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The Impact of Adapted Physical Education on Physical Fitness of Students with Intellectual Disabilities: A Three-Year Study

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Title: The Impact of Adapted Physical Education on Physical Fitness of Students with Intellectual Disabilities: A Three-Year Study
Language: English
Authors: Pan, Cheng-Chen (ORCID 0000-0001-8482-0513), Mcnamara, Scott
Source: International Journal of Disability, Development and Education. 2022 69(4):1257-1272.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 16
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Education Level: High Schools
Secondary Education
Descriptors: Adapted Physical Education, Adolescents, Intellectual Disability, Students with Disabilities, Body Composition, Muscular Strength, Physical Fitness, Program Effectiveness, Special Education, Foreign Countries, Special Schools, High School Students
Geographic Terms: Taiwan
DOI: 10.1080/1034912X.2020.1776851
ISSN: 1034-912X
1465-346X
Abstract: The purpose of this study was twofold: (1) to examine the effect of an adapted physical education (APE) program on physical fitness of adolescents with intellectual disabilities, and (2) to investigate the associations between the changes of physical fitness tests over the course of a three-year period. A secondary data analysis design was used to evaluate the long-term effects of an adapted physical education program on physical fitness components of the participants. Forty-four students (age, 15.9 ± 0.4 years) with intellectual disabilities were included in this study. A series of repeated measures ANOVA revealed significant positive outcomes over time in body composition, muscular endurance, explosive strength, flexibility, and cardiovascular fitness. The findings were mixed, as the participants performed better in muscular strength/endurance and cardiovascular fitness by Year Three. However, participants had lower scores in body composition and flexibility. Additional research is needed to explore the factors affecting physical fitness of students with intellectual disabilities by APE programs.
Abstractor: As Provided
Entry Date: 2022
Accession Number: EJ1356375
Database: ERIC
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  Value: <anid>AN0157908525;54q01jul.22;2022Jul13.01:57;v2.2.500</anid> <title id="AN0157908525-1">The Impact of Adapted Physical Education on Physical Fitness of Students with Intellectual Disabilities: A Three-year Study </title> <p>The purpose of this study was twofold: (<reflink idref="bib1" id="ref1">1</reflink>) to examine the effect of an adapted physical education (APE) program on physical fitness of adolescents with intellectual disabilities, and (<reflink idref="bib2" id="ref2">2</reflink>) to investigate the associations between the changes of physical fitness tests over the course of a three-year period. A secondary data analysis design was used to evaluate the long-term effects of an adapted physical education program on physical fitness components of the participants. Forty-four students (age, 15.9 ± 0.4 years) with intellectual disabilities were included in this study. A series of repeated measures ANOVA revealed significant positive outcomes over time in body composition, muscular endurance, explosive strength, flexibility, and cardiovascular fitness. The findings were mixed, as the participants performed better in muscular strength/endurance and cardiovascular fitness by Year Three. However, participants had lower scores in body composition and flexibility. Additional research is needed to explore the factors affecting physical fitness of students with intellectual disabilities by APE programs.</p> <p>Keywords: Adolescents; curriculum; exercise; physical activity; school-based programme; secondary data analysis; special education; Taiwan</p> <hd id="AN0157908525-2">Introduction</hd> <p>Over the last two decades, there has been an increased emphasis physical activity and physical fitness for people with intellectual disabilities (IDs) (Hassan, Landorf, Shields, & Munteanu, [<reflink idref="bib21" id="ref3">21</reflink>]; Kapsal et al., [<reflink idref="bib26" id="ref4">26</reflink>]; Pérez-Cruzado & Cuesta-Vargas, [<reflink idref="bib42" id="ref5">42</reflink>]; Wallén, Müllersdorf, Christensson, & Marcus, [<reflink idref="bib61" id="ref6">61</reflink>]). Several studies have demonstrated that regardless of age, individuals with IDs typically lead sedentary lifestyles, have lower physical activity levels, and have higher rates of being overweight and obese compared to their peers without disabilities (Chow, Choi, & Huang, [<reflink idref="bib10" id="ref7">10</reflink>]; Hinckson & Curtis, [<reflink idref="bib22" id="ref8">22</reflink>]; Pan, Davis, Nichols, Hwang, & Hsieh, [<reflink idref="bib40" id="ref9">40</reflink>]; Sundahl, Zetterberg, Wester, Rehn, & Blomqvist, [<reflink idref="bib56" id="ref10">56</reflink>]). Haegele, Foley, Healy, and Paller ([<reflink idref="bib19" id="ref11">19</reflink>]) analysed data from National Survey of Children's Health, and found that adolescents with IDs had some of the highest levels of being identified as being overweight (53.6%). In addition, Pan et al. ([<reflink idref="bib40" id="ref12">40</reflink>]) reported that approximately 30% of adolescents with IDs had regular physical activity habits in Taiwan. Another study reported that only eight percent of this population were getting the recommended amount of exercise per week according to Taiwan's national physical activity standards (30 minutes a day, 3 times a week) (Lin et al., [<reflink idref="bib31" id="ref13">31</reflink>]).</p> <p>It is also well-established that many individuals with IDs have lower physical fitness, including lower cardiovascular fitness, poor muscular strength, and unhealthy weight, when compared to their able-bodied peers (Baran et al., [<reflink idref="bib3" id="ref14">3</reflink>]; Frey & Chow, [<reflink idref="bib17" id="ref15">17</reflink>]; Lahtinen, Rintala, & Malin, [<reflink idref="bib29" id="ref16">29</reflink>]; Oppewal, Hilgenkamp, van Wijck, & Evenhuis, [<reflink idref="bib39" id="ref17">39</reflink>]; Salaun & Berthouze-Aranda, [<reflink idref="bib49" id="ref18">49</reflink>]; Ślężyńska, Mięsok, & Mięsok, [<reflink idref="bib54" id="ref19">54</reflink>]; Sundahl et al., [<reflink idref="bib56" id="ref20">56</reflink>]). For example, Pan et al. ([<reflink idref="bib40" id="ref21">40</reflink>]) retrieved health records from 7 to 18 year-olds with IDs (<emph>n</emph> = 1936) in 10 special education schools in Taiwan to examine the prevalence of obesity in this population across ages. Obesity rates rose throughout their time in schools. For example, students with ID in primary school were significantly less likely to be obese than compared to students with ID in high school. In addition, Pan, Liu, Chung, and Hsu ([<reflink idref="bib41" id="ref22">41</reflink>]) noted lower physical activity levels during school hours in adolescents with IDs than in their peers