第九屆 The effects of physical activity on body composition in children with disabiliti

Wei Ho1 Ting-Chun Kuo1 Pei-Ying Wu2 He-Hsun Liu3 Mei-Wun Tsai1 Shwn-Jen Lee1,*
1. Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taipei, Taiwan
2. Section of Physical Therapy, Taipei City Hospital, Yang Ming Branch, Taipei, Taiwan
3. Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

Background:
The prevalence of abnormal body composition among children with physical and cognitive disabilities is higher than typically developmental, age-matched peers, and it may increase health risks in this population. Many medical and psychosocial problems, such as diabetes mellitus, high blood pressure, cardiovascular disease, poor immune function, and depression, have been reported accompanied with abnormal body composition. Thus it is important to promote proper development of body composition among this population. Some studies have reported the effects of interventions with physical activity; however findings of these studies were inconsistent.

Purpose:
To investigate the effects of physical activity on body composition in children with disabilities

Methods:
A systematic review and meta-analysis of studies published in English and Chinese were completed following multiple electronic database searching. Studies with isolated or adjunctive physical activity interventions in children with disabilities and outcomes with body composition related anthropometric measures were selected, excluding case studies or qualitative studies. The methodological quality of the study was assessed by four reviewers independently using an appraisal form developed by Cho and Bero (1994 ), which can be used for all kinds of study design. Besides, the level of the evidence of each article was also assessed using the form from Oxford Center for Evidence-based Medicine. Results: Literature searches identified 2407 studies initially, of which 11 studies were selected based on inclusion and exclusion criteria.1-11 Nine studies were entered in meta-analysis. There are 4 RCTs, 3 CCTs, 1 cross-over design study and 1 pre-post study, published during 1998~2007. The subjects of these studies are aged from 4 to 17 years old and are diagnosed of intellectual disabilities, Down's syndrome, Prader-Willi syndrome, cerebral palsy or autism. Pooled effect size of physical activity intervention on body mass index (BMI) are significantly different from zero (ES: -0.271; 95% CI: -0.541~-0.001). Besides, there are positive but not significant effects on subgroups of overweight children (ES: -0.23; 95%CI: -0.747~0.287), children with autism (ES: -0.186; 95% CI: -0.967~0.596) and children with intellectual disability (ID) (ES: -0.308; 95% CI:-0.666~0.051).

Conclusions:
PA intervention is beneficial for body composition in children with disabilities. However, there is still limited data to clarify the modulators of weight-loss outcomes in children with disabilities. It is needed to strengthen the evidence-based PA intervention in children with disabilities in the future.


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