European Journal of Adapted Physical Activity 16, 14 (2023) | DOI: 10.5507/euj.2023.005

Difference in balance capacity for Special Olympics athletes and non-athletes with intellectual disabilities

Sanna Fjellström1, Johanna Oskarsson1, Elisabeth Hansen1,2, Anna Nordström1,3,4, Marie Lund Ohlsson1*
1 Department of Heath Sciences, Swedish Winter Sport Research Center, Mid Sweden University, Sweden
2 The Faculty of Education and Arts, Nord University, Bodø, Norway
3 Department of Public Health and Clinical Medicine, Section for Sustainable Health, Umeå University, Umeå, Sweden
4 School of Sports Science, UiT, The Arctic University of Norway, Tromsø, Norway

Fall incidents are a significant health problem for people with intellectual disabilities (ID) and physical activity improves balance capacity and can prevent the risk of falling. The Special Olympics Healthy Athletes® offers health screenings and education to athletes with ID. The aim of this cross-sectional study was to explore whether Special Olympics athletes have better balance capacity than non-athletes with ID. During the Special Olympics Sweden Invitational Games 2020, athletes and non-athletes participated in the Healthy Athletes programme. The results of athletes (n=47) and non-athletes (n=25) for balance tests (i.e. single leg stance, functional reach and timed sit-to stand test) and health markers (i.e. blood pressure and body mass index) were analysed. Athletes showed higher balance capacity, more physical activity at moderate intensity and a lower body mass index and diastolic blood pressure compared to non-athletes. However, the balance capacity of both athletes and non-athletes with ID were low, lower than for people without ID. From this study, Special Olympics athletes showed higher physical activity on moderate intensity and higher balance capacity which can decrease the risk of fall incidents compared to non-athletes.

Keywords: balance tests; intellectual impairment; para sports; physical activity

Received: April 1, 2022; Revised: February 8, 2023; Accepted: April 4, 2023; Prepublished online: October 4, 2023; Published online: March 28, 2024  Show citation

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Fjellström, S., Oskarsson, J., Hansen, E., Nordström, A., & Lund Ohlsson, M. (2023). Difference in balance capacity for Special Olympics athletes and non-athletes with intellectual disabilities. European Journal of Adapted Physical Activity, 16, Article 14. https://doi.org/10.5507/euj.2023.005
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    References

