智力残疾儿童身体活动及其影响因素研究

目的基于ICF分析智力残疾儿童参加身体活动发展现状,讨论身体活动对智力残疾儿童健康的影响,以及智力残疾儿童参加身体活动的方法和注意事项。方法采用ICF的理论框架,结合文献研究和理论研究方法。结果智力残疾儿童很少或不参加身体活动;身体活动种类较少,形式单一,缺少活动场地器材与活动指导,缺乏社会支持。低龄智力残疾儿童参加的游戏类身体活动应以自由游戏和包含简单身体技能类活动为主;高龄智力残疾儿童除参加多种的身体活动类以外,还应适当开展增加肌肉力量的身体活动。结论智力残疾儿童身体活动存在很大障碍,需要制定促进智力残疾儿童身体活动的政策,并提供相关的支持与指导服务。鼓励智力残疾儿童多参加各种形式的身体活动,不仅可改善智力残疾儿童的体质,还能改善他们的情绪和生活质量,降低健康风险。应该制定鼓励智力残疾儿童参加社区类身体活动的政策,并提供场地、器材,身体活动指导与支持服务。     

基于WHO-FICs架构智力残疾儿童青少年身体活动与运动康复的健康结局：系统综述的系统综述

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建智力残疾儿童青少年参与身体活动和运动康复的健康和功能结局的研究架构,系统分析智力残疾儿童青少年的主要健康与功能障碍表现、参与身体活动的方案以及健康和功能结局。 方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF),对智力残疾儿童青少年身体活动干预方案以及健康与功能结局进行系统分析,构建智力残疾儿童青少年健康与功能状况、身体活动干预方案以及健康与功能结局架构。检索Scopus、PubMed、Embase、Web of Science、中国知网、维普、万方数据,收集建库至2022年8月18日公开发表的智力残疾儿童青少年参与身体活动与运动康复的健康及功能结局的系统综述,进行系统综述。 结果 最终纳入系统综述8篇,来自5个国家,包括190项随机对照试验和7 011例参与者,研究领域主要涉及智力障碍、儿童神经病学、康复科学、残疾与健康、适应性体育、特殊教育等,发表时间集中在2018年至2022年。常见的健康状况主要有唐氏综合征、孤独症谱系障碍、脆性X综合征、Prade-Willi综合征、智力障碍、认知障碍;身体活动干预形式分为体适能类、技能类和活动类3类,活动频率每周1~5次,活动强度为中-高强度,持续时间1周~1.5年;健康结局体现在智力功能和适应性行为、身体活动、心理行为健康与社会适应、整体生活质量和福祉方面。 结论 基于WHO-FICs构建了智力残疾儿童青少年参与身体活动和运动康复的健康效果的理论架构。智力残疾儿童青少年主要功能障碍表现为智力功能和适应性行为、活动和心理健康、生活质量和福祉3个层面。其中智力功能和适应性行为层面涉及概念性技能、社交性技能和实践性技能,活动和参与层面表现为低体育活动参与度、久坐和肥胖,活动能力低,没有发展基本运动能力和身体素质。生活质量和福祉层面涉及情绪和情感、自尊、一般自我概念、幸福感、友谊、与他人的关系或社会成熟度、生活质量和福祉等。身体活动方式可以分为体适能类、技能类和运动项目类。主要健康和功能结局主要表现在三个领域：智力功能与适应性行为,活动和参与以及心理行为健康与社会适应、生活质量和福祉。在智力功能和适应性行为领域,主要健康结局涉及认知功能(执行功能、认知可塑性、工作记忆等)、心理功能(情绪自我控制、自我价值和自尊)。在活动和参与领域,主要健康结局涉及体适能(肌力和肌耐力、速度、灵敏性)和动作技能(基本动作技能、平衡、核心稳定性),提高体育活动参与度,促进其更好地适应与赋能(社交、亲社会行为等),达成健康目标(降低疾病风险、缓解焦虑和抑郁、肥胖管理)。在心理行为健康与社会适应、生活质量和福祉领域,参与身体活动与运动康复可以提升儿童青少年整体的生活质量和福祉。     