without disabilities, especially for those placed in the self-contained special education setting. Accumulation of physical activity at school may reach up to 50% of their daily physical activity during physical education classes and school recesses in both genders for adolescents with IDs (Queralt, Vicente-Ortiz, & Molina-García, [<reflink idref="bib47" id="ref23">47</reflink>]). Research has also suggested that these health disparities, such as lower physical activity levels and obesity, increase as people with IDs reach adulthood, and continue to be exaggerated with age (Lahtinen et al., [<reflink idref="bib29" id="ref24">29</reflink>]; Lin et al., [<reflink idref="bib31" id="ref25">31</reflink>]; Peterson, Janz, & Lowe, [<reflink idref="bib44" id="ref26">44</reflink>]; Ślężyńska et al., [<reflink idref="bib54" id="ref27">54</reflink>]). Studies suggest that limited intellectual functioning may hinder physical fitness development from early years to adulthood (Lahtinen et al., [<reflink idref="bib29" id="ref28">29</reflink>]; Ślężyńska et al., [<reflink idref="bib54" id="ref29">54</reflink>]; Wu et al., [<reflink idref="bib69" id="ref30">69</reflink>]). Thus, a quality physical education for children and adolescents with IDs may help mitigate this trend and lead them to being more physically active.</p> <p>Physical education is an important academic subject that 'provides students with a planned, sequential, standards-based programme of curricula and instruction designed to develop motor skills, knowledge and behaviours for active living, physical fitness, sportsmanship, self-efficacy, and emotional intelligence' (Society of Health and Physical Educators, [<reflink idref="bib55" id="ref31">55</reflink>]). Specially designed physical education, which is commonly referred to as adapted physical education (APE), is a service that is best described as the development and implementation of a specially-designed physical education programme that meets a student with a disability's unique needs (McNamara & Pan, [<reflink idref="bib34" id="ref32">34</reflink>]; Sherrill, [<reflink idref="bib52" id="ref33">52</reflink>]). APE has the same goals and objectives as physical education; however, the importance and precedence of those same goals and objectives should vary and be based on a student with a disability's needs.</p> <p>An APE programme could improve physical activity levels and physical fitness outcomes for students with IDs, as it has been repeatedly demonstrated that being involved early in physical activity experiences (e.g., sport) may be associated with a higher probability of physical activity levels in later life (Telama, Yang, Laakso, & Viikari, [<reflink idref="bib58" id="ref34">58</reflink>]; Yang, Telama, Leino, & Viikari, [<reflink idref="bib70" id="ref35">70</reflink>]). In particular, organised sports participation has to lead to greater participation in being physically active (Perkins, Jacobs, Barber, & Eccles, [<reflink idref="bib43" id="ref36">43</reflink>]). Hence, implementing quality APE programmes may be able to combat health disparities and increase physical activity levels, physical-fitness, and overall health throughout a lifespan for people with IDs (Dobbins, Husson, DeCorby, & LaRocca, [<reflink idref="bib15" id="ref37">15</reflink>]).</p> <p>Positive health-related outcomes that have been associated with specially designed physical activity programmes include reduced risks of chronic diseases (e.g., obesity, hypertension) and improved muscular strength and cardiovascular capacity (Davis, Zhang, & Hodson, [<reflink idref="bib14" id="ref38">14</reflink>]; Kapsal et al., [<reflink idref="bib26" id="ref39">26</reflink>]; Wallén et al., [<reflink idref="bib61" id="ref40">61</reflink>]; Wu et al., [<reflink idref="bib69" id="ref41">69</reflink>]). In a school context, improvement in cardiovascular fitness, sit-and-reach, muscular strength, and endurance have also been observed (e.g., Wallén et al., [<reflink idref="bib61" id="ref42">61</reflink>]). Although there appears to be many benefits to specially designed physical activity and APE programmes for students with ID, there is often non-significant changes to Body Mass Index (BMI) observed (Davis et al., [<reflink idref="bib14" id="ref43">14</reflink>]). In addition, few studies have evaluated the long-term effects of an exercise programme on people with IDs' health and physical fitness, with even less research devoted to the impacts of APE programmes on this population (Hassan et al., [<reflink idref="bib21" id="ref44">21</reflink>]). Preliminary research, mostly observational research (e.g., Davis et al., [<reflink idref="bib14" id="ref45">14</reflink>]; Wallén et al., [<reflink idref="bib61" id="ref46">61</reflink>]; Wu et al., [<reflink idref="bib69" id="ref47">69</reflink>]) has focused on how exercise programmes affect health-related outcomes (e.g. body fat, cardiovascular fitness) for children and adolescents with IDs over a relatively short period of time (i.e., eight weeks to less than six months). However, it is unknown to the extent a long-term physical activity programme would impact health-related outcomes for this population.</p> <p>While some literature (e.g., Lahtinen et al., [<reflink idref="bib29" id="ref48">29</reflink>]; Wallén et al., [<reflink idref="bib61" id="ref49">61</reflink>]) has focused on how physical fitness may change over time for people with IDs, there is still a dearth of empirical research on the long-term effects of school-based APE programmes on the physical fitness of students with IDs. Thus, the purpose of this study was twofold: (<reflink idref="bib1" id="ref50">1</reflink>) to examine the effect of a structured APE programme on physical fitness of adolescents with IDs, and (<reflink idref="bib2" id="ref51">2</reflink>) to investigate the underlying associations between the changes of physical fitness tests over the course of a three-year period.</p> <hd id="AN0157908525-3">Methods</hd> <p></p> <hd id="AN0157908525-4">Study Design</hd> <p>The present study was conducted in collaboration with a Taiwanese special education high school for students with IDs between the ages of 15 to 18 years old, to examine the physical fitness profile across a three-year APE programme. After the school approval letter to conduct the research was granted, we employed a secondary data analysis for the existing school record to conduct 3-point data retrieval for a time-series design. One of the advantages to adopt the secondary analysis was to investigate some other purposes different from the initial intention (Portney & Watkins, [<reflink idref="bib46" id="ref52">46</reflink>]). This school physical fitness outcomes were to report for parents of their children with ID during the individualised education plan (IEP) meetings.