    1. Bhaumik, S., Watson, J. M., Thorp, C. F., Tyrer, F., & McGrother, C. W. (2008). Body mass index in adults with intellectual disability: distribution, associations and service implications: a population-based prevalence study. Journal of Intellectual Disability Research, 52(4), 287-298. https://doi:10.1111/j.1365-2788.2007.01018.x Go to original source... Go to PubMed...
    2. Blomqvist, S., Lönnberg, L., Sundelin, G., Wester, A., & Rehn, B. (2017). Physical exercise frequency seem not to influence postural balance but trunk muscle endurance in young persons with intellectual disability. Journal of Physical Education and Sport Management, 4(2), 38-47. https://doi:10.15640/jpesm.v4n2a5 Go to original source...
    3. Blomqvist, S., Wester, A., & Rehn, B. (2014). Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability. Gait & Posture, 39(3), 904-908. https://doi:10.1016/j.gaitpost.2013.11.018 Go to original source... Go to PubMed...
    4. Blomqvist, S., Wester, A., Sundelin, G., & Rehn, B. (2012). Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability. Physiotherapy, 98(4), 313-319. https://doi:10.1016/j.physio.2011.05.006 Go to original source... Go to PubMed...
    5. Boer, P. H. (2018). Effects of detraining on anthropometry, aerobic capacity and functional ability in adults with Down syndrome. Journal of Applied Research in Intellectual Disabilities, 31(Suppl 1), 144-150. https://doi:10.1111/jar.12327 Go to original source... Go to PubMed...
    6. Bohannon, R. W., Larkin, P. A., Cook, A. C., Gear, J., & Singer, J. (1984). Decrease in timed balance test scores with aging. Physical Therapy, 64(7), 1067-1070. https://doi:10.1093/ptj/64.7.1067 Go to original source... Go to PubMed...
    7. Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G.,... Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451-1462. https://doi:10.1136/bjsports-2020-102955 Go to original source... Go to PubMed...
    8. Burns, E. R., Stevens, J. A., & Lee, R. (2016). The direct costs of fatal and non-fatal falls among older adults - United States. Journal of Safety Research, 58, 99-103. https://doi:10.1016/j.jsr.2016.05.001 Go to original source... Go to PubMed...
    9. Cahill, S., Stancliffe, R. J., Clemson, L., & Durvasula, S. (2014). Reconstructing the fall: individual, behavioural and contextual factors associated with falls in individuals with intellectual disability. Journal of Intellectual Disability Research, 58(4), 321-332. https://doi:10.1111/jir.12015 Go to original source... Go to PubMed...
    10. Carmeli, E., Kessel, S., Coleman, R., & Ayalon, M. (2002). Effects of a treadmill walking program on muscle strength and balance in elderly people with Down syndrome. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 57(2), M106-110. https://doi:10.1093/gerona/57.2.m106 Go to original source... Go to PubMed...
    11. Carmeli, E., Zinger-Vaknin, T., Morad, M., & Merrick, J. (2005). Can physical training have an effect on well-being in adults with mild intellectual disability? Mechanisms of Ageing and Development, 126(2), 299-304. https://doi:10.1016/j.mad.2004.08.021 Go to original source... Go to PubMed...
    12. Chiba, Y., Shimada, A., Yoshida, F., Keino, H., Hasegawa, M., Ikari, H.,... Hosokawa, M. (2009). Risk of fall for individuals with intellectual disability. American Journal on Intellectual and Developmental Disabilities, 114(4), 225-236. https://doi:10.1352/1944-7558-114.4:225-236 Go to original source... Go to PubMed...
    13. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Erlbaum.
    14. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159. https://doi:10.1037//0033-2909.112.1.155 Go to original source... Go to PubMed...
    15. Connolly, B. H. (2006). Issues in aging in individuals with life long disabilities. Brazilian Journal of Physical Therapy, 10, 249-262. https://doi.org/10.1590/S1413-35552006000300002 Go to original source...
    16. Cox, C. R., Clemson, L., Stancliffe, R. J., Durvasula, S., & Sherrington, C. (2010). Incidence of and risk factors for falls among adults with an intellectual disability. Journal of Intellectual Disability Research, 54(12), 1045-1057. https://doi:10.1111/j.1365-2788.2010.01333.x Go to original source... Go to PubMed...
    17. Cuesta-Vargas, A., & Gine-Garriga, M. (2014). Development of a new index of balance in adults with intellectual and developmental disabilities. PLoS One, 9(5), e96529. https://doi:10.1371/journal.pone.0096529 Go to original source... Go to PubMed...
    18. Deprey, S. M., Biedrzycki, L., & Klenz, K. (2017). Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005-2012. Injury Epidemiology, 4(1), 21. https://doi:10.1186/s40621-017-0117-8 Go to original source... Go to PubMed...
    19. Domholdt, E. (2000). Statistical analysis of relationships: the basics. In E. Domholdt (Ed.), Physical Therapy Research, Principles and Applications (2nd ed., pp. 379-398). Saunders.
    20. Duncan, P. W., Studenski, S., Chandler, J., & Prescott, B. (1992). Functional reach: predictive validity in a sample of elderly male veterans. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 47(3), M93-98. https://doi:10.1093/geronj/47.3.m93 Go to original source... Go to PubMed...
