Physical performance of individuals with DS is a widely researched topic; however, research data on the difference in performance between individuals with and without DS has often been inconsistent. A review of literature reveals the DS adolescents perform at the same level as their normal counterparts in some tasks and poorly in others. A comprehensive method of determining the existence or non-existence of these differences is proposed in this article. The method involves subjecting both normal and DS individuals to six test items to measure, compare and contrast their physical performance. The data obtained is subjected to analysis using a simple MANOVA technique and results can be drawn.
Key Words: Fitness performance, adolescents, Down syndrome
The Difference of Fitness Performance between Students with and without Down Syndrome
According to Mendonca, Pereira, & Fernahall (2010), Down syndrome (DS) is also defined as a chromosomal disorder that occurs is approximately 1 per 650-1000 live births. However, it has been found that there is an increased occurrence rate of DS with the superior material age of about 1 – 5 years. The prevalence of DS disorder has been determined to vary across the world, but it accounts for about 8% of all registered incidences of congenital anomalies in Europe. In fact, Down syndrome is said to be the most prevalent cause of the intellectual disability (ID) that may affect children at a tender age. DS is characterized by distorted psychomotor development and an augmented risk of associated congenital deficiencies and organic disorders including congenital heart and gastrointestinal abnormalities (Mendonca, Pereira, & Fernahall, 2010). In the recent years, research has discovered a substantial increase in the cases of people with DS in the population despite that life expectancy is very low. However, the above discovery was based on minute data available about DS disorder due to the scanty research that has been conducted specifically on Down syndrome.
The scantiness of research and their inconsistent findings on this topic prevents a comprehensive understanding and/or confirmation of these allegations. Gonzalez-Aguero et al., (2010) recognized the scarcity of data while conducting a study on physical fitness in children and adolescent youths with DS related to health and their response to training. Perhaps a recent review of the literature has been considered as a force that would trigger a start of research that would stimulate new study perspectives. The information concerning physical fitness in Down syndrome populace, however, is insufficient, particularly the data for children and adolescents (Gonzalez-Aguero et al., 2010). Goncalo et al. also echo the above researchers by confirming the insufficiency of data about Down syndrome and fitness performance or exercise capacity. Since data about the supramaximal exercise capacity of people with Down syndrome are scanty and unreliable, this literature review is restricted to acute and chronic reactions to submaximal and peak exercise intensities in people with DS (Goncalo et al., 2010).
According to Pitetti, Baynard, Agiovlasitis (2013), the effects of Down syndrome involve many medical conditions besides intellectual disorder that may be categorized at birth or build up during the lifespan of the children and adolescents. Children and adolescents experiencing the DS have a number of health, anatomical, physiological, cognitive, and psycho-social attributes that expose them to limited physical fitness and physical activity capabilities (Pitetti, Baynard, & Agiovlasitis, 2013). Precisely, the severe complications associated with DS include higher risk of congenital heart disease, loss of hearing, eye conditions, obstructive sleep apnea, thyroid disease, and gastrointestinal disease as well as atlanto-occipital instability. Due to so many health issues such as congenital heart disease, musculoskeletal problems, such as poor muscle tone, joint hypermobility and ligamentous laxity are frequently encountered individuals with DS have such a low aerobic capacity (Goncalo, 2011). In addition, another major concern for the lack of sports participation is the atlantoaxial instability (Esposito, MacDonald, Hornyak, & Ulrich, April 2012). The scantiness of research and their respective conflicting findings thwart a clear knowledge and substantiation of the limitations of DS in the above-mentioned population.
In reference to physical performance, children and adolescents with the DS have been observed to exhibit two behavioral responses, these are fragility and sociability motivation (Dunn, 2010). The term fragility may have a number of meanings, however in this context it is used to refer to a backsliding behavior and regression. Children usually display the ability to perform a physical activity in one session but fail to perform the same task in the subsequent session. It is worth noting that all children exhibit this backsliding and regression behavior; the backsliding is, however, more pronounced in children with DS than those without at the same developmental stage. A second attribute of behavior characteristics of DS children is their enthusiasm towards hospitality. Research shows that children with DS display high standards of socially oriented behaviors right from tender ages (Dunn, 2010).
