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Reliability of Y Balance Test in Runners With Intellectual Disability

Ghada Jouira, Haithem Rebai, and Sonia Sahli

Context: The Y Balance Test (YBT) is a simple, reliable, cost-effective screening test. It is used to evaluate dynamic balance as well as to determine the potential risk of injury of the lower limbs. The reliability of YBT has been widely reported in the general population. However, there are no studies evaluating the reliability of YBT use in athletes with intellectual disability (ID). The aim of the study was to examine the reliability of the YBT in runners with ID. Design: A reliability study. Methods: Twelve male runners (short-distance running) with ID (age 25.1 [4.50] y, height 169.1 [4.2] cm, weight 69.5 [5.5] kg, and intelligence quotient 60.8 [2.4]). The YBT was used to measure participants’ dynamic balance in the anterior, posteromedial, and posterolateral reach directions. The analysis used the normalized values to the relative length of the lower limbs. A 1-way (trial) repeated-measures (5) analysis of variance for each direction was used. Intraclass correlation coefficient, standard error of measurement, and minimal detectable change were computed to assess the reliability of the YBT between trials. Results: After 6 practice trials, 3 out of 5 consecutive ones achieved results stabilization for all directions and both legs (P < .05). The intraclass correlation coefficient, standard error of measurement, and minimal detectable change values for all trials ranged from .76 to .87, 5% to <7%, and 11% to <15%, respectively. Conclusion : The YBT is a highly reliable tool to measure the dynamic balance of male runners with ID. Therefore, it is recommended to perform 6 practice trials and 3 measurements in these runners.

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Tibiofemoral Joint Kinetics during Squatting with Increasing External Load

Sonia Sahli, Haithem Rebai, Mohamed Habib Elleuch, Zouheir Tabka, and Georges Poumarat

Context:

There is limited information about the effects of increasing load while squatting

Objective:

To quantify tibiofemoral joint kinetics during squatting with variable loads.

Setting:

Research laboratory.

Participants:

20 male students.

Intervention:

Tibiofemoral joint kinetics and electromyographic (EMG) activity of four involved muscles were determined by recording the half squat with variable external loads.

Main Outcome Measures:

Tibiofemoral joint force and external moment components and EMG activity of four involved muscles.

Results:

Throughout the exercise, a posterior direction for the antero-posterior shear force and a net extension for the external moment were observed. They increased with knee flexion reaching peak force of 29% of the subject body weight (BW) and moment of 88Nm (without external load). All force and moment components and muscle activities increased as the external load increased.

Conclusion:

These findings suggest that half squat may be safe to use for quadriceps strengthening with very low potential loading on the anterior cruciate ligament (ACL). Our data can help clinicians choose the appropriate external load.

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Neuromuscular Fatigue in Individuals With Intellectual Disability: Comparison Between Sedentary Individuals and Athletes

Rihab Borji, Firas Zghal, Nidhal Zarrouk, Sonia Sahli, and Haithem Rebai

The authors explored neuromuscular fatigue in athletes with intellectual disability (AID) compared with sedentary individuals with intellectual disability (SID) and individuals with typical development. Force, voluntary activation level, potentiated resting twitch, and electromyography signals were assessed during isometric maximal voluntary contractions performed before and immediately after an isometric submaximal exhaustive contraction (15% isometric maximal voluntary contractions) and during recovery period. AID presented shorter time to task failure than SID (p < .05). The three groups presented similar isometric maximal voluntary contraction decline and recovery kinetic. Both groups with intellectual disability presented higher voluntary activation level and root mean square normalized to peak-to-peak M-wave amplitude declines (p < .05) compared with individuals with typical development. These declines were more pronounced in SID (p < .05) than in AID. The AID recovered their initial voluntary activation level later than controls, whereas SID did not. SID presented lower potentiated resting twitch decline compared with AID and controls with faster recovery (p < .05). AID presented attenuated central fatigue and accentuated peripheral fatigue compared with their sedentary counterparts, suggesting a neuromuscular profile close to that of individuals with typical development.

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Postural Balance in Boys With Intellectual Disabilities Who Participate in Soccer Training

Ghada Jouira, Haithem Rebai, Dan Iulian Alexe, and Sonia Sahli

Purpose: The aim of this study is to investigate the postural balance in children with intellectual disabilities who participate in soccer training compared with their sedentary peers. Method: Two groups of boys with intellectual disabilities aged 8–10 years participated in this study: a soccer group (n = 12) and a sedentary group (n = 12). Postural balance was assessed using a force platform under 4 different conditions: open eyes, and closed eyes, on firm and foam surfaces. The Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test were also conducted. Results: The soccer group had significantly lower (P < .05) center of pressure values compared with the sedentary group, on both firm and foam surfaces, but only under the open eyes condition. They were significantly faster (P < .05) in the Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test compared with their sedentary peers. However, there were no significant differences between the 2 groups on the sit-to-stand and turn-to-sit phases of the Timed Up and Go Test. Conclusion: Soccer participation may have a positive effect on postural balance in boys with intellectual disabilities. These findings may have implications for the development of exercise programs to improve postural balance and reduce the risk of falls in this population.

