EVIDENCE ON PHYSICAL ACTIVITY FOR CHILDREN, ADOLESCENTS AND ADULTS LIVING WITH DISABILITY

F1EVIDENCE ON PHYSICAL ACTIVITY FOR CHILDREN, ADOLESCENTS AND ADULTS LIVING WITH DISABILITY

Publication Details

Guiding Questions

F1.: What is the association between physical activity and health-related outcomes?

Inclusion Criteria

Population: People living with impairments as a result of any of the following health conditions:

F1.a.: Multiple sclerosis (MS)

F1.b.: Spinal cord injury (SCI)

F1.c.: Intellectual Disability (ID)

F1.d.: Parkinson’s disease (PD)

F1.d.: Stroke (Str)

F1.e.: Major clinical depression (MCD)

F1.g.: Schizophrenia (Sch)

F1.h.: ADHD

Exposure: Greater volume, duration, frequency or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Table

Evidence identified

Twenty-seven reviews were identified (published from 2016 to 2019) that examined the association between physical activity and health-related outcomes among people with impairments (Table F1.1) (1–38). Each of the reviews focused on different subpopulations with impairments including four reviews that included people with multiple sclerosis, no reviews among people with a spinal cord injury, two reviews among children and adolescents with intellectual disabilities including Down syndrome, three reviews among older adults with Parkinson’s disease, 12 reviews included people with a history of stroke, two reviews including people with major clinical depression, 3 reviews among adults with schizophrenia, and one among children with attention deficit hyperactivity disorder (Table F1.1).

The primary outcomes for each review varied according to the population of interest. For instance, measures of physical function were most commonly reported for reviews of exercise interventions among adults with a history of stroke whereas measures of cognition were most commonly reported for the reviews among children with ADHD. None of the reviews included evidence published in 2019; most reviews included evidence published through 2017. The included bodies of evidence for each review was relatively small ranging from 3 to 39 included studies. Three reviews were reviews-of-reviews and synthesized the evidence from existing systematic reviews and meta-analyses. Extracted data for each review is included in Appendix A. A summary of the U.S. Physical Activity Guidelines evidence for people with common chronic conditions is provided within each Evidence Profile.

In general, these reviews had many limitations in their design, execution, and reporting. None of the systematic reviews were rated as having high credibility based on the AMSTAR 2 instrument. Ten were rated as having moderate credibility, 14 were rated as having low credibility, and the remaining 12 were rated as having critically low credibility. Given concerns regarding the comprehensiveness and the validity of the results presented in reviews rated as having critically low credibility, they were not incorporated into the final Evidence Profiles. Table F1.2 presents the ratings for each review according to all the AMSTAR 2 main domains. Two additional reviews were excluded given the scope or focus of the reviews (7, 17). The paper by Christiansen 2019 (7) is not a systematic review and the review by Hendrey (2018) (17) was excluded given the research question (do resistance training interventions that have been studied among patients with a history of stroke adhere to American College of Sports Medicine guidelines?).

Table F1.1

Systematic Reviews Assessed, by condition.

Table F1.2

Credibility Ratings (AMSTAR 2).

F.1. Physical Activity in children, adolescents and adults living with disability

Table F.1.a. People with multiple sclerosis, relationship between physical activity and health-related outcomes (PDF, 109K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with multiple sclerosis

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Risk of co-morbid conditions (including disease progression and symptoms of disease), physical function, cognitive function, health-related QOL

Table F.1.b. People with spinal cord injury, relationship between physical activity and health-related outcomes (PDF, 69K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with spinal cord injury

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Risk of co-morbid conditions (including disease progression and symptoms of disease), physical function, health-related QOL

Table F.1.c. People with intellectual disabilities, relationship between physical activity and health-related outcomes (PDF, 83K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with intellectual disabilities

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Risk of co-morbid conditions (including disease progression and symptoms of disease), physical function, health-related QOL

Table F.1.d. People with Parkinson’s disease, relationship between physical activity and health-related outcomes (PDF, 106K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with Parkinson’s disease

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Physical function, cognitive function