残疾儿童青少年身体活动及其健康效果：系统综述的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建身体活动对残疾儿童青少年健康效果的范畴及研究架构,系统分析残疾儿童青少年的主要残疾类型、身体活动处方及其健康效果。     

基于ICF智力与发展性障碍儿童体质健康研究

目的 探讨接受特殊教育的智力与发展性障碍儿童体质健康功能状况及影响因素,基于《国际功能、残疾和健康分类》(ICF)建立结构化的体质分析与运动干预方案。方法 基于ICF架构和方法,分析智力与发展性障碍学生功能状态和体质特点以及影响因素,参照世界卫生组织(WHO)身体活动指南要求,构建基于功能的智力与发展性残疾儿童体质干预方案。结果 基于ICF对智力与发展性障碍儿童的整体功能状态,特别是与智力残疾相关智力功能、活动和参与以及环境因素进行系统分析,并且结合相关的运动功能和体质健康进行讨论。基于ICF,参照《WHO关于身体活动和久坐行为的指南》(儿童青少年)制定身体活动方案,研究相关的适应性支持策略。结论 基于ICF可以对智力与发展性障碍儿童进行整体功能状态分析,涉及身体功能(包括智力功能和运动功能)、活动和参与以及环境因素。基于《WHO关于身体活动和久坐行为的指南》和ICF架构,构建了适用于智力与发展性障碍儿童的针对体质健康的身体活动方案,以及实施方案的适应性和支持性教学与训练方法。     

基于ICF-CY残疾儿童青少年身体活动与功能康复的系统综述

基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法,建立残疾儿童青少年身体活动和康复体育活动范畴和结构,对残疾儿童青少年的身体活动和康复体育活动文献进行系统综述。     

适用于残疾儿童青少年身体活动测量报告工具结构、内容及心理测量特性的系统综述

目的 综述适用于残疾儿童青少年的身体活动测量报告工具的结构、内容和心理测量特性。方法 检索PubMed、Medline、EBSCO、Web of Science、中国知网，收集建库至2023年6月发表的有关残疾儿童身体活动的测量报告工具的文献，运用《国际功能、残疾与健康分类(儿童青少年版)》(ICF-CY)对工具的主要结构和内容特征进行分析，采用基于共识的健康测量工具选择标准(COSMIN)的方法对测量工具的心理测量特性进行评估。结果 确定6种工具，最终纳入9篇文献。两种为全球化标准工具：儿童和青少年身体活动全球报告矩阵卡4.0(Global Matrix 4.0)、残疾儿童和青少年身体活动全球报告矩阵卡(Para Report Card)，测量内容包括b455运动耐受功能，b7神经肌肉骨骼和运动有关功能；d4活动，d450步行，d470利用交通工具，d820学校教育，d910社区生活，d920娱乐和休闲；e310直系亲属家庭，e320朋友，e460社会的态度，e575全社会支持的服务、体制和政策等。该类测量工具具有完整的结构，测量工具的信度、效度和适用性高，测量方式可以是残疾学生自我...     