</p> <hd id="AN0157908525-5">Participants</hd> <p>Fifty-seven students with IDs were initially included in the dataset. All participants had a diagnosis of IDs from trained physicians or by qualified educational psychologists. Severity ratings of IDs were categorised into four distinct categories based on their intelligence quotient and adapted behaviour performance (e.g., real-life skills, following school rules): (a) mild (<emph>n</emph> = 4), (b) moderate (<emph>n</emph> = 31), (c) severe (<emph>n</emph> = 18), and (d) profound (<emph>n</emph> = 4) (American Psychiatric Association, [<reflink idref="bib1" id="ref53">1</reflink>]; Ministry of Health and Welfare, [<reflink idref="bib36" id="ref54">36</reflink>]). The following inclusion and exclusion criteria were specified for further data retrieval and analysis: (<reflink idref="bib1" id="ref55">1</reflink>) active enrolment in the school from Year One (Y1) to Year Three (Y3) and (<reflink idref="bib2" id="ref56">2</reflink>) official diagnosis of IDs with severity levels at a mild to severe level, and (<reflink idref="bib3" id="ref57">3</reflink>) did not have any physical disabilities (e.g., cerebral palsy). Finally, thirteen students (22.8%) of students with IDs in the participating school were excluded, according to the above-mentioned criteria. Forty-four students (boys: 28, girls: 16, <emph>M</emph> = 15.9 ± 0.4 in the year of enrolment) were further sub-grouped (see APE programme for details).</p> <p>Individuals with missing data in one or more fitness variables were retained in the study. For example, if a student missed the height or weight measurement in Y1, but completed the remaining the fitness items (e.g., standing long jump) in Y1, as well as the other items in Y2 and Y3, this participant was still included. Table 1 provides an overview of the demographic information of the participants. The results showed that height was the only significant difference between the genders before the start of the APE programme at the beginning of Y1.</p> <p>Table 1. Demographic data of participants between genders.</p> <p> <ephtml> <table><thead><tr><td /><td>Male (n = 28)</td><td>Female (n = 16)</td><td>Total (n = 44)</td></tr></thead><tbody><tr><td>Age (First year of enrolment)</td><td>15.9 ± 0.5</td><td>15.9 ± 0.3</td><td>15.9 ± 0.4</td></tr><tr><td>Height (cm)</td><td>160.7 ± 11.4</td><td>153.0 ± 6.3</td><td>158.2 ± 10.3*</td></tr><tr><td>Weight (kg)</td><td>62.3 ± 18.0</td><td>56.5 ± 11.1</td><td>60.2 ± 16.0</td></tr><tr><td>BMI</td><td>23.8 ± 5.5</td><td>24.0 ± 5.9</td><td>23.9 ± 5.6</td></tr><tr><td>Weight status</td><td /><td /><td /></tr><tr><td>Non-OW/OB</td><td>13 (53.6%)</td><td>6 (37.5%)</td><td>19 (43.2%)</td></tr><tr><td>OW/OB</td><td>15 (56.5%)</td><td>10 (62.5%)</td><td>25 (56.8%)</td></tr><tr><td>Comorbidity</td><td /><td /><td /></tr><tr><td>Only ID</td><td>19 (67.9%)</td><td>15 (93.8%)</td><td>34 (77.3%)</td></tr><tr><td>DS</td><td>3 (10.7%)</td><td>0</td><td>3 (6.8%)</td></tr><tr><td>ASD</td><td>6 (21.4%)</td><td>1 (6.3%)</td><td>7 (15.9%)</td></tr><tr><td>Levels of ID</td><td /><td /><td /></tr><tr><td>Mild</td><td>3 (10.7%)</td><td>1 (6.3%)</td><td>4 (10.0%)</td></tr><tr><td>Moderate</td><td>15 (53.6%)</td><td>12 (75.2%)</td><td>27 (61.3%)</td></tr><tr><td>Severe</td><td>10 (35.7%)</td><td>3 (18.8%)</td><td>13 (29.5%)</td></tr></tbody></table> </ephtml> </p> <p>1 * = p <.05. BMI = Body mass index; OW/OB = Overweight/obese; ID = Intellectual disabilities; DS = Down syndrome, ASD = Autism spectrum disorders.</p> <hd id="AN0157908525-6">Adapted Physical Education Programme</hd> <p>After receiving the agency approval letter, the primary researcher received the dataset of three-year physical fitness records, from Section Chief of Physical Education from the school, with the identities (student card numbers and names) of the students masked to protect their confidentiality. Students were further grouped into three separate APE classes. Placement decisions were made by the school APE curriculum committee, which comprised of special education teachers and campus health professionals (i.e., nurse, physical, and occupational therapist). Each APE class ranged between 7 to 22 students with IDs, with grouping decisions being based on students' overall intellectual functioning, fundamental movement skills, and adaptive behaviours with physical education. For example, a smallest group of approximately eight students with more severe disabilities would be placed in one class, while a mid-size subgroup may contain between 12 to 17 students with moderate disabilities, and a larger group may have 18 to 22 students with mild to moderate disabilities. The teaching contents of the APE programme were also developed by the school APE committee and were based on the Curricular Development Plan and the governmental special education guidelines. The flow chart in Figure 1 depicts the teaching contents for each semester and the timing for data retrieval as well as how the APE programme was implemented.</p> <p>PHOTO (COLOR): Figure 1. Descriptions of the APE program.</p> <p>The certified special education teachers were assigned to teach APE courses if they had physical education related background and/or training (e.g., physical education degree, Special Olympics sports coaching certificates, and/or participation in related APE workshops). Each semester was 20 weeks in duration, with each class receiving 50-minute APE sessions twice a week.</p> <hd id="AN0157908525-7">Data Collection</hd> <p>Each student was assessed for five fitness-testing items (i.e., body composition, explosive strength, muscular strength, flexibility, and cardiovascular fitness) two-times per semester (fall and spring term) over a three-year period. The five testing items were assessed during a one-week period in the beginning (1<sups>st</sups> week) of the fall semester and reassessed again at the end (20<sups>th</sups> week) of the same semester. This was repeated each semester for three years. However, the data collected at the end of the 2<sups>nd</sups> semester of Y3 was dropped due to students' frequent absences, which was in large part due to a conflicting internship for vocational preparation that was also a part of many students' individualised curriculum.</p> <p>As noted in the protocol of fitness testing items, all assessments should be conducted by teachers who had related physical education backgrounds, assisted by health professionals (e.g., nurses, and physical/occupational therapists) following the government fitness testing guideline to ensure the validity of the test results (Ministry of Education [MOE], [<reflink idref="bib35" id="ref58">35</reflink>]). Before administering the assessments for each semester, debriefing the assessment procedures for teachers and familiarisation sessions for students with IDs were conducted by the lead teacher. All test components were explained and demonstrated by their teacher. In addition, the teachers checked for understanding (e.g., catechetical teaching, demonstration) prior to the students performing the test item. Each participant completed the fitness tests individually in their typical APE class setting. The APE teachers was allowed to verbally encourage them to their maximum efforts, but was not allowed to physically assist during tests. One teacher and one support personnel (e.g., physical therapist) administered the fitness tests.