    21. Duncan, P. W., Weiner, D. K., Chandler, J., & Studenski, S. (1990). Functional reach: a new clinical measure of balance. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 45(6), M192-197. https://doi:10.1093/geronj/45.6.m192 Go to original source... Go to PubMed...
    22. El Shennawy, A. (2015). Balance problems in Down syndrome children: various sensory elements and contribution to middle ear problems. Journal of Hearing Science, 5(1), 17-21. Retrieved from https://www.journalofhearingscience.com/pdf-120541-49197 Go to original source...
    23. Elliott, A. C., & Woodward, W. A. (2007). Statistical analysis quick reference guidebook: With SPSS examples. Sage. Go to original source...
    24. Enkelaar, L., Smulders, E., van Schrojenstein Lantman-de Valk, H., Geurts, A. C., & Weerdesteyn, V. (2012). A review of balance and gait capacities in relation to falls in persons with intellectual disability. Research in Developmental Disabilities, 33(1), 291-306. https://doi:10.1016/j.ridd.2011.08.028 Go to original source... Go to PubMed...
    25. Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society, 66(4), 693-698. https://doi:10.1111/jgs.15304 Go to original source... Go to PubMed...
    26. Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., de Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simasek, M., Thaker, V. V., & Urbina, E. M. (2017). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140(3). https://doi:10.1542/peds.2017-1904 Go to original source... Go to PubMed...
    27. Frzovic, D., Morris, M. E., & Vowels, L. (2000). Clinical tests of standing balance: performance of persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 81(2), 215-221. https://doi:10.1016/s0003-9993(00)90144-8 Go to original source... Go to PubMed...
    28. Gangavati, A., Hajjar, I., Quach, L., Jones, R. N., Kiely, D. K., Gagnon, P., & Lipsitz, L. A. (2011). Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: The maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. Journal of the American Geriatrics Society, 59(3), 383-389. https://doi:10.1111/j.1532-5415.2011.03317.x Go to original source... Go to PubMed...
    29. Gouveia, E. R., Ihle, A., Gouveia, B. R., Kliegel, M., Marques, A., & Freitas, D. L. (2020). Muscle mass and muscle strength relationships to balance: The role of age and physical activity. Journal of Aging and Physical Activity, 28(2), 262-268. https://doi:10.1123/japa.2018-0113 Go to original source... Go to PubMed...
    30. Guidetti, L., Franciosi, E., Gallotta, M. C., Emerenziani, G. P., & Baldari, C. (2010). Could sport specialization influence fitness and health of adults with mental retardation? Research in Developmental Disabilities, 31(5), 1070-1075. https://doi:10.1016/j.ridd.2010.04.002 Go to original source... Go to PubMed...
    31. Haddad, Y. K., Bergen, G., & Florence, C. S. (2019). Estimating the economic burden related to older adult falls by state. Journal of Public Health Management and Practice, 25(2), E17-E24. https://doi:10.1097/PHH.0000000000000816 Go to original source... Go to PubMed...
    32. Hale, L., Bray, A., & Littmann, A. (2007). Assessing the balance capabilities of people with profound intellectual disabilities who have experienced a fall. Journal of Intellectual Disability Research, 51(Pt 4), 260-268. https://doi:10.1111/j.1365-2788.2006.00873.x Go to original source... Go to PubMed...
    33. Hinckson, E. A., & Curtis, A. (2013). Measuring physical activity in children and youth living with intellectual disabilities: A systematic review. Research in Developmental Disabilities, 34(1), 72-86. https://doi:10.1016/j.ridd.2012.07.022 Go to original source... Go to PubMed...
    34. Hsieh, K., Heller, T., & Miller, A. B. (2001). Risk factors for injuries and falls among adults with developmental disabilities. Journal of Intellectual Disability Research, 45(Pt 1), 76-82. https://doi:10.1046/j.1365-2788.2001.00277.x Go to original source... Go to PubMed...
    35. Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780-791. https://doi:10.1111/j.1532-5415.2007.01156.x Go to original source... Go to PubMed...
    36. Johnson, M., Yun, J., & McCubbin, J. A. (2014). Validity evidence for self-report with assistance to measure physical activity behavior in adults with intellectual disabilities. Intellectual and Developmental Disabilities, 52(4), 273-281. https://doi:10.1352/1934-9556-52.4.273 Go to original source... Go to PubMed...
    37. Jouira, G., Srihi, S., Kachouri, H., Ben Waer, F., Rebai, H., & Sahli, S. (2021). Static postural balance between male athletes with intellectual disabilities and their sedentary peers: A comparative study. Journal of Applied Research in Intellectual Disabilities, 34(4), 1136-1144. https://doi:10.1111/jar.12874 Go to original source... Go to PubMed...
    38. Kozinc, Z., Lofler, S., Hofer, C., Carraro, U., & Sarabon, N. (2020). Diagnostic balance tests for assessing risk of falls and distinguishing older adult fallers and non-fallers: A systematic review with meta-analysis. Diagnostics (Basel), 10(9). https://doi:10.3390/diagnostics10090667 Go to original source... Go to PubMed...