Table F.1.e. People with history of stroke, relationship between physical activity and health-related outcomes (PDF, 98K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with history of stroke

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Physical function, cognitive function

Table F.1.f. People with major clinical depression, relationship between physical activity and health-related outcomes (PDF, 77K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with major clinical depression

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Health-related QOL

Table F.1.g. People with schizophrenia, relationship between physical activity and health-related outcomes (PDF, 77K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with schizophrenia

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Cognitive function, health-related QOL

Table F.1.h. People with attention deficit hyperactivity disorder (ADHD), relationship between physical activity and health-related outcomes (PDF, 75K)

Questions: What is the association between physical activity and health-related outcomes?

Population: People with attention deficit hyperactivity disorder (ADHD)

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Cognitive function

Appendix A. Data Extractions

Download PDF (226K)

References

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NLM Citation

WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: World Health Organization; 2020. F1, EVIDENCE ON PHYSICAL ACTIVITY FOR CHILDREN, ADOLESCENTS AND ADULTS LIVING WITH DISABILITY.

		Outcomes
Population	1.1 Comorbidity	1.2 Physical functioning	1.3 Cognition	1.4 Quality of Life
F1.a Multiple sclerosis	✕	✕	✕	✕
F1.b Spinal cord injury	✕	✕		✕
F1.c Intellectual disability	✕	✕		✕
F1.d Parkinson’s disease		✕	✕
F1.e Stroke		✕	✕
F1.f Major clinical depression				✕
F1.g Schizophrenia			✕	✕
F1.h ADHD			✕

	Conditions								Outcomes
Author, Year	MS	SCI	ID	Park	Stroke	MCD	Schizophrenia	ADHD	Risk of comorbid conditions	Physical function	Cognitive function	QOL	Last search date	# of included studies	AMSTAR 2
People with multiple sclerosis
Alphonsus, 2019 (1)	✕											✕	NR 2017	18	Low
Campbell, 2018 (5)	✕									✕			Sep 2017	7	Low
Charron, 2018 (6)	✕									✕			Nov 2016	12	Critically Low
Manca, 2018 (24)	✕									✕			May 2017	11	Moderate
Morrison, 2017 (27)	✕										✕		May 2016	19	Critically Low
Patterson, 2018 (28)	✕	✕			✕					✕			Aug 2017	9	Moderate
Veneri, 2018 (34)	✕				✕					✕	✕	✕	May 2016	32	Critically Low
People with spinal cord injury
Eitivipart, 2019^a (12)		✕								✕			Aug 2018	16	Critically Low
Gaspar, 2019 (14)		✕								✕		✕	Feb 2017	25	Critically Low
Melo, 2019 (25)		✕								✕			Nov 2015	7	Critically Low
Patterson, 2018 (28)	✕	✕			✕					✕			Aug 2017	9	Critically Low
People with intellectual disabilities
Maïano, 2018 (23)			✕							✕			Mar 2018	15	Low
Maïano, 2019 (22)			✕							✕			Jun 2017	11	Moderate
People with Parkinson’s disease
Cugusi, 2017a (8)				✕						✕		✕	Feb 2017	6	Low
Ćwiękała-Lewis, 2017 (10)				✕						✕		✕	Apr 2015	11	Critically Low
Dos Santos Delabary, 2017 (11)				✕						✕		✕	Aug 2017	5	Low
Kalyani, 2019 (19)				✕						✕	✕		Sep 2017	12	Critically Low
Stuckenschneider, 2019 (32)				✕							✕		Mar 2018	11	Moderate
People with a history of stroke
Bonini-Rocha, 2018 (3)					✕					✕			Mar 2017	11	Moderate
Boyne, 2017 (4)					✕					✕			Nov 2015	20	Low
Cugusi, 2017b (9)					✕					✕			Oct 2016	15	Moderate
Ge, 2017 (15)					✕					✕			Feb 2017	32	Moderate
Hendrey, 2018^b (17)					✕					✕			Oct 2016	39	N/A
Ilunga Tshiswaka, 2018 (18)					✕					✕			Oct 2016	29	Critically Low
Li, 2018 (21)					✕					✕			NR	5	Low
Miranda, 2018 (26)					✕					✕			Nov 2017	12	Low
Patterson, 2018 (28)	✕	✕			✕					✕			Aug 2017	9	Moderate
Pogrebnoy, 2019 (29)					✕					✕			Aug 2018	10	Low
Schröder, 2019 (30)					✕					✕			Apr 2018	7	Low
Veneri, 2018 (34)	✕				✕					✕	✕	✕	NR	32	Critically Low
Wiener, 2019 (35)					✕					✕			Jan 2018	6	Low
Wu, 2018 (36)					✕					✕			May 2017	6	Critically Low
Zou, 2018a (37)					✕					✕			NR	20	Low
Zou, 2018b (38)					✕				✕	✕			NR	16	Low
People with major clinical depression
Ashdown-Franks, 2019^a (2)						✕	✕	✕	✕		✕		Jan 2018	27	Moderate
Krogh, 2017 (20)						✕			✕			✕	Jun 2017	35	Moderate
Stubbs, 2018^a (31)						✕	✕		✕	✕	✕	✕	Jan 2018	20	Moderate
People with schizophrenia
Ashdown-Franks, 2019^a (2)						✕	✕	✕	✕		✕		Jan 2018	27	Moderate
Firth, 2016 (13)							✕				✕		Apr 2016	10	Low
Stubbs, 2018^a (31)						✕	✕		✕	✕	✕	✕	Jan 2018	20	Critically Low
People with attention deficit hyperactivity disorder
Ashdown-Franks, 2019^a (2)						✕	✕	✕	✕		✕		Jan 2018	27	Moderate
Christiansen, 2019^c (7)								✕			✕		NR	18	N/A
Grassmann, 2017 (16)								✕			✕		NR 2013	3	Critically Low
Suarez-Manzano, 2018 (33)								✕			✕		Jan 2017	16	Critically Low