</p> <p>As recommended by Ministry of Education (Ministry of Education [MOE], [<reflink idref="bib35" id="ref59">35</reflink>]), the fitness test items included the estimation of body composition, using weight (kg) and height (m) measurement for body mass index (BMI) computed by kg/m<sups>2</sups>, standing long jump for muscular strength, one-minute sit-ups for muscular endurance, sit-reach for flexibility, and a progressive aerobic cardiovascular endurance run test (PACER) performed through 20-m shuttle run for cardiovascular endurance measurement.</p> <p>For weight and height measurement, participants were instructed to take off unnecessary clothes and accessories, and then to step on an automatic height and weighting scale with bare feet. The calculated BMI values were checked to exclude unreasonable values (i.e., a BMI above or below five standard deviations (SD) of the BMI mean, following the statistical analysis guideline from WHO Child Growth Standard for SPSS (World Health Organization [WHO], [<reflink idref="bib65" id="ref60">65</reflink>], [<reflink idref="bib63" id="ref61">63</reflink>]). The results showed that there were no cases excluded. The BMI values were then transferred to suitable ranges of percentile charts and classified into two weight status categories, that is, the non-overweight and obese (underweight/normal weight), and the overweight/obese group according to the sex and age-appropriate references in the new growth charts for Taiwanese children and adolescents (Chen & Chang, [<reflink idref="bib9" id="ref62">9</reflink>]).</p> <p>Muscular strength was measured by a standing long jump (cm) test. Students stood behind a line with their feet apart in a normal distance. Knees bended with their arms swinging provided a force forward. They attempted to jump as far as possible, landing on two feet on a measuring mat. One practice and two attempts were allowed and the better trial was recorded. A tally of one-minute sit-ups was used to measure muscular endurance of abdominal muscles. Participants laid down on a mat with arms placed in a crossed position over the chest and both feet bent at about a 90 degree angle. A partner assisted to hold the angles to stabilise the body. When starting the sit-ups, participants did as many as possible in one minute. Each sit-up was counted if the participant's elbows touch the thigh. The sit-reach test was used to assess the participants' flexibility. Participants began by sitting on a mat barefoot, with both legs fully extended against a sit-reach measure scale, where 25 cm was at the level of the feet. Participants were instructed to extend their arms and to reach with fingertips forward as far as they could for two seconds. Two attempts were allowed. The better performance of two attempts was recorded to the nearest centimetre. Finally, the PACER test measured cardiovascular fitness and required participants to run 20-m lengths back and forth at a specified pace. The final score during the PACER testing is the number of lap completed after participants failed to run 20 m two consecutive times. All the above discussed fitness test items have been widely used in people with IDs (e.g., Frey & Chow, [<reflink idref="bib17" id="ref63">17</reflink>]; Hartman, Smith, Westendorp, & Visscher, [<reflink idref="bib20" id="ref64">20</reflink>]; Lahtinen et al., [<reflink idref="bib29" id="ref65">29</reflink>]; Salaun & Berthouze-Aranda, [<reflink idref="bib49" id="ref66">49</reflink>]).</p> <hd id="AN0157908525-8">Data Analysis</hd> <p>The analysis used the SPSS 23.0 statistical software package (IBM Corp, [<reflink idref="bib24" id="ref67">24</reflink>]). First, descriptive statistics were computed for demographic data. Second, five repeated measure ANOVA were used to detect significant differences among the five fitness items. A Bonferroni post hoc analysis identified any group differences across the three-point records. Partial eta squared (η<sups>2</sups>p) was used to estimate the magnitude and practical significance and interpreted using the following criteria: small (η<sups>2</sups>p < 0.06), medium (0.06 ≤ η<sups>2</sups>p < 0.14), large (η<sups>2</sups>p ≥ 0.14) (Cohen, [<reflink idref="bib11" id="ref68">11</reflink>]). Pearson product-moment correlations were used to identify correlations among areas of improvement of physical fitness levels to evaluate effects between Y1 and Y3 of the APE programme. Age, gender, and ID level were controlled using partial correlations. Statistical significance was set at <emph>p</emph> <.05.</p> <hd id="AN0157908525-9">Results</hd> <p>Among the physical fitness variables, ANOVA found BMI (<emph>p</emph> =.01), standing long jump (<emph>p</emph> =.001), one-minute sit-ups (<emph>p</emph> =.024), sit-and-reach (<emph>p</emph> =.002), and PACER (<emph>p</emph> <.001) to differ significantly across the school years. Furthermore, the effect sizes of partial η<sups>2</sups> (range from.173 to.512) all suggested major practical significance. Table 2 also shows a post hoc analysis and the details of comparisons of mean averages in physical fitness across the time series. In general, improvement in fitness outcomes (standing long jump, one-minute sit-ups, and PACER) was observed; however, there was an overall limited success in the BMI and sit-and-reach items by Y3. It is worth noting that the BMI appeared to be stable but with large deviations across the three years, and the post hoc analysis showed an increase in BMI in Y3 based on mean differences of the pairwise comparisons.</p> <p>Table 2. Comparison of physical fitness variables across time periods.</p> <p> <ephtml> <table><thead><tr><td>Variables</td><td>Year one</td><td>Year two</td><td>Year three</td><td>W</td><td><italic>p</italic></td><td>df</td><td>Pillai's Trace</td><td>F</td><td><italic>p</italic></td><td>Partial η<sup>2</sup></td><td>Post hoc</td></tr></thead><tbody><tr><td>BMI <italic>n</italic> = 44</td><td>23.9 ± 5.6</td><td>24.4 ± 6.2</td><td>24.6 ± 6.0</td><td>.797</td><td>.009</td><td>2, 42</td><td>.195</td><td>5.09</td><td>.010</td><td>.195</td><td>Y3 > Y1 Y2 > Y1</td></tr><tr><td>Standing long jump (cm) <italic>n</italic> = 37</td><td>91.2 ± 42.6</td><td>101.7 ± 40.0</td><td>112.7 ± 47.8</td><td>.793</td><td>.017</td><td>2, 35</td><td>.338</td><td>8.94</td><td>.001</td><td>.338</td><td>Y3 > Y1 Y3 > Y2</td></tr><tr><td>One-minute sit-ups <italic>n</italic> = 41</td><td>19.0 ± 7.6</td><td>19.02 ± 7.7</td><td>21.2 ± 9.2</td><td>.954</td><td>.396</td><td>2, 39</td><td>.173</td><td>4.09</td><td>.024</td><td>.173</td><td>Y3 > Y1</td></tr><tr><td>Sit-and- reach (cm) <italic>n</italic> = 40</td><td>23.7 ± 9.4</td><td>19.2 ± 10.5</td><td>20.2 ± 9.0</td><td>.930</td><td>.250</td><td>2, 38</td><td>.286</td><td>7.60</td><td>.002</td><td>.286</td><td>Y3 < Y1 Y2 < Y1</td></tr><tr><td>PACER (laps) <italic>n</italic> = 36</td><td>13.5 ± 6.8</td><td>18.3 ± 10.7</td><td>20.3 ± 10.8</td><td>.839</td><td>.051</td><td>2, 34</td><td>.499</td><td>16.92</td><td><.001</td><td>.512</td><td>Y3 > Y1 Y2 > Y1</td></tr></tbody></table> </ephtml> </p> <p>2 cm = Centimetre; BMI = Body Mass Index; PACER = Progressive aerobic cardiovascular endurance run. W = Mauchly's W, df = Degrees of freedom, Partial η<sups>2</sups> = Effect size, Post hoc = Significance between post hoc mean differences.