Problem statement lesson 6 by ziyi lim

Overview of Adolescents (13-16) with intellectual disabilities

ziyilim28 — 2022-11-22 04:56:19 UTC

Intellectual disability is a term used when a person has certain limitations in cognitive functioning and skills, including communication, social and self-care skill. This causes adolescence with intellectual disabilities to learn thing more slowly or differently than those without them. Fitness Assessment is usually done for adolescents with intellectual disability in order to identify areas of strength or weakness to justify and make important decisions regarding physical activity involvement.

Par Q questionnaire and screening

ziyilim28 — 2022-11-22 04:56:47 UTC

Zi Yi
Fitness coaches or trainers frequently utilize the PAR-Q, a straightforward self-screening tool, to assess the safety of exercise and potential dangers based on your medical history, present symptoms, and risk factors. It can also assist a trainer in prescribing the best exercises for a client.
Procedure:

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

However, they are adolescents with intellectual disabilities so it will be difficult for them to understand the Par-Q questions. Therefore, we would need to simplify the questions for them. It will be easier for them to understand the question better.

Assessment 1 (stork test) Darshan

ziyilim28 — 2022-11-22 04:56:59 UTC

Purpose:

The purpose of this test is to assess whole body balance ability (static), as it requires the participant to balance on the ball of one foot for as long as possible. The longer the time (in seconds), the higher the score.

Rationale:

Static balance is defined as the ability to maintain in a vertical line from the centre of mass of the body within the base of support. This type of balance is important when doing activities such as squatting or standing on one leg, and hence is appropriate for individuals with ID to see if they are at risk of falls while doing everyday tasks.

Procedure:

Remove the shoes and place the hands on the hips, then position the non-supporting foot against the inside knee of the supporting leg. The subject is given one minute to practice the balance. The subject raises the heel to balance on the ball of the foot. The stopwatch is started as the heel is raised from the floor. The stopwatch is stopped if any of the follow occur:

The hand(s) come off the hips.
The supporting foot swivels or moves (hops) in any direction.
The non-supporting foot loses contact with the knee.
The heel of the supporting foot touches the floor.

Assessment considerations

This test is appropriate because it provides comprehensive information needed for program planning. There is also no equipment needed and is simple to understand and perform, making it suitable for those with ID, in terms of safety. Assessment of performance can also be calculated easily and compared to normative data to analyse balance ability. Reliability of test is based on strictness of tester conducting, and validity dependent on intrinsic and extrinsic factors concerning the participant.

Conclusion:

Postural stability is a prerequisite for performing a number of complex gross motor activities and hence affects child's or adolescent's interaction with peers, physical activities, and participation in social activities. This test enable us to address these problems by analysis the static balance ability and programming an appropriate training plan.

Static or dynamic timed standing balance tests (SDSBT) have been proven to be appropriate and reliable in healthy adolescents, and although tested in different patient populations, psychometric properties in measuring balance among the children and adolescents with Down Syndrome (a form of ID) are not yet established. There is no standardized balance test for individuals with ID, and hence this makes the test as reliable as can be.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750347/

Assessment 2 (wall sit)

ziyilim28 — 2022-11-22 04:57:06 UTC

The purpose of this assessment is to measure the strength endurance of the lower body, particularly the quadriceps muscle group.
Procedure:

Stand comfortably with feet around shoulder width apart, with your back against a smooth wall.
Slowly slide your back down the wall to assume a sitting position with both knees and hips at a 90 degree angle as if there is an invisible chair.
The timing starts when one foot is lifted off the ground and is stopped when the foot touches to the ground.
Rest, and test on the other leg.

Assessment 3 (3 minute step test)

ziyilim28 — 2022-11-22 04:57:12 UTC

Purpose:

The purpose of this test is to provide a submaximal measure of cardio-respiratory or endurance fitness. This is determined by the using the participant's heart rate 1 min after exercise, in comparison to resting heart rate to obtain a score. The quicker heart rate returns to normal after exercise, the higher the level of cardiovascular fitness.

Rationale:

Cardiorespiratory fitness (CRF) levels of children and adolescents with ID are already low, with further decline with increasing age. Low CRF has been associated with a high risk of cardiovascular disease and all-cause mortality. Participation in regular exercise can help adults with ID increase their CRF. This assessment would then help to plan a program centred around CRF for the ID.

Procedure:

Begin by demonstrating the alternating stepping cadence to the subject. In time with the beat step one foot up on the bench (1st beat), step up with the second foot (2nd beat), step down with one foot (3rd beat), and step down with the other foot (4th beat.) Allow the subject to practice the stepping to the metronome cadence, which is set at 96 beats per minute (4 clicks = one step cycle) for a stepping rate of 24 steps per minute. The athlete steps up and down on the platform at the given rate for a total of 3 minutes. The athlete immediately stops on completion of the test and sits down and remains still. Starting within 5 seconds, the tester is to count the participant's heart rate (ideally with a stethoscope) for one complete minute.

Assessment considerations:

There is minimal equipment needed, and requires simple motor movement, which is also a common daily activity ( climbing stairs). This makes the assessment a functional one as well, and safe when performed in the appropriate environment. Modifications can be made based on the disability, in the form of slowing down the tempo on the metronome, or lowering the height on the step.

References:

https://pubmed.ncbi.nlm.nih.gov/23892875/