Cardiorespiratory fitness in individuals with intellectual disabilities--a review.
Fitness is already low in youth with ID and drops with age, but valid treadmill tests and simple field flags can guide early, effective exercise plans.
01Research in Context
What this study did
Oppewal et al. (2013) pulled together every paper they could find on how well people with intellectual disability can use oxygen. They looked at both lab treadmill tests and simple field tests like step-ups.
The team asked two questions: How fit are these clients? And which tests give us numbers we can trust?
What they found
The review shows low fitness starts young and gets worse with age. Treadmill tests work, but only after you let the client walk on the belt a few times first.
Field tests are easy to repeat, yet they do a poor job of guessing the real VO2max number.
How this fits with other research
Wouters et al. (2017) agrees: the six-minute walk and body-composition tests are both doable and reliable in kids with moderate to severe ID. Oppewal et al. (2014) adds that slow gait speed, weak grip, and poor balance forecast later trouble with daily tasks.
Bigham et al. (2013) and Borji et al. (2013) help explain why fitness is low. They found blunted heart-rate reflexes and faster muscle fatigue, not just lack of effort.
Andrews et al. (2024) extends the story by showing high-intensity sprint intervals can boost performance in older adults, even if resting heart-rate variability stays the same.
Why it matters
When you test a client with ID, plan extra practice runs on any treadmill protocol and treat step tests as rough flags, not precise scores. Expect poor heart-rate recovery and early muscle fatigue, so build longer rest breaks into exercise plans. Use simple gait or grip tests to spot who may lose independence soon, then refer for targeted fitness programs that have since been proven to work.
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02At a glance
03Original abstract
Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of this review were to update previous reviews about (a) the cardiorespiratory fitness levels and their determinants in individuals with ID, and (b) the validity and reliability of cardiorespiratory fitness testing in individuals with ID. We searched the databases of Pubmed and Embase for relevant studies, resulting in 31 included articles. These studies mainly included younger participants with mild to moderate ID. Results confirmed previous findings of low cardiorespiratory fitness levels in individuals with ID. Cardiorespiratory fitness levels of children and adolescents with ID are already low, with further decline with increasing age. Furthermore, females have lower cardiorespiratory fitness levels than males. Physical inactivity and chronotropic incompetence are most likely to contribute to low cardiorespiratory fitness levels. Peak cardiorespiratory fitness levels of individuals with ID can be assessed with maximal treadmill protocols, after allowing for familiarization sessions. Although, predicting maximal oxygen uptake from field tests is problematic, field tests have been found valid and reliable as indicators of cardiorespiratory fitness.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.07.005