Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy*

Henderson, Charles; Rosasco, Marcela García; Robinson, Laura M.; Meccarello, Jon; Janicki, Matthew P.; Turk, Margaret A.; Davidson, Philip W.

doi:10.1111/j.1365-2788.2009.01199.x

Cited by 40 publications

(59 citation statements)

References 43 publications

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“…Primarily, the included studies were cross-sectional observational (n = 31 81,82,98,[100][101][102]104,106,[109][110][111]114,116,119,121,124,[126][127][128][129][130][131][132][133][134][135]137,139,142,143,145 ). The remaining studies involved retrospective database or medical records data (n = 22 [83][84][85][86][87][88][89]94,95,99,107,113,115,117,118,120,122,123,136,…”

Section: Study Characteristicsmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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Section: Study Characteristicsmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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“…Uma vez que a fonoterapia não modificou favoravelmente o desempenho da biomecânica da deglutição nem o nível de ingestão oral, sugere-se que as complicações, sejam estas de origem orgânica ou intelectual encontradas nesta população, sejam discutidas como marcadores deste controle de eficácia 27,28 .…”

Section: Discussionunclassified

Ingestão Oral e Grau de Comprometimento da Disfagia Orofaríngea Neurogênica Pré e Pós-Fonoterapia

Pinto

Cola

Carvalho

et al. 2014

RNC

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Objective. To compare, pre-and post-swallowing therapy, the level of oral intake scale, and the degree of severity of neurogenic oropharyngeal dysphagia. Method. 19 patients with oropharyngeal dysphagia: 10 Post-Stroke adults, aged from 44 years to 76 years (group 1 -G1), and nine children with Cerebral Palsy, aged from two years and five months to 15 years (group 2 -G2). We excluded individuals in the process of spontaneous recovery. We held retrospective analysis of clinical protocols for clinical speech therapy evaluation with classification of the degree of dysphagia severity, applied before and after swallowing therapy. We used the Functional Oral Intake Scale -FOIS to assess the level of oral ingestion, pre and post-swallowing therapy. Results. The degree of commitment of dysphagia was favorable change only in adults, and in FOIS these changes occurred in both groups. Conclusion. There were favorable changes in the degree of impairment of oropharyngeal dysphagia and levels of FOIS, pre and post -speech therapy in stroke, but in ECINP markers used showed no favorable changes should even be reviewed for application in this population. Future studies are needed to investigate the variables in this sample.

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“…Generally speaking, physical health issues appeared to be unrelated to the type of CP; however, difficulties in motor activity and ADLs may have contributed to some of these health concerns. In some studies, gender impacted the prevalence or risk for certain comorbid physical issues, such as fragility fractures from osteopenia in women (Henderson et al, 2009). Additionally, other social determinants of health, such as ethnicity or socioeconomic status (SES), may also impact the prevalence of comorbid physical issues in individuals with CP, although these were not specifically examined in the reviewed literature.…”

Section: Chronic Physical Health Issues In Adults With Cpmentioning

confidence: 98%

“…Only one of the studies reviewed (Henderson et al, 2009) investigated physical health issues in a sample of adults with CP and ID. Although Turk, Geremski, Rosenbaum, and Weber (1997) indicated that the sample included individuals with CP and ID; the authors failed to present findings specific to individuals with CP and ID.…”

Section: Chronic Physical Health Issues In Adults With Cpmentioning

confidence: 98%

“…CP is a set of nonprogressive and heterogeneous movement disorders resulting from injury to the central nervous system early in development, primarily impacting movement and posture (Henderson et al, 2009). Given the severe motor impairments inherent to those with CP, individuals tend to experience activity limitations and difficulties in daily functioning (Rosenbaum, Paneth, Leviton, Goldstein, & Bax, 2006).…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Adults with Cerebral Palsy

McMorris¹,

Lake²,

Lunsky³

et al. 2015

Health Disparities and Intellectual Disabilities

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Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy*

Cited by 40 publications

References 43 publications

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Ingestão Oral e Grau de Comprometimento da Disfagia Orofaríngea Neurogênica Pré e Pós-Fonoterapia

Adults with Cerebral Palsy

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