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Cardiopulmonary Profile of Individuals with Intellectual Disability

BOONMAN, ANNE J. N.1; SCHROEDER, ELIZABETH C.2,3; HOPMAN, MARIA T. E.1; FERNHALL, BO2,3; Hilgenkamp, THESSA I. M.2,3,4

Medicine & Science in Sports & Exercise: September 2019 - Volume 51 - Issue 9 - p 1802–1808
doi: 10.1249/MSS.0000000000001995
CLINICAL SCIENCES
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Introduction Individuals with intellectual disabilities (ID) are often sedentary and have low fitness levels. Current knowledge supports the existence of physiological barriers resulting in low fitness and exercise intolerance in individuals with Down syndrome, which might be applicable to other ID etiologies. If physiological barriers exist in ID, this would require adaptation of the physical activity guidelines.

Purpose The aim of this study was to assess differences in cardiopulmonary profiles, including maximal oxygen uptake, during a cardiopulmonary exercise test in individuals with ID without Down syndrome and healthy controls.

Methods Participants performed an incremental cardiopulmonary exercise test on a treadmill until exhaustion. Outcomes were peak heart rate (HRpeak), absolute peak oxygen uptake (V˙O2peak), relative V˙O2peak, peak minute ventilation, peak CO2 expenditure, oxygen uptake efficiency slope, V˙E/V˙CO2 slope, absolute O2 pulse, relative O2 pulse, difference from predicted HRpeak, HR reserve, RERpeak, ventilatory threshold (VT), and VT as a percentage of V˙O2peak. Differences between groups were analyzed with Student’s t-tests and multiple linear regression after adjusting for potential confounders (sex, age, body mass index, and activity level).

Results Individuals with ID had worse outcomes on all of the cardiopulmonary outcomes, except for VT expressed as a percentage of V˙O2peak and V˙E/V˙CO2 slope (P < 0.05). Having ID was an independent predictor of reduced physiologic function during exercise (P < 0.05).

Conclusion These results demonstrate that individuals with ID present exercise intolerance potentially related to lower HRpeak and impairments in ventilatory function, and these results also suggest the possibility of peripheral muscle hypoperfusion. Existing physical activity guidelines likely underestimate the actual intensity of activity performed by individuals with ID and need to be adapted.

1Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS

2Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL

3Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL

4Department of General Practice, Erasmus MC University Medical Center Rotterdam, THE NETHERLANDS

Address for correspondence: Thessa Hilgenkamp, Ph.D., Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor St., 502A AHSB (MC 517), Chicago, IL 60612-7256; E-mail: thessa@uic.edu.

Submitted for publication December 2018.

Accepted for publication March 2019.

Online date: March 29, 2019

© 2019 American College of Sports Medicine