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Dynamic Balance in Athletes With Intellectual Disability: Effect of Dynamic Stretching and Plyometric Warm-Ups

Ghada Jouira, Selim Srihi, Fatma Ben Waer, Haithem Rebai, and Sonia Sahli

Context: Athletes with intellectual disability (ID) have a high risk of injury while participating in various sports. Warm-up (WU) is the most preventive measure to reduce injuries in sports. Objective: To investigate the effects of dynamic stretching WU (DS-WU) and plyometric WU (PL-WU) on dynamic balance in athletes with ID. Design: Crossover study. Setting: Research laboratory. Participants: A total of 12 athletes with ID (age 24.5 [3.22] y, height 165.7 [8.4] cm, weight 61.5 [7.1] kg, intelligence quotient 61.1 [3.5]). Main Outcome Measures: Dynamic balance was assessed using the Star Excursion Balance Test (SEBT) at pre-WU, post-WU, and 15 minutes post-WU for both the DS-WU and the PL-WU. A 2-way analysis of variance (3 sessions × 2 WU methods) with repeated-measures was used in this study. Results: Following the DS-WU, participants demonstrated significant improvements in the SEBT composite score post-WU (89.12% [5.54%] vs 87.04% [5.35%]; P < .01) and at 15 minutes post-WU (89.55% [5.28%] vs 87.04%, P < .01) compared with pre-WU. However, no significant difference between these two post-WU scores (post-WU and 15 min post-WU) was found. For the PL-WU, participants demonstrated a significant decrease in the SEBT composite score at post-WU (85.95% [5.49%] vs 87.02% [5.73%]; P < .05); however, these scores increased significantly at 15 minutes post-WU (88.60% [5.42%] vs 87.02% [5.49%]; P < .05) compared with that at pre-WU. The SEBT composite scores are significantly higher in the DS-WU than in the PL-WU at both post-WU sessions (P < .05). Conclusion: Both DS-WU and PL-WU could improve dynamic balance and may be recommended as WUs in athletes with ID; however, particular caution should be exercised immediately after the PL-WU.

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Effect of Combined Training With Balance, Strength, and Plyometrics on Physical Performance in Male Sprint Athletes With Intellectual Disabilities

Ghada Jouira, Haithem Rebai, Dan Iulian Alexe, and Sonia Sahli

Individuals with intellectual disabilities often face unique challenges in physical capabilities, making traditional training methods less effective for their specific needs. This study aimed to investigate the effect of combining balance, plyometric, and strength (CBPS) training with sprint training on physical performance in male athletes with intellectual disabilities. Twenty-seven participants were randomly assigned to either a CBPS group or a control group that only maintained their regular sprint training. Participants underwent pre- and posttraining tests, including measures of balance, jumping, agility, and sprinting ability. The results showed that the CBPS group demonstrated significant improvements (p < .05) in one-leg stance, crossover-hop jump, squat jump, countermovement jump, and 10- and 30-m sprint at posttraining compared with pretraining. CBPS training combined with sprinting significantly improves physical performance in male athletes with intellectual disabilities, suggesting implications for tailored training programs to enhance their physical fitness and overall health.

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Time Course Effects of Different Intensities of Running Exercise on Cognitive and Motor Performances in Individuals With Intellectual Disability

Sana Affes, Rihab Borji, Nidhal Zarrouk, Thouraya Fendri, Sonia Sahli, and Haithem Rebai

This study explored the acute effects of different running intensities on cognitive and motor performances in individuals with intellectual disability (ID). An ID group (age, M = 15.25 years, SD = 2.76) and a control group without ID (age, M = 15.11 years, SD = 1.54) performed visual simple and choice reaction times, auditory simple reaction time, and finger tapping tests before and after running at low or moderate intensity (30% and 60% of heart rate reserve [HRR], respectively). Visual simple reaction time values decreased (p < .001) after both intensities at all time points with higher (p = .007) extend after the 60% HRR intensity for both groups. After both intensities, the VCRT decreased (p < .001) in the ID group at all time points compared with preexercise (Pre-EX) while, in the control group, these values decreased (p < .001) only immediately (IM-EX) and after 10 min (Post-10) of exercise cessation. Compared withs Pre-EX, in the ID group, the auditory simple reaction time values decreased (p < .001) at all time points after the 30% HHR intensity whereas, after the 60% HRR, these values decreased only at IM-EX (p < .001), Post-10 (p = .001) and Post-20 (p < .001). In the control group, auditory simple reaction time values decreased (p = .002) only after the 30% HRR intensity at IM-EX. The finger tapping test increased at IM-EX (p < .001) and at Post-20 (p = .001) compared to Pre-EX in both groups only after the 30% HHR intensity and for the dominant hand. The effect of physical exercise on cognitive performances in individuals with ID seems to depend on the cognitive test type as well as the exercise intensity.