    39. Lahtinen, U., Rintala, P., & Malin, A. (2007). Physical performance of individuals with intellectual disability: A 30-year follow-up. Adapted Physical Activity Quarterly, 24(2), 125-143. https://doi:10.1123/apaq.24.2.125 Go to original source... Go to PubMed...
    40. Liu, S. W., Obermeyer, Z., Chang, Y., & Shankar, K. N. (2015). Frequency of ED revisits and death among older adults after a fall. American Journal of Emergency Medicine, 33(8), 1012-1018. https://doi:10.1016/j.ajem.2015.04.023 Go to original source... Go to PubMed...
    41. Lloyd, M., Foley, J. T., & Temple, V. A. (2018). Maximizing the use of Special Olympics International's Healthy Athletes database: A call to action. Research in Developmental Disabilities, 73, 58-66. https://doi.org/10.1016/j.ridd.2017.12.009 Go to original source... Go to PubMed...
    42. Lord, S. R., Murray, S. M., Chapman, K., Munro, B., & Tiedemann, A. (2002). Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 57(8), M539-543. https://doi:10.1093/gerona/57.8.m539 Go to original source... Go to PubMed...
    43. Newcomer, K. L., Krug, H. E., & Mahowald, M. L. (1993). Validity and reliability of the timed-stands test for patients with rheumatoid arthritis and other chronic diseases. Journal of Rheumatology, 20(1), 21-27.
    44. Nuttall, F. Q. (2015). Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today, 50(3), 117-128. https://doi:10.1097/NT.0000000000000092 Go to original source... Go to PubMed...
    45. Paillard, T. (2017). Plasticity of the postural function to sport and/or motor experience. Neuroscience and Biobehavioral Reviews, 72, 129-152. https://doi.org/10.1016/j.neubiorev.2016.11.015 Go to original source... Go to PubMed...
    46. Peat, J., & Barton, B. (2008). Medical statistics: A guide to data analysis and critical appraisal. John Wiley & Sons.
    47. Pollock, A. S., Durward, B. R., Rowe, P. J., & Paul, J. P. (2000). What is balance? Clinical Rehabilitation, 14(4), 402-406. https://doi:10.1191/0269215500cr342oa Go to original source... Go to PubMed...
    48. Sparrow, W. A., Shinkfield, A. J., & Summers, J. J. (1998). Gait characteristics in individuals with mental retardation: Unobstructed level-walking, negotiating obstacles, and stair climbing. Human Movement Science, 17(2), 167-187. https://doi:10.1016/S0167-9457(97)00028-6 Go to original source...
    49. Special Olympics. (2019). Screening Reference Guide - Blood Pressure (Adult and Pediatric). Retrieved from https://media.specialolympics.org/resources/health/disciplines/health-promotion/Health-Promotion-BP-Screening-Reference-Guide-2019-c.pdf
    50. Special Olympics (Producer). (2020a). FUNfitness: Learn how to Organize, Promote and Present. Retrieved from https://media.specialolympics.org/resources/health/disciplines/funfitness/FUNfitness-Training-Manual-September-2020.pdf
    51. Special Olympics (Producer). (2020b). Health promotion: Clinical Director Manual. Retrieved from https://media.specialolympics.org/resources/health/disciplines/health-promotion/manual/Health-Promotion-Clinical-Director-Manual-Sept-2020-2.pdf
    52. Strydom, A., Chan, T., King, M., Hassiotis, A., & Livingston, G. (2013). Incidence of dementia in older adults with intellectual disabilities. Research in Developmental Disabilities, 34(6), 1881-1885. https://doi:10.1016/j.ridd.2013.02.021 Go to original source... Go to PubMed...
    53. Terblanche, E., & Boer, P. H. (2013). The functional fitness capacity of adults with Down syndrome in South Africa. Journal of Intellectual Disability Research, 57(9), 826-836. https://doi:10.1111/j.1365-2788.2012.01594.x Go to original source... Go to PubMed...
    54. Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., & Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27). https://doi:10.1097/MD.0000000000016218 Go to original source... Go to PubMed...
    55. Thomas, J. I., & Lane, J. V. (2005). A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients. Archives of Physical Medicine and Rehabilitation, 86(8), 1636-1640. https://doi.org/10.1016/j.apmr.2005.03.004 Go to original source... Go to PubMed...
    56. Van Duijnhoven, H. J., Heeren, A., Peters, M. A., Veerbeek, J. M., Kwakkel, G., Geurts, A. C., & Weerdesteyn, V. (2016). Effects of Exercise Therapy on Balance Capacity in Chronic Stroke: Systematic Review and Meta-Analysis. Stroke, 47(10), 2603-2610. https://doi:10.1161/STROKEAHA.116.013839 Go to original source... Go to PubMed...
    57. Wei, T.-M., Lu, L.-C., Ye, X.-L., Li, S., & Wang, L.-X. (2008). Impact of postures on blood pressure in healthy subjects. Acta Clinica Belgica, 63(6), 376-380. https://doi:10.1179/acb.2008.078 Go to original source... Go to PubMed...
    58. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S., C., Spencer, C. C., Stafford, R. S., Taler, S. T., Thomas, R. R., Williams, K. A., . . . Wright, J. T. (2018). 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), 1269-1324. https://doi:10.1161/HYP.0000000000000066 Go to original source... Go to PubMed...

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