However, scant direct information is available on the aerobic fitness, functional exercise capacity and muscle strength of people with intellectual disability. In part, this may be due to them being a difficult-to-test population because of comprehension and acquiescence with standard strength and fitness assessments. To aid health-related campaigns targeted towards people with intellectual disability it is important to identify accessible assessment methods to gain accurate knowledge on the aerobic fitness and muscle strength of this population. The purpose of this trial is twofold; to establish accessible assessment methods and to collect descriptive data. Methods: Preliminary data has been collected on 29 adults with intellectual disability (45% with Down Syndrome) between 27 and 53 years of age. Participants undertook a series of physical assessments, selected to be accessible to adults with intellectual disability. A submaximal exercise aerobic fitness (cycle) test was used to determine aerobic fitness, a six-minute walk test assessed functional exercise capacity and muscle strength was assessed using handgrip force, squat strength, elbow flexion and extension.