</p> <p>Pearson correlation coefficients and improvement of physical fitness (e.g., mean difference and standard deviations) were calculated for each physical fitness component between Y1 and Y3 (see Table 3). The only positive correlation observed was between the standing long jump (explosive strength) and one-minute sit-ups (muscular endurance) (r =.51, <emph>p</emph> =.004). Three negative correlations were found between BMI and the rest of the fitness variables, standing long jump (r = −.41, <emph>p</emph> =.02), one-minute sit-ups (r = −.37, <emph>p</emph> =.04), and PACER (r = −.41, <emph>p</emph> =.02) except for sit-reach, with a list-wise deletion process (<emph>n</emph> = 33) controlling for age, gender, and ID level. Between Y1 and Y3, the greater the change in the standing long jump, the higher the likelihood that the one-minute sit-up performance was improved. At Y3 there were overall improvements with the standing long jump, one-minute sit-ups, and PACER items.</p> <p>Table 3. Correlations of improvement of physical fitness variables between Year one and Year three.</p> <p> <ephtml> <table><thead><tr><td><italic>n</italic> = 33</td><td>BMI</td><td>Standing long jump</td><td>One-minute sit-ups</td><td>Sit-and-reach</td><td>PACER</td></tr></thead><tbody><tr><td>BMI</td><td>1</td><td>-</td><td>-</td><td>-</td><td>-</td></tr><tr><td>Standing long jump</td><td>−.41*</td><td>1</td><td>-</td><td>-</td><td>-</td></tr><tr><td>One-minute sit-ups</td><td>−.37*</td><td>.51*</td><td>1</td><td>-</td><td>-</td></tr><tr><td>Sit-and-reach</td><td>−.30</td><td>.07</td><td>−.11</td><td>1</td><td>-</td></tr><tr><td>PACER</td><td>−.41*</td><td>.16</td><td>.03</td><td>.17</td><td>1</td></tr><tr><td>Mean Diff. (SD)</td><td>.72 (1.62)</td><td>27.97 (28.13)</td><td>2.33 (5.27)</td><td>−3.39 (8.01)</td><td>7.03 (6.98)</td></tr></tbody></table> </ephtml> </p> <p>3 * p <.05. BMI = body mass index; PACER = progressive aerobic cardiovascular endurance run; The mean difference and standard deviation were computed based on a list-wise analysis. Correlation analyses was performed, controlling for age, gender, and intellectual disability level.</p> <hd id="AN0157908525-10">Discussion</hd> <p>The purpose of this study was twofold: (<reflink idref="bib1" id="ref69">1</reflink>) to examine the effect of a structured APE programme on physical fitness of adolescents with IDs, and (<reflink idref="bib2" id="ref70">2</reflink>) to investigate the underlying associations between the changes of physical fitness tests over the course of a three-year period. There is a limited amount of research that has shown that structured exercise programmes benefit health-related outcomes for children and adolescents with IDs (Li. et al., [<reflink idref="bib30" id="ref71">30</reflink>]; Wong et al., [<reflink idref="bib64" id="ref72">64</reflink>]); however, there is even less literature to support the role APE programmes may play in improving health-related outcomes for this population. The results of this study were mixed, as overall the participants performed at a significantly higher level in muscular strength/endurance and cardiovascular fitness over time, but also had poorer BMI and flexibility levels.</p> <p>Our findings are in line with those of Wallén et al. ([<reflink idref="bib61" id="ref73">61</reflink>]), which also examined a school-based multiple component intervention among similar aged students with ID, and showed that improved cardiovascular fitness could be observed two years afterwards. The distinction between the two studies is that Wallén's programme also offered healthy food in school while our study did not control or monitor the students' nutrition and food in-take. Furthermore, our findings are also consistent with those of several studies examining short-term interventions (e.g., Calders et al., [<reflink idref="bib5" id="ref74">5</reflink>]; Davis et al., [<reflink idref="bib14" id="ref75">14</reflink>]) and evaluating BMI before and after an exercise programme, in that we likewise found limited success in maintaining a healthy weight. Despite the fact that the post hoc analysis showed the statistical mean differences in BMI (Y3 > Y1 and Y2 > Y1), we should carefully interpret with caution due to large standard deviations concurrently (see Table 2). Instead, we may see this as a long-term pattern of a difficulty of weight management to reduce BMI or maintaining a healthy weight status, as shown in other studies with the similar study population (e.g., Calders et al., [<reflink idref="bib5" id="ref76">5</reflink>]; Davis et al., [<reflink idref="bib14" id="ref77">14</reflink>]; Kapsal et al., [<reflink idref="bib26" id="ref78">26</reflink>]; Pan et al., [<reflink idref="bib40" id="ref79">40</reflink>]). Again, although the findings from the present study were promising, the APE programme as a standalone intervention was not enough to change most of the participants' BMI weight classification. It should be noted, though, that being overweight and/or obesity may not hamper the development of physical fitness in youth with IDs until adolescence (Frey & Chow, [<reflink idref="bib17" id="ref80">17</reflink>]). During puberty, we have acknowledged that the muscle mass gain and height growth is a common physical bodily process in adolescence. However, with an increase in BMI and more students with IDs becoming overweight and obese in later adolescence (Pan et al., [<reflink idref="bib40" id="ref81">40</reflink>]), the present study support the notion that changes in BMI may have a significant negative association with the change in one-minute sit-ups and PACER at this age. The difficulty in reducing BMI in adolescents with IDs may be attributable to poorer fundamental movement skills and to a severe intellectual disability level (Maïano, Hue, & April, [<reflink idref="bib33" id="ref82">33</reflink>]; Wu et al., [<reflink idref="bib69" id="ref83">69</reflink>]), consistent with lower physical fitness (Foley, Harvey, Chun, & Kim, [<reflink idref="bib16" id="ref84">16</reflink>]). Our study sample included 30% of those with severe IDs, which may suggest that this group may experience more difficulties with weight loss.