EFFECTS OF PHYSICAL EXERCISE FOR ADULTS WITH INTELLECTUAL DISABILITIES: A SYSTEMATIC REVIEW

<div><p>ABSTRACT The literature presents the benefits of physical activity programs for people with intellectual disabilities (ID), but aspects such as those related to physical exercise prescription, benefits of the type of exercise program, the most recommended exercises, load control, and limitations of the interventions for adults with ID are subjects awaiting scientific research. The aim of this study was to verify, through a systematic review, the effects of physical activity programs for adults with ID. The procedure included an electronic search of the literature published from January 1960 to August 2014, considering terms related to physical activity, ID, and physical activity programs. Eight manuscripts met the eligibility criteria and were included in the study. Based on the systematic review, we found a limited number of studies that investigated, in a structured way, the effect of physical activity programs for adults with ID. In general, the systematized programs of physical exercise promoted consistent and significant benefits for adults with ID. However, there seems to be no consensus on the type of intervention to be used to promote the practice of physical activity in adults with ID. In addition, the methodological quality of the studies appears to be limited. We conclude that intervention studies with physical activity in adults with ID that involve aerobic exercise, sports specialization, and a combination of muscular and aerobic exercise performed two or three times a week for more than 40 minutes seem to be the most highly recommended for adults with ID.</p></div

Challenging Postural Tasks Increase Asymmetry in Patients with Parkinson’s Disease

<div><p>The unilateral predominance of Parkinson’s disease (PD) symptoms suggests that balance control could be asymmetrical during static tasks. Although studies have shown that balance control asymmetries exist in patients with PD, these analyses were performed using only simple bipedal standing tasks. Challenging postural tasks, such as unipedal or tandem standing, could exacerbate balance control asymmetries. To address this, we studied the impact of challenging standing tasks on postural control asymmetry in patients with PD. Twenty patients with PD and twenty neurologically healthy individuals (control group) participated in this study. Participants performed three 30s trials for each postural task: bipedal, tandem adapted and unipedal standing. The center of pressure parameter was calculated for both limbs in each of these conditions, and the asymmetry between limbs was assessed using the symmetric index. A significant effect of condition was observed, with unipedal standing and tandem standing showing greater asymmetry than bipedal standing for the mediolateral root mean square (RMS) and area of sway parameters, respectively. In addition, a group*condition interaction indicated that, only for patients with PD, the unipedal condition showed greater asymmetry in the mediolateral RMS and area of sway than the bipedal condition and the tandem condition showed greater asymmetry in the area of sway than the bipedal condition. Patients with PD exhibited greater asymmetry while performing tasks requiring postural control when compared to neurologically healthy individuals, especially for challenging tasks such as tandem and unipedal standing.</p></div

Group*condition interactions for mediolateral (ML) RMS and area of body sway.

<p>* indicates a significant difference between the PD and CG; # indicates a significant difference between the bipedal and tandem conditions; & indicates a significant difference between the bipedal and unipedal conditions.</p

Means and standard deviations of the anthropometric and clinical data of patients with PD (PD) and the control group (CG).

<p>MMSE- Mini Mental State Examination</p><p>H&Y–Hoehn & Yahr scale</p><p>UPDRS—Unified Parkinson’s Disease Rating Scale.</p><p>Means and standard deviations of the anthropometric and clinical data of patients with PD (PD) and the control group (CG).</p

Means and standard deviations of the CoP parameters symmetric index (%) in patients with PD (PD) and the control group (CG).

<p>* indicates a significant difference between the PD and CG.</p><p># indicates a significant difference between the bipedal and tandem conditions.</p><p>&indicates a significant difference between the bipedal and unipedal conditions.</p><p>Means and standard deviations of the CoP parameters symmetric index (%) in patients with PD (PD) and the control group (CG).</p

Means and standard deviations of the variability of spatial-temporal parameters interaction group * step * condition.^*

<p>Means and standard deviations of the variability of spatial-temporal parameters interaction group * step * condition.^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0184134#t003fn001" target="_blank">*</a>}</p

Means and standard deviations of anthropometric characteristics and cognitive function for the PD group and control group.

<p>MMSE: Mini Mental State Examination.</p

Means and standard deviations for walking variability of spatial-temporal parameters for each condition.

<p>Un.Walk.: unobstructed walking; Low: walking with low obstacle avoidance; Interm.: walking with intermediate obstacle avoidance; High: walking with high obstacle avoidance. p<0.05, *: Difference between groups, ^#: difference between unobstructed walking and walking with obstacle avoidance, regardless of obstacle height; ^a: difference between Un.Walk and Low; ^d: difference between Low and Interm.; ^e: difference between Low and High; ^f: difference between Interm. and High.</p

Means and standard deviations of variability of horizontal distance between the foot and obstacle in each step, for the conditions with the presence of an obstacle.

<p>§—difference between n-1 and all other analyzed steps.</p

Mean and standard deviation (in parenthesis) of toe-clearance for leading and trailing limb in each group.

<p>Mean and standard deviation (in parenthesis) of toe-clearance for leading and trailing limb in each group.</p