Yeshayahu Hutzler

Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy

Swimming and aquatic exercise are known for their effects on respiration in normal and asthmatic people. The purpose of the present study was to evaluate the effect of a 6‐month movement and swimming program on the respiratory function and water orientation skills of children with cerebral palsy (CP). Forty‐six kindergarten children aged 5 to 7 years were assigned either to a treatment or control group. The intervention program consisted of swimming sessions twice weekly and sessions of group physical activity in a gym once weekly, each session lasting 30 minutes, for a period of 6 months. Children in the control group were treated (30 minutes, 4 days per week) with Bobath physical therapy. The children in the treatment and control groups had comparable disability types, age, and anthropometric measurements. A 2 × 2 (group × test period) repeated measures ANOVA design confirmed a significant effect of interaction of time with group. The results also confirmed that children with CP have reduced lung function compared with normative data for children in the same age category. The treatment program improved baseline vital capacity results by 65%, while children in the control group improved by only 23%. The movement and swimming exercise program had a better effect than a physical therapy routine implemented in a previous study, consisting of respiratory exercise alone.

Perspectives of Children With Physical Disabilities on Inclusion and Empowerment: Supporting and Limiting Factors

The purpose was to explore the personal experiences of children with physical disabilities in physical education (PE) and to identify supporting and limiting mechanisms to their inclusion and empowerment. A computerized analysis of individual profiles was performed based on in-depth interviews with 8 females and 2 males, ages 9 to 15, who were included in regular PE classes. Two individual profiles served as examples for situations faced during inclusive settings and typical reaction patterns. A comparative qualitative analysis of interview themes generated five main categories of themes: assistive devices, physical activity, peers, important adults, and self. Experiences during physical activity were identified as supporting or limiting empowerment within each category, based on selected criteria. An almost equal distribution of supporting and limiting factors was observed.

Motivational correlates of physical activity in persons with an intellectual disability: a systematic literature review

BACKGROUND The purpose of this study is to systematically retrieve, examine and discuss scientific studies focusing on motivational correlates that both contribute to, and can be assumed to be effects of, participation in sport, recreation, or health-related physical activities in persons with intellectual disability (ID). METHODS A systematic analysis of the literature retrieved through electronic databases and other resources was performed, covering articles published from 1980 through 2009. Inclusion criteria were based on terms referring to the participants, the psychosocial correlates and the type of activity. RESULTS Twenty-three articles satisfied the inclusion criteria, and were divided into four categories of studies: (1) cross-sectional designs, (2) experimental prospective one-group designs, (3) longitudinal comparative intervention designs, and (4) qualitative designs. The level of quality regarding the intervention studies was assessed using four different scales, and on average they depicted a moderate level of evidence. CONCLUSIONS Both exercise and sport-related activities seem to contribute to well-being. Improved physical fitness and elevated skill level gained during exercise and sport activities appear to serve as mediators for increased perceptions of self-efficacy and social competence. Peer modelling, as well as video and audio reinforcement, appear to be important modalities in maintaining compliance to exercise programmes.

Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature

Objective: To determine the effectiveness of aquatic interventions in children with neuromotor impairments. Design: A search of electronic databases that included MEDLINE, PubMed, ERIC, PsychLit, PEDro, Sport Discus, CINAHL and Cochrane between 1966 and January 2005 was conducted using the following keywords: ‘hydrotherapy’, ‘aquatic therapy’, ‘water exercise’, ‘aquatics’, ‘adapted aquatics’, ‘aquatic exercise’ and ‘swimming’. An additional resource, the Aquatic Therapy Research Bibliography until 1999, was explored manually. Titles and abstracts were assessed manually according to the following inclusion criteria: (1) population (children with neuromotor or neuromuscular impairments), (2) intervention (aquatic programme). Articles were reviewed according to merit of design, population participants and outcome measures with respect to International Classification of Function and Disability terminology (changes in body function, activity level and participation). Results: Eleven of the 173 articles that were retrieved met the inclusion criteria: one randomized control trial, two quasi-experimental studies, one cohort study, two case control studies and five case reports. Seven articles reported improvement in body functions, and seven articles reported improvement in activity level. Two of the four articles that investigated outcome measures regarding participation described positive effects while the findings of the other two revealed no change. None of the articles reported negative effects due to aquatic interventions. Conclusion: According to this review, there is a substantial lack of evidence-based research evaluating the specific effects of aquatic interventions in this population.

