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Adaptive behavior consists of the social, conceptual and practical skills an individual must execute to function independently in their everyday life. Individuals with Down syndrome have limitations in their adaptive behavior due to cognitive and physical deficits. The aim of this study was to examine if an exercise program would

Adaptive behavior consists of the social, conceptual and practical skills an individual must execute to function independently in their everyday life. Individuals with Down syndrome have limitations in their adaptive behavior due to cognitive and physical deficits. The aim of this study was to examine if an exercise program would improve the adaptive behavior skills in persons with Down syndrome. The exercise intervention, Exercise for Adults with Down Syndrome (ExDS), was a semester long program where adults with Down syndrome participate in twice weekly workouts planned and executed by Arizona State University students. The workouts consisted of an aerobic warm up, aerobic exercises, resistance exercises, balance exercises and stretches. The participants' adaptive behavior and cognitive planning ability were assessed before ExDS and after ExDS. The Adaptive Behavior Assessment System Second Edition (ABAS-II) was used to measure adaptive behavior. The ABAS-II consisted of a forum that addressed the Social, Conceptual and Practical domains of adaptive behavior and was filled out by the participants' caregiver. The Tower of London (ToL) was used to measure cognitive planning ability. The change in the ABAS-II scores from pre- to post-testing were statistically insignificant. The change from pre- to post-testing in the ToL scores approached statistical significance. Limitations included bias caregiver perception and respondent inconsistency. There is a need for further research on the effect of exercise on the adaptive behavior in adults with Down syndrome.
ContributorsRoss, Alexandra Jill (Author) / Holzapfel, Simon (Thesis director) / Ringenbach, Shannon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar

Individuals with Down Syndrome (DS) are subject to a spectrum of behavioral, cognitive and physical impairments. This population is more predisposed to comorbidity and typically has an increased risk of inactivity resulting in a lower level of fitness. Previous studies on physical activity have shown that routine exercise has similar health benefits for those with DS as those individuals without a disability and in turn progresses their balance ability. Due to limited exercise program opportunities and studies that intentionally investigate the benefits of specific modes of exercise on the DS population, a community-based Exercise Program for Adults with DS (ExDS) was created with the goal of improving their physical and mental health and measuring changes in their balance capabilities throughout the program. ExDS partnered with Arizona State University (ASU) students to create biweekly customized workouts, that followed exercise prescription guidelines, consisting of an aerobic warm-up, main aerobic exercise bout, resistance training, balance training, and stretching for each participant with DS. Participant dynamic and static balance ability was measured using the Berg Balance Scale (BBS) during program pre- and post-assessments. The BBS composite score did not change and no significant improvement was seen in the p-values for each line item of the BBS from pre- to post-testing. For follow-up analyses, the participants with low treatment fidelity were removed. Follow-up analyses showed significant increases in BBS composite score and line item 13 from pre- to post-testing. Treatment fidelity was a limitation in this study and future studies should aim to increase fidelity and consistency of tester for pre- and post-testing. In conclusion, holistic exercise programming for adults with DS appears to benefit balance as long as treatment fidelity is high. It is unclear which mode of exercise had the greatest impact on changes in balance.
ContributorsShikles, Ann Kelly (Author) / Holzapfel, Simon (Thesis director) / Ringenbach, Shannon (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
Background and Purpose— There is limited conclusive data on both pharmacological and holistic treatment options to improve cognition in adults after stroke. In particular, there is lacking evidence for cognitive rehabilitation in the subacute and chronic phases when cognitive impairment may be more perceptible. In this meta-analytic review, our primary

