Swim, Strength, or Combined Programs: Effect on Health-Related Physical Fitness in Adolescents With Down Syndrome.

The adolescent population with Down syndrome (DS) appears to show higher levels of body fat and lower levels of cardiorespiratory fitness or muscle strength than their peers without disabilities. There is a need to create physical activity programs to improve these data. The aim of this research was to determine the effects of a 16-week swimming program, strength program, and combined program (swimming and strength training) on body composition and health-related physical fitness on adolescents with DS and to assess whether there are differences in the results of the different training programs. Forty-five adolescents (17 female and 28 male; average age 15.5 [1.53] years) with DS were recruited and randomized to three groups (swim [n = 15], strength [n = 15], and combined [n = 15]). Results showed that the swim group had significant improvements in all health-related physical fitness variables and there was an improvement in some body-composition variables (p < .05). The strength and combined groups obtained minor improvements in the variables analyzed. In summary, a 16-week swim program consisting of three sessions of 60 min is able to improve levels of body composition and health-related physical fitness in adolescents with DS. The swim training program seems to be more effective in improving body composition and health-related physical fitness than the strength or combined program. These findings could be useful in different special-education centers due to the predisposition shown by the population with DS to this sport modality.

Effectiveness of exergames programme to modify body composition and health-related physical fitness in adolescents with down syndrome after COVID-19 quarantine.

AIMS: to determine the effect of a 20-week exergame program on different indicators of body composition and components of health-related physical fitness in adolescents with Down syndrome. Methods and Procedures Outcomes: 49 adolescents (19 female and 30 males; average age, 14.19 ± 2.06 years) with Down syndrome were recruited and randomized to two groups (control group vs. intervention group). Adolescents allocated in the control group carried out a physical activity program three times a week for 20 weeks meanwhile adolescents allocated in the exercise group performed an exergame program three times a week for 20 weeks. RESULTS: The exercise group had significant improvements in all health-related physical fitness variables and there is an improvement in some body composition variables (p < 0.05). CONCLUSIONS AND IMPLICATIONS: 20 week exergame program consisting of 3 sessions of 60 minutes is able to improve levels of body composition and health-related physical fitness in adolescents with Down syndrome.Highlights Research in body composition and health-related physical fitness of people with Down syndrome has revealed that an exergame programme increases levels of health-related physical fitness in adolescents with Down syndromeAn exergame programme can improve differences in markers of body composition between the control group and the intervention groupThe intervention group that performed the exergame programme showed increases in health-related physical fitness levels after 20 weeks of intervention.The control group that performed a based on developing motor behaviour programme did not show differences in body composition or health-related physical fitness after 20 weeks of intervention.

Prospective Associations of Physical Activity and Health-Related Physical Fitness in Adolescents with Down Syndrome: The UP&DOWN Longitudinal Study.

(1) Background: Numerous studies have focused on examining the association between PA levels and health-related physical fitness components in children or adolescents without disabilities. However, research on the association between PA and health-related physical fitness in adolescents with DS (Down syndrome) is limited, and most of the previous studies have been developed with a cross-sectional perspective. Therefore, the aim of the present study was to assess the prospective association of accelerometer-based PA at baseline with health-related physical fitness at a 2-year follow-up in a relatively large sample of adolescents with DS from the UP&DOWN study. (2) Methods: A total of 92 adolescents with DS (58 males) between 11 and 20 years old with full data were eligible from an initial sample of 110 participants. Fitness was assessed by the ALPHA health-related fitness test battery for youth, and physical activity was assessed by Actigraph accelerometers. (3) Results: The high tertile of total PA was related to decreased motor (Beta [95% CI] = -1.46 [-2.88; -0.05]) and cardiorespiratory fitness (Beta [95% CI] = -2.22 [-4.42; 0.02]) in adolescents with DS. (4) Conclusions: In adolescents with DS, (i) PA level was not prospectively associated with muscular fitness and (ii) high levels of total PA at the baseline were inversely associated with motor and cardiorespiratory fitness at the 2-year follow-up. For comparative purposes, these relationships were also examined in a subsample of adolescents without DS.

Bidirectional longitudinal associations of fatness with physical fitness in adolescents with Down syndrome. The UP&DOWN Longitudinal study.

BACKGROUND: The aim of this study was to examine the bidirectional longitudinal associations of several markers of fatness and physical fitness in adolescents with Down syndrome. METHODS: This study comprised a total of 111 adolescents (41 females), aged from 11 to 20 years with complete data at the baseline. We had a drop-out of <10% from the baseline to the 2-year follow-up. The ALPHA health-related fitness test battery for youth was used. RESULTS: Our results show that all fatness variables at the baseline were associated with a 2-year change in cardiorespiratory fitness (ß ranging from -0.32 to -0.38; all p < .05), but not with muscular and motor fitness (p > .05). However, no associations were found between physical fitness components as predictors and fatness indicators (p > .05). CONCLUSIONS: Results suggest that reducing fatness during adolescence might represent a modifiable factor to improve cardiorespiratory fitness at the 2-year follow-up, but not vice versa since associations were not bidirectional.

