Morsani College of Medicine (Ms. Jones, Ms. Rivera, and Drs. Bindas and Woodward) and College of Behavioral and Community Sciences (Dr. Perkins), University of South Florida, Tampa kjones15@usf.edu
The authors reported no potential conflict of interest relevant to this article.
*Kristina Jones and Cianna Rivera contributed equally as first authors of this work.
Sport activities promote health and well-being in this population, which is disproportionately affected by obesity, sedentary lifestyle, and social isolation.
› Recommend physical activity as an adjunct to traditional medical management to maximize physical and psychosocial benefits in patients with intellectual/developmental disabilities. B
Strength of recommendation (SOR) A Good-quality patient-oriented evidence B Inconsistent or limited-quality patient-oriented evidence C Consensus, usual practice, opinion, disease-oriented evidence, case series
References
Approximately 6.5 million people in the United States have an intellectual disability, the most common type of developmental disability.1 People with disabilities are 3 times more likely to have heart disease, stroke, or diabetes than adults without disabilities.2
Sports as a treatment modality are not used to full advantage to combat these conditions in people with intellectual/developmental disabilities (IDDs). Participation in sport activities can lead to weight loss, reduce risk for cardiovascular disease, and optimize physical health. Sports also can help enhance social and communication skills and improve quality of life for this patient population (TABLE).3-6
However, a 2014 report found that while inactive adults with disabilities (hearing, vision, cognition, mobility) were 50% more likely to report 1 or more chronic diseases than those who were physically active, only 44% of adults with disabilities who visited a health professional in the previous 12 months received a physical activity recommendation.7 In addition, more than 50% of adults with disabilities are not meeting US recommended exercise guidelines.7-9
Family physicians may not feel they have adequate training to counsel patients with IDDs. Additional limiting factors include dependence on caregivers for exercise participation, expense, transportation difficulties, a lack of choice in sporting activities, and the patient’s level of motivation.10The guidance reviewed here details how to modify the pre-participation sports physical exam specifically for patients with IDDs.It alsoprovides sport and exercise recommendations for patients with 3 disabilities: Down syndrome, cerebral palsy, and autism spectrum disorder.
Worth noting: As is true for adults without disabilities, those with IDDs should participate in at least 150 minutes of moderate-intensity, or 75 minutes of vigorous intensity, aerobic physical activity each week.9 Recommend muscle-strengthening activities be performed at least 2 days each week.9
Exercise recommendations for patients with Down syndrome
One in every 700 babies receives a diagnosis of Down syndrome.11 Among its many possible manifestations—which include intellectual disability, heart disease, and diabetes—Down syndrome is associated with an increased risk for obesity, which makes exercise an extremely important lifestyle modification for these patients. Obesity can lead to obstructive sleep apnea causing cor pulmonale and even premature death. Continuous positive airway pressure intervention can be difficult in terms of patient compliance. However, weight loss through exercise and sports is an effective intervention to mitigate these obesity-related health comorbidities.
Pre-participation exam.A focused history and physical exam are often conducted before a patient engages in organized competitive or recreational sports. The pre-participation sports physical exam typically focuses on cardiac, neurologic, hereditary, and musculoskeletal disorders. While we recommend including these baseline elements as part of the exam for patients with disabilities, we also recommend modifying the exam to include disability-specific screening for associated comorbidities.
