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Stamatis Agiovlasitis

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Adam Love and Stamatis Agiovlasitis

Adults with Down syndrome (DS) tend to have low physical activity levels, which may relate to how they perceive participation in physical activities. The current study entailed interviews with 30 adults with DS (age 18–71 yr, 18 women) to examine how they perceived physical activity, exercise, and sport. Through qualitative analysis informed by grounded theory, the investigators found that adults with DS have positive perceptions of physical activity that center on enjoyment. Three facets of enjoyment were identified: interaction, achievement, and process. Interaction reflected enjoyment of social contact with others including relatives, peers, caregivers, and animals. Achievement involved enjoyment of achieving particular ends including accomplishment of tasks, material rewards, formation of athletic identities, and improvement of health. Process represented enjoyment from performing a particular activity itself. This multifaceted enjoyment expressed by adults with DS may facilitate physical activity and should be considered when developing programs to improve their well-being.

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Stamatis Agiovlasitis and Robert W. Motl

This study examined whether the relationship between metabolic equivalent units (METs) and step-rate is altered in persons with multiple sclerosis (MS) and developed step-rate thresholds for activity intensity for these persons. Participants were 24 persons with MS (20 women; age = 44 ± 12) and 24 healthy persons without MS (20 women; age = 41 ± 11). The MS group was divided using the 12-item MS Walking Scale (MSWS-12) into two walking impairment subgroups: (a) minimal (n = 13, MSWS-12 ≤ 12.5) and (b) mild-moderate (n = 11, MSWS-12 > 12.5). METs were measured with spirometry and step-rate with hand-tally. Steprate, height, group, the step-rate by group interaction, and the square of step-rate significantly predicted METs. At a given height, the step-rate thresholds at 3 and 6 METs were lower for persons with minimal impairment than persons without MS and even lower for persons with mild-moderate impairment. The relationship between METs and step-rate is altered in persons with MS, lowering their step-rate thresholds for activity intensity, especially for persons with MS who have higher levels of walking impairment.

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Stamatis Agiovlasitis, Jooyeon Jin and Joonkoo Yun

The authors examined if body mass index (BMI), weight, and height across age groups differ between adults with Down syndrome (DS) and adults with intellectual disability but without DS. They conducted secondary analyses of cross-sectional data from 45,803 individuals from the United States from 2009 to 2014 of the National Core Indicators Adult Consumer Survey across five age groups: 18–29, 30–39, 40–49, 50–59, and 60+ years. For both men and women with DS, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups and decreased thereafter. For both men and women with intellectual disability, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups, stayed about the same until the 50- to 59-year age group, and decreased thereafter. Height demonstrated a small but significant decrease with older age in all groups. These cross-sectional comparisons indicate that BMI and weight may start decreasing at a younger age in adults with DS than in adults with intellectual disability.

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Jian Xu, Poram Choi, Robert W. Motl and Stamatis Agiovlasitis

Physical activity (PA) and sedentary behavior may contribute to physical function in adults with intellectual disability (ID). This study examined whether objectively measured PA and sedentary behavior levels are associated with physical performance in adults with ID. Fifty-eight adults with ID (29 women and 29 men, age 44 ± 14 years) underwent a measurement of physical performance with the Short Physical Performance Battery (SPPB) and PA and sedentary time using a hip-worn accelerometer (wGT3X-BT; ActiGraph, Pensacola, FL). Moderate PA and age were significantly associated with the SPPB score (r = .39 and .34, respectively; p < .01). A hierarchical-regression model with moderate PA and age as independent variables indicated that moderate PA was a significant predictor of SPPB (p < .001; R 2 = .153), but age was not (p = .123; R 2 change = .036). Overall, moderate PA was significantly associated with the SPPB score, even after accounting for age, in adults with ID.

