Douma-van Riet D, Verschuren O, Jelsma D, Kruitwagen C, Smits-Engelsman B, Takken T. Reference values for the muscle power sprint test in 6- to 12-year-old.
Anaerobic performance of the Indian children with Down’s syndrome - A Pilot
® study
Asir John Samuel, MPT (Neuro Paed) FA0188 Faculty
Introduction • Bursts
of
high-intensity
physical
activity
alternating with brief periods of rest forms the major part of daily activities of childhood*
• Sufficient levels of anaerobic performance is required† • Failure leads to an inability to keep up with peers‡ - Bailey RC, Olson J, Pepper SL, Porszasz J, Barstow TJ, Cooper DM. The level and tempo of children's physical activities: an observational study. Med Sci Sports Exerc. 1995 Jul;27(7):1033-41 *
† - Verschuren O, Ketelaar M, Gorter JW, Helders PJ, Takken T. Relation between physical fitness and gross motor capacity in children and adolescents with cerebral palsy. Dev Med Child Neurol. 2009 Nov;51(11):866-7 ‡ - Douma-van Riet D, Verschuren O, Jelsma D, Kruitwagen C, Smits-Engelsman B, Takken T. Reference values for the muscle power sprint test in 6- to 12-year-old children. Pediatr Phys Ther. 2012 Winter;24(4):327-32
Anaerobic muscle power • Yield
of
maximal
anaerobic
adenosine
triphosphate (ATP) per second during a specific type of short-duration, maximal exercise (30 s)* • Ability of the neuromuscular system to produce work in a short time period*
• Functional connectivity of inter-hemispheric brain network in Down’s syndrome (DS) is disrupted† * - Verschuren O, Takken T, Ketelaar M, Gorter JW, Helders PJ. Reliability for running tests for measuring agility and anaerobic muscle power in children and adolescents with cerebral palsy. Pediatr Phys Ther. 2007 Summer;19(2):108-15 † - Ahmadlou M, Gharib M, Hemmati S, Vameghi R, Sajedi F. Disrupted small-world brain network in children with Down Syndrome. Clin Neurophysiol. 2013 Sep;124(9):1755-64
Anaerobic performance in DS* • In laboratory setting, the anaerobic performance
of individual with DS is estimated using the Wingate Anaerobic cycling Test (WAnT)
• Valid measure but not much reliable • Adolescents
with
DS
exhibit
low
WAnT
performance compared to normal peers * - Guerra M, Gine-Garriga M, Fernhall B. Reliability of Wingate testing in adolescents with Down syndrome. Pediatr Exerc Sci. 2009 Feb;21(1):47-54
MPST in DS • As WAnT is more sophisticated and costly, an
equivalent field test, Muscle Power Sprint Test (MPST) has been developed*
• More relevant to daily physical activity behaviors† • To date, no studies have examined the reliability of MPST in individual with DS * - Verschuren O, Bongers BC, Obeid J, Ruyten T, Takken T. Validity of the muscle power sprint test in ambulatory youth with cerebral palsy. Pediatr Phys Ther. 2013 Spring;25(1):25-8 † - Douma-van Riet D, Verschuren O, Jelsma D, Kruitwagen C, Smits-Engelsman B, Takken T. Reference values for the muscle power sprint test in 6- to 12-year-old children. Pediatr Phys Ther. 2012 Winter;24(4):327-32
Definite need for the study • Reliability is an important issue for clinical use, in
follow-up* • As far as to our knowledge, there is no reliable measures available to evaluate the effects of training programs that focuses on anaerobic muscle power in children with DS * - Verschuren O, Takken T, Ketelaar M, Gorter JW, Helders PJ. Reliability for running tests for measuring agility and anaerobic muscle power in children and adolescents with cerebral palsy. Pediatr Phys Ther. 2007 Summer;19(2):108-15
Objective • To evaluate the reliability and the anaerobic
performance of the Indian children with DS using MPST
Methodology • Sample
population:
Children
with
DS
from
recognized Indian Special school/Rehabilitation centre • Study design: Cross sectional study • Sampling technique: Convenience sampling
• Sample size: n = 11 (Reliability study) www.cct.cuhk.edu.hk/stat/other/correlation.htm
(α = 5%; β = 20%; ICC = 0.75)
n = 13 (Pilot study)* * - Julious S. Sample size of 12 per group rule of thumb for a pilot study. Pharm Stat 2009;4(4);287-91
Inclusion criteria • Children with DS • Age: 6-14 years • Run without support • Obey and follow the simple commands
Exclusion criteria • Uncooperative • Visual/hearing impaired
• Lower limb surgeries within last 6 months • Pulmonary/cardiovascular diseases • Any medical contraindications to exercise
testing
Materials used • Measuring tape • 2 bright coloured cones • Marker • Stopwatch • Weigh scale
Procedure • Study protocol approved by the Institutional
Review Board
(ACP/OP/2013/OL 07)
• Registered in CTRI
(CTRI/2013/09/3987)
and ICTRP
(U1111-
1147-9903)
• Conducted
in
accordance
with
Declaration (revised 2008) and ICMR (revised 2006) • Assent and consent
Helsinki
Participant recruitment • Children with DS were screened for inclusion
criteria • 13 children with DS were recruited for the pilot study to estimate the anaerobic performance • While first 11 children to establish the reliability of
MPST • Height (cm) and body participant were noted
mass (Kg) of each
Prior to MPST • Testing was performed in a school corridor
• Usual clothing and footwear • Child performed the test at walking speed as a warm-up session ( 3 min to recover) • Made sure that the subject understood how to perform the test
• 15-m distance was marked by 2 lines taped to the floor with bright coloured cones
Performing MPST • Participants were instructed to complete six 15-m runs at maximum pace • Given the cues “ready,” “three,” “two,” “one,” and “go” for the first run • Second through the sixth run the assessors
counted backwards from “ten” to “one” and then gave the cue “go”
• Two student therapists recorded the time on a score form
Outcome measures • Power output for each sprint was calculated from
the collected data using the following equations, • Velocity (m/sec) = 15 meter/time • Acceleration (m/sec2) = velocity/time
• Force (kgm/sec2) = body mass * acceleration • Power (Watts) = force * velocity
Reliability measures • Test-retest reliability
- Same assessor recorded MPST separated by a minimum of 2 day • Inter-rater reliability
- First and second assessor recorded MPST with an interval min of 1 day
Data analysis • SPSS v • 20 • Shapiro-Wilk test for normality • Correlation coefficients
- Pearson’s correlations (r) - Intraclass correlations (ICC2,1; two-way mixed) • Limits of agreement (LOA) - Bland Altman analysis • The level of significance was set at α< 0.05
Demographic Data Characteristic
Children with DS (n=13)
Males
9
Females
4
Age (years)
10.6 ± 2.9
Height (cm)
133.9 ± 19.9
Weight (Kg)
35.4 ± 16.1
Reliability measures Reliability
Pearson
ICC (2,1)
Cronbach’s
correlation (r)
α
Test-retest 0.98*
(p
