Developing and Maintaining Physical Fitness in Adolescents with Down Syndrome

唐氏综合症青少年的体能发展和保持

• 批准号: 8133977
• 负责人: RICHARD K FLEMING
• 金额: $ 17.85万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8133977
• 关键词: Address; Adolescent; Adult; Aerobic; Aerobic Exercise; Age; Attention; Behavior; Biolectric Impedance; Body Composition; Body fat; Cardiovascular system; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Chronic Disease; Communities; Control Groups; Development; Disabled Children; Disabled Persons; Down Syndrome; Enrollment; Ensure; Exercise; Fatty acid glycerol esters; Foundations; Glare; Goals; Government; Guidelines; Health; Health Benefit; Health Promotion; Health Status; Healthy People 2010; Individual; Instruction; Intellectual functioning disability; Intervention; Investigation; Left; Leg; Life Style; Maintenance; Measurement; Measures; Mental Retardation; Muscle; Obesity; Outcome; Overweight; Participant; Persons; Physical Fitness; Physical activity; Population; Psyche structure; Public Health; Randomized; Relative (related person); Reporting; Research; Risk; Risk Factors; Running; Speed; Stress; Structure; Surgeon; Time; Training; Translational Research; Underserved Population; United States Dept. of Health and Human Services; Waiting Lists; Weight; Writing; Youth; base; blood pressure regulation; bone health; care systems; community setting; design; experience; falls; fitness; follow-up; health disparity; improved; indexing; peer; post intervention; programs; psychologic; public health relevance; sedentary; skills; strength training

DESCRIPTION (provided by applicant): Children in the US fall far below current guidelines for daily physical activity (PA), and spend considerable free time in sedentary pursuits (CDC, 2009; Gordon-Larsen, Nelson, & Popkin, 2004). This assessment appears true for our underserved population of children and adolescents with intellectual disabilities (ID), including Down syndrome (DS) (Whitt-Glover, O'Neill, & Stettler, 2006). The health benefits of regular and sustained PA are compelling. If progressive resistance training is combined with aerobic activity, benefits may include improvements in muscular strength, muscular endurance and cardiovascular fitness; control of blood pressure; bone health; reduced risk for overweight/obesity; and psychological wellbeing. PA is listed as a "leading health indicator" in Healthy People 2010. Research with children with ID has demonstrated increases in health-related fitness, but under tightly controlled training conditions. Translational research is needed to begin to determine whether similar improvements in fitness can be achieved under more naturalistic conditions (e.g., in community YMCAs), and, importantly, whether PA and its outcomes are maintained. This proposed study seeks to determine whether adolescents with DS who participate in a 16-week, YMCA- based exercise intervention (INT), as compared with participants in a wait-list control group (WL) will: 1) show greater improvements in indices of muscular strength, muscular endurance and aerobic fitness at 8 and 16 weeks, relative to baseline (primary aim); 2) maintain exercise behavior and fitness outcomes over a 16-week post-intervention period, with follow-up measurement at 24 and 32 weeks (primary aim); 3) show more favorable changes in body composition (fat-free mass) and BMI, measured at baseline, 16 and 32 weeks (secondary aim); and 4) engage in more generalized PA in and outside of the YMCA, as measured by accelerometry, at baseline, 16 and 32 weeks. Forty (40) participants with Down syndrome, ages 16-22 years, will be randomly assigned to the INT (N=20) and WL (N=20) groups. Measures will include 1-RM bench and leg press for muscular strength, maximum repetitions of 50% 1-RM bench and leg press for muscular endurance, 20m shuttle run for aerobic fitness, bioelectrical impedance for body composition, and accelerometry showing average time in different levels of PA. The INT will be provide supervised training and coaching in weights and aerobic exercise, the formal peer dyads, and focused educational messages on maintaining the exercise program and extending PA to outside of the YMCA. Our long-term programmatic goal is to more effectively address the health disparities noted in the ID population; the present R21 project was designed provide the foundation for accomplishing our long-term goal. PUBLIC HEALTH RELEVANCE: The US Department of Health and Human Services has identified major heath disparities among children, adolescents, and adults with intellectual disabilities, including those with Down syndrome. There is a need for more community-based health promotion programs for individuals with DS in order to offset the elevated risk factors for chronic disease observed in this underserved population. Physical activity is listed prominently as a leading health indicator in Healthy People 2010, and objectives include improving activity levels and reducing sedentary behavior in children with disabilities.

描述（由申请人提供）：美国的儿童远低于当前的日常体育锻炼指南（PA），并在久坐的追求中花费大量空闲时间（CDC，2009； Gordon-Larsen，Nelson，Nelson和Popkin，2004年）。对于我们服务不足的智障儿童和青少年（包括唐氏综合症（DS））（Whitt-Glover，O'Neill，＆Stettler，2006年）的儿童和青少年人群，这一评估似乎是正确的。常规和持续PA的健康益处令人信服。如果将进行性耐药性训练与有氧活性相结合，则益处可能包括改善肌肉力量，肌肉耐力和心血管健康；控制血压；骨骼健康；降低了超重/肥胖的风险；和心理健康。 PA在Healthy People 2010中被列为“领先的健康指标”。与患有ID的儿童的研究表明，与健康相关的健康状况增加，但在严格控制的培训条件下。需要转化研究以确定在更自然的条件下（例如，在社区YMCAS中）是否可以实现类似的健身改善，重要的是，重要的是，PA及其结果是否得到维护。这项拟议的研究旨在确定参加16周，基于YMCA的运动干预（INT）的DS的青少年与等待名单对照组（WL）的参与者相比，是否会显示出肌肉力量，肌肉力量，肌肉耐力和有氧运动的肌肉适应性的指标，相对于基础8和16周，相对于基础，相对于基础，相对于基础，肌肉强度和有氧运动的适应性有所更大改善（主要目标）； 2）在干预后16周内保持运动行为和健身结果，并在24和32周时进行随访测量（主要目的）； 3）在基线，16和32周（次要目标）测量的身体成分（无脂肪质量）和BMI的更有利变化； 4）在基线，16和32周时通过ACCELEREMETRY测量，在基督教青年会内外进行了更广泛的PA。唐氏综合症的四十（40）名参与者，年龄在16-22岁之间，将随机分配给INT（n = 20）和WL（n = 20）组。措施将包括1-RM板凳和腿部按下肌肉力量，最大重复重复为50％1-RM板凳以及肌肉耐力的腿部按压，有氧运动的20m班车运行，身体组成的生物电阻抗以及在不同水平的平均时间的平均时间。 INT将在体重和有氧运动，正式的同伴二元组中提供监督的培训和教练，并专注于维护锻炼计划并将PA扩展到基督教青年会之外的教育信息。我们的长期程序化目标是更有效地解决ID人群中指出的健康差异。目前的R21项目旨在实现我们的长期目标。 公共卫生相关性：美国卫生与公共服务部已经确定了儿童，青少年和智障成年人（包括唐氏综合症患者）之间的主要荒地差异。为了抵消在服务不足的人群中观察到的慢性疾病的危险因素升高的危险因素，需要对DS患者进行更多基于社区的健康促进计划。在2010年健康人员中，体育锻炼被列为主要的健康指标，目标包括提高活动水平和减少残疾儿童久坐行为。