Reliability of isokinetic strength measurements of the knee in children with cerebral palsy

This study evaluates the reliability of isokinetic testing of the knee flexors and extensors in children with cerebral palsy (CP). Twelve children (seven girls, five boys), aged 9 to 15 years, participated in this study. The childrens strength was measured bilaterally, using a dynamometer. Each participant was tested twice at an interval of 1 week. During each session, the participant performed five consecutive cycles of knee extension and flexion. Testing velocity was set at 90°/s, and the range of motion was 80°, starting with the knee flexed at 80° and ending in full extension. The measured variable was the peak torque. Reliabilities were determined using intraclass coefficient (ICC) with two‐way ANOVA model. The ICCs for individual sessions range from 0.90 to 0.99. ICCs for the eight repetitions over the two sessions range from 0.95 to 0.98. The findings indicate that measuring isokinetic strength in the tested population is highly reliable and should be considered in rehabilitation protocols.

Physical education students’ attitudes and self‐efficacy towards the participation of children with special needs in regular classes

The purpose of the present study was to investigate the relationship between personal variables of physical education students and their attitudes towards participation of children with disabilities and self‐efficacy (SE) in teaching students with disabilities in regular classes. A total 153 PE majors (95 females and 58 males) participated in the study. A 15‐item attitude instrument and a 15‐item SE instrument concerning dilemmas during educational tasks were administered as a part of the didactic assignments. Factor analysis revealed one challenge and two threat factors in the attitude instrument. The statistical analysis revealed significant effects on attitudes to gender (females higher than males) and years in college (advanced students higher than novices). Significant effects on SE were found in the coursework, previous experience and years in college variables. SE was inversely related to both threat factors of the attitude instrument (r = − 0.42 and − 0.43 respectively).

Aerobic and anaerobic arm-cranking power outputs of males with lower limb impairments : Relationship with sport participation intensity, age, impairment and functional classification

Fifty individuals with lower limb impairments including spinal cord injury, polio and amputations underwent aerobic and anaerobic arm-cranking tests in a standardized laboratory setting. Based on linear regression models applied with age as dependent variable aerobic performance variable including HRmax (R=0.395, P=0.004), and POaer (R=0.31, P=0.021) were subjected to ANCOVA adjusting for age in order to determine the significance of participation intensity (competitive vs leisure) and type of physical impairment. Anaerobic performance variables were not influenced by age and thereby subjected to 1-Way ANOVA with the same independent variables. Participation intensity and type of impairment significantly discriminated (P<0.001) between athletes in all power variables. Linear regression models have shown moderate but significant (P<0.001) relationship with functional ability (bases on International Wheelchair Basketball Federation classification system). In anaerobic mean power (MP) classification accounted for 42% of the variance, while in anaerobic peak power (PP) and aerobic Power (POaer) for 38% and 30% respectively. By means of a post hoc Tukey analysis significant differences were observed between athletes with a high level paraplegia (class 1) and those with one leg affected by polio or amputations (classes 4, 4.5). Athletes with low level paraplegia and two legs affected by polio (classes 2–3.5) had values in-between. Based on the descriptive evaluation, a three group scheme was conceptualized and resubjected to ANOVA. Significant intergroup differences were thus obtained only for PP. Descriptive PP data for each group were transformed into a five category table in order to provide reference values for fitness estimation in males with lower limb impairments of various etiologies.

