Kathryn D. Campbell

Mentally retarded individuals--a population at risk?

When comparing the aging process of mentally retarded (MR) persons with the nondisabled population, researchers have established an earlier lower limit for the onset of old age for MR persons and a higher mortality rate. The reason for early senescence has not been successfully resolved, but the finding that cardiovascular disorders are the most prevalent form of disease among elderly MR persons suggests a relationship between lifestyles and higher mortality rate. Indeed, studies that evaluated the cardiovascular fitness (CVF) of MR individuals demonstrated substandard levels of fitness. The results of these studies, however, are not conclusive due to variation in test methodologies, motivational factors, and issues of test validity and reliability. Training studies which have purported to determine trainability of this population have also shown confusing results, perhaps attributed to the same protocol inconsistencies. Therefore, the purposes of this article are 1) to review previous methods of evaluating CVF of MR adults and determine whether testing methodologies invalidate the results of these studies, 2) to review training studies involving adult MR individuals and determine whether this population is capable of improving their CVF, and 3) to identify areas where further research is needed to fully describe the functional cardiovascular characteristics of MR adults.

The cardiovascular capacities of adults with Down syndrome: a comparative study

The purpose of this study was to compare the cardiovascular capacities of individuals with Down syndrome (DS) to individuals without Down syndrome who are mentally retarded. Sixteen young adults with DS and 16 individuals without DS (12 males and 4 females, respectively), all with mild/moderate mental retardation, participated in this study. Peak VO2 (absolute and relative), VE (1.min-1), heart rate (HR, b.min-1), and RER (VCO2/VO2) were determined by exercise tests utilizing a treadmill (TM) and Schwinn Air-Dyne ergometer (SAE). The best test result was chosen from the TM and SAE tests and used for statistical comparisons. Cardiac output (Q, 1.min-1) was measured while standing quietly and while walking at 3 mph, 0% grade, using the CO2 rebreathing method for 11 (9 males and 2 females) subjects from each group. Arteriovenous oxygen differences (a-v O2), cardiac index (QI), and stroke volume (SV) were calculated from VO2, Q, HR, and body surface area. Peripheral vascular resistance (PVR), left ventricular work index (LVWI), and left ventricular stroke work index (LVSWI) were calculated from mean arterial pressure, Q, QI, and stroke volume index. Results showed that individuals without DS had statistically significant (P less than 0.01) higher mean peak VO2 (35.6 vs 24.6 ml.kg-1.min-1; 2567 vs 1683 ml.min-1), VE (89.3 vs 59.2 1/min-1), and HR (179 vs 159 b.min-1) than individuals with DS, respectively. No differences in RER were seen between the groups. No differences were seen in cardiovascular parameters measured while quietly standing.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of lower body positive pressure on the exercise capacity of individuals with spinal cord injury.

The purpose of this study was to determine the effect lower body positive pressure (LBPP) has on the cardiovascular/exercise capacities of individuals with spinal cord injury (SCI) during both arm crank exercise (ACE) and wheelchair exercise performed on a treadmill (WCTM). Ten male adults (age = 31.1 +/- 10 yr) with SCI and five male nondisabled (ND) adults (31.2 +/- 10 yr) participated in this study. The ND subjects performed ACE only. For subjects with SCI, significantly higher (P < 0.025) peak VO2 (1042 +/- 212 vs 839 +/- 218 ml.min-1), peak VE (46 +/- 17 vs 35 +/- 9 l.min-1), and work rate (50 +/- 15 vs 40 +/- 13 W) were seen during ACE with LBPP. No significant differences for peak VO2, VE, or work rate were seen for the ND subjects with LBPP during ACE. In addition, significantly higher peak VO2 (960 +/- 322 vs 828 +/- 312 ml.min-1) was recorded with LBPP for the subjects with SCI during WCTM. Cardiac output (Q, l.min-1; CO2 rebreathing method) was measured at 50% peak VO2 for both ND subjects and subjects with SCI during ACE. Subjects with SCI demonstrated significantly higher SV (94 +/- 20 vs 84 +/- 20 ml) with LBPP. No differences were observed in SV at 50% peak VO2 during ACE for the ND subjects with LBPP. The results of this study suggest that for individuals with SCI, LBPP augments exercise capacity by preventing the redistribution of blood to the lower extremities.