The effect of different exercise intensities on knee and ankle joints' torque and functional mobility in children with Down Syndrome
Abstract
The aim of this study was to compare the effect of mild and moderate exercise intensity on selected knee and ankle isokinetic parameters and functional mobility in children with Down Syndrome (DS), in order to find the appropriate exercise intensity that is beneficial for them. A clinical controlled trial was conducted on thirty-four male children with DS, aged between eight and twelve years, which were randomly divided into two groups (Group 1 and Group 2). The first group (Group 1) received mild-intensity treadmill aerobic exercises [T-AE] and the second group (Group 2) received moderate-intensity T-AE, three sessions weekly for three months. The timed up and go (TUG) test was utilized to evaluate the functional mobility while the peak eccentric torque of knee extensors and ankle plantar flexors of the dominant leg was evaluated by isokinetic dynamometry. IBM SPSS Program (version 20) was utilized to conduct the statistical analysis. There was a statistically significant improvement in the three variables after intervention with the moderate-intensity program (p<0.05), while the improvement was not statistically significant after intervention with the mild-intensity program (p>0.05). A moderate-intensity exercise program is an appropriate and beneficial intervention and should be considered as a part of rehabilitation programs for DS children.
Downloads
References
Ahmadi, N., Peyk, F., Hovanloo, F., & Hemati Garekani, S. (2020). Effect of functional strength training on gait kinematics, muscle strength and static balance of young adults with Down syndrome. International Journal of Motor Control and Learning, 2(1), 1-10.
Alsakhawi, R. S., & Elshafey, M. A. (2019). Effect of Core Stability Exercises and Treadmill Training on Balance in Children with Down Syndrome: Randomized Controlled Trial. Advances in Therapy, 36(9), 2364–2373. https://doi.org/10.1007/s12325-019-01024-2
Baecke, J. A., Burema, J., & Frijters, J. E. (1982). A short questionnaire for the measurement of habitual physical activity in epidemiological studies. The American Journal of Clinical Nutrition, 36(5), 936–942. https://doi.org/10.1093/ajcn/36.5.936
Balic, M. G., Mateos, E. C., Blasco, C. G., & Fernhall, B. O. (2000). Physical fitness levels of physically active and sedentary adults with Down syndrome. Adapted Physical Activity Quarterly, 17(3), 310-321.
Brightwell, C. R., Markofski, M. M., Moro, T., Fry, C. S., Porter, C., Volpi, E., & Rasmussen, B. B. (2019). Moderate‐intensity aerobic exercise improves skeletal muscle quality in older adults. Translational Sports Medicine, 2(3), 109-119.
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, 57(2), 106–110. https://doi.org/10.1093/gerona/57.2.m106
Chapman, D., Newton, M., Sacco, P., & Nosaka, K. (2006). Greater muscle damage induced by fast versus slow velocity eccentric exercise. International Journal of Sports Medicine, 27(08), 591-598.
Cioni, M., Cocilovo, A., Di Pasquale, F., Araujo, M. B., Siqueira, C. R., & Bianco, M. (1994). Strength deficit of knee extensor muscles of individuals with Down syndrome from childhood to adolescence. American Journal of Mental Retardation, 99(2), 166–174.
De Ste Croix, M. (2012). Isokinetic assessment and interpretation in paediatric populations: Why do we know relatively little? Isokinetics and Exercise Science, 20(4), 275-291.
Ferri, A., Scaglioni, G., Pousson, M., Capodaglio, P., Van Hoecke, J., & Narici, M. V. (2003). Strength and power changes of the human plantar flexors and knee extensors in response to resistance training in old age. Acta physiologica Scandinavica, 177(1), 69–78. https://doi.org/10.1046/j.1365-201X.2003.01050.x
Garnier, Y. M., Lepers, R., Dubau, Q., Pageaux, B., & Paizis, C. (2018). Neuromuscular and perceptual responses to moderate-intensity incline, level and decline treadmill exercise. European Journal of Applied Physiology, 118(10), 2039–2053. https://doi.org/10.1007/s00421-018-3934-8
Ignaszewski, M., Lau, B., Wong, S., & Isserow, S. (2017). The science of exercise prescription: Martti Karvonen and his contributions. British Columbia Medical Journal, 59(1), 38-41.
