Turkiye Klinikleri Journal of Sports Sciences

.: ORIGINAL RESEARCH
Eğitmen ve Aile Destekli Uyarlanmış Fiziksel Aktivitelerin Otizm Spektrum Bozukluğu Olan Gençlerin Fiziksel Uygunluk Düzeylerine Etkileri: Deneysel Çalışma
The Effects of Trainer-and Family-Supported Adjusted Physical Activities on the Physical Fitness Levels of Youngsters with Autism Spectrum Disorder: Experimental Study
Ebubekir AKSAYa
aTurnverein 1846 Eberbach, Baden-Württemberg, Almanya
Turkiye Klinikleri J Sports Sci. 2021;13(3):416-24
doi: 10.5336/sportsci.2021-83608
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışma, eğitmen ve aile destekli fiziksel aktivitelerin otizm spektrum bozukluğu (OSB) tanısı almış gençlerin fiziksel uygunluk belirlemesinde eğitmen ve aile etkileri arasındaki ilişkinin değerlendirilmesi amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışmaya Almanya Eberbach/Heidelberg kentlerinde 10-13 yaş arası hafif düzeyde OSB tanısı konulmuş (Mental Bozuklukların Tanısal ve Sayımsal El Kitabı-5) toplam 39 genç erkek katılmıştır ve 2 grup oluşturulmuştur: Eğitmen grubu (n=21): yaş ortalaması 11,38±1,02 yıl; aile grubu (n=18): yaş ortalaması 10,83±0,85 yıl. Deney grubu (sadece eğitmenler ile) ve aile grubu (eğitmen ve aileler beraber) 36 hafta süreyle, haftada 1 gün 45 dk'lık fiziksel aktivite programına katılmışlardır. Fiziksel uygunluğun belirlenmesinde Brockport Fiziksel Uygunluk Testi [Brockport Physical Fitness Test (BPFT)] kullanılmış ve vücut kompozisyonu, aerobik dayanıklılık, kas kuvveti ve esneklik değerleri öntest/son-test karşılaştırmasıyla belirlenmiştir. Bulgular: Uygulanan 36 haftalık düzenli fiziksel aktivite programı ile aerobik dayanıklılık, kuvvet ve esneklik gibi fiziksel uygunluk bileşenleri arasında anlamlı ilişki olduğu saptanmıştır. Eğitmen grubu, aile grubuna oranla testlerin tamamında daha yüksek performans sergilerken, son-testlerde gruplar arasında anlamlı farklılık olduğu belirlenmiştir. Ayrıca katılımcıların beden kitle indeksi değerlerinden aşırı kilo/obezite sınırında oldukları görülmektedir. Sonuç: Sonuçlar, fiziksel aktivite ve fiziksel uygunluk değerlendirmeleri için önemli ip uçları vererek, fiziksel aktivitenin uzman eğitmenler tarafından ailelerin katılmadığı ya da sınırlı olarak katıldıkları programlarda günlük yaşama entegre edilmesinin OSB tanısı alan gençlerin fiziksel uygunluklarını geliştirmede daha etkili olacağı düşünülmektedir.

Anahtar Kelimeler: Otizm spektrum bozukluğu; aile-destekli; Brockport Fiziksel Uygunluk Testi; fiziksel aktivite
ABSTRACT
 Objective: The present study was carried out in order to assess the relationship between trainer and family effects in determining the effects of trainer-and family-supported physical activities on the physical fitness level of youngsters diagnosed with autism spectrum disorder (ASD). Material and Methods: In the present study in Germany Eberbach/Heidelberg, 39 young boys aged between 10 and 13 years and diagnosed with mild-level ASD (Diagnostic and Statistical Manual of Mental Disorders-5) were involved and 2 groups were established: Trainer group (n=21): mean age of 11.38±1.02 years, Family group (n=18): mean age of 10.83±0.85 years. Experiment group (only with trainer) and family group (with trainer and families) participated in a 36-week physical activity program (45 minutes in a day every week). Physical fitness was assessed using Brockport Physical Fitness Test (BPFT) and pretest-posttest comparisons were made in body comparison, aerobic endurance, muscular force, and flexibility values. Results: It was determined that there was a significant relationship between 36-week regular physical activity program and physical fitness components such as aerobic endurance, force, and flexibility. When compared to the family group, trainer group showed higher performance in all the tests and there was a statistically significant difference in posttest scores. In addition, the participants' body mass index values are observed to be at the limit of overweight/obesity. Conclusion: The results provided important tips for physical activity and physical fitness assessments and it is thought that involving the physical activities in programs, which are provided by the trainers and not incorporating the families or involving limited incorporation, would be more effective in improving the physical fitness while integrating the youngsters diagnosed with ASD into daily life.

