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      Assessment of Objectively Measured Physical Activity Levels in Individuals with Intellectual Disabilities with and without Down's Syndrome

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      PLoS ONE
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          Abstract

          Objective

          To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down's syndrome.

          Methods

          One hundred and fifty two individuals with intellectual disabilities aged 12–70 years from East and South-East England. Physical activity levels in counts per minute (counts/min), steps per day (steps/day), and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) measured with a uni-axial accelerometer (Actigraph GT1M) for seven days.

          Results

          No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down's syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down's syndrome and levels of activity declined significantly with age.

          Conclusions

          Individuals with intellectual disabilities, especially those with Down's syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotion strategies and interventions designed to raise the levels of physical activity for individuals with intellectual disabilities. We propose that there are physiological reasons why individuals with Down's syndrome have particularly low levels of physical activity that also decline markedly with age.

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          Most cited references65

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          Limits to the measurement of habitual physical activity by questionnaires.

          Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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            Updating the evidence that physical activity is good for health: an epidemiological review 2000-2003.

            A Bauman (2004)
            Developing policy and strategic initiatives to increase population levels of physical activity (PA) requires constant referral to the epidemiological evidence base. This paper updates the evidence that PA confers a positive benefit on health, using research studies in the peer-reviewed scientific literature published between 2000-2003. Areas covered include updates in all-cause mortality and in cardiovascular disease prevention, diabetes, stroke, mental health, falls and injuries, and in obesity prevention. Recent evidence on PA and all-cause mortality replicates previous findings, and is consistent with current Australian moderate PA recommendations. Recent papers have reinforced our understanding of the cardiovascular protective effects of moderate PA, with new evidence that walking reduces the risk of CVD and, in two studies, at least as much as vigorous activity. The evidence base for protective effects of activity for women, older adults and for special populations has strengthened. Cancer prevention studies have proliferated during this period but the best evidence remains for colon cancer, with better evidence accumulating for breast cancer prevention, and uncertain or mixed evidence for the primary prevention of other cancers. Important new controlled-trial evidence has accumulated in the area of type 2 diabetes: moderate PA combined with weight loss, and a balanced diet can confer a 50-60% reduction in risk of developing diabetes among those already at high risk. Limited new evidence has accumulated for the role of PA in promoting mental health and preventing falls.
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              Calibration of accelerometer output for children.

              Understanding the determinants of physical activity behavior in children and youths is essential to the design and implementation of intervention studies to increase physical activity. Objective methods to assess physical activity behavior using various types of motion detectors have been recommended as an alternative to self-report for this population because they are not subject to many of the sources of error associated with children's recall required for self-report measures. This paper reviews the calibration of four different accelerometers used most frequently to assess physical activity and sedentary behavior in children. These accelerometers are the ActiGraph, Actical, Actiwatch, and the RT3 Triaxial Research Tracker. Studies are reviewed that describe the regression modeling approaches used to calibrate these devices using directly measured energy expenditure as the criterion. Point estimates of energy expenditure or count ranges corresponding to different activity intensities from several studies are presented. For a given accelerometer, the count cut points defining the boundaries for 3 and 6 METs vary substantially among the studies reviewed even though most studies include walking, running and free-living activities in the testing protocol. Alternative data processing using the raw acceleration signal is recommended as a possible alternative approach where the actual acceleration pattern is used to characterize activity behavior. Important considerations for defining best practices for accelerometer calibration in children and youths are presented.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                21 December 2011
                : 6
                : 12
                : e28618
                Affiliations
                [1]Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
                Karolinska Institutet, Sweden
                Author notes

                Conceived and designed the experiments: ACP AJH. Performed the experiments: ACP. Analyzed the data: ACP AJH. Wrote the paper: ACP AJH.

                Article
                PONE-D-11-20648
                10.1371/journal.pone.0028618
                3244403
                22205957
                3a5d2a99-30cd-472d-93b2-97554cdd94ab
                Phillips, Holland. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 20 October 2011
                : 11 November 2011
                Page count
                Pages: 7
                Categories
                Research Article
                Biology
                Genetics
                Human Genetics
                Chromosomal Disorders
                Down Syndrome
                Medicine
                Epidemiology
                Environmental Epidemiology
                Epidemiology of Aging
                Genetic Epidemiology
                Social Epidemiology
                Non-Clinical Medicine
                Health Care Policy
                Health Education and Awareness
                Health Care Providers
                Allied Health Care Professionals

                Uncategorized
                Uncategorized

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