Physical Fitness of Adults with an Intellectual Disability: A 13-Year Follow-Up Study

Graham, Andrew, Reid, Greg, Research Quarterly for Exercise and Sport

The purpose of this study was to describe the change in physical fitness of middle-aged adults with an intellectual disability over a period of 13 years. Participants were 32 adults who worked in a supported work environment in Montreal and had been participants in a physical fitness study in 1983. Using the Canadian Standardized Test of Fitness, the participants were evaluated for cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. A home visit prior to the testing session refamiliqrized the participants with the test procedures. Two forms of analysis were used to describe the change in fitness over 13 years. First, a 2 x 2 (Group x Time) analysis of variance for each dependent variable assessed change over time. Second, effect sizes were calculated to measure the magnitude of change in fitness over the 13-year period in comparison to those without an intellectual disability. As expected, the physical fitness levels of the participants were low when compared to those without a disability and declined over the 13 years. In addition, the magnitude of change over the 13 years, as compared to those without a disability, was greater for male and female participants for body mass index and percentage of body fat and for female participants for cardiovascular endurance and sit-ups. It appears that adults with an intellectual disability may be particularly at risk for declining health associated with aging and low physical fitness.

Key words: mental retardation, aging, physical activity, cardiovascular health

Research has demonstrated a significant decline in fitness throughout middle age (ages 30-60 years; Going, Williams, Lohman, & Hewitt, 1994; Lee, Paffenbarger, & Hsieh, 1992; Paffenbarger et al., 1994). This decline is related to a decrease in physical activity during this same period. Large epidemiological studies have shown that people need an adequate level of fitness to live healthy, disease-free lives (Blair et al., 1995; Lee, Hseih, & Paffenbarger, 1995; Paffenbarger et al., 1994). The benefits to be gained from an active lifestyle are numerous and may result in a reduction of coronary heart disease, osteoporosis, depression, hypertension, renal disease, Type II diabetes, and some forms of cancer (Rauramma, Tuomainen, Vaisanen, & Rankinen, 1995; Shephard, 1995). Estimates suggest that if half the population of sedentary individuals in the United States became moderately active, the number of deaths from coronary heart disease, colon cancer, and diabetes would fall by 22,000 per year (Blair, 1995). Speci fically during middle age, there is an inverse relationship with heart disease and physical activity (Sandvik et al., 1995; Seccarecia & Menotti, 1992). Thus, physical activity and physical fitness have become important and meaningful areas of inquiry, particularly during middle age.

Perhaps the most extensive and comprehensive study of physical fitness and physical activity patterns was undertaken in Canada (Government of Canada, 1982). The Canada Fitness Survey assessed approximately 16,000 Canadians, ranging in age from 7 to 69 years, on fitness measures of body composition, cardiovascular endurance, muscular endurance, strength, and flexibility. It produced a cross-sectional view of the decline in fitness over the middle-age years. In addition, an extensive questionnaire explored issues such as preferred physical activities, extent of involvement, and barriers to present and future activity.

Most people have the ability and opportunity to attend to their own physical activity needs. However, others may require assistance to live a healthy and active lifestyle. This includes individuals with an intellectual disability, previously referred to as mental retardation. It is questionable whether they are aware of the debilitating consequences of a sedentary lifestyle or have enough self-direction to modify their lifestyle (Pitetti, Rimmer, & Fernhall 1993), particularly when one considers how difficult it is for people without a disability to initiate and adhere to an exercise program (Dishman, 1994).

It is well known that people with an intellectual disability exhibit poor fitness performance on standard fitness tests. This has been demonstrated with adults on measures of cardiovascular endurance (Beasley, 1982; Fernhall et al., 1996; Pitetti & Campbell, 1991; Reid, Montgomery, & Seidl, 1985), body composition (Fox & Rotatori, 1982; Reid et al., 1985; Rimmer, Braddock, & Fujiura, 1993), muscular strength and endurance (Horvat, Pitetti, & Croce, 1997; Pitetti, Climstein, Mays, & Barrett, 1992; Reid et al., 1985;) and flexibility (Reid et al., 1985). Reid and Montgomery (1999) attributed the low levels on fitness tests to five potential factors: (a) a sedentary lifestyle (Hoge & Dattilo, 1995) and fewer opportunities for participation in structured programs; (b) physical characteristics such as short stature (Dobbins, Garron, & Rarick, 1981; Reid, et al., 1985); (c) lack of coordination and efficiency (Seidl, Montgomery, & Reid, 1989); (d) infrequent opportunities to practice test items; and, (e) lack of m otivation during testing and a tendency to stop when uncomfortable (Reid et al., 1985; Rimmer, 1994).

People with intellectual disabilities face many challenges in community living (Pedlar, 1990) as they continue to be included in all phases in society. Many facets such as work, maintaining a household, cooking, selfcare, and recreation require the individual to possess a certain degree of physical stamina. People with an intellectual disability will need an adequate amount of fitness to contribute to work-related tasks and enjoy and benefit from participation in recreational activities (Fernhall, Tymeson, & Webster, 1988).

The decline in fitness during middle age, although well established for the nondisabled population (Spirduso, 1995), has received little attention with regard to people who have an intellectual disability. It is likely that health risks associated with substandard levels of fitness would become exacerbated with these individuals, given their low levels of fitness, greater propensity for obesity, and sedentary lifestyle. In fact, Pitetti and Campbell (1991) pointed out that people with an intellectual disability have an earlier onset of physical old age and a higher mortality rate than the general population. They postulated that people with an intellectual disability have a faster rate of decline in physical fitness than the general population, although no empirical support was offered. Given the need for physical fitness as a factor in community and work participation, and the link between fitness and health, the investigation of the expected decline in physical fitness during middle age seems …

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Publication information: Article title: Physical Fitness of Adults with an Intellectual Disability: A 13-Year Follow-Up Study. Contributors: Graham, Andrew - Author, Reid, Greg - Author. Journal title: Research Quarterly for Exercise and Sport. Volume: 71. Issue: 2 Publication date: June 2000. Page number: 152. © 1999 American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD). COPYRIGHT 2000 Gale Group.

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