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Res Dev Disabil. 2013 Oct;34(10):3301-16. doi: 10.1016/j.ridd.2013.07.005. Epub 2013 Jul 26.

Cardiorespiratory fitness in individuals with intellectual disabilities--a review.

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Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address:


Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of this review were to update previous reviews about (a) the cardiorespiratory fitness levels and their determinants in individuals with ID, and (b) the validity and reliability of cardiorespiratory fitness testing in individuals with ID. We searched the databases of Pubmed and Embase for relevant studies, resulting in 31 included articles. These studies mainly included younger participants with mild to moderate ID. Results confirmed previous findings of low cardiorespiratory fitness levels in individuals with ID. Cardiorespiratory fitness levels of children and adolescents with ID are already low, with further decline with increasing age. Furthermore, females have lower cardiorespiratory fitness levels than males. Physical inactivity and chronotropic incompetence are most likely to contribute to low cardiorespiratory fitness levels. Peak cardiorespiratory fitness levels of individuals with ID can be assessed with maximal treadmill protocols, after allowing for familiarization sessions. Although, predicting maximal oxygen uptake from field tests is problematic, field tests have been found valid and reliable as indicators of cardiorespiratory fitness.


Cardiorespiratory fitness; Heart rate; Intellectual disabilities; Oxygen uptake; Testing

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