Effects of a Special Olympics Unified Sports soccer program on psycho-social attributes of youth with and without intellectual disability.

The purpose of the study was to investigate the effects of a Special Olympics (SO) Unified Sports (UNS) soccer program on psycho-social attributes of youth with and without intellectual disabilities (ID). Participants were 76 male youth with (n=38) and without (n=38) ID. Participants with ID were randomly allocated into a SO athletes group (n=23, mean age=14.5; SD=1.2 years) and a control group (CG) (n=15, mean age=14.5; SD=.8 years). Twenty-three randomly selected youth without ID formed the partner group (mean age=14.1; SD=.9 years) and 15 youth without ID (mean age=13.8; SD=.5 years) formed the CG. Instruments included the Friendship Activity Scale (FAS) (Siperstein, 1980), the Adjective Checklist (Siperstein, 1980), and the Children Behavior Checklist (Achenbach, 1991). The soccer training program lasted eight weeks, 1.5h per session, three times per week, in addition to school physical education (PE). The CG did not participate in any sports in addition to PE. The findings showed that the UNS program was effective in decreasing the problem behaviors of youth with ID and increasing their social competence and FAS scores. In addition, the program was found to be effective in improving the attitude of youth without disabilities toward participants with disabilities. In conclusion, the present findings demonstrate the utility of a UNS program for both youth with and without disabilities.

Anaerobic Fitness Testing of Wheelchair Users

SummaryAnaerobic exercise testing has been applied since the 1970s as a procedure for estimating the capacity of local energy mechanisms dominating short term exercise. Compared with lower-body anaerobic testing, upper-body anaerobic testing is relatively new and less fully investigated. The reported data in this area are limited, and there is a paucity of reference values.For this review, the literature was searched by computerised inquiries of international and local databases, as well as personal access to PhD theses and congress proceedings. This article reviews the existing literature, covering a period of 20 years from 1976 to 1995. Data are reported concerning the findings of variables relevant to the anaerobic capacity of wheelchair users. The research findings revealed in the literature published so far are analysed here with particular attention paid to the methods and instrumentation used (type of ergometer and protocol utilised in the tests). Limitations in existing instrumentation and research designs and goals for further study have been suggested.Specific sections analyse the relevance of anaerobic performance variables to the classification and activity level of the individuals involved and their relevance to daily life and sports-related physical performance. Inter-relationships observed between anaerobic and aerobic capacity indices are discussed with respect to the limiting nature of local muscular fatigue over central processes. This information may be helpful in better understanding the exercise limitations and potential of wheelchair users with lower-limb impairments. Thus, clinical application of anaerobic fitness testing in these individuals may be enhanced.

Physical performance of elite wheelchair basketball players in armcranking ergometry and in selected wheeling tasks

This study compared the aerobic and the anaerobic performance of 11 elite Israeli wheelchair basketball players in arm ergometric tests and corresponding wheeling tasks, derived from basketball practice. The ergometric tests included a continuous aerobic maximal peak work capacity test (PWCmax), and a 30-second arm-all-out anaerobic test of mean anaerobic capacity (MANC) and peak anaerobic power (PANP). The wheeling tasks included a 428 meter race, slalom and 6-minute endurance race. We examined the relationship of performance variables to personal variables, age, bodyweight and classification as athletes. The results were analysed by Spearman correlation tables, revealing the following: (1) HRmax (maximal heart rate) correlated highly (r = .884-.962) with performance in all wheeling tasks; (2) no relationship was found between variables in the arm ergometric tests and variables in the wheeling tasks; (3) bodyweight correlated significantly with MANC and PWCmax (r = .817 and .783 respectively). This relationship was better than the other independent variables (classification and age). It is concluded that HRmax can be used for performance evaluation in wheelchair basketball practice, and that arm ergometric work capacity has only limited predictive value of performance in wheeling tasks.