</p> <p>It is important to note that the results of evaluating body composition were solely based on participants' BMI values. The use of BMI and waist circumference has been recommended and mostly used for individuals with IDs (Casey, [<reflink idref="bib7" id="ref85">7</reflink>]; Temple, Walkley, & Greenway, [<reflink idref="bib59" id="ref86">59</reflink>]) and can be measured feasible and reliable in adolescents with moderate to severe IDs (Wouters, van der Zanden, Evenhuis, & Hilgenkamp, [<reflink idref="bib68" id="ref87">68</reflink>]). As the current sample were adolescents, which is an age that often sees great body composition variation and weight gain, strategies were put in place to reduce interpretation biases related to the use of BMI measures, the age and sex-matched reference values in the growth charts for Taiwanese children and adolescents were used as cut-off for different weight statuses in the present study (Chen & Chang, [<reflink idref="bib9" id="ref88">9</reflink>]). BMI was not considered best and a direct measure to estimate body composition (e.g., fat-free mass) because BMI itself was not capable of discriminating fat mass and fat-free mass (O'Neill, [<reflink idref="bib38" id="ref89">38</reflink>]), and was not likely to accurately evaluate body composition on people with Down's syndrome (Bandini, Fleming, Scampini, Gleason, & Must, [<reflink idref="bib2" id="ref90">2</reflink>]). The alternative methods such as plicometry and waist circumference measure, could be very low cost to estimate body fat. When used in a school setting, it should not be ignored that the plicometry should be executed by an experienced health professional or a clinical practitioner to avoid inaccurate results (Casey, [<reflink idref="bib7" id="ref91">7</reflink>]; Castro-Sanchez, Valenzuela-Rubio, & Vergara-Jimenez, [<reflink idref="bib8" id="ref92">8</reflink>]).</p> <p>The level of aerobic fitness in individuals with IDs was considered low when compared to peers with disabilities (Hinckson & Curtis, [<reflink idref="bib22" id="ref93">22</reflink>]; Sundahl et al., [<reflink idref="bib56" id="ref94">56</reflink>]), and has been reported to decline with age (Oppewal et al., [<reflink idref="bib39" id="ref95">39</reflink>]). A recent meta-analysis concluded that physical activity interventions yielded a large effect on physical health (reaction time, flexibility, movement/sport skills, cardiovascular fitness, and muscular strength/endurance) and a moderate to large effect on psychosocial benefits (e.g., self-concept, efficacy), but not found these effect sizes of the physical health outcomes associated with BMI, in youth and adolescents with IDs (Kapsal et al., [<reflink idref="bib26" id="ref96">26</reflink>]). This investigation suggests that physical fitness can be improved and was in line with the results of our study, which leads us to believe in the benefits of the long-term involvement of an APE programme. Again, physical fitness improvement may be based on the quality of an individual's fundamental movement skills (Collins & Staples, [<reflink idref="bib12" id="ref97">12</reflink>]; Foley et al., [<reflink idref="bib16" id="ref98">16</reflink>]; Maïano et al., [<reflink idref="bib33" id="ref99">33</reflink>]; Wouters, Evenhuis, & Hilgenkamp, [<reflink idref="bib67" id="ref100">67</reflink>]).</p> <p>A recent review article investigating field-based physical fitness assessments for people with IDs noted that the fitness items used in the present study appeared to be recommended for youth and adolescents (Wouters, Evenhuis, et al., [<reflink idref="bib66" id="ref101">66</reflink>]), the potential effects of intellectual functioning levels on physical fitness outcomes should not be ignored (Hartman et al., [<reflink idref="bib20" id="ref102">20</reflink>]; Kapsal et al., [<reflink idref="bib26" id="ref103">26</reflink>]; Ślężyńska et al., [<reflink idref="bib54" id="ref104">54</reflink>]; Wu et al., [<reflink idref="bib69" id="ref105">69</reflink>]). Significant differences in physical performance may occur between people with various levels of IDs may naturally result from differing levels of intellectual functioning. For example, PACER is recommended for youth and adolescents with IDs (Short & Winnick, [<reflink idref="bib53" id="ref106">53</reflink>]); however, a large percentage error in the mean may result from different levels of ID (Mac Donncha, Watson, McSweeney, & O'Donovan, [<reflink idref="bib32" id="ref107">32</reflink>]), resulting in overestimated measured VO<subs>2peak</subs> (Guerra, Pitetti, & Fernhall, [<reflink idref="bib18" id="ref108">18</reflink>]). Further research is needed to examine the variances between people with differing levels of IDs on physical fitness.</p> <p>The PE curriculum in high schools with a focus on the sports-centred programme in Taiwan is recommended (MOE, [<reflink idref="bib37" id="ref109">37</reflink>]). The APE programme plans should be approved by the school APE committee before implementation. As mentioned earlier, exercise and physical activity could have large, and moderate to large effects on physical health and psychosocial variables with the current sample (Kapsal et al., [<reflink idref="bib26" id="ref110">26</reflink>]). To reach the greatest improvement in physical health, playing sports and training sports/movement skills (e.g., basketball and soccer skills training) appeared more effective and were recommended (Kapsal et al., [<reflink idref="bib26" id="ref111">26</reflink>]). In the present study, it is noteworthy that the APE programme consisted of the above-mentioned teaching units and the participation in sports twice per week. It may affect fitness to some extent but the existing dataset was not capable of providing its causality with a clear pathway due to insufficient variables available.</p> <p>The literature also suggests that physical activity levels on weekdays in adolescents with IDs were higher than during weekends (Izquierdo-Gomez et al., [<reflink idref="bib25" id="ref112">25</reflink>]). Furthermore, Queralt et al. ([<reflink idref="bib47" id="ref113">47</reflink>]) reported that adolescents with IDs attained at least half of their recommended daily physical activity while at school. This is likely due to the nature of a school environment, which promotes curriculums that help to facilitate the attainment of specific learning goals and engagement of physical activity. An additional factor likely contributing to significant physical activity differences between weekdays and weekends may be due to students with IDs experiencing more barriers to exercise, such as limited physical activity opportunities and overprotective parents, at a home environment. In order to continue to increase at school physical activity levels, APE programmes must continue to emphasise the need for exercise during school time, as well as promote parents and individuals with ID to continue to be physically active outside of school.