Effect Of Adapted Physical Exercise Program On Physical Fitness,Physical Function And Quality Of Life Of Adolescents With Visual Impairment

PurposePeople with visual impairment had decreased physical activity,low level of fitness and physical function,comparing with typical developed people,because of visual loss and the limitation of body function,which lead to various negative health consequences,such as the deterioration of health and reduced quality of life,and it will undoubtedly bring great burden to the society,family and themselves.Physical activity had been identified as one of the most successful strategies for reducing these health risks and improving quality of life.The research on physical fitness,physical function,quality of life and exercise intervention study on adolescents with visual impaired in China is relatively weak,which greatly restricts the design of adapted exercise program and the formulation of related policies and plans,and is not beneficial to the promotion of their health and quality of life.Adolescence is a critical period for developing a healthy physical lifestyle,and people with visual impairment begin to experience a sharp decline in physical activity during adolescence.Relevant exercise interventions are urgently needed to avoid or reduce potential health risks.Therefore,from the perspective of science in Ti Yu,this paper designed an adapted exercise program that conformed to the physical and mental characteristics of adolescents with visual impairment and empirically verified its effectiveness,explored possible underlying mechanisms,which had important theoretical and practical significance for improving their physical fitness,physical function,and health-related quality of life.MethodsFirstly,this paper used cross-sectional study to investigate and analyze the physical fitness,physical function and quality of life of adolescents with visual impairment aged 15-18,through testing and questionnaire,so as to understand the current situation and shortage of their physical fitness,physical function and quality of life.Secondly,partial correlation analysis and multiple stepwise regression analysis were used to explore the internal correlation among physical fitness,physical function and quality of life,and to select the key indicators of physical fitness and physical function that were closely related to the quality of life.Then,on the basis of evidence from literature review and comprehensive cross-sectional research information,the adapted exercise program for adolescents with visual impairment was designed theoretically.Finally,a mixed-method（quantitative and qualitative）design was used to empirically examine the effectiveness of the adapted exercise program,and focus group interviews were used to further explore the effects and mechanisms of adapted exercise program in promoting physical fitness,physical function and quality of life.Results（1）The overall fitness level of adolescents with visual impairment was low,and their mean values of lung capacity,grip strength,standing long jump as well as sit and reach were significantly lower than those even-aged and typically developed adolescents（P<0.05）.Their overweight obesity rate was prominent,and boys were higher than girls.The obesity rate was highest among adolescents with 2^nd visual impairment,and senior three has the highest rate of overweight and obesity among adolescents visual impairment.（2）The physical function ability of adolescents with visual impairment was lower than those typically developed adolescents.There were significant differences in Berg balance score and functional reach in adolescents with different levels of visual impairment（P<0.05）.The physical function level of boys with visual impairment was better than that of girls.Adolescents with visual impairment of level 3 have the best balance and walking ability while those with visual impairment of level 1 had the best postural stability.There was no significant difference in physical function between sex and grade level（P>0.05）.（3）The scores of quality of life of students with visual impairment were low,and scores of energy,general health status,as well as mental health were lower than those lower than even-aged and typically developed students,and scores of physical function,body pain and energy were lower than the scores of national norm.The quality of life of girls with visual impairment was better than that of boys.There was no significant difference in quality of life scores among different grades and levels of visual impairment There was no significant difference in physical function between sex and grade level（P>0.05）.（4）There was low to moderate correlation in different content indexes of physical fitness with physical function and quality of life,among which hip to body ratio,two-minute step,standing long jump and trunl lift were closely related to quality of life.All physical function indexes had low to moderate correlation with different areas of quality of life.Among these indexes,two-minute step,trunl lift,time up to go,one-leg with closed eyes and functional reach,were the key factors affecting the quality of life of adolescents with visual impairment which explained 53.8%of the variation in quality of life（R²=0.538,F=33.5,P<0.01）.（5）Ten-week adapted exercise program could improve the cardiopulmonary fitness,lower limb strength and flexibility of adolescents with visual impairment,and reduce body weight（P<0.05、P<0.01）,improve their balance,postural stability and walking ability;It could improve the physiological function,energy,social function,emotional function and health change of the quality of life of adolescents with visual impairment（P<0.05、P<0.01）.The results of focus group interviews indicated that adapted exercise program improved physical fitness and physical function which reduced the physiological and functional limitations,increased the energy,but also related to the change of the positive emotional experience,the enhancement of social communication and the positive health change during the physical exercise program which led to improvement in quality of life.Conclusion（1）The overall fitness level of adolescents with visual impairment was lower than those even-aged and typically developed adolescents.They also had low overall level of physical function and scores in some areas of quality of life were lower than typically developed adolescents.（2）Some indexes of physical fitness and physical function of adolescents with visual impairment had close correlation with quality of life.The core factors affecting the quality of life of adolescents with visual impairment were the following five indexes:two-minute step,trunl lift,time up to go,one-leg with closed eyes and functional reach.（3）The evidence-based adapted physical exercise program was feasible and effective,which could improve the cardiopulmonary fitness,lower limb strength and flexibility of adolescents with visual impairment,and improved their physical function as well as quality of life.The mechanism was not only due to the improvement of physical fitness and physical function which reduced the physiological and functional limitations,increased the energy,but also related to the change of the positive emotional experience,the enhancement of social communication and the positive health change during the physical exercise program.