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      Physical Activity and Physical Fitness of Adults with Intellectual Disabilities in Group Homes in Hong Kong

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          Abstract

          Adults with intellectual disabilities (ID) typically have a sedentary lifestyle and higher rates of overweight and obesity. This study describes the habitual daily physical activity (PA) and the health-related physical fitness (PF) of adults with mild and moderate ID who resided in four group homes and worked in sheltered workshops. We also assessed the contribution of PF variables towards PA levels and sedentary behavior of this population subgroup. Adults with mild and moderate ID ( N = 114) were assessed on PF tests (percent body fat, waist and hip circumferences, 6-min walk (6MWT), arm curl, and sit and reach). PA and sedentary behavior on weekdays were determined using Actigraph accelerometers. Results showed these adults averaged 2% of their daily time (or 10 min) engaged in moderate-to-vigorous PA (MVPA) and 67% of the time (495 min) being sedentary. No significant differences between mild and moderate ID were found for any PA or PF variable. Linear multiple regression analyses showed 6MWT to be the only significant PF variable contributing to the variance of PA and sedentary behavior. In conclusion, adults with ID reside in group home have low PA and low fitness levels. Among fitness variables, the walking test (i.e., cardiovascular fitness) had the highest positive association with participants’ daily PA, MVPA, and negative association with sedentary behavior. Future intervention studies in promoting PA and fitness for adults with ID are warranted.

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          Most cited references51

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          Physical fitness and all-cause mortality. A prospective study of healthy men and women.

          We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.
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            Adult self-reported and objectively monitored physical activity and sedentary behavior: NHANES 2005–2006

            Background It remains unclear what people are attempting to communicate, in terms of objectively monitored behavior, when describing their physical activity and sedentary behavior through self-report. The purpose of this study was to examine various objectively monitored accelerometer variables (e.g., moderate-to-vigorous physical activity [MVPA], steps/day, sedentary time, etc.) across categories of self-reported MVPA (< 150 vs. ≥ 150 minutes/week), usual occupational/domestic activity (UODA; “mostly sitting” vs. “stand, walk, lift, or carry”), and leisure-time sedentary behavior (LTSB; ≥ 3 vs. < 3 hours/day) in a nationally representative sample of U.S. adults (≥ 20 years). Methods This is a secondary analysis of 3,725 participants from the 2005–2006 National Health and Nutrition Examination Survey (NHANES) who provided relevant questionnaire responses and ≥ 1 day of valid accelerometer data. Descriptive statistics were computed for various objectively monitored accelerometer variables across categories of self-reported MVPA, UODA, and LTSB. Pairwise comparisons were conducted to examine differences in objectively monitored behavior between categories of self-reported MVPA, UODA, and LTSB. Results On average, adults reporting compliance with physical activity guidelines (≥ 150 minutes/week of MVPA) accumulated more objectively measured physical activity and similar amounts of sedentary time relative to those reporting not achieving guidelines. Adults reporting their daily UODA as “mostly sitting” or accruing ≥ 3 hours/day of LTSB accumulated less objectively monitored physical activity and more sedentary time than those who described their UODA as “stand, walk, lift, or carry” or accrued < 3 hours/day of LTSB. The most active cross-classified category (7,935 steps/day; ≥ 150 minutes/week of self-reported MVPA, “stand, walk, lift, or carry” UODA, and < 3 hours/day of LTSB) accumulated more than twice as many daily steps as the least active cross-classified category (3,532 steps/day; < 150 minutes/week of self-reported MVPA, “mostly sitting” UODA, and ≥ 3 hours/day of LTSB). Conclusions A number of objectively monitored physical activity indicators varied significantly between self-reported MVPA, UODA, and LTSB categories, while objectively monitored sedentary time only varied between UODA and LTSB categories. Cross-classifications of self-reported MVPA, UODA, and LTSB responses depict a greater range of physical activity than viewing dichotomous responses for these variables one-at-a-time.
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              Physical activity levels in adults with intellectual disabilities: A systematic review

              Despite evidence that inactivity is a major factor causing ill health in people with intellectual disabilities (pwID) there are gaps in our knowledge of their physical activity (PA). To date, there is no published systematic review of their PA levels. Therefore, we performed a systematic review from January–October 2015, comprising studies from across the globe to establish PA levels, determine how they were measured, and what factors influenced PA in adults with intellectual disabilities (awID). Five databases were searched. Studies were included if written in English, peer-reviewed, had primary research data, and measured PA levels of awID. Quality was assessed using a 19-item checklist. Meta-summary of the findings was performed and a meta-analysis of factors influencing PA using multiple regression. Fifteen studies were included consisting of 3159 awID, aged 16–81 years, 54% male and 46% female. Only 9% of participants achieved minimum PA guidelines. PA levels were measured using objective and subjective methods. ID severity, living in care, gender, and age were independently significantly correlated with the number of participants achieving PA guidelines with the strongest predictor being ID severity (Beta 0.631, p < 0.001). Findings should be in the context that most of the participants were in the mild/moderate range of ID severity and none of the studies objectively measured PA in people with profound ID. To inform measurement and intervention design for improved PA, we recommend that there is an urgent need for future PA studies in awID population to include all disability severity levels. PROSPERO registration number CRD42015016675.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                29 June 2018
                July 2018
                : 15
                : 7
                : 1370
                Affiliations
                [1 ]Department of Physical Education, Hong Kong Baptist University, Kowloon Tong, Hong Kong; wendyhuang@ 123456hkbu.edu.hk
                [2 ]Department of Sports and Recreation Management, Technological and Higher Education Institute of Hong Kong, Chai Wan, Hong Kong; pchoi@ 123456vtc.edu.hk
                Author notes
                [* ]Correspondence: bchow@ 123456hkbu.edu.hk ; Tel.: +852-3411-7007
                Author information
                https://orcid.org/0000-0002-0282-3743
                Article
                ijerph-15-01370
                10.3390/ijerph15071370
                6068912
                29966299
                6063f159-0eb8-46a4-90f6-51408a567911
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 May 2018
                : 27 June 2018
                Categories
                Article

                Public health
                physical activity,physical fitness,adults,intellectual disabilities,group home
                Public health
                physical activity, physical fitness, adults, intellectual disabilities, group home

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