Objective: Investigating the effect of combined aerobic and strength training on metabolic and physical fitness in adults with intellectual disabilities compared to endurance training and no training.
Design: A controlled trial with patients receiving either combined (COM), endurance (END) or no training (C).
Setting: Two centres for intellectual disabilities (Sterrenhuis, Brasschaat and Emiliani, Lokeren, Belgium).
Subjects: Forty-five adults with intellectual disabilities (mean age: 42 (9,2), mean body mass index (BMI): 24 (3,9), mean IQ: 56 (5,6)).
Intervention: Combined exercise training (n = 15) and endurance training (n = 15) twice a week for 70 minutes per session for 20 weeks and no training (n = 15). Groups were matched for age, sex and intellectual disability.
Main measures: Lipid profile, physical fitness (primary); blood pressure and body composition.
Results: Compared to no training, combined exercise training has significant positive effects on total cholesterol levels, aerobic capacity, muscle strength and resting systolic blood pressure, while endurance exercise training has significant effects on aerobic capacity and resting systolic blood pressure. Compared to endurance training, combined exercise training resulted in a significant better evolution of total cholesterol (mean differences: −18 versus −3 mg/dl), 1RM upper (+6 versus +1 kg) and lower limb (+25 versus +8 kg) and abdominal muscles (+15 versus +1 kg), hand grip strength (+9 versus +2 kg), muscle fatigue resistance (+11 versus +5 sec), sit-to-stand (+5 versus +2/30 sec) and systolic blood pressure (−15 versus −10 mmHg).
Conclusion: This study revealed a tendency towards more beneficial effects of combined exercise training in adults with intellectual disability.
SkowronskiWHorvatMNoceraJRoswalGCroceREurofit special: European fitness battery score variation among individuals with intellectual disabilities. Adapt PhysActiv Q2009; 26: 54–67.
2.
BaynardTPitettiKHGuerraMUnnithanVBFernhallBAge-related changes in aerobic capacity in individuals with intellectual disabilities: a 20-year review. Med Sci Sports Exe2008; 40: 1984–89.
3.
FlorePBricoutVAvan BiesenDOxidative stress and metabolism at rest and during exercise in persons with Down syndrome. Eur J Cardiovasc Prev Rehabil2008; 15: 35–42.
4.
PitettiKHBonehSCardiovascular fitness as related to leg strength in adults with mental retardation. Med Sci Sports Exerc1995; 27: 423–8.
5.
de WinterCFMagilsenKWvan AlfenJCPenningCEvenhuisHMPrevalence of cardiovascular risk factors in older people with intellectual disability. Am J Intellect Dev Disabil2009; 114: 427–36.
6.
SohlerNLubetkinELevyJSoghomonianCRimmermanAFactors associatedwith obesity and coronary heart disease in people with intellectual disabilities. Soc Work Health Care2009; 48: 76–89.
7.
StewartLVan de VenLKatsarouVHigh prevalence of obesity in ambulatory children and adolescentswith intellectual disability. J Intellect Disabil Res2009; 53: 882–6.
8.
PedersenBKSaltinBEvidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports2006; 16(Suppl 1): 3–63.
9.
LambersSVan LaethemCVan AckerKCaldersPInfluence of combinedexercise training on indices of obesity, diabetes and cardiovascular risk in type2 diabetes patients. Clin Rehabil2008; 22: 483–92.
10.
DavidsonLEHudsonRKilpatrickKEffects of exercise modality on insulin resistance andfunctional limitation in older adults: a randomized controlled trial. Arch Intern Med2009; 169: 122–3.
11.
ChaniasAKReidGHooverMLExercise effects on health-related physical fitness of individuals with an intellectual disability: a meta-analysis. Adapted Physical Activity Q1998; 15: 119–40.
12.
AndrioloRBEl DibRPRamosLRAerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome. Cochrane Database Syst Rev2005; 0: CD005176–CD005176.
13.
DoddKJShieldsNA systematic review of the outcomes of cardiovascular exercise programs for people with Down syndrome. Arch Phys Med Rehabil2005; 86: 2051–8.
14.
MendoncaGVPereiraFDInfluence of long-term exercise training on submaximal and peak aerobic capacity and locomotor economy in adult males with Down's syndrome. Med Sci Monit2009; 15: CR33–39.
15.