</p> <p>That being said, schools must implement high-quality APE. The Achievement-Based Curriculum (ABC) model (Kelly & Melograno, [<reflink idref="bib27" id="ref114">27</reflink>]) provides a systematic mapping process of five integrated components underscoring its importance of the entire implementation. Using the ABC model is considered relevant to guide APE educators to effectively teach students with disabilities in physical education (Block, [<reflink idref="bib4" id="ref115">4</reflink>]). The five components are programme planning, assessment, implementation planning, teaching, and evaluation. Programme planning is a top-down approach to clearly define local constraints (e.g., participant's characteristics, programme goal emphasis, class size, facilities) and the programme goal emphasis. An APE programme should emphasise that students with disabilities meet physical activity guidelines and develop the motor skills needed to engage in physical activity for a lifetime. Hutzler and Korsensky ([<reflink idref="bib23" id="ref116">23</reflink>]) suggested that improved physical fitness and sport-specific skills may play a critical role in improving self-efficacy towards engaging in community-based sports among individuals with IDs. The assessment portion of the ABC model encourages APE teachers to document and analyse students' present levels of academic achievement and functional performance (PLAAFP), such as their abilities and needs in a physical education setting. Implementation planning sets up goals and objectives related to PLAAFP is documented in a student's IEP. The next step of the ABC model, teaching, directs APE teachers to manage the learning environment in order for students to master their learning contents. Peer-tutoring and differentiated instruction has been noted as evidence-based practices that can be used with students with ID to enable them to meet their fullest potential (Hutzler & Korsensky, [<reflink idref="bib23" id="ref117">23</reflink>]; Sands, Kulinna, van der Mars, & Dorantes, [<reflink idref="bib50" id="ref118">50</reflink>]; van Munster, Lieberman, & Grenier, [<reflink idref="bib60" id="ref119">60</reflink>]). Finally, the evaluation component allows APE teachers to determine if the goals and objectives set up for students' IEP and programme goal emphasis are successfully achieved. The ABC model, as a procedural guide can be used to formulate an APE curriculum for all levels of physical education and make APE outcomes more insightful rather than just in the fitness outcomes aspects.</p> <p>Health-related outcomes and students with disabilities attainment of the physical education curriculum is also influenced not only by the five integrated components of the ABC model, but also by professional knowledge and practice of teachers (Rimmer, Riley, Wang, Rauworth, & Jurkowski, [<reflink idref="bib48" id="ref120">48</reflink>]). One major flaw with this study is that the teachers leading the APE programmes were special educators with limited training and expertise in APE. Training in APE is imperative for APE teachers, as they need a full understanding of the physical education curriculum, how to properly modify and adapt instruction specific to physical education, and how to develop individualised education programmes that enable them to attain the physical education curriculum (McNamara & Pan, [<reflink idref="bib34" id="ref121">34</reflink>]; Sherrill, [<reflink idref="bib52" id="ref122">52</reflink>]). Although it is problematic that the teachers in this study had limited training with regards to APE, this is likely not atypical (Kwon, [<reflink idref="bib28" id="ref123">28</reflink>]). In the United States, Piletic and Davis ([<reflink idref="bib45" id="ref124">45</reflink>]) surveyed 136 US PETE faculty that taught the Introduction to APE course. Piletic and Davis aimed 'to describe the course profile, course content, mechanism of delivery, and the application of teacher standards on content for the Introduction to APE course' (p. 27). The vast majority (69%) of physical education teacher training programmes represented in this survey offered only one course in APE. Furthermore, the content areas that were identified as a major emphasis within the courses included disability (72%), instructional and motivational strategies (70%), and modifications (70%). These results indicated that the general content of the introduction to APE course focused primarily on disability specific content, with less time spent on content related to motor development which is pertinent to effectively impacting students with disabilities health-related outcomes. It has also been noted that although introductory APE courses should be considered highly valuable within the scope of preparing future physical educators (Taliaferro, Hammond, & Wyant, [<reflink idref="bib57" id="ref125">57</reflink>]), little guidance is given on how to develop and implement these courses at the college level. Thus, many physical education teacher preparation programmes are inefficiently preparing future APE teachers, especially in areas that would prepare APE teachers to improve students with disabilities health and physical fitness outcomes. Additional efforts are needed to better prepare future APE teachers to more comprehensively teach students with disabilities.</p> <hd id="AN0157908525-11">Limitations</hd> <p>The limitations of this investigation should be considered in terms of generalisability of the results. First, there were additional confounding factors (e.g., maturation, nutrition, exercise outside of class, Special Olympics) that could not be controlled for because of the nature of a longitudinal study. For example, the numbers of students with IDs associated with local Special Olympics long-term training on a regular basis outside the school were unclear; however, they may be more physically active, which suggests that our dataset may overestimate the fitness outcomes compared with the majority of students with IDs who simply received school-based PE programmes as their major source of physical activity participation. Indeed, factors contributing to improved or decreased physical fitness may be due to the interaction of the programme setting and individual characteristics. For example, approximately 30% of the study participants were diagnosed as having a severe ID, which means their intellectual functioning may potentially impact their physical fitness outcomes (Hartman et al., [<reflink idref="bib20" id="ref126">20</reflink>]; Kapsal et al., [<reflink idref="bib26" id="ref127">26</reflink>]; Ślężyńska et al., [<reflink idref="bib54" id="ref128">54</reflink>]; Wu et al., [<reflink idref="bib69" id="ref129">69</reflink>]). In addition, better fundamental movement skills and better physical fitness contributed to decrease body fat (Foley et al., [<reflink idref="bib16" id="ref130">16</reflink>]). While this study did not examine fundamental movement skills and their changes over time, these could be of significant value to the development of an APE programme. Given the limitations of this study, we should treat these findings with caution. Further research is needed to better understand on how a quality APE programme may impact the fundamental movement skills and physical fitness of students with various levels of ID (Maïano et al., [<reflink idref="bib33" id="ref131">33</reflink>]). Second, the study was an evaluation of routinely collected data, and as such, methodological issues should be noted. In particular, test errors may occur for those with moderate to profound ID (Hartman et al., [<reflink idref="bib20" id="ref132">20</reflink>]; Wouters, van der Zanden, et al., [<reflink idref="bib68" id="ref133">68</reflink>]). Participant