Keywords: Autism spectrum disorder; family-supported; Brockport Physical Fitness Test; physical activity
REFERENCES:
  1. Aksay E, Alp A. "The effects of a physical activity rehabilitation program on the motor skills and physical performance of children with autism spectrum disorder (ASD)" movement therapy and ASD. IJAR. 2014;6(1):12-9. [Crossref] 
  2. Ozonoff S, Young GS, Goldring S, Greiss-Hess L, Herrera AM, Steele J, et al. Gross motor development, movement abnormalities, and early identification of autism. J Autism Dev Disord. 2008;38(4):644-56. [Crossref] [PubMed] [PMC] 
  3. Murray-Slutsky C, Paris BA. Exploring the Spectrum of Autism and Pervasive Developmental Disorders. 1st ed. Texas, USA: Therapy Skill Builders; 2000. [Link] 
  4. Davis KL, Zhang G, Hodson PS, Boswell BB. Decker JT. A close look at the physical fitness levels of elementary age students with intellectual disabilities. Sport Science Review. 2010;XIX(3-4):77-92. [Crossref] 
  5. Vernazza-Martin S, Martin N, Vernazza A, Lepellec-Muller A, Rufo M, Massion J, et al. Goal directed locomotion and balance control in autistic children. J Autism Dev Disord. 2005;35(1):91-102. [Crossref] [PubMed] 
  6. Baranek GT. Efficacy of sensory and motor inter ventions for children with autism. J Autism Dev Disord. 2002;32(5):397-422. [Crossref] [PubMed] 
  7. Byrne NM, Hills AP. The importance of physical activity in the growth and development of children. In: Hills AP, King NA, Byrne NM, eds. Children, Obesity and Exercise. Prevention, Treatment and Management of Childhood and Adolescent Obesity. 1st ed. Washington, USA: Routledge; 2007. p.50-60.[Link] 
  8. Hoppen T. Kinder mit Autismus-Spektrum-Störung bewegen sich zu wenig! [Children with autism spectrum disorder don't get enough exercise!]. Pädiatrie. 2021;33:15. [Crossref] 
  9. Aksay E, Güllü M. "Effects of physical activity programs with visual stimuli on physical development of children with autism spectrum disorder" visual stimuli and movement therapy. JES. 2014;5(1):34-43. [Crossref] 
  10. Curtin C, Anderson SE, Must A, Bandini L. The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children's Health. BMC Pediatr. 2010;10:11. [Crossref] [PubMed] [PMC] 
  11. Podgorski CA, Kessler K, Cacia B, Peterson DR, Henderson CM. Physical activity intervention for older adults with intellectual disability: report on a pilot project. Ment Retard. 2004;42(4):272-83. [Crossref] [PubMed] 
  12. Tomporowski PD, Jameson LD. Effects of a physical fitness-training program on the exercise behavior of institutionalized mentally retarded adults. Adapt Phys Activ Q. 1985; 2(3):197-205. [Crossref] 
  13. Yarımkaya E, Esentürk OK, İlhan EL. The effects of family-mediated physical activities on communication skills of a student with autism spectrum disorders: a pilot study. IJDSHS. 2020;3(1):52-65. [Crossref] 
  14. Aydın I, Sarol H. Otizmli bireylerin fiziksel aktivite programlarına katılımını engelleyen faktörlerin incelenmesi [Examination of con straints on physical activity programs participation to individuals with autism]. Int JSCS. 2014;1:870-80. [Crossref] 
  15. Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med. 2004;26(5):419-25. [Crossref] [PubMed] 
  16. Shields N, Synnot AJ. An exploratory study of how sports and recreation industry personnel perceive the barriers and facilitators of physical activity in children with disability. Disabil Rehabil. 2014;36(24):2080-4. [Crossref] [PubMed] 
  17. Stiller A, Neumann M. (2021). Freizeitsangebote für autistiche Kinder und Jugendliche: Wie zufrieden sind Eltern und was wünschen sich für ihre Kinder [Leisure opportunities for autistic children and adolescents: how satisfed are parents and what do they think their children would like?] Prax. Kinderpsychol. Kinderpsychiat. 2021;70:217-38. [Crossref] [PubMed] 
