The Physical Impacts of Autism on the Body through a Bio-Mechanical Lens

- By Simon Griffin

This presentation aims to examine how autism impacts the physical body of an individual throughout their life.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave.

This presentation aims to examine how autism impacts the physical body of an individual throughout their life.

Firstly, we must understand the physical and bio-mechanical lens we will use to examine autism through.

Bio-Mechanics

Bio-Mechanics is the study of the mechanical movements of the body. Within the context of both the gym, and day to day life, bio-mechanics analyses whether the correct muscles and joints are performing any given motion both correctly and efficiently.

Aspects of bio-mechanical physicality to be considered are:

mobility, stability & posture.

Mobility

Mobility is the combination of range of motion in every joint structure and the healthy flexibility of your soft tissue (muscles, tendons and fascia).
Posture

Posture is how you hold your body.
There are two types:
Dynamic posture is how you hold yourself when you are moving, like when you are walking, running, or bending over to pick up something.
Static posture is how you hold yourself when you are not moving, like when you are sitting, standing, or sleeping.
Joint Stability

Joint Stability is defined as the ability to maintain or control joint movement or position. Stability is achieved by the coordinating actions of surrounding tissues and the neuromuscular system.

Autism & Inactivity

How much time can be spent inactive?

24 Hours - 5 Days per week

7:00am - 8:00am - Breakfast etc > 1 hour - Sitting

8:00am - 9:00am - Commuting > 1 hour - Sitting

9:00am - 5:00pm - Work/School > 8 hours - Sitting

5:00pm - 6:00pm - Commuting > 1 hour - Sitting

6:00pm - 7:00pm - Rest/Dinner > 1 hour - Sitting

7:00pm - 8:00pm - Walk/Gym/Cycle/Yoga etc > 1 hour - Activity

8:00pm - 11:00 - Television/Reading/Relaxing > 3 hours - Sitting

This is the average daily activity level for an adolescence with autism according to the National Library of Medicine’s.

Only 14% of adolescence with autism meet the daily physical requirements to stay healthy.

According to the National Library of Medicine’s Physical Activity Guidelines for Americans, only 29% of typically developing young adolescents meet the Physical Activity Guidelines daily, whereas only 14% of young adolescents with autism meet the daily physical requirement.

Both are worrying numbers, but ultimately young adults with autism only have a 14% chance of being physically active enough to maintain their health.

Sitting is considered a physiological stress as it is not a ‘natural bio-mechanical movement or non-movement’.

However, the body is resourceful and will adapt according to lines of physiological stress.

When we have repetitive movement or non-movements such as sitting, this adaptation causes muscles and other soft tissues to remodel to become stronger in the direction of stress.

This typically causes in an imbalance of strength to weakness in joints, **resulting the loss of both joint mobility and joint stability, alongside pain in one of these 3 areas of the body:**

Declining activity levels will directly affect the MOBILITY of these 3 joints

Hip Immobility
Thoracic Spine Immobility
Gleno-humeral Immobility

Declining activity levels will directly affect the STABILITY of these 3 joints

Knee Instability
Lumbar Instability
Scapula Instability

Obesity Levels

Globally, obesity levels are rising.

Increased obesity has been directly linked to:

Type 2 diabetes
High blood pressure
Stroke
Cancer
Sleep apnea
Osteoarthritis
Fatty liver disease/Galbladder disease/Kidney disease/Coronary heart disease
Pregnancy problems
Depression/Anxiety
alongside Immobility, Postural and Bio-Mechanical Issues

Obesity & Autism

According to the CDC, people with autism are more likely to be obese than their peers.
Researchers examined this issue in 2019 and discovered adolescents with autism were two times more likely to be obese than their neurotypical peers.
Researchers broke obesity rates down by group:
- Of those without disabilities, 13.1% were obese.
- Of those with attention deficit hyperactivity disorder, 17.6% were obese.
- Of those with an intellectual disability, 19.8% were obese.
- Of those with any behavioral development disability, 20.4% were obese.
- Of those with autism, 31.8% were obese.

A 2014 study of more than 6,000 children and teenagers on the spectrum found that they are more than twice as likely to be overweight and nearly five times as likely to be obese as their typical peers.

Those statistics translate to higher rates of a host of associated health issues.

A 2016 analysis of Taiwan’s National Health Insurance Research Database revealed that teens with autism are nearly three times more likely to have type 2 diabetes than their typical peers.

A 2016 review of medical records from 48,762 children with autism in the United States showed that they also have significantly higher rates of other obesity-related conditions, such as hypertension, high cholesterol and nonalcoholic fatty liver disease.

Obesity, Immobility and Health Related Quality of Life (HRQoL)

Forhan & Gill have highlighted the direct correlation between rising obesity levels and decreasing mobility levels, and have also examined how higher levels of obesity, coupled with lower levels of mobility leads to a poor ‘health related quality of life’ (HRQoL).

So, how to address these issues?

We have established that adolescence with autism are far more likely to be both inactive and overweight than their typically developing peers. However, what is often overlooked or ignored, is the fact that an adolescent with autism may have a differently wired brain, but their physicality has the same template as their typically developing peers and therefore their bodies can be treated with the same physical approach.

This means that Optimal Standards of Strength (for adults) to ensure efficient Mobility, Posture & Bio-Mechanics can also be respectively applied to adolescence with autism. This Standard of Strength is the basic level of strength required to maintain efficient Mobility, Posture & Bio-Mechanics, and additionally offset the likelihood of obesity among adolescents with autism.

In simple terms, if an adolescent with autism can aim towards the physical standards of strength mentioned below, they will maintain their weight, mobility, stability and posture.

Male Standards (Reduce respectively for age)
Vertical Pull: Bodyweight x 5 repetitions
Horizontal Push: Bodyweight x 1 rep
Squat: Bodