Abstract:

Objective To analyze the effect of adapted physical activity (APA) on physical function, motor skills, mental health and social participation in children with intellectual and developmental disabilities (IDD).
Methods Literature on the effect of APA on function and activity of children with IDD were searched in PubMed, Google Scholar, Cochrane Library and PsycINFO databases, from January, 2014 to May, 2024. The methodological quality was evaluated with Physiotherapy Evidence Database (PEDro) scale, and a systematic review was conducted.
Results A total of nine English articles were included, and the PEDro scale scored five to eight, with medium to high quality. Included literature was from seven countries, including China, Ukraine, Iran, the United States, Australia, Brazil and Turkey, involving 327 children with IDD. The articles were mainly from journals in the fields of intellectual disability research, health, sports and rehabilitation, and adapted physical education. They were publicated mainly between 2018 and 2022. The subjects were seven to 18 years old, covering a variety of IDD types, including intellectual disability, autism and attention deficit hyperactivity disorder. APA intervention involved a single approach and comprehensive approaches, the comprehensive approaches included various types of APA, sports behavior management and assistive technology application, etc., and the activity was designed by adapted physical education teachers or coaches based on the interests and physical activity needs of children with IDD. Specific intervention methods included adaptive ball games (football, gymnastics, basketball, tennis and table tennis, etc.), adaptive strength training (standing weightlifting and chest passing, etc.), executive function training (playing whack-a-mole, frisbee, hitting and throwing, etc.) and adaptive skiing, walking, balance exercises, etc., with an intervention frequency of two to three times a week, 30 to 70 minutes a time, low intensity to strenuous, lasting eight to 36 weeks. The functional and health benefits of different types of APA on children with IDD were reflected in four aspects. In terms of physical function, it could improve cardiopulmonary endurance (maximum oxygen uptake and heart rate recovery, etc.), enhance muscle strength and endurance (grip strength, push-ups and sit-ups, etc.), improve flexibility (rapid, accurate and coordinated movement changes, etc.) and flexibility (sitting body forward bending and shoulder joint range of motion, etc.), and improve balance and movement coordination (static/dynamic balance test and movement coordination assessment, etc.) and body composition (body mass index, body fat percentage and waist-to-hip ratio, etc.). In terms of motor skills and abilities, it could develop basic motor skills (walking, running, jumping, throwing and catching, etc.) and complex motor skills (ball games, gymnastics and dance, etc.), and improve athletic ability test scores. In terms of mental health, it helped to reduce anxiety and depression, improved self-esteem, and improved executive function. In terms of social participation, APA improved the physical activity participation, the frequency and quality of social interaction and quality of life.
Conclusion This study systematically reviewed the evidence for the effect of APA on the function, activity and participation of children with IDD. Diversified APA and adaptive physical education programs designed according to children's functional and developmental levels have significantly improved the physical function, motor skills, mental health and social participation of children with IDD, and promoted their overall development.

Key words: intellectual and developmental disabilities, children, adapted physical activity, systematic review