A study conducted to inspect the effects of combined aerobic and resistance exercise training in adults with and without Down syndrome reveals no significant differences in performance for students with and those without DS in terms of body mass index and relative fat mass (Hsiu-Ching Lin a, 2012). However, performance in walking economy and Vo2 peak were relatively lower in students with DS compared to their normal counterparts (Goncalo, 2011). A similar study conducted to determine the effects of Weight Resistance Training on Swimmers with Down syndrome (Campos, Víquez & Andrea, 2011) produced similar data. Results indicated positive changes in the total strength of pectoral muscles with the changes being maintained. The bicep muscle, however, did not show any significant changes during the entire program.
However, studies also present different findings regarding the impacts of combined aerobic and resistance exercise training in kids and grown-ups with and without DS. In a study to investigate the fitness of blacks with and without mild Down syndrome Pitetti, Baynard, & Agiovlasitis (2013), found that adolescents with DS have reduced physical work capacity. Instead, this group of persons has a higher body mass index, reduced exercise capacity, and poorer aerobic fitness compared to their counterparts who have no mental retardation. Based on their finding, these researchers concluded that optimal aerobic capacity (VO2peak) in both youngsters and adults with Down syndrome is lower compared to their counterparts without this disorder and with ID although lacking DS. The study identified three factors that significantly contribute to reduced VO2peak values in people that have DS. These factors include automatic dysfunction, diminished ventilator capacity, and metabolic dysfunction (Pitetti, Baynard, & Agiovlasitis, 2013). In the contrary to the findings identified and reviewed above in this literature, Pitetti et al. (2013) found a significant difference between aerobic fitness and resistance exercise training in a sample population of youths and adults with and without DS. Therefore, this review considers a wide range of published literature to establish the relationship between these critical factors underpinned in this review.
Questions have continuously risen on the relationship of Down syndrome and age. What exactly is the effect of age on physical performance of individuals suffering from the chromosomal defect resulting in the Down syndrome? This has prompted numerous studies and research in the field, and a number of results have been published. Statistics points out that the current population of over 60 years of age with developmental delays is expected to double come the year 2030. Research also points out that Down syndrome (DS) is the most common source of human developmental delays (Cambridge, 2005). Changes in body functions and structural functions increase with increasing age in populations suffering from DS. These changes have a prospective of physical involvement restrictions and action limitations (Barnhart & Connolly, 2007).
In another a study, Erickson (2007) conducted a study to establish the relationship between DS, paternal age, maternal age, and birth order in a population with Down syndrome. The cytogenetic evidence indicated that trisomy 21 is likely to increase, maybe even in significant portion, from paternal non-disjunction (Erickson, 2007). After examining a sample of over 4000 Down syndrome cases, Erickson confirmed a relationship between maternal age with an awfully high degree of statistical significance and Down syndrome. In the same study, it was discovered that there was no independent impact of paternal age because the rate of paternal age exceeding 45 years appears to be close to constant level. Accordingly, the incidence of DS among young mothers can be high particularly for the ages of 15 years and less; although these rates seem to be similar to those experienced by mothers aged between 30 to 35 years. Based on the findings and conclusions summarized by this study, it is important to first indentify the portion of cases that occur as a result of maternal and paternal nondisjunction at varying parental ages. The information can help in establishing whether there is a significant statistical relationship between age and prevalence of Down syndrome.
Lahtinen, Rantala, & Malin (2007) also discovered that there is a significant variability in the performance of students aged 11 years and above. The research collected and analyzed data in two periods from 1973 and 1979 to establish whether there is a substantial difference in the physical performance of students of varying ages with and without Down syndrome. In this research, they found that the physical activity during of the participants declined from 11 to 3 hours per week during leisure time (Lahtinen, Rintala, & Malin, 2007). Among the important discoveries is was that the participants who stayed at home and went to work or attended school developed better eye-hand synchronization and better adaptive behavior in a period of time.