familiarity with physical fitness assessments and discussion of test results with participants are vital for ensuring that participants understand the measurement values and implications of the test results (Seidl, [<reflink idref="bib51" id="ref134">51</reflink>]). Providing printed educational materials (e.g., sequencing pictures with simple text) may be beneficial to student-aged adolescents with IDs for a better comprehensive understanding of assessments and teaching contents during the APE programme (Wareing, [<reflink idref="bib62" id="ref135">62</reflink>]). Another related methodological issue is that this observational study could not avoid the problem of possible variations in teaching techniques and background experiences by APE teachers across the study timeline, such as differences in motivation strategies and their understanding of adapting and modifying equipment, could contribute to differing outcomes (Davis et al., [<reflink idref="bib13" id="ref136">13</reflink>]). Further research is that designs an APE intervention is needed to obtain more detailed data that accounts for these confounding and mediating variables. Finally, a third limitation was the limited sample size, especially for a correlational analysis. Further research should be conducted with larger populations and with other types of disabilities (e.g., autism, visual impairments).</p> <hd id="AN0157908525-12">Conclusion</hd> <p>For adolescents with disabilities, a school environment is an important, if not essential, venue for developing a physically active lifestyle habit (Carbonneau, Belley-Ranger, Duquette, & Roult, [<reflink idref="bib6" id="ref137">6</reflink>]; Wareing, [<reflink idref="bib62" id="ref138">62</reflink>]). Although the results of this study were mixed, this study was able to suggest that a quality APE programme could be an effective and practical setting that generates encouraging outcomes. 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  Data: The Impact of Adapted Physical Education on Physical Fitness of Students with Intellectual Disabilities: A Three-Year Study
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  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Pan%2C+Cheng-Chen%22">Pan, Cheng-Chen</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-8482-0513">0000-0001-8482-0513</externalLink>)<br /><searchLink fieldCode="AR" term="%22Mcnamara%2C+Scott%22">Mcnamara, Scott</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Disability%2C+Development+and+Education%22"><i>International Journal of Disability, Development and Education</i></searchLink>. 2022 69(4):1257-1272.
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 16
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2022
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22High+Schools%22">High Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Secondary+Education%22">Secondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Adapted+Physical+Education%22">Adapted Physical Education</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Intellectual+Disability%22">Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Students+with+Disabilities%22">Students with Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Body+Composition%22">Body Composition</searchLink><br /><searchLink fieldCode="DE" term="%22Muscular+Strength%22">Muscular Strength</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Fitness%22">Physical Fitness</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Special+Education%22">Special Education</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Special+Schools%22">Special Schools</searchLink><br /><searchLink fieldCode="DE" term="%22High+School+Students%22">High School Students</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Taiwan%22">Taiwan</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/1034912X.2020.1776851
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1034-912X<br />1465-346X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The purpose of this study was twofold: (1) to examine the effect of an adapted physical education (APE) program on physical fitness of adolescents with intellectual disabilities, and (2) to investigate the associations between the changes of physical fitness tests over the course of a three-year period. A secondary data analysis design was used to evaluate the long-term effects of an adapted physical education program on physical fitness components of the participants. Forty-four students (age, 15.9 ± 0.4 years) with intellectual disabilities were included in this study. A series of repeated measures ANOVA revealed significant positive outcomes over time in body composition, muscular endurance, explosive strength, flexibility, and cardiovascular fitness. The findings were mixed, as the participants performed better in muscular strength/endurance and cardiovascular fitness by Year Three. However, participants had lower scores in body composition and flexibility. Additional research is needed to explore the factors affecting physical fitness of students with intellectual disabilities by APE programs.
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– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2022
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  Label: Accession Number
  Group: ID
  Data: EJ1356375
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1356375
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  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/1034912X.2020.1776851
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 1257
    Subjects:
      – SubjectFull: Adapted Physical Education
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Intellectual Disability
        Type: general
      – SubjectFull: Students with Disabilities
        Type: general
      – SubjectFull: Body Composition
        Type: general
      – SubjectFull: Muscular Strength
        Type: general
      – SubjectFull: Physical Fitness
        Type: general
      – SubjectFull: Program Effectiveness
        Type: general
      – SubjectFull: Special Education
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Special Schools
        Type: general
      – SubjectFull: High School Students
        Type: general
      – SubjectFull: Taiwan
        Type: general
    Titles:
      – TitleFull: The Impact of Adapted Physical Education on Physical Fitness of Students with Intellectual Disabilities: A Three-Year Study
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            NameFull: Pan, Cheng-Chen
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            NameFull: Mcnamara, Scott
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      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 1034-912X
            – Type: issn-electronic
              Value: 1465-346X
          Numbering:
            – Type: volume
              Value: 69
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: International Journal of Disability, Development and Education
              Type: main
ResultId 1