Author, Year	PICO¹	Apriori Methods²	Study Design Selection³	Lit Search Strategy⁴	Study Selection⁵	Data Extraction⁶	Excluded Studies⁷	Included Studies⁸	RoB Assessment⁹	Funding Sources¹⁰	Statistical Methods¹¹	Impact of RoB¹²	RoB Results¹³	Heterogeneity¹⁴	Publication Bias¹⁵	COI¹⁶	Overall Rating¹⁷
Alphonsus, 2019	Y	N	N	PY	Y	N	PY	N	PY	N	Y	Y	Y	Y	Y	N	Low
Ashdown-Franks, 2019	Y	N	N	PY	Y	Y	PY	Y	Y	N	N/A	N/A	Y	Y	N/A	Y	Moderate
Bonini-Rocha, 2018	Y	N	N	PY	Y	N	PY	PY	Y	N	Y	N	Y	Y	Y	Y	Moderate
Boyne, 2017	Y	N	N	PY	N	N	PY	PY	PY	N	Y	N	N	Y	Y	N	Low
Campbell, 2018	Y	N	N	PY	N	N	PY	PY	PY	N	N/A	N/A	N	Y	N/A	Y	Low
Charron, 2018	Y	N	N	PY	N	N	PY	PY	N	N	N/A	N/A	N	N	N/A	Y	Critically Low
Cugusi, 2017a	Y	N	N	PY	Y	Y	Y	PY	PY	N	N/A	N/A	N	Y	N/A	Y	Low
Cugusi, 2017b	N	N	N	PY	Y	Y	Y	Y	Y	N	Y	N	N	Y	Y	Y	Moderate
Ćwiękała-Lewis, 2017	N	N	N	PY	N	N	PY	PY	N	N	N/A	N/A	N	N	N/A	Y	Critically Low
Dos Santos Delabary, 2017	Y	N	N	PY	Y	Y	PY	PY	Y	N	Y	N	N	Y	Y	Y	Low
Eitivipart, 2019¹⁸	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	Critically Low
Firth, 2016	Y	N	N	PY	Y	N	PY	PY	Y	N	Y	Y	Y	Y	Y	Y	Low
Gaspar, 2019	N	N	N	PY	Y	Y	N	N	N	N	N/A	N/A	N	Y	N/A	N	Critically Low
Ge, 2017	Y	N	N	PY	Y	Y	PY	PY	Y	N	Y	N	Y	Y	Y	N	Moderate
Grassmann, 2017	Y	N	N	PY	N	N	N	PY	N	N	N/A	N/A	N	N	N/A	Y	Critically Low
Ilunga Tshiswaka, 2018	N	N	N	PY	Y	N	N	N	N	N	N/A	N/A	N	N	N/A	Y	Critically Low
Kalyani, 2019	Y	PY	N	PY	Y	Y	PY	PY	Y	N	N	N	Y	N	N	N	Critically Low
Krogh, 2017	Y	PY	N	PY	Y	Y	N	Y	Y	Y	Y	Y	Y	Y	Y	Y	Moderate
Li, 2018	Y	N	N	PY	Y	Y	PY	PY	Y	N	Y	N	Y	Y	N	Y	Low