  18. Haegele JA, Lee J, Chang SH. Physical activity of parents of children with autism spectrum disorder. IJDDE. 2017;64(4):368-77. [Crossref] 
  19. Lee B. Parental values and concerns about participation in physical activity by persons with intellectual disabilities. Eugene, OR: Kinesiology Publications, University of Oregon; 2004. [Erişim tarihi: 04.02.2021]. Erişim linki: [Link] 
  20. Crollick JL, Richmond-Mancil G, Stopka C. Physical activity for children with autism spectrum disorder. Teaching Elementary Physical Education. 2006;17(2):30-4. [Link] 
  21. Schultheis SF, Boswell BB, Decker J. Successful physical activity programming for students with autism. Focus on Autism and Other Developmental Disabilities. Pro Quest Psychology Journal. 2000;15(3):159-62. [Crossref] 
  22. Tröster H, Lange S. Anforderungen, belastungen und ressourcen der eltern von kindern und jugendlichen mit autismus-spektrum-störungen. Eltern von Kindern mit Autismus-Spektrum-Störungen. 1st ed. Wiesbaden: Springer; 2019. [Crossref] 
  23. Bahrami F, Movahedi A, Marandi SM, Sorensen C. The effect of karate techniques training on communication deficit of children with autism spectrum disorders. J Autism Dev Disord. 2016;46(3):978-86. [Crossref] [PubMed] 
  24. Anderson-Hanley C, Tureck K, Schneiderman RL. Autism and exergaming: effects on repetitive behaviors and cognition. Psychol Res Behav Manag. 2011;4:129-37. [Crossref] [PubMed] [PMC] 
  25. American Psychological Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. [Link] 
  26. Winnick J, Short F. The Brockport Physical Fitness Test Manual. New York: State University of New York, College at Brockport; 1998. [Link] 
  27. Winnick J, Short F. Brockport Physical Fitness Test Manual: A Health-Related Assessment for Youngsters with Disabilities. 2nd ed. Champaign, IL: Human Kinetics; 2014. [Crossref] 
  28. Doolittle TL, Dominic JA, Doolittle J. The reliability of selected cardio-respiratory endurance field tests with adolescent female populations. Am Correct Ther J. 1969; 23(5): 135-8. [PubMed] 
  29. Fernhall B, Pitetti K. Limitations to work capacity in individuals with intellectual disabilities. Clin Exerc Physio. 2011;3:176-85. [Link] 
  30. Clapham ED, Lamon LS, Shim M, Armitano C. A case report illustrating the implementation of a therapeutic surfing intervention for an adolescent with autism. Palaestra. 2018;32(2): 49-53. [Link] 
  31. Collins K, Staples K. The role of physical activity in improving physical fitness in children with intellectual and developmental disabilities. Res Dev Disabil. 2017;69:49-60. [Crossref] [PubMed] 
  32. Pan CY, Tsai CL, Chu CH, Sung MC, Ma WY, Huang CY. Objectively measured physical activity and health-related physical fitness in secondary school-aged male students with autism spectrum disorders. Phys Ther. 2016;96(4): 511-20. [Crossref] [PubMed] 
  33. Tyler K, MacDonald M, Menear K. Physical activity and physical fitness of school-aged children and youth with autism spectrum disor ders. Autism Res Treat. 2014;2014:3121 63. [Crossref] [PubMed] [PMC] 
  34. Aksay E. The Effects of Rehabilitation Sports on the Physical Fitness and Motor Skills in Autism Spectrum Disorder. Which one is more effective, Family or Trainer? 17th International Sport Sciences Congress 13-16 November, 2019, Antalya, Turkey. Book of Full Text, 2019. P.1640-41. [Link] 
  35. Egan AM, Dreyer ML, Odar CC, Beckwith M, Garrison CB. Obesity in young children with autism spectrum disorders: prevalence and associated factors. Childhood Obesity. 2013;9(2):125-31. [Crossref] [PubMed] 

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