Children with intellectual challenge:are they physically fit?

The study was conducted to assess health related physical fitness in children with intellectual disability and that was compared with their age matched tyoically developing peers. The study hypothesized that there is a difference between health related physical fitness of intellectually disabled children and typically developing children. A case-control study was conducted in the population of children with ID and typically developing children with the sample size of 32. Post approval from the institutional ethical committee of the trial was registered with the clinical trials registry, India . Total 32 participants in the age group of 8-12 were included in this case-control study. Out of which 12 were included in the case group (intellectually challenged children) and 16 were included in the control group (typically developing children) after obtaining their consent. Data collection was carried out using convenient sampling in Pune,India. Children in the case group were recruited from few special schools with prior permission from the school authorities. They were included based on their intellectual quotient (IQ) and level of intellectual disability. DSM-5 Criterion provided by American psychiatric association (APA) was used for selection of participants. As per this criterion, intellectual disability can be classified based on the IQ as mild (50-69), moderate (36-49), severe (20-35) and profound (<20). Children with mild to moderate intellectual disability were included in the study. For inclusion in the control group IQ of children were not taken into consideration, but children going to regular schools, with no different behaviour than expected for the age group of 8-12 and children who did not fail exams in academics were recruited to rule out undiagnosed learning or intellectual disability. Exclusion criteria were children with physical involvement such as in conditions of spasticity, polio or other loco-motor conditions. Data collection was carried out over a period of 18 months from April 2020 to September 2021. Assessment of physical fitness was carried out using Brockport physical fitness test and fitnesgram for five components; mass index (BMI), the 20-meter modified Progressive Aerobic Cardiovascular Endurance Run (PACER) to measure cardiovascular endurance, the modified curl-up test of abdominal strength and endurance, the modified pull-up test to measure arm strength and the back-saver sit-and-reach (BSSR) test to measure flexibility. Results of the study showed that there is statistically significant difference for modified curl up and modified pull up test between case and control group which was representing lesser upper limb and abdominal muscle strength for children with intellectual disability. This indicated that children with intellectual disability fail to match healthy fitness standards on fitnessgram.本研究旨在评估智力障碍（intellectual disability, ID）儿童的健康相关体能，并与年龄匹配的典型发育儿童进行对比。本研究提出假设：智力障碍儿童与典型发育儿童的健康相关体能存在差异。本研究采用病例对照研究设计，研究对象为智力障碍儿童与典型发育儿童，总样本量为32。本研究经机构伦理委员会批准后，在印度临床试验注册库完成注册。本研究共纳入32名8-12岁的儿童作为参与者，其中病例组（智力障碍儿童）12名，对照组（典型发育儿童）16名，所有参与者均已获得知情同意。数据收集在印度浦那采用便利抽样法开展。病例组儿童通过几所特殊学校招募，已获得学校管理方的事前许可，纳入标准基于其智商（intelligence quotient, IQ）与智力障碍程度，采用美国精神病学协会（American Psychiatric Association, APA）发布的《精神障碍诊断与统计手册第五版》（Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, DSM-5）标准进行参与者筛选。根据该标准，智力障碍可按IQ分为轻度（50-69）、中度（36-49）、重度（20-35）及极重度（<20），本研究纳入轻中度智力障碍儿童。对照组的纳入标准不考量儿童的IQ，仅招募就读普通学校、行为表现符合其8-12岁年龄预期、学业考试未不及格的儿童，以排除未被诊断的学习障碍或智力障碍。排除标准为存在躯体受累情况的儿童，如痉挛状态、脊髓灰质炎或其他运动系统疾病。数据收集周期为2020年4月至2021年9月，共计18个月。体能评估采用Brockport体能测试与Fitnessgram，涵盖五大测评指标：身体质量指数（body mass index, BMI）、改良版20米渐进式有氧运动耐力测试（Progressive Aerobic Cardiovascular Endurance Run, PACER）以评估心血管耐力、改良卷腹测试评估腹部力量与耐力、改良引体向上测试评估上肢力量、背部保护坐位体前屈（back-saver sit-and-reach, BSSR）测试评估柔韧性。研究结果显示，病例组与对照组在改良卷腹测试与改良引体向上测试中存在统计学显著差异，表现为智力障碍儿童的上肢与腹部肌肉力量较弱，这表明智力障碍儿童未能达到Fitnessgram设定的健康体能标准。