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Stamatis Agiovlasitis, Kenneth H. Pitetti, Myriam Guerra and Bo Fernhall

This study examined whether 20-m shuttle-run performance, sex, body mass index (BMI), age, height, and weight are associated with peak oxygen uptake (VO2peak) in youth with Down syndrome (DS; n = 53; 25 women, age 8–20 years) and whether these variables can be used to develop an equation to predict VO2peak. BMI, 20-m shuttle-run performance, and sex were significantly associated with VO2peak in youth with DS, whereas age, height, and weight were not. A regression model included only shuttle-run performance as a significant predictor of VO2peak; however, the developed prediction equation had low individual predictability. Therefore, 20-m shuttle-run performance alone does not provide valid prediction of VO2peak in youth with DS. Sex, BMI, age, height, and weight do not improve the prediction of VO2peak.

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Stamatis Agiovlasitis, Robert W. Motl, John T. Foley and Bo Fernhall

This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS (age: 24.7 ± 6.9 years; 9 women) and 21 persons without DS (age: 26.3 ± 5.2 years; 12 women) during six over-ground walking trials. Combined groups regression showed that the relationship between METs and activity-count rate differed between groups (p < .001). Separate models for each group included activity-count rate and squared activity-count rate as significant predictors of METs (p ≤ .005). Prediction of METs appeared accurate based on Bland-Altman plots and the lack of between-group difference in mean absolute prediction error (DS: 17.07%; Non-DS: 18.74%). Although persons with DS show altered METs to activity-count rate relationship during walking, prediction of their energy expenditure from wrist accelerometry appears feasible.

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Stamatis Agiovlasitis, Jeffrey A. McCubbin, Joonkoo Yun, Michael J. Pavol and Jeffrey J. Widrick

This study examined whether the net rate of oxygen uptake (VO2net) and the net oxygen uptake per kilometer (VO2net/km) are affected during walking in adults with Down syndrome (DS) and whether their preferred walking speed (PWS) minimizes the VO2net/km. Respiratory gases were collected as 14 adults with DS and 15 adults without DS completed a series of treadmill walking trials. PWS was measured over 15 meters in a hallway. The VO2net and the VO2net/km were higher in adults with DS than adults without DS. The overground PWS normalized for leg length was the same for both groups and did not appear to minimize the VO2net/km. Thus, adults with DS are less economical during walking than adults without DS. The overground PWS does not minimize the metabolic cost during treadmill walking.

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Stamatis Agiovlasitis, Joonkoo Yun, Jooyeon Jin, Jeffrey A. McCubbin and Robert W. Motl

This paper examines the need for interdisciplinary knowledge in the formation of public health models for health-promoting physical activity (PA) for people experiencing disability. PA promotion for people experiencing disability is a multifaceted endeavor and requires navigating a multitude of complicated and interactive factors. Both disability and health are multifaceted constructs and the relationship between PA and health is embedded within a complicated web of interactive influences. PA promotion must consider interacting biological and psychosocial factors within the person and in the sociopolitical environment. Models for research and practice need to evolve from value and belief systems that center on people experiencing disability without stigmatizing them. We argue that interdisciplinary research and practice is needed in navigating the intricacies of PA promotion toward improving the health of people experiencing disability and facilitating inclusion, empowerment, and dignity.

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Fabio Bertapelli, Stamatis Agiovlasitis, Robert W. Motl, Roberto A. Soares, Marcos M. de Barros-Filho, Wilson D. do Amaral-Junior and Gil Guerra-Junior

The purpose of this study was to develop and cross-validate an equation for estimating percentage body fat (%BF) from body mass index and other potential independent variables among young persons with intellectual disability. Participants were 128 persons with intellectual disability (62 women; age 16–24 years) split between development (n = 98) and cross-validation (n = 30) samples. Dual-energy X-ray absorptiometry served as the reference method for %BF. An equation including 1/body mass index and sex (0 = male; 1 = female) was highly accurate in estimating %BF (p < .001; R 2 = .82; standard error of estimate  = 5.22%). Mean absolute and root mean square errors were small (3.1% and 3.9%, respectively). A Bland–Altman plot indicated nearly zero mean difference between actual and predicted %BF with modest 95% confidence intervals. The prediction equation was %BF = 56.708 − (729.200 × [1/body mass index]) + (12.134 × sex). Health care professionals may use the prediction equation for monitoring %BF among young people with intellectual disability.