PommeringTLBroseJARandolphEEffects of an aerobic exercise program on community-based adults with mental retardation. Ment Retard1994; 32: 218–26.
16.
TsimarasVKFotiadouEGEffect of training on the muscle strength and dynamic balance ability of adults with down syndrome. J Strength Cond Res2004; 18: 343–7.
17.
VarelaAMSardinhaLBPitettiKHEffects of an aerobic rowing training regimen in young adults with Down syndrome. Am J Ment Retard2001; 106: 135–44.
18.
CarmeliEZinger-VakninTMoradMMerrickJCan physical training have an effect on well-being in adults with mild mental retardation?Mech Ageing Dev2005; 126: 299–304.
19.
ShieldsNTaylorNFDoddKJEffects 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 Rehabil2008; 89: 1215–20.
20.
SuomiRSelf-directed strength training: its effect on leg strength in men with mental retardation. Arch Phys Med Rehabil1998; 79: 323–8.
21.
HellerTHsiehKRimmerJHAttitudinal and psychosocial outcomes of a fitness and health education program on adults with down syndrome. Am J Ment Retard2004; 109: 175–85.
22.
RimmerJHHellerTWangEValerioIImprovements in physical fitness in adults with Down syndrome. Am J Ment Retard2004; 109: 165–74.
23.
ElmahgoubSMLambersSStegenSThe influence of combined exercise training on indices of obesity, physical fitness and lipid profile in overweight and obese adolescents with intellectual disability. Eur J Pediatr2009; 168: 1327–33.
MezzaniAAgostoniPCohen-SolalAStandards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil2009; 16: 249–67.
26.
VerdijkLBvan LoonLMeijerKSavelbergHHOne-repetition maximum strength test represents a valid means to assess leg strength in vivo in humans. J Sports Sci2009; 27: 59–68.
27.
JonesCJRikliREBeamWCA 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport1999; 70: 113–19.
28.
DunnJMReliability of selected psychomotor measures with mentally retarded adult males. Percept Mot Skills1978; 46: 295–301.
29.
BautmansIGorusENjeminiRMetsTHandgrip performance in relation to self-perceived fatigue, physical functioning and circulating IL-6 in elderly persons without inflammation. BMC Geriatr2007; 7: 5–9.
30.
CohenJStatistical Power Analysis for the Behavioral Sciences1988. Hillside, NJ: Lawrence Erlbaum Associates, 24–30.
31.
HagobianTASharoffCGStephensBREffects of exercise on energy-regulating hormones and appetite in men and women. Am J Physiol Regul Integr Comp Physiol2009; 296: R233–42.
32.
CornelissenVAFagardRHEffect of resistance training on resting blood pressure: a meta-analysis of randomized controlled trials. J Hypertens2005; 23: 251–9.
33.
SnowlingNJHopkinsWGEffects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care2006; 29: 2518–27.
34.
AsikainenTMKukkonen-HarjulaKMiilunpaloSExercise for health for early postmenopausal women: a systematic review of randomised controlled trials. Sports Med2004; 34: 753–78.
35.
MuellerPJExercise training and sympathetic nervous system activity: evidence for physical activity dependent neural plasticity. Clin Exp Pharmacol Physiol2007; 34: 377–84.
36.
KrausWESlentzCAExercise training, lipid regulation, and insulin action: a tangled web of cause and effect. Obesity (Silver Spring)2009; 17(Suppl 3): S21–6.
37.
TambalisKPanagiotakosDBKavourasSASidossisLSResponses of blood lipids to aerobic, resistance, and combined aerobic with resistance exercise training: a systematic review of current evidence. Angiology2009; 60: 614–32.
38.
SlentzCAHoumardJAKrausWEExercise, abdominal obesity, skeletal muscle, and metabolic risk: evidence for a dose response. Obesity (Silver Spring)2009; 17(Suppl 3): S27–33.
39.
EnrightPLThe six-minute walk test. Respir Care2003; 48: 783–5.
40.
HulensMVansantGClaessensALLysensRMulsEPredictors of 6-minute walk test results in lean, obese and morbidly obese women. Scand J Med Sci Sports2003; 13: 98–105.
41.
BernardiMRosponiACastellanoVDeterminants of sit-to-stand capability in the motor impaired elderly. J Electromyogr Kinesiol2004; 14: 401–10.