Krinsky-McHale, S. J., Jenkins, E. C., Zigman, W. B., & Silverman, W. (2012). Ophthalmic disorders in adults with down syndrome. Current gerontology and geriatrics research, 2012, 974253. https://doi.org/10.1155/2012/974253
Mendonca, G. V., Pereira, F. D., Morato, P. P., & Fernhall, B. (2010). Walking economy of adults with Down syndrome. International Journal of Sports Medicine, 31(1), 10–15. https://doi.org/10.1055/s-0029-1241211
Mercer, V. S., & Lewis, C. L. (2001). Hip abductor and knee extensor muscle strength of children with and without Down syndrome. Pediatric Physical Therapy, 13(1), 18-26.
Parikh, A. P., & Goyel, N. A. (1990). Mental performance in Down syndrome. Indian Journal of Pediatrics, 57(2), 261–263. https://doi.org/10.1007/BF02722099
Roizen, N. J., & Patterson, D. (2003). Down's syndrome. Lancet, 361(9365), 1281–1289. https://doi.org/10.1016/S0140-6736(03)12987-X
Serrão, P. R., Gramani-Say, K., Lessi, G. C., & Mattiello, S. M. (2012). Knee extensor torque of men with early degrees of osteoarthritis is associated with pain, stiffness and function. Revista Brasileira de Fisioterapia, 16(4), 289–294. https://doi.org/10.1590/s1413-35552012005000031
Törpel, A., Becker, T., Thiers, A., Hamacher, D., & Schega, L. (2017). Intersession Reliability of Isokinetic Strength Testing in Knee and Elbow Extension and Flexion Using the BTE PrimusRS. Journal of sport rehabilitation, 26(4), 1-14. https://doi.org/10.1123/jsr.2016-0209
Tsimaras, V. K., & Fotiadou, E. G. (2004). Effect of training on the muscle strength and dynamic balance ability of adults with down syndrome. Journal of Strength and Conditioning Research, 18(2), 343–347. https://doi.org/10.1519/R-12832.1
Tuttle, L. J., Hastings, M. K., & Mueller, M. J. (2012). A moderate-intensity weight-bearing exercise program for a person with type 2 diabetes and peripheral neuropathy. Physical therapy, 92(1), 133–141. https://doi.org/10.2522/ptj.20110048
Ulrich, D. A., Lloyd, M. C., Tiernan, C. W., Looper, J. E., & Angulo-Barroso, R. M. (2008). Effects of intensity of treadmill training on developmental outcomes and stepping in infants with Down syndrome: a randomized trial. Physical therapy, 88(1), 114–122. https://doi.org/10.2522/ptj.20070139
Wang, X., Lu, D., & Liu, X. (2000). Isokinetic Peak Torque of Concentric and Eccentric Contraction. In ISBS-Conference Proceedings Archive.
Weijerman, M. E., & de Winter, J. P. (2010). Clinical practice. The care of children with Down syndrome. European Journal of Pediatrics, 169(12), 1445–1452. https://doi.org/10.1007/s00431-010-1253-0.
Wiggin, M., Wilkinson, K., Habetz, S., Chorley, J., & Watson, M. (2006). Percentile values of isokinetic peak torque in children six through thirteen years old. Pediatric Physical Therapy,18(1), 3–18. https://doi.org/10.1097/01.pep.0000202097.76939.0e
Williams, E. N., Carroll, S. G., Reddihough, D. S., Phillips, B. A., & Galea, M. P. (2005). Investigation of the timed ‘up & go’test in children. Developmental Medicine and Child Neurology, 47(8), 518-524.
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.