However, this group of participants showed a greater prevalence of obesity compared to counterparts learning in boarding schools or those who lived at home every day without attending school. Earlier on, Dr. G. Lawrence Rarick conducted an independent study about physical performance of individuals with intellectual disability and DS. The research published an exciting summary of findings by stating that ID is almost invariably escorted by substandard levels of physical performance (Rarick, 1973; Lahtinen, Rintala, & Malin, 2007). Rarick concluded that adolescents with mild intellectual disability trailed 2 – 4 years behind their equal aged peers who had no IN based on metrics of physical and motor performance. However, the majority of the data presented in the above studies need reevaluation since today’s adolescents have larger access to education or physical education, community fitness centers, and sports programs in the form of Special Olympics.
Research has also been done with aims of comparing the experiences of families with Down syndrome with other families with a similar count of children and family aspect but without DS disability. Studies have showed that majority of families living with children with DS disability lead normal lives considering that there are no additional demands or challenges. Most of these studies have focused on studying the experiences of mothers although some have investigated the experiences of fathers and brothers (Cuskelly, 2002). The results of the studies have indicated that most families do not find difficulties in taking care of DS children whereas some experience difficulties (Cuskelly, 2002). A few studies conducted to compare these two groups of families have found insignificant differences on levels of resilience. However, mothers of children with Down syndrome disability seem to report additional parenting demands and higher levels of stress. Resilience is a primary factor identified by researchers to describe families’ ability to cope well especially with the increased vulnerability to stress. Essentially, families that experience a higher vulnerability is said to be worse off in coping with stress caused by mentally retarded children compared with families with no or one case of DS disability. Measurement of physical performance differences I usually through cardiovascular and strength exercises (Rimmer, 2004).
Moreover, a wide range of studies has been conducted to examine and compare physical fitness in the youths with Down syndrome and those without DS. The youths with Down syndrome in North America and Europe show higher rates of obesity or overweight compared to their counterparts without DS disabilities (Pitetti, Baynard, & Agiovlasitis, 2013). The essence of these studies was to examine how the body composition is affected by mental retardation. The low rate of body activity leading to overweight can be accounted for by various critical factors that may be physiological, societal, psychological, or environmental factors among many others. The findings from the studies is that there is no improvement in body composition from physical fitness training of the youths with DS because of other related factors such as inadequate dietary control (Pitetti, Baynard, & Agiovlasitis, 2013).
In a different study Elshemy (2013) conducted an experiment purposed to identify, measure, and compare the spatiotemporal parameters of gait in obese children as a result of genetic composition and other obese DS children. The research attempted to understand how physical fitness training affects body composition in genetically overweight DS children and non-genetically obese children. The findings indicated that there is a significant relationship between the physical performance of genetically overweight DS children and non-genetically obese children (Elshemy, 2013). However, there is scanty data describing how the physical performance is influenced by the body composition of non-genetically overweight children and genetically obese DS children
Data Collection
Since all the test items involve physical activities, primary data collection methods are used for data collection these include; observation, counting and measurement. In measuring strength, counting is used for both the bench presses and leg presses. To avoid bias and ensure accuracy, an assistant will be required be to aid the test administrator in counting. Measurement will be used to collect data for the AROM tests. The test items requiring measurement are shoulder flex, groin flexibility and calf flexibility. Either a meter rule or a tape measure may be used in taking these measurements. The third data collection technique used is simple observation; this is used in taking note of the shoulder stretch where either a yes or no answer is required.
Data analysis
Once all the participants in the study have successfully completed their tests and raw data recorded, the data will be subjected to analysis and conclusions drawn. Data will be analyzed using multiple analysis of variance (MANOVA) technique using SPSS software package. Data shall be analyzed first based on gender to determine any significant differences between males and female. Each test item will then be analyzed separately and comparisons made for the two sample populations. The results and conclusions will be drawn and presented in form of a report.
References
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