The functional fitness capacity of adults with Down Syndrome in South Africa

Boer, Pieter (2010-12)

Thesis (M Sport Sc (Sport Science)--University of Stellenbosch, 2010.

Thesis

ENGLISH ABSTRACT: Functional fitness refers to the physical capacity to perform normal everyday activities safely and independently without undue fatigue. More specifically, functional fitness refers to having adequate strength, flexibility, mobility and endurance to execute essential tasks efficiently and effortlessly. Being functionally fit is important for all populations, but even more so for populations at risk for loosing functional capacity such as the elderly, disabled, and those with chronic medical conditions. Down syndrome individuals form part of the intellectually disabled population and show even more marked reductions in physical and functional capacities when compared to this already functionally limited population. Most DS individuals live sedentary lives, are obese, and age prematurely. For these reasons it is important to develop their functional capacities optimally. Although standardised tests are available for youngsters with intellectual disability, this is not the case for DS individuals. This study therefore endeavoured to describe the physical and functional fitness capacity of DS adults and to determine how much individual physical attributes contribute to functional capacity. 17 items, of which the validity and reliability have been determined, were included in the test battery. This included 2 balance tests, 2 flexibility tests, 2 coordination tests, 5 muscular strength and endurance tests, 2 functional tasks and an aerobic test. A total of 371 individuals from DS centres and institutions across seven provinces in South Africa volunteered to participate in the study. The study sample was categorised according to gender and four different age groups (18-25, 26-35, 36-45, >45 years) for further analysis. DS men were taller, heavier and had a greater arm span and sitting height than DS women. The majority of the participants were either overweight or obese. DS men performed significantly better on all but three tests compared to the women. The women performed better on the sit- and- reach flexibility test and the chair stand test, however, differences were not statistically significant. Physical test items correlated significantly and strongly to functional performance in 9 items for DS men and 5 items for DS women. Importantly, balance items correlated stronger with functional performance in DS women than in DS men. This is not a new finding and suggests that separate training programs should be developed for DS men and DS women. This is the first study of its kind in South Africa and confirms the findings of previous studies that DS adults have both low physical and functional capacities. They are particularly weak in terms of basic endurance and strength, which have been shown are trainable variables in DS individuals. The study also provides valuable criterion referenced values for an adult DS population. This information will assist health professionals in tailoring appropriate training programs to address functional limitations, as well as the negative health consequences associated with ageing. This special population thus need the assistance of sport scientists, as well as the community, to integrate them into special training and activity programs to improve their quality of life.

AFRIKAANSE OPSOMMING : Funksionele fiksheid verwys na die fisieke kapasiteit om alledaagse aktiwiteite op ‘n veilige en onafhanklike wyse uit te voer sonder om oormatige vermoeienis te ervaar. Meer spesifiek beteken funksionele fiksheid dat ‘n person voldoende krag, lenigheid, beweeglikheid en uithouvermoë besit om essensiële take doeltreffend en moeiteloos te voltooi. Alle populasies behoort funksioneel fiks te wees, maar dit is self meer belangrik vir populasies wat die risiko het om hul funksionele kapasiteit te verloor, soos bejaardes, persone met gestremdhede en diegene met kroniese mediese toestande. Down sindroom individue is deel van die populasie met intellektueel gestremdhede en hulle het selfs meer fisieke en funksionele beperkinge as die intellektueel gestremdes. Die meeste persone met DS het ‘n onaktiewe leefstyl, is vetsugtig en ervaar premature veroudering. Vir hierdie redes is dit uiters belangrik om hulle funksionele kapasiteit optimaal te ontwikkel. Hoewel gestandaardiseerde toetse beskikbaar is vir jong persone met intellektueel gestremdhede, is dit nie die geval met DS individue nie. Hierdie studie was ‘n poging om die fisieke en funksionele fiksheidkapasiteit van DS volwassenes te beskryf en te bepaal tot watter mate fisieke eienskappe funksionele kapasiteit bepaal. 17 items, waarvan die geldigheid en herhaalbaarheid bepaal is, is ingelsuit in die toetsbattery. Dit het die volgende ingesluit: 2 balanstoetse, 2 lenigheidstoetse, 2 koordinasietoetse. 5 spierkrag en uithouvermoë toetse, 2 funksionale take en een aërobiese toets. ‘n Totaal van 371 individue van DS sentrums en instellings in sewe provinsies in Suid Afrika het vrywillig ingestem om aan die studie deel te neem. Die steekproef is volgens geslag en ouderdom in vier kategorieë verdeel (18-25, 26-35, 36-45, >45 jaar) vir verdere analise. DS mans was langer, swaarder en het ‘n langer armlengte en sithoogte gehad as DS vroue. Die meerderheid van die deelnemers was of oorgewig of vetsugtig. DS mans het beduidend beter as die vroue gevaar in al die toetse, behalwe drie. Die vroue het beter gevaar in die sit en strek lenigheidstoets en die stoel opstaan toets, maar die verskille was nie statisties betekenisvol nie. Nege fisieke toetsitems vir mans het sterk en betekenisvol gekorreleer met funksionele kapasiteit, terwyl 5 items vir vroue betekenisvolle korrelasies gewys het. Balans items het sterker met funksionele kapasiteit in vroue as in mans gekorreleer. Hierdie is nie ‘n nuwe bevinding nie en bevestig dat verskillende oefenprogramme vir DS mans en vroue ontwikkel moet word. Hierdie is die eerste studie van sy soort in Suid Afrika en bevestig die resultate van vorige studies dat DS volwassenes beide lae fisieke en funksionele kapasiteite het. Hulle is veral swak ten opsigte van basiese uithouvermoë en spierkrag, maar beide hierdie veranderlikes kan by DS persone ingeoefen word. Hierdie studie voorsien ook waardevolle kriterium verwysingswaardes vir ‘n volasse DS populasie. Hierdie inligting kan persone in die gesondheidsberoepe help om gepaste oefenprogramme saam te stel om die funksionele beperkings en negatiewe gesondheidsgevolge wat met veroudering geassosieer word, aan te spreek. Hierdie spesiale populasie benodig dus die hulp van sportwetenskaplikes, sowel as die gemeenskap, om hulle te integreer in spesiale oefen- en aktiwiteitsprogramme om sodoende hulle kwaliteit van lewe te verbeter.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/5263
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