智力残疾儿童青少年体质健康的可视化分析

目的 运用CiteSpace文献计量分析近10年国际智力残疾儿童青少年体质健康领域的研究现状和热点，并进行文献循证研究。     

基于ICF构建智力残疾儿童适应性体育课程体系

目的 应用《国际功能、残疾和健康分类》(ICF)对智力残疾儿童的运动功能特点进行分析,并参照教育部《义务教育体育与健康课程标准(2022年版)》构建适用智力残疾儿童的功能定向和体育运动核心素养的适应性体育课程体系。方法 运用《国际疾病分类》(ICD-11)和ICF对智力残疾儿童运动功能、活动和参与功能进行系统分析。依据ICF“生物-心理-社会”的功能、残疾和健康模式以及教育部《义务教育体育与健康课程标准(2022 年版)》,参照美国《适应体育国家标准(第三版)》(APENS-3),构建适用于智力残疾儿童运动功能和运动能力发展要求的、功能定向的适应性体育课程体系。结果 智力残疾儿童可能表现出基本动作发展缓慢、体适能水平较差、运动能力弱、运动动机不足等问题。适应性体育课程目标主要是促进儿童核心素养,即运动能力、健康行为、体育品德的发展,并且掌握运动技能和发展运动能力,包括运动能力发展目标、动作发展目标、体育活动参与度目标、健康目标、适应与赋能目标。根据体育活动的类型,课程内容包括体适能类活动、运动技能训练类活动以及运动项目相关类活动。适应性体育课程实施过程涉及教材编写和教学建议。适应性体育课程实施效果评价可以从运动能力的发展、动作发展、体育活动的参与程度、健康行为的养成、对自然环境和社会环境的适应能力方面进行,运用整体、多维的评价方式全面评价智力残疾儿童的动作发展以及运动核心素养的养成。在开发适应性体育课程中,还应该确定无障碍环境与辅助技术的适用性。结论 运用ICD-11和ICF对智力残疾儿童的健康状况、主要功能和运动能力进行了系统分析。基于ICF的生物-心理-社会的健康模式,参照教育部《义务教育体育与健康课程标准(2022年版)》和APENS-3,构建了智力残疾儿童适应性体育课程开发的理论架构,并且建立了功能导向的适应性体育课程体系,该课程体系强调儿童体育运动核心素养的养成,即运动能力、健康行为、体育品德的发展。     

适用于残疾儿童青少年运动功能和运动能力测量工具的结构、内容和心理测量特性的系统综述

目的 基于《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)对4种残疾儿童青少年运动功能和运动能力评估工具的主要结构和内容特征及其心理测量特性进行评估。方法 检索PubMed、Medline、Web of Science数据库，收集建库至2023年5月发表的有关残疾儿童青少年身体活动的测量/报告工具的文献。运用ICF-CY对残疾儿童青少年运动功能和运动能力的评估工具的主要结构和内容特征进行分析，采用基于共识的健康测量工具选择标准(COSMIN)对评估工具的心理测量特性进行质量评估。结果 最终纳入9篇文献，确定4项工具，包括粗大运动功能测试(GMFM-88)、Peabody发育性运动量表2(PDMS-2)、 Bruininks-Oseretsky运动能力测试2(BOT-2)和儿童运动评估成套测验第二版(MABC-2)。GMFM-88由A区(卧位与翻身)、B区(坐位)、C区(爬行与跪)、D区(站立位)、E区(行走于跑跳)5个维度88个项目组成；涉及身体功能和结构中的关节活动功能(b710)、随意运动控制功能(b760)等，活动与参与的改变身体的基本姿保持(d410)、保持一种身...     

基于WHO-HPS架构学校身体活动相关健康服务及其健康效益：系统综述的系统综述

目的 系统综述世界卫生组织健康促进学校(WHO-HPS)架构下学校课程体系、身体活动相关健康服务类型及其对儿童青少年健康的影响。方法 检索EBSCO、PubMed、Web of Science和中国知网2017年至2023年6月公开发表的有关基于WHO-HPS架构的学校身体活动相关服务及其健康效益的系统综述，并进行系统综述。结果 最终纳入7篇英文系统综述，涉及147项研究，来自5个国家，包括瑞士、美国、意大利、英国和瑞典，主要来源于儿童体育与健康、HPS、学校身体活动等领域期刊，发表时间主要集中在2017年至2022年。基于WHO-HPS架构，学校实施的健康促进类课程体系主要涉及体育课(增加专门的运动项目课程如瑜伽、舞蹈，增加身体活动时间)和身体活动相关的健康教育课程、课外活动(包括实施儿童体育、娱乐和休闲计划、午餐享受活动和游戏计划，在学校常规课程中增加身体活动时间，创造课间休息和放学后额外的身体活动机会，提供日常身体活动计划)以及融入身体活动的其他课程。身体活动相关健康服务主要包括身体活动相关的健康筛查和监测、身体活动相关的青少年健康管理和健康促进活动。这些干预措施带来的健康效益主...     