The effect of swimming program on body composition levels in adolescents with Down syndrome.

BACKGROUND: Down syndrome has been associated with more than 80 clinical characteristics such as diabetes, cardiovascular problems or obesity. AIMS: The current study determined the effect of a 36 weeks swimming program on different indicators of body composition in adolescents with Down syndrome. METHODS AND PROCEDURES OUTCOMES: 45 adolescents with Down syndrome were recruited and randomized to two groups (control group vs. exercise group). Adolescents allocated in the control group carried out a recreational swimming program twice a week during 36 weeks meanwhile adolescents allocated in the exercise group did exercise three time a week during 36 weeks. BMI, Waist circumference, waist-to-height ratio, triceps, subscapular, suprailiac and thigh skinfold were measured. RESULTS: ANCOVA tests were used to evaluate differences between groups in post-test intervention. Repeated measures of ANOVA were performed in order to assess differences in pre-test intervention in each group. t test were carried out to compare the pre-post-intervention differences in physical characteristics and body composition within each group. The exercise group had significant improvements in all variables of body composition (p < 0.05) except in subscapular and thigh skinfold. CONCLUSIONS AND IMPLICATIONS: The results suggest that a 36 weeks swimming program consisting of 3 sessions of 50 minutes is able to decrease levels of body composition in a sample of adolescents with Down syndrome. The findings indicate that it would be important to generate high intensity sports programs in sports associations in order to obtain positive impact on body composition levels within this population.

Changes in Body Composition and Physical Fitness in Adolescents with Down Syndrome: The UP&DOWN Longitudinal Study.

Background: Adolescents with Down syndrome (DS) demonstrate higher values of body composition and lower levels of physical fitness when compared with their peers with typically developing (TD) or their peers with intellectual disability but without DS. Objective: To examine, during a 2-year period, changes in indicators of body composition and physical fitness components in TD adolescents and adolescents with DS. Methods: Hundred adolescents with DS (64 males) aged 11-20 years old were matched by sex to 163 TD adolescents (108 males) aged 12-18. Indicators of body composition were determined by body mass index (BMI), waist circumference, waist-to-height ratio, skinfolds, and percentage of body fat (%BF). Components of physical fitness were assessed by the Assessing Level of Physical Activity (ALPHA) health-related fitness test battery for youth. Results: In the 2-year follow-up, significant (p < 0.05) decreases in BMI and increases in cardiorespiratory fitness and handgrip strength were seen for both groups; decreases in %BF were only seen for participants with DS; and increases in standing long jump were seen only for TD adolescents. Conclusions: Results indicate that during the 2-year study period, there were significant decreases in BMI and significant increases in handgrip strength and cardiorespiratory fitness in the TD group. For participants with DS, there was a significant decrease in %BF. However, participants with DS did not exhibit improvements in physical fitness.

Correlates of objectively measured physical activity in adolescents with Down syndrome: the UP & DOWN study.

INTRODUCTION: Correlates of physical activity (PA) have not been explored in adolescents with Down syndrome (DS). Understanding correlates of PA could provide information to develop strategies to increase levels of PA in this target population. OBJECTIVE: The aim of this study was to identify potential correlates of PA in adolescents with DS. METHOD: Information about levels of PA and their potential correlates was collected in 98 adolescents with DS (63 males, aged 11-20 years) using accelerometers and proxy-reported questionnaires. Analysis of covariance and multiple linear regression analyses were conducted to examine correlates of PA. RESULT: Our findings showed that participant's age and socioeconomic status were associated with levels of PA as non-modifiable correlates. Also, parental support, father PA, television-viewing time with siblings and with friends were associated with levels of PA as modifiable correlates. DISCUSSION AND CONCLUSION: Both modifiable and non-modifiable factors are associated with levels of PA in adolescents with DS. Therefore, a better understanding of correlates of PA could contribute to develop strategies on PA promotion in adolescents with DS.

