Ogg-Groenendaal Marloes, Hermans Heidi, Claessens Brigitte
Amarant Groep, P.O. Box 715, 5000 AS Tilburg, The Netherlands.
Amarant Groep, P.O. Box 715, 5000 AS Tilburg, The Netherlands.
Res Dev Disabil. 2014 Jul;35(7):1507-17. doi: 10.1016/j.ridd.2014.04.003. Epub 2014 Apr 21.
Challenging behavior, such as aggressive or self-injurious behavior, is a major concern for the health and well-being of people with intellectual disabilities (ID) and for their relatives, friends, and caregivers. The most common contemporary treatments have drawbacks, such as the adverse side effects of antipsychotics. Exercise interventions could be a good alternative, but little is known about its beneficial effects on challenging behavior in people with ID yet.
A systematic review of the literature was done and methodological quality of the selected studies has been judged on four points. With one-way Analysis of Variance (ANOVA), the effect of exercise interventions on challenging behavior was studied. The effect of low versus high intensity exercise interventions was studied with independent samples T-test using mean improvement scores.
Twenty studies studying the effects of exercise interventions on challenging behavior in people with ID have been found. A quantitative evaluation of the results showed a significant decrease in challenging behavior after participating in an exercise intervention (M=30.9%, 95% CI: 25.0, 36.8). Furthermore, no significant difference was found between high (M=32.2%) and low (M=22.9%) intensity exercise interventions.
The found decrease in challenging behavior shows that exercise seems to be recommendable as an effective treatment for people with challenging behavior and ID. However, most studies were of low methodological quality and more research is needed to optimize recommendations about the exact intensity, duration, frequency, and mode (group or individual) of exercise interventions for this group of people.
具有挑战性的行为，如攻击性行为或自伤行为，是智障人士及其亲属、朋友和照顾者健康与福祉的主要担忧。当代最常见的治疗方法存在弊端，如抗精神病药物的副作用。运动干预可能是一个很好的替代方法，但目前对于其对智障人士具有挑战性的行为的有益影响知之甚少。
对文献进行了系统综述，并从四个方面对所选研究的方法学质量进行了评判。使用单因素方差分析（ANOVA）研究运动干预对具有挑战性的行为的影响。使用平均改善得分，通过独立样本t检验研究低强度与高强度运动干预的效果。
已发现20项研究运动干预对智障人士具有挑战性的行为的影响的研究。对结果的定量评估显示，参与运动干预后，具有挑战性的行为显著减少（M = 30.9%，95%置信区间：25.0，36.8）。此外，高强度（M = 32.2%）和低强度（M = 22.9%）运动干预之间未发现显著差异。
所发现的具有挑战性的行为的减少表明，运动似乎可作为对有具有挑战性的行为的智障人士的一种有效治疗方法而被推荐。然而，大多数研究的方法学质量较低，需要更多研究来优化针对该群体运动干预的确切强度、持续时间、频率和方式（团体或个体）的建议。
