Analysis of the physical fitness development trajectory of children and adolescents with severe intellectual disabilities in orphanages: A three-year longitudinal follow-up study.

PURPOSE: This study aimed to systematically characterise the development trajectory of physical fitness in children (7-12 years) and adolescents (13-18 years) with severe intellectual disability living in orphanages, based on 12 repeated assessments over three years.

METHODS

A total of 132 children and adolescents aged 7-18 years with severe intellectual disabilities from orphanages in four regions of China were selected. Longitudinal trends in fitness indicators were assessed using generalised estimating equations (GEE).

RESULTS

At baseline, the cohort included 93 boys (70.5%) and 39 girls (29.5%), comprising 57 children aged 7-12 years (9.29 ± 1.81 years) and 75 adolescents aged 13-18 years (14.80 ± 1.65 years). Most participants were normal weight (81.8%), with 3.1% overweight/obese and 15.1% underweight/severely thin at baseline. Baseline analyses indicated sex differences in several strength-related indicators (P ≤ 0.008), whereas BMI did not differ by sex (P = 0.21). Longitudinal analyses showed that (1) The BMI of children and adolescents with severe intellectual disabilities is on the rise (P < 0.01); (2) gains in strength and balance were more pronounced and developmentally sensitive during childhood; (3) in adolescents, core strength and balance displayed an atypical pattern with a mid-period decline followed by gradual recovery, suggesting potential neuromuscular coordination challenges; (4) overall physical fitness improved over time in children and adolescents (7-18 years) (P < 0.001), but remained lower than typically developing reference levels, indicating an atypical developmental trajectory.

CONCLUSION

Physical fitness development in children and adolescents with severe intellectual disability is age-specific. Strength and balance training should be prioritised in childhood, whereas weight monitoring and core stability interventions should be strengthened in adolescence. Orphanage-based programmes should integrate motor skill development with metabolic risk management to address the dual challenges of developmental delay and obesity.