Health care transition planning for adolescents and emerging adults with intellectual disabilities and developmental disabilities: Distinctions and challenges

Purpose

The purpose of this article is to provide the reader with insight and enhanced understanding of the health care transition planning process for adolescents and emerging adults with intellectual disabilities and developmental disabilities. There are distinctly different programmatic considerations that need to be addressed in advancing their transfer of care to adult providers and promoting their transition to adulthood. These differences are due in part to the federal and state legislative initiatives that were established in the education, rehabilitation, employment, and developmental disabilities service systems. In contrast, no comparable federal and state mandates exist in the system of health care. The legislative mandates in education, rehabilitation, and employment are presented and discussed as well as the federal legislation on rights and protections for individuals with intellectual disabilities and developmental disabilities. Consequently, health care transition (HCT) planning involves application of a framework of care that is characteristically different than the planning efforts undertaken for adolescents and emerging adults (AEA) with special health care needs (SHCN)/disabilities and for typically developing AEA. The best practice HCT recommendations are discussed in the context of this intellectual disabilities and developmental disabilities framework of care.

Conclusions

Health care transition planning for adolescents and emerging adults with intellectual disabilities and developmental disabilities involves additional and distinctly clinical and programmatic models of care.

Practice Implications

Health care transition planning guidance for adolescents and emerging adults with intellectual disabilities and developmental disabilities are provided based upon best practice recommendations.     

Carer Knowledge and Perceptions of Healthy Lifestyles for Adults with Intellectual Disabilities

Background Carers can have a significant impact supporting people with intellectual disabilities to make healthy lifestyle choices. This study examines carers’ training needs on diet and physical activity. Methods A cross‐sectional survey was undertaken of the knowledge and perceptions of carers supporting adults with intellectual disabilities. An interviewer administered questionnaire was used to examine carer knowledge of public health recommendations on diet and physical activity; perceptions of the benefits of healthy diets and physical activity levels; and the carer views on the barriers to change experienced by individuals with intellectual disabilities. Results Sixty‐three carers took part in the study. They generally had a low level of knowledge around public health recommendations on diet and physical activity. Greater importance was attributed to the health benefits of diet than physical activity. Carers rated intrapersonal barriers to change within the person with intellectual disabilities as more important, than interpersonal or external barriers to change, with significant differences in perceived barriers relevant to diet and physical activity. Conclusions Carers supporting adults with intellectual disabilities have significant training needs relevant to promoting healthy lifestyles. This highlights the opportunity to promote health improvement via the development, and provision, of effective training initiatives.     

Promoting Leisure Physical Activity Participation among Adults with Intellectual Disabilities: Validation of Self‐Efficacy and Social Support Scales

Background Many individuals with intellectual disabilities are not sufficiently active for availing health benefits. Little is known about correlates of physical activity among this population on which to build health promotion interventions. Materials and Methods We developed scales for measurement of self‐efficacy and social support for leisure physical activity among adults with intellectual disabilities. Study participants were 152 adults with mild to moderate intellectual disabilities. Results The scales demonstrated good internal consistency and fair to excellent test–re‐test reliability. Confirmatory factor analyses revealed good fit for each of the scales, supporting the hypothesized structure of each. Scales also correlated with self‐reported leisure physical activity, providing evidence of construct validity. Conclusions Studies of physical activity correlates are needed to formulate evidence‐based programmes to promote physical activity participation. This measure demonstrated good psychometric properties, and will be useful for examining social support and self‐efficacy for physical activity by adults with intellectual disabilities.     

智力障碍儿童青少年体力活动的研究进展

本研究综述智力障碍儿童青少年的体力活动现状、测量方法、影响因素及干预方法等,发现智力障碍儿童青少年的体力活动水平较低,健康状况不容乐观;提高智力障碍儿童青少年的体力活动水平需要个体、家庭和社会的共同努力;现有的体力活动干预方法有效性有待进一步探讨。聚焦智力障碍儿童青少年的健康诉求,深入分析体力活动与健康指标间的量效关系,探索行之有效的体力活动干预模式将是今后的研究方向。     

Correlations between motor competencies,physical activity and self-concept in children with intellectual disabilities in inclusive education

Background

Reciprocal relationships exist between motor competencies, physical activity and self-concept.