Introducción: los correlatos de actividad física (AF) no han sido estudiados en adolescentes con síndrome de Down (SD). Entendiendo los correlatos de AF se podría aportar información para desarrollar estrategias para incrementar los niveles de AF en esta población diana. Objetivo: el objetivo de este estudio fue identificar correlatos de AF en adolescentes con SD. Métodos: la información de los niveles de AF y sus potenciales correlatos fue recogida en 98 adolescentes con SD (63 hombres, con edades comprendidas entre 11-20 años), usando acelerómetros y cuestionarios proxy-reportados. Se utilizó análisis de covarianza y análisis de regresión lineal múltiple para examinar los correlatos de AF. Resultados: nuestros resultados muestran que la edad y el estatus socioeconómico de los participantes fue asociado con niveles de AF como correlatos no modificables. Además, el apoyo de los padres, la AF del padre y el tiempo dedicado a ver la televisión con hermanos y amigos fueron asociados con niveles de AF como correlatos modificables. Discusión y conclusión: ambos factores modificables y no modificables se asocian con niveles de AF en adolescentes con SD. Por lo tanto, una mejor comprensión de los correlatos de AF podría contribuir a desarrollar estrategias de promoción de la AF en adolescentes con SD.

Correlates of sedentary behaviour in youths with Down syndrome: the UP&DOWN study.

The aim of this study was to identify potential correlates of sedentary time and television (TV) viewing time in youth with Down syndrome (DS). A total of 98 adolescents with DS (63 males) aged 11-20 years old participated in this study. Total sedentary time was measured using accelerometers, while total TV viewing time and potential correlates were measured using proxy-report questionnaire. Analyses of covariance and a stepwise multiple linear regression were performed to examine correlates of total sedentary time and total TV viewing time. Different potential correlates were associated with total sedentary time (mother age, mother TV viewing time, perceived benefits of physical activity, birth order and having nearby shops in the neighbourhood) and total TV viewing time (father TV viewing time, TV viewing time with parents, family dietary habits during watching TV and weekend days time indoor). The identification of correlates associated with sedentary behaviour, principally those considered modifiable such as social and environmental factors, may contribute to development strategies to decrease sedentary behaviour in adolescents with DS and consequently promote a healthier lifestyle.

Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study.

The aim of the present study was to examine the associations of objectively measured physical activity (PA) with several markers of fatness and fitness in a relatively large sample of adolescents with Down syndrome (DS). This study comprised a total of 100 adolescents with DS (37 females) aged 11-20 years-old, and a sex-matched sample of 100 adolescents without disabilities, participating in the UP&DOWN study. The ALPHA health-related fitness test battery for adolescents was used to assess fatness and fitness. PA was measured by accelerometry. Adolescents with DS had higher fatness and significantly lower fitness levels in all variables measured than adolescents without DS (all p<0.05). Moderate-to-large effects were observed in fatness variables (d=0.65-1.42), but particularly large values were found in fitness variables (d=2.05-2.43). In addition, PA levels was not associated with fatness variables, whereas total PA and vigorous PA were associated with all fitness variables (p<0.05), and moderate-vigorous PA (MVPA) was associated with muscular fitness (p<0.05), after adjusting for potential confounders. Further analysis revealed that there were differences in fitness by tertiles of vigorous PA between the lowest and the highest groups in all fitness variables (all p<0.05). However, no significant differences were found in fitness by tertiles of MVPA according with PA guidelines (≥60min in MVPA). Our findings indicate that PA levels are not associated with fatness variables, whereas high PA levels, in particular vigorous PA, are positively associated with high fitness in adolescents with DS.

Objective assessment of sedentary time and physical activity throughout the week in adolescents with Down syndrome. The UP&DOWN study.

This study aimed to examine the patterns of sedentary time and physical activity (PA) throughout the week in adolescents with Down syndrome (DS). The study comprised 109 adolescents with DS (68 males and 41 females) aged 11-20 years, participating in the UP&DOWN study, but only a total of 100 adolescents provided valid data. Sedentary time and total, light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were measured by accelerometers. There were no significant differences in the time spent in sedentary time and PA levels between weekdays vs. weekend days, as well as between school time vs. after school-time periods (all p>0.05). Adolescent males engaged in more total PA, moderate PA, vigorous PA and MVPA than females on weekend days (all p<0.05). Differences between age groups showed that sedentary time increases and PA decreases with advancing age in all analyses, so that the oldest groups were more sedentary and less active (all p<0.05). Only 43% of adolescents with DS met the PA recommendations of ≥60min/day of MVPA. Our findings show valuable information to be considered in future interventions aiming to decrease sedentary time and increase PA levels in adolescents with DS.

Physical activity as a preventive measure against overweight, obesity, infections, allergies and cardiovascular disease risk factors in adolescents: AFINOS Study protocol.