Background and Purpose— There is limited conclusive data on both pharmacological and holistic treatment options to improve cognition in adults after stroke. In particular, there is lacking evidence for cognitive rehabilitation in the subacute and chronic phases when cognitive impairment may be more perceptible. In this meta-analytic review, our primary objective was to determine the cognitive effects of aerobic exercise on post-stroke adults in the post-acute phases. Secondary objectives were to investigate the differential effects of aerobic exercise on sub-domains of cognitive function.
Methods— Data were extracted and filtered from electronic databases PubMed (MEDLINE), CINAHL, Embase, PsycINFO, and Scopus. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random effects models. Heterogeneity was evaluated using the Chi-squared (Q) and I-squared statistics.
Results— Five studies met inclusion criteria, representing data from 182 participants. The primary analysis produced a positive overall effect of aerobic exercise on cognitive performance (Hedges’ g [95% confidence interval]= 0.42 [0.007–0.77]). Effects were significantly different from zero for aerobic interventions combined with other physical activity interventions (Hedges’ g [CI] =0.59 [0.26 to 0.92]), but not for aerobic interventions alone (P= 0.40). In specific subdomains, positive moderate effects were found for global cognitive function (Hedges’ g [CI] =0.79 [0.31 to 1.26]) but not for attention and processing speed (P=0.08), executive function (P= 0.84), and working memory (P=0.92).
Conclusions— We determined that aerobic exercise combined with other modes of training produced a significant positive effect on cognition in adults after stroke in the subacute and chronic phases. Our analysis supports the use of combined training as a treatment option to enhance long-term cognitive function in adults after stroke. Further research is needed to determine the efficacy of aerobic training alone.
ContributorsMitchell, Michaela (Author) / Holzapfel, Simon (Thesis director) / Bosch, Pamela (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Description
The aim of this study was to examine the effects of Assisted Cycle Therapy (ACT) on self-efficacy and exercise perception in older adults with Down syndrome (DS) after a three times a week for 8 weeks intervention. Thirteen participants were in the ACT group in which a motor assisted their

The aim of this study was to examine the effects of Assisted Cycle Therapy (ACT) on self-efficacy and exercise perception in older adults with Down syndrome (DS) after a three times a week for 8 weeks intervention. Thirteen participants were in the ACT group in which a motor assisted their cycling to be performed at least 30% faster than voluntary cycling (VC), 11 participants were in the voluntary cycling group and two participants were in the no cycling (NC) group. The results showed that both exercise groups (i.e., ACT and VC) improved in their self-efficacy after the 8 week intervention. In addition, exercise perception improved following ACT and not VC or NC. Our results are discussed with respect to their future implications for exercise in the DS population. It might be that the yielded results were due to differences in effort required by each intervention group as well as the neurotrophic factors that occur when muscle contractions create synaptic connections resulting in improvement in cognition and feelings of satisfaction. In the future, research should focus on the psychological factors such as social accountability and peer interaction as they relate to ACT and physical activity in person's with DS.
ContributorsTucker, Kori Ann (Author) / Ringenbach, Shannon (Thesis director) / Arnold, Nathaniel (Committee member) / Holzapfel, Simon (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Description
Previous research has found improvements in motor and cognitive measures following Assisted Cycle Therapy (AC) in adolescence with Down syndrome (DS). Our study investigated whether we would find improvements in older adults with DS on measures of leisure physical activity (GLTEQ) and sleep, which are early indicators of Alzheimer's disease

Previous research has found improvements in motor and cognitive measures following Assisted Cycle Therapy (AC) in adolescence with Down syndrome (DS). Our study investigated whether we would find improvements in older adults with DS on measures of leisure physical activity (GLTEQ) and sleep, which are early indicators of Alzheimer's disease (AD) in persons with Down syndrome. This study consisted of eight participants with Down syndrome between 31 and 51 years old that cycled for 30 minutes 3 x/week for eight weeks either at their voluntary cycling rate (VC) or approximately 35% faster with the help of a mechanical motor (AC). We predicted that, based on pilot data (Gomez, 2015), GLTEQ would either maintain or improve after AC, but would decrease after VC and would stay the same after NC. We predicted that the sleep score may improve after both VC or AC or it may improve more after VC than AC based on pilot data related to leisure activity. Our results were consistent with our prediction that GLTEQ will either maintain or improve after AC but will decrease after VC. Our results were not consistent with our prediction that sleep may improve after both VC or AC or it may improve more after VC than AC, possibly because we did not pre-screen for sleep disorders. Future research should focus on recruiting more participants and using both objective and subjective measures of sleep and physical activity to improve the efficacy of the study.
ContributorsParker, Lucas Maury (Author) / Ringenbach, Shannon (Thesis director) / Buman, Matthew (Committee member) / Holzapfel, Simon (Committee member) / School of Social and Behavioral Sciences (Contributor) / School of Nutrition and Health Promotion (Contributor) / College of Public Service and Community Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05