Aims

Using a structural equation model, this study examined whether these relationships also appear in children with intellectual disabilities, how they can be validly measured, and if there are differences between children with and without intellectual disabilities.

Materials & Methods

Data from a cross-sectional research project involving 121 children with intellectual disabilities and 1721 without intellectual disabilities were analysed.

Results

The results demonstrate that reciprocal relationships also apply to children with intellectual disabilities and can be elucidated if inverse items are omitted.

Discussion

Children with intellectual disabilities have less developed motor competencies and are less physically active but have a higher general self-concept compared to children without intellectual disabilities. The sport-related ability self-concept of both groups is comparable.

Conclusions

The results are broadly consistent with extant research and illustrate that the development of motor competencies, physical activity and self-concept in children with intellectual disabilities must be encouraged.     

Parental perceptions of barriers to physical activity in children with developmental disabilities living in Trinidad and Tobago

Abstract

Background: Parents have a strong influence on their child’s engagement in physical activities, especially for children with developmental disabilities, as these children are less likely to initiate physical activity. Knowledge is limited regarding parents’ perceptions of this phenomenon in low- and middle-income countries (LMICs); yet many rehabilitation providers work with children with developmental disabilities and their parents in these contexts. Purpose: The aim of this study was to explore the barriers perceived by parents of children with developmental disabilities to their children’s engagement in physical activity. Methods: An occupational perspective was used to explore how parents speak about barriers to their child’s engagement in physical activity. Interviews were conducted with nine parents in Port-of-Spain, Trinidad and Tobago. Findings: Parent’s perceived barriers were categorized into four themes: family priorities, not an option in our environment, need to match the activity to the child’s ability, and need for specialized supports. Conclusions: Findings provide opportunities for future rehabilitation and community programming in LMICs.

• Implications for Rehabilitation

• Children living with a developmental disability may engage more in solitary and sedentary pursuits as a result of parents choosing activities that do not present extensive social and physical demands for their child.

• Therapists can play an important role in providing knowledge to parents of appropriate physical activity and the benefits of physical activity for children with developmental disabilities in order to promote children’s participation.

• In environments where there is limited social support for families, therapists need to consider and be particularly supportive of parental priorities and schedules.

     

Efficacy of a Peer‐Guided Exercise Programme for Adolescents with Intellectual Disability

Background Peer support is strongly associated with physical activity of adolescents. This study examined the efficacy of a YMCA‐based, peer‐guided exercise training programme for increasing health‐related physical fitness among adolescents with intellectual disabilities. Materials and Methods Adolescents with intellectual disabilities and typically developing peer partners provided reciprocal support during 1‐h exercise sessions that included aerobic exercise, weight training and stretching activities. The programme was conducted 2 days/week for 15 weeks and pre‐ and post‐test fitness testing was conducted. Results Participants demonstrated significant improvements in curl‐ups, 6‐min walk and BMI. Exercise session attendance was high and participants typically completed all of the prescribed aerobic and stretching exercises, whereas weight training exercises were completed less consistently. Conclusions This peer‐guided model integrates social and instructional support for adolescents with intellectual disabilities and may encourage exercise participation in community settings.     

Self-Esteem of Children and Adolescents with Physical Disabilities: Quantitative Evidence from Meta-Analysis

Previous studies on self-esteem of young people with physical disabilities have yielded discrepant results. There is a need for the succinct synthesis of the studies to understand the relationship between physical disabilities and self-esteem. This study aimed to examine the effects of minor physical disabilities (e.g., clumsiness, developmental coordination disorder) on different domains of self-esteem, and major physical disabilities (e.g, cerebral palsy, spina bifida) on general self-esteem in children and adolescents. A total of 1984 young people from 13 studies were included in meta analyses. The effect of minor physical disabilities on the self-esteem of physical competence was large. Although the effects of minor physical disabilities on the global self worth, physical appearance, and social acceptance were moderate, the effect of major physical disabilities on the general self-esteem of young people was mild. Major physical disabilities do not seem to affect general self-esteem as much as minor physical disabilities do.