BACKGROUND: Prior studies addressing the impacts of regular physical activity or sedentary habits on the immune system have been conducted in adults and laboratory settings. Thus, it is practically unknown how a healthy active lifestyle could affect low-grade inflammation processes, infections or allergies in young persons. The AFINOS Study was designed to determine the relationship between the regular physical activity levels of adolescents and overweight, infection, and allergies along with the presence of metabolic and immunological biomarkers of a deteriorated health status. A further objective of the AFINOS Study is to assess the health status and lifestyle habits of an adolescent population in an effort to identify any protective factors that could be used as preventive measures, since many chronic diseases and their associated co-morbidities often persist from adolescence into adulthood. METHODS/DESIGN: This study was conducted as three separate sub-studies in three different populations as follows: (a) Study 1 was performed on a population sample of adolescents; (b) Study 2 on the adolescents' parents; and (c) Study 3 on a subset of the adolescents from Study 1. Study 1 assessed health and lifestyle indicators through a questionnaire administered to a representative sample of adolescents from the Madrid Region (n = 2400) aged 13 to 16 years. In Study 2, the parents of the teenagers participating in Study 1 were required to fill out a questionnaire. Finally in Study 3, body composition, physical activity, health-related physical fitness, and blood measurements were determined in a subset (n = 200) of the individuals included in Study 1. DISCUSSION: This paper describes the rationale, design, and methodologies used in the AFINOS Study. This multidisciplinary, multicenter study seeks to evaluate several aspects of existing relationships between routine physical activity/sedentary behaviour and several health status markers, specifically those related to the immune system. The results of this cross-sectional study will serve for comparisons with the available data obtained in laboratory settings and in adults. In addition, knowledge regarding the health status and lifestyle habits of Spanish adolescents and their parents will be useful for designing preventive measures.

[Reliability and validity of the PAQ-A questionnaire to assess physical activity in Spanish adolescents]. / Fiabilidad y validez del cuestionario de actividad física PAQ-A en adolescentes españoles.

BACKGROUND: Questionnaires are feasible instruments to assess physical activity (PA) in large samples. The aim of the current study was to evaluate the reliability and validity of the PAQ-A questionnaire in Spanish adolescents using the measurement of PA by accelerometer as criterion. METHODS: In a sample of 82 adolescents, aged 12 to 17 years, 1-week PAQ-A test-retest was administered. Reliability was analyzed by the Intraclass Correlation Coefficient (ICC) and the internal consistency by the Cronbach's alpha Coefficient. Two hundred thirty-two adolescents, aged 13-17 years, completed the PAQ-A and wore the ActiGraph GT1M accelerometer during 7-days. The PAQ-A was compared against total PA and moderate to vigorous PA (MVPA) obtained by the accelerometer. RESULTS: Test-retest reliability showed ICC = 0.71 for the final score of PAQ-A. Internal consistency was alpha = 0.65 in the first self-report, alpha = 0.67 in the retest in 82 adolescents sample, and alpha = 0.74 in the 232 adolescents sample. The PAQ-A was moderately correlated with total PA (rho = 0.39) and MVPA (rho= 0.34) assessed by the accelerometer. The PAQ-A obtained significantly moderate correlations in boys but not in girls against the accelerometer. CONCLUSIONS: The PAQ-A questionnaire shows an adequate reliability and a reasonable validity for assessing PA in Spanish adolescents.

[Validity of four questionnaires to assess physical activity in Spanish adolescents]. / Validez de cuatro cuestionarios para valorar la actividad física en adolescentes españoles.

OBJECTIVES: The physical activity (PA) levels of Spanish adolescents must be determined to assess how the lack of PA may affect the increasing prevalence of obesity. Thus, to assess PA in this age range valid measurement instruments are essential. The aim of this study was to evaluate the validity of four easily applied questionnaires (the enKid and FITNESSGRAM questions, the Patient-Centered Assessment and Counselling [PACE] questionnaire, and an activity rating) to assess PA in Spanish adolescents by using an accelerometer as the criterion instrument. METHODS: A total of 232 adolescents (113 girls) completed the questionnaires and wore an ActiGraph accelerometer for 7 consecutive days. Spearman's correlation coefficient (rho) was used to compare the questionnaires and total PA, moderate PA, vigorous PA and moderate-to-vigorous PA (MVPA) assessed by the accelerometer. RESULTS: All the questionnaires showed moderate correlations when compared against total PA (rho=0.36-0.43) and MVPA (rho=0.34-0.46) obtained by the accelerometer in the total sample. Higher correlations were found when comparing the questionnaires against vigorous PA (rho=0.42-0.51) than against moderate PA (rho=0.15-0.17). The FITNESSGRAM question and the PACE questionnaire obtained weak correlations in girls and the enKid question and activity rating were moderately correlated for boys and girls. CONCLUSIONS: The four questionnaires evaluated showed acceptable validity in the assessment of PA in the Spanish adolescent population.