{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:12:50Z","timestamp":1770905570094,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["UIDP\/04748\/2020"],"award-info":[{"award-number":["UIDP\/04748\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We developed a physical exercise (PE) program for people with Intellectual and Developmental Disabilities (IDD), aiming to determine the effects on physical fitness, health, cognitive ability, and quality of life (QoL). Using experimental methodology, this intervention study recruited 21 adults (18 to 65 years old), institutionalized and with no other associated pathology, who will be allocated to one of the different groups: (i) gym\/indoor intervention group (using weight machines), (ii) outdoor intervention group (using low-cost materials), or (iii) control group (without specific intervention, who continue with their normal daily activities). Both intervention groups will engage in 45 min of training per session, twice a week, for 24 weeks. Assessments will be conducted at baseline (initial assessment), 3 months (mid-term assessment), and 6 months (final assessment). Variables assessed include anthropometrics, body composition, functional capacity, muscle strength, general health, cognitive ability, and QoL. The results of this study will assist in the development of more effective strategies, recommendations, and interventions to ensure better and greater adherence to PE by institutionalized individuals with IDD, namely, recommendations for assessment, prescription, and implementation of PE for this population. Additionally, we intend to make available two PE programs, if they are adapted and promote positive effects.<\/jats:p>","DOI":"10.3390\/jcm11247485","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T08:41:41Z","timestamp":1671439301000},"page":"7485","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of Physical Exercise Program in Adults with Intellectual and Developmental Disabilities\u2014A Study Protocol"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4427-3276","authenticated-orcid":false,"given":"Jos\u00e9 Pedro","family":"Ferreira","sequence":"first","affiliation":[{"name":"Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal"},{"name":"Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-0585","authenticated-orcid":false,"given":"Rui","family":"Matos","sequence":"additional","affiliation":[{"name":"ESECS\u2013Polytechnic of Leiria, 2411-901 Leiria, Portugal"},{"name":"Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2148-3534","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Campos","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal"},{"name":"Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7179-6814","authenticated-orcid":false,"given":"Diogo","family":"Monteiro","sequence":"additional","affiliation":[{"name":"ESECS\u2013Polytechnic of Leiria, 2411-901 Leiria, Portugal"},{"name":"Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal"},{"name":"Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-9430","authenticated-orcid":false,"given":"Raul","family":"Antunes","sequence":"additional","affiliation":[{"name":"ESECS\u2013Polytechnic of Leiria, 2411-901 Leiria, Portugal"},{"name":"Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal"},{"name":"Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411-901 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1727-3537","authenticated-orcid":false,"given":"Miguel","family":"Jacinto","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal"},{"name":"ESECS\u2013Polytechnic of Leiria, 2411-901 Leiria, Portugal"},{"name":"Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (2022). ICD-11 International Classification of Diseases 11th Revision."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM\u20135), American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Schalock, R.L., Luckasson, R., and Tass\u00e9, M.J. (2021). Intellectual Disability: Definition, Diagnosis, Classification, and Systems of Supports, American Association on Intellectual and Developmental Disabilities. [12th ed.].","DOI":"10.1352\/1944-7558-126.6.439"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jacinto, M., Oliveira, R., Brito, J.P., Martins, A.D., Matos, R., and Ferreira, J.P. (2021). Prescription and Effects of Strength Training in Individuals with Intellectual Disability\u2014A Systematic Review. Sports, 9.","DOI":"10.3390\/sports9090125"},{"key":"ref_5","first-page":"13","article-title":"Efeito do Treinamento com Pesos nas Atividades da Vida Di\u00e1ria em Deficientes Intelectuais","volume":"36","author":"Raulino","year":"2014","journal-title":"Rev. Bras. Ci\u00eancias Esporte"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.bbr.2011.10.015","article-title":"Exercise, Mood and Cognitive Performance in Intellectual Disability\u2014A Neurophysiological Approach","volume":"226","author":"Vogt","year":"2012","journal-title":"Behav. Brain Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.neubiorev.2017.06.012","article-title":"Physical Exercise as an Epigenetic Modulator of Brain Plasticity and Cognition","volume":"80","author":"Fernandes","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_8","unstructured":"Weinberg, R.S., and Gould, D. (2015). Fundamentals of Sport and Exercise