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Speed Improves With Eccentric Hamstring Training in Athletes of Different Maturity Status

Raouf Hammami, Javier Gene-Morales, Ammar Nebigh, Haithem Rebai, and Juan C. Colado

Purpose: To investigate the effects of an eccentric hamstring strength training program (EHT) on sprint performance (10-, 20-, and 30-m sprint times) and change of direction speed (4 × 5-m shuttle run and T-Half test) in male European handball athletes at 2 maturity statuses (prepeak and postpeak height velocity [PHV]). Methods: Forty-five participants (12.68 [1.58] y) were divided into pre-PHV and post-PHV and randomly allocated to a control or intervention group, which performed a guided 2 day per week 6-week EHT of 5 exercises. A mixed-model (within- and between-factor) analysis of variance was conducted. Results: A significant effect (P < .05) of the interaction time × maturity × training was observed in the T-Half, 10, and 30 m tests. Both intervention groups significantly improved in all the tests, except in the 20 m sprint and the post-PHV in the 10 m sprint. Improvements ranged between 0.93% and 5.74% (effect size: 0.07–0.79). Both control groups yielded no improvements in almost all the tests. The improvements of both groups undergoing the intervention (pre-PHV and post-PHV) were not significantly different (only a tendency in the 10 m sprint). Conclusion: An EHT program combined with European-handball training improve change of direction and sprint performance in pre-PHV and post-PHV male players. Professionals training European handball and similar team-sport athletes should consider including EHT regardless of athlete’s maturity.

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Bone Turnover Markers and Lean Mass in Pubescent Boys: Comparison Between Elite Soccer Players and Controls

Ammar Nebigh, Mohamed Elfethi Abed, Rihab Borji, Sonia Sahli, Slaheddine Sellami, Zouhair Tabka, and Haithem Rebai

The aim of this study was to examine the relationship between bone mass and bone turnover markers with lean mass (LM) in pubescent soccer players. Two groups participated in this study, which included 65 elite young soccer players who trained for 6–8 hours per week and 60 controls. Bone mineral density; bone mineral content in the whole body, lower limbs, lumbar spine, and femoral neck; biochemical markers of osteocalcin; bone-specific alkaline phosphatase; C-telopeptide type I collagen; and total LM were assessed. Young soccer players showed higher bone mineral density and bone mineral content in the whole body and weight-bearing sites (P < .001). Indeed, the total LM correlated with whole-body bone mineral density and bone mineral content (P < .001). There were significant differences within the bone formation markers and osteocalcin (formation)/C-telopeptide type I collagen (resorption) ratio between young soccer players compared with the control group, but no significant difference in C-telopeptide type I collagen was observed between the 2 groups. This study showed a significant positive correlation among bone-specific alkaline phosphatase, osteocalcin, and total LM (r = .29; r = .31; P < .05) only for the young soccer players. Findings of this study highlight the importance of soccer practice for bone mineral parameters and bone turnover markers during the puberty stage.

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Do Motor–Cognitive and Motor–Motor Dual-Task Training Differently Affect Dual-Task Interference in Individuals With Intellectual Disability?

Rihab Borji, Rym Baccouch, Rabeb Laatar, Sirine Falhi, Sonia Sahli, and Haithem Rebai

This study explored the effect of different dual-task (DT) training programs on DT interference in adults with intellectual disability. Center-of-pressure (CoP) mean velocity in single-task (ST) and cognitive-DT conditions and the Timed Up-and-Go Test (TUGT) during ST, cognitive-DT, and motor-DT conditions were assessed before and after intervention in a cognitive–motor training group, a motor–motor training group, and a control group. Before training, CoP mean velocity and TUGT time increased (p < .001) in DT compared with the ST condition. After training, the CoP mean velocity values remained unchanged (p = .07) in DT compared with the ST condition among the cognitive–motor training group. Furthermore, compared with the ST condition, no increase (p = 1) was reported in the TUGT time during the cognitive-DT condition for the cognitive–motor training group and during the motor-DT for the motor–motor training group (p = .12). The effect of DT training on DT interference depends on the training modality.