Maïano, 2018	Y	N	N	PY	Y	Y	N	Y	PY	N	Y	Y	Y	Y	Y	Y	Low
Maïano, 2019	Y	N	N	PY	Y	Y	PY	Y	Y	N	N/A	N/A	Y	N	N/A	Y	Moderate
Manca, 2018	Y	N	N	PY	Y	Y	Y	PY	Y	N	Y	N	Y	Y	Y	Y	Moderate
Melo, 2019	Y	N	N	PY	Y	Y	PY	PY	N	N	N/A	N/A	N	N	N/A	N	Critically Low
Miranda, 2018	N	N	N	PY	N	Y	Y	Y	PY	N	N/A	N/A	Y	Y	N/A	Y	Low
Morrison, 2017	N	N	N	PY	N	N	N	Y	PY	N	N/A	N/A	Y	N	N/A	Y	Critically Low
Patterson, 2018	Y	N	N	PY	Y	Y	PY	PY	Y	N	N/A	N/A	Y	Y	N/A	Y	Moderate
Pogrebnoy, 2019	Y	N	Y	PY	Y	N	PY	PY	PY	N	Y	N	N	Y	N	N	Low
Schröder, 2018	Y	N	N	PY	Y	Y	N	PY	Y	N	N/A	N/A	Y	Y	N/A	Y	Low
Stubbs, 2018	Y	N	Y	PY	Y	Y	PY	PY	Y	N	N/A	N/A	Y	Y	N/A	Y	Moderate
Stuckenschneider, 2019	Y	N	N	PY	N	Y	PY	Y	PY	N	N/A	N/A	Y	Y	N/A	Y	Moderate
Suarez-Manzano, 2018	N	N	N	PY	Y	N	N	PY	N	N	N/A	N/A	N	N	N/A	Y	Critically Low
Veneri, 2018	N	N	N	PY	Y	N	N	PY	N	N	N	N	N	N	N	Y	Critically Low
Wiener, 2019	Y	N	N	PY	Y	N	N	PY	PY	N	N/A	N/A	N	Y	N/A	Y	Low
Wu, 2018	Y	N	N	PY	Y	Y	N	PY	N	N	N	N	Y	Y	N	N	Critically Low
Zou, 2018a	Y	N	N	PY	Y	Y	PY	PY	PY	N	Y	Y	Y	Y	Y	N	Low
Zou, 2018b	Y	N	N	PY	Y	Y	PY	PY	PY	N	N	N	Y	Y	N	Y	Low

F1EVIDENCE ON PHYSICAL ACTIVITY FOR CHILDREN, ADOLESCENTS AND ADULTS LIVING WITH DISABILITY

Guiding Questions

Inclusion Criteria

Table

Evidence identified

Table F1.1

Table F1.2

F.1. Physical Activity in children, adolescents and adults living with disability

Appendix A. Data Extractions

References

Publication Details

Copyright

Publisher

NLM Citation

Table F1.1Systematic Reviews Assessed, by condition

Table F1.2Credibility Ratings (AMSTAR 2)