Psychology, Human Kinetics. [6a ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/jir.12163","article-title":"The Association between a Single Bout of Moderate Physical Activity and Executive Function in Young Adults with Down Syndrome: A Preliminary Study","volume":"59","author":"Chen","year":"2015","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/jir.12258","article-title":"Dose-Response Relationship between Intensity of Exercise and Cognitive Performance in Individuals with Down Syndrome: A Preliminary Study","volume":"60","author":"Chen","year":"2016","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_11","first-page":"e2920","article-title":"Effects of Physical Exercise for Adults with Intellectual Disabilities: A Systematic Review","volume":"29","author":"Pestana","year":"2018","journal-title":"J. Phys. Educ."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Schalock, R., Keith, K., Verdugo, M., and G\u00f3mez, L. (2011). Quality of Life Model Development and Use in the Field of Intellectual Disability. Enhancing the Quality of Life of People with Intellectual Disabilities, Springer.","DOI":"10.1007\/978-90-481-9650-0_2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1352\/0047-6765(2002)040<0457:CMAAOQ>2.0.CO;2","article-title":"Conceptualization, Measurement, and Application of Quality of Life for Persons with Intellectual Disabilities: Report of an International Panel of Experts","volume":"40","author":"Schalock","year":"2002","journal-title":"Ment. Retard."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/08856257.2016.1187876","article-title":"Changes on Quality of Life, Self-Efficacy and Social Support for Activities and Physical Fitness in People with Intellectual Disabilities through Multimodal Intervention","volume":"31","year":"2016","journal-title":"Eur. J. Spec. Needs Educ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.ijchp.2015.11.001","article-title":"A Structural Equation Model of the Relationship between Physical Activity and Quality of Life","volume":"16","author":"Schalock","year":"2016","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.pmedr.2016.06.008","article-title":"Physical Activity Levels in Adults with Intellectual Disabilities: A Systematic Review","volume":"4","author":"Dairo","year":"2016","journal-title":"Prev. Med. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.pmedr.2017.11.010","article-title":"Correlates of Objectively Measured Sedentary Time in Adults with Intellectual Disabilities","volume":"9","author":"Harris","year":"2017","journal-title":"Prev. Med. Rep."},{"key":"ref_18","unstructured":"American College of Sports Medicine (2021). ACSM\u2019s Guidelines for Exercise Testing and Prescription, LWW. [11th ed.]. Spiral Edition."},{"key":"ref_19","unstructured":"World Health Organization (2020). Guidelines on Physical Activity and Sedentary Behaviour: At a Glance."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1016\/j.ridd.2012.04.010","article-title":"Cardiovascular Risk Factors (Diabetes, Hypertension, Hypercholesterolemia and Metabolic Syndrome) in Older People with Intellectual Disability: Results of the HA-ID Study","volume":"33","author":"Bastiaanse","year":"2012","journal-title":"Res. Dev. Disabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/jar.12417","article-title":"Early Death and Causes of Death of People with Intellectual Disabilities: A Systematic Review","volume":"31","author":"Cooper","year":"2018","journal-title":"J. Appl. Res. Intellect. Disabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e013489","DOI":"10.1136\/bmjopen-2016-013489","article-title":"Cause of Death and Potentially Avoidable Deaths in Australian Adults with Intellectual Disability Using Retrospective Linked Data","volume":"7","author":"Trollor","year":"2017","journal-title":"BMJ Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1123\/jpah.2013-0014","article-title":"A Systematic Review of Interventions Aiming to Improve Involvement in Physical Activity among Adults with Intellectual Disability","volume":"12","author":"Brooker","year":"2015","journal-title":"J. Phys. Act. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"416","DOI":"10.21149\/8204","article-title":"Body Mass Index and Waist Circumference of Latin American Adult Athletes with Intellectual Disability","volume":"59","author":"Foley","year":"2017","journal-title":"Salud P\u00fablica M\u00e9xico"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ypmed.2008.01.007","article-title":"Physical Activity among Adults with Intellectual Disabilities Living in Community Settings","volume":"47","author":"Peterson","year":"2008","journal-title":"Prev. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1016\/j.ridd.2014.05.027","article-title":"Physical Fitness Is Predictive for a Decline in Daily Functioning in Older Adults with Intellectual Disabilities: Results of the HA-ID Study","volume":"35","author":"Oppewal","year":"2014","journal-title":"Res. Dev. Disabil."