Leontien Bossink

Motor activation in people with profound intellectual and multiple disabilities in daily practice

ABSTRACT Background People with profound intellectual and multiple disabilities (PIMD) are at risk of being motorically inactive. This study investigated the degree and type of motor activation in daily practice and its relationship to personal and contextual factors. Method A total of 58 participants with PIMD participated in the study. Data concerning the motor activation were collected by means of a diary over a period of 14 days. Relationships to personal and contextual factors were analysed using multilevel analyses. Results The mean number of transfers was 3.1 times per day (range: 0–9, SD = 1.4), the mean number of relocations was 7.7 times per day (range: 2–13, SD = 2.5), and the mean number of motor activities offered was 1.5 per day (range: 0–10, SD = 1.9). Relationships to age, gender, location, and day of week were found. Conclusion Motor activation seems to be a minor part of the support provided to people with PIMD.

Understanding low levels of physical activity in people with intellectual disabilities: A systematic review to identify barriers and facilitators

BACKGROUND People with intellectual disabilities (ID) undertake extremely low levels of physical activity. AIMS To enhance understanding concerning low levels of physical activity in people with ID, this study has three aims: (1) to identify barriers to and facilitators of physical activity in people with ID; (2) to examine differences in barriers and facilitators between levels of ID (mild, moderate, severe, and profound); (3) to examine differences in barriers and facilitators between various stakeholder groups. METHODS AND PROCEDURES A systematic search was performed using the following databases from the year 1990: MEDLINE, ERIC, and PsycINFO. The studies included were peer reviewed, available as full text, and written in English, addressing barriers to and facilitators of physical activity in people with ID. The quality of the studies was assessed using existing critical review forms. All studies were subjected to qualitative synthesis to identify and compare barriers and facilitators. OUTCOMES AND RESULTS In all, 24 studies were retrieved, describing 14 personal and 23 environmental barriers and/or facilitators. The quality of the studies varied, particularly for qualitative studies. Only two studies included people with severe or profound ID. Stakeholder groups tend to identify barriers outside their own responsibility. CONCLUSIONS AND IMPLICATIONS Results reveal a broad range of barriers and facilitators, but not for people with more severe ID. Further research should also examine these factors among stakeholders responsible for providing support.

A power-assisted exercise intervention in people with profound intellectual and multiple disabilities living in a residential facility : a pilot randomised controlled trial

Objective: To assess the feasibility of conducting a randomised controlled trial to determine the effectiveness of a twenty-week power-assisted exercise intervention in people with profound intellectual and multiple disabilities and to evaluate the potential beneficial effects of this intervention. Design: Pilot randomised controlled trial. Setting: A large-scale twenty-four-hour residential facility in the Netherlands. Subjects: Thirty-seven persons with profound intellectual and multiple disabilities. Intervention: Participants in the intervention group received a power-assisted exercise intervention three times a week for thirty minutes over a twenty-week period. Participants in the control group received care as usual. Main measures: Trial feasibility by recruitment process and outcomes completion rates; intervention feasibility by programme compliance rates; potential outcomes by functional abilities, alertness, body composition, muscle tone, oxygen saturation, cardiovascular fitness and quality of life. Results: Thirty-seven participants were recruited (M age = 32.1, SD = 14.6) and were randomly allocated to intervention (n = 19) and control (n = 18) groups. Programme compliance rates ranged from 54.2% to 97.7% with a mean (SD) of 81.5% (13.4). Oxygen saturation significantly increased in the intervention group. Standardised effect sizes on the difference between groups in outcome varied between 0.02 and 0.62. Conclusions: The power-assisted exercise intervention and the trial design were feasible and acceptable to people with profound intellectual and multiple disabilities living in a residential facility. This pilot study suggests that the intervention improves oxygen saturation, but further implementation with the aim of improving other outcomes should be considered with caution.

The effects of a power-assisted exercise intervention on alertness in people with profound intellectual and multiple disabilities

One of the benefits of physical activity in people with profound intellectual and multiple disabilities (PIMD) is an increase in alertness. This study investigated the effect of a power-assisted exercise intervention on alertness and the relationship of this effect to the level of additional motor and visual impairments in people with PIMD. A randomized controlled trial design (N = 37) was used with five measurements. Using individual plots and multilevel analysis, differences in change of alertness over time were analyzed between the intervention and control group, as was the relationship of changes to additional impairments. Considerable variation in alertness over time was found. The results showed no difference between the control and intervention groups in terms of alertness. No relationship with additional impairments was found. This study underlines the importance of looking at the effectiveness of interventions for people with PIMD because those interventions may not be as effective as expected.