Children with intellectual challenge:are they physically fit?
The study was conducted to assess health related physical fitness in children with intellectual disability and that was compared with their age matched tyoically developing peers. The study hypothesized that there is a difference between health related physical fitness of intellectually disabled children and typically developing children. A case-control study was conducted in the population of children with ID and typically developing children with the sample size of 32. Post approval from the institutional ethical committee of the trial was registered with the clinical trials registry, India . Total 32 participants in the age group of 8-12 were included in this case-control study. Out of which 12 were included in the case group (intellectually challenged children) and 16 were included in the control group (typically developing children) after obtaining their consent. Data collection was carried out using convenient sampling in Pune,India. Children in the case group were recruited from few special schools with prior permission from the school authorities. They were included based on their intellectual quotient (IQ) and level of intellectual disability. DSM-5 Criterion provided by American psychiatric association (APA) was used for selection of participants. As per this criterion, intellectual disability can be classified based on the IQ as mild (50-69), moderate (36-49), severe (20-35) and profound (<20). Children with mild to moderate intellectual disability were included in the study. For inclusion in the control group IQ of children were not taken into consideration, but children going to regular schools, with no different behaviour than expected for the age group of 8-12 and children who did not fail exams in academics were recruited to rule out undiagnosed learning or intellectual disability. Exclusion criteria were children with physical involvement such as in conditions of spasticity, polio or other loco-motor conditions. Data collection was carried out over a period of 18 months from April 2020 to September 2021. Assessment of physical fitness was carried out using Brockport physical fitness test and fitnesgram for five components; mass index (BMI), the 20-meter modified Progressive Aerobic Cardiovascular Endurance Run (PACER) to measure cardiovascular endurance, the modified curl-up test of abdominal strength and endurance, the modified pull-up test to measure arm strength and the back-saver sit-and-reach (BSSR) test to measure flexibility. Results of the study showed that there is statistically significant difference for modified curl up and modified pull up test between case and control group which was representing lesser upper limb and abdominal muscle strength for children with intellectual disability. This indicated that children with intellectual disability fail to match healthy fitness standards on fitnessgram.
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Data of the study was collected using convenient sampling for children with intellectual disability and typically developing children. Special schools and residential societies were approached for data collection. Quantative measures for assessment of health related physical fitness were chosen for making the analysis of the data easier. Outcome measures chosen were for body composition (BMI), muscular strength and endurance (modified curl up and modified pull up tests), flexibility (back saver sit and reach test) and cardiovascular endurance (20m PACER test), which were selected from BPFT fitness battery. The sample size for the study was calculated using G power version 220.127.116.11 where the minimally clinically important difference in 20m PACER test for case and control group was obtained as 32.55±2.61 SD and 35.72±0.11 SD from a pilot study. For a one tailed test, α is < 0.05 and 1-β at 0.95. Sample size was obtained as 16 per group. Data of the otcomes was analysed using SPSS version 26 (IBM Chicago). Baseline matching of age and intergroup analysis of parameters of muscular strength and endurance (curl up and modified pull up), flexibility (BSSR) and aerobic capacity (20m PACER) was performed using independent ‘t’ test.Descriptive statistics was used for the analysis of non-parametric data (body composition). Mann-Whitney U test was applied for the intergroup analysis of BMI.