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jacinto, M., Vitorino, A.S., Palmeira, D., Antunes, R., Matos, R., Ferreira, J.P., and Bento, T. (2021). Perceived Barriers of Physical Activity Participation in Individuals with Intellectual Disability\u2014A Systematic Review. Healthcare, 9.","DOI":"10.3390\/healthcare9111521"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1352\/1934-9556-52.3.175","article-title":"Facilitators and Barriers to Physical Activity as Perceived by Older Adults with Intellectual Disability","volume":"52","author":"Evenhuis","year":"2014","journal-title":"Intellect. Dev. Disabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1123\/pes.2017-0281","article-title":"Age-Predicted Maximal Heart Rate Equations Are Inaccurate for Use in Youth Male Soccer Players","volume":"30","author":"Cicone","year":"2018","journal-title":"Pediatr. Exerc. Sci."},{"key":"ref_31","first-page":"1","article-title":"Auditory Information Reduces Response Time for Ball Rotation Perception, Increasing Counterattack Performance in Table Tennis","volume":"6","author":"Fujita","year":"2021","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1352\/1944-7558-116.3.220","article-title":"Physical Activity Benefits and Needs in Adults with Intellectual Disabilities: Systematic Review of the Literature","volume":"116","author":"Bartlo","year":"2011","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4549","DOI":"10.1080\/09638288.2021.1910738","article-title":"Effects of Resistance Training Interventions on Muscular Strength in Adults with Intellectual Disability: A Systematic Review and Meta-Analysis","volume":"44","author":"Obrusnikova","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1352\/1944-7558-125.4.274","article-title":"A Systematic Review and Meta-Analysis Examining the Effect of Exercise on Individuals With Intellectual Disability","volume":"125","author":"Borschneck","year":"2020","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_35","first-page":"307","article-title":"The Effects of Training on Heart Rate; a Longitudinal Study","volume":"35","author":"Karvonen","year":"1957","journal-title":"Ann. Med. Exp. Biol. Fenn."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9545","DOI":"10.1021\/acs.est.8b01781","article-title":"Advancing Environmental Epidemiology to Assess the Beneficial Influence of the Natural Environment on Human Health and Well-Being","volume":"52","author":"Silva","year":"2018","journal-title":"Environ. Sci. Technol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1352\/1944-7558-122.5.422","article-title":"Feasibility and Reliability of Tests Measuring Health-Related Physical Fitness in Children With Moderate to Severe Levels of Intellectual Disability","volume":"122","author":"Wouters","year":"2017","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ridd.2015.09.003","article-title":"Feasibility of Bioelectrical Impedance Analysis in Persons with Severe Intellectual and Visual Disabilities","volume":"47","author":"Waninge","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_39","first-page":"669","article-title":"A Reliable Isokinetic Strength Test for Arm and Leg Musculature for Mildly Mentally Retarded Adults","volume":"71","author":"Pitetti","year":"1990","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_40","first-page":"45","article-title":"Isokinetic Dynamometry: Implications for Muscle Testing and Rehabilitation","volume":"14","author":"Osternig","year":"1986","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1139\/H09-064","article-title":"Age- and Sex-Associated Differences in Isokinetic Knee Muscle Endurance between Young Children and Adults","volume":"34","author":"Deighan","year":"2009","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"138","DOI":"10.2519\/jospt.1991.13.3.138","article-title":"Sources of Error in Isokinetic Dynamometry: Effects of Visual Feedback on Maximum Torque","volume":"13","author":"Baltzopoulos","year":"1991","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_43","unstructured":"Perrin, D.H. (1993). Isokinetic Exercise and Assessment, Human Kinetics."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Cabeza-Ruiz, R., Alc\u00e1ntara-Cordero, F.J., Ruiz-Gavil\u00e1n, I., and S\u00e1nchez-L\u00f3pez, A.M. (2019). Feasibility and Reliability of a Physical Fitness Test Battery in Individuals with Down Syndrome. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16152685"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1080\/09638288.2018.1527399","article-title":"Adding Meaning to Physical Fitness Test Results in Individuals with Intellectual Disabilities","volume":"42","author":"Oppewal","year":"2020","journal-title":"Disabil. Rehabil."},{"key":"ref_46","unstructured":"Winnick, J.P., and Short, F.X. (2001). Testes de Aptid\u00e3o F\u00edsica para Jovens com Necessidades Especiais: Manual Brockport de Testes, Manole."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1519\/JSC.0b013e3181ecd27b","article-title":"The Seated Medicine Ball Throw as a Test of Upper Body Power in Older Adults","volume":"25","author":"Harris","year":"2011","journal-title":"J. Strength Cond. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1123\/japa.7.2.129","article-title":"Development and Validation of a Functional Fitness Test for Community-Residing Older Adults","volume":"7","author":"Rikli","year":"1999","journal-title":"J. Aging Phys. Act."