From exercise training to school-based sports : The effects on fitness and health in youth with physical disabilities

Youth with physical disabilities participate less in sports compared to their typically developing peers. In 2011, only 26% of Dutch youth with physical disabilities participate at least once a week in sports compared to 71% of the typically developing youth. This has negative consequences regarding fitness and health purposes; they have lower physical fitness levels and are at greater risk developing chronic diseases. Reasons for this lower sport participation are: being physically active is more challenging because of their disability, lack of trained support personnel, transportation problems, lack of acceptance, and lack of sports clubs in the neighborhood. When a sports program is provided at school, extracurricular, most of these barriers can possibly be eliminated, because this setting offers a familiar environment with supported trainers, acceptance, and no additional transportation except a postponed pick-up from school. The main objective of the current thesis was to investigate the effects of a short-term high-intensity interval training (HIT) followed by a school-based sports program for six months on fitness and health in youth with physical disabilities. We found that the increased anaerobic performance, agility and aerobic performance after eight weeks of HIT sustained following school-based sports in both the sport and control group, where anaerobic performance increased further compared to the control group. Regarding health, only fat mass improved in favor of the sport group. The once a week school-based sports program showed no effects on psychosocial health and attention. Although school-based sports are safe and feasible, it has been argued that youth with physically disabilities should ideally participate at sports club within society. To facilitate sports participation at sports clubs in society, trainers, staff and volunteers should be educated and instructed in how to train youth with physical disabilities. The secondary objective was to investigate ecological time trends over a decade in fitness levels of youth with cerebral palsy (CP). Between 2004 and 2014, positive time trends were shown in anaerobic performance, agility and aerobic performance, but not in VO2peak. Furthermore, the substantial higher body mass and BMI of youth with CP in 2014 compared to a comparable sample from 2004 is alarming. Health care professionals are advised to emphasize the importance of an active and healthy lifestyle to create awareness of the benefits