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3109\/13668250.2012.681773","article-title":"Feasibility and Reliability of Physical Fitness Tests in Older Adults with Intellectual Disability: A Pilot Study","volume":"37","author":"Hilgenkamp","year":"2012","journal-title":"J. Intellect. Dev. Disabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3109\/13668250.2012.748885","article-title":"The Six-Minute Walk Test for Adults with Intellectual Disability: A Study of Validity and Reliability","volume":"38","author":"Nasuti","year":"2013","journal-title":"J. Intellect. Dev. Disabil."},{"key":"ref_51","unstructured":"World Health Organization (2010). WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1519\/JSC.0000000000001795","article-title":"Heart Rate Variability Discriminates Competitive Levels in Professional Soccer Players","volume":"31","author":"Proietti","year":"2017","journal-title":"J. Strength Cond. Res."},{"key":"ref_54","unstructured":"(1996). Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology Heart Rate Variability: Standards of Measurement, Physiological Interpretation and Clinical Use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation, 93, 1043\u20131065."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.cmpb.2013.07.024","article-title":"Kubios HRV\u2014Heart Rate Variability Analysis Software","volume":"113","author":"Tarvainen","year":"2014","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11205-009-9517-7","article-title":"Quality of Life Measurement in the Field of Intellectual Disabilities: Eight Principles for Assessing Quality of Life-Related Personal Outcomes","volume":"98","author":"Claes","year":"2010","journal-title":"Soc. Indic. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/09362835.2010.513924","article-title":"Assessing Individual Support. Needs to Enhance Personal Outcomes","volume":"18","author":"Loon","year":"2010","journal-title":"Exceptionality"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ijchp.2015.11.002","article-title":"Validation of the Portuguese Version of the Personal Outcomes Scale","volume":"16","author":"Santos","year":"2016","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_59","first-page":"184","article-title":"Handbook on Quality of Life for Human Service Practitioners. Robert Schalock and Miguel Angel Verdugo Alonso, American Association on Mental Retardation (AAMR), Washington, DC (Aamr@pmds.Com) 2002, 430 Pp, ISBN 0-940898-77-2","volume":"5","author":"Hind","year":"2003","journal-title":"Deaf. Educ. Int."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-Mental State\u201d. A Practical Method for Grading the Cognitive State of Patients for the Clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_61","first-page":"9","article-title":"Adapta\u00e7\u00e3o \u00e0 Popula\u00e7\u00e3o Portuguesa Da Tradu\u00e7\u00e3o Do \u201cMini Mental State Examination\u201d (MMSE)","volume":"1","author":"Guerreiro","year":"1994","journal-title":"Rev. Port. Neurol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Paiva, A.F., Nolan, A., Thumser, C., and Santos, F.H. (2020). Screening of Cognitive Changes in Adults with Intellectual Disabilities: A Systematic Review. Brain Sci., 10.","DOI":"10.20944\/preprints202009.0739.v1"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Fischer, H. (2011). A History of the Central Limit Theorem, Springer.","DOI":"10.1007\/978-0-387-87857-7"},{"key":"ref_64","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Routledge. [2nd ed.]."},{"key":"ref_65","unstructured":"Cohen, J., Cohen, P., West, S.G., and Aiken, L.S. (2002). Applied Multiple Regression\/Correlation Analysis for the Behavioral Sciences, Routledge. [3rd ed.]."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1021\/acs.est.1c05151","article-title":"Benefits to Performance and Well-Being of Nature-Based Exercise: A Critical Systematic Review and Meta-Analysis","volume":"56","author":"Brito","year":"2022","journal-title":"Environ. Sci. Technol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/cphy.c110007","article-title":"Bioenergetics of Exercising Humans","volume":"2","author":"Brooks","year":"2012","journal-title":"Compr. Physiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.pbb.2003.10.020","article-title":"Exercise, Antidepressant Treatment, and BDNF MRNA Expression in the Aging Brain","volume":"77","author":"Garza","year":"2004","journal-title":"Pharm. Biochem. Behav."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3390\/brainsci3010039","article-title":"Exercise Benefits Brain Function: The Monoamine Connection","volume":"3","author":"Lin","year":"2013","journal-title":"Brain Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jad.2013.01.014","article-title":"A Review of Lifestyle Factors That Contribute to Important Pathways Associated with Major Depression: Diet, Sleep and Exercise","volume":"148","author":"Lopresti","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"109502","DOI":"10.1155\/2008\/109502","article-title":"Exercise as a Mean to Control Low-Grade Systemic Inflammation","volume":"2008","author":"Mathur","year":"2008","journal-title":"Mediat. Inflamm."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7485\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:43:08Z","timestamp":1760146988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":71,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11247485"],"URL":"https:\/\/doi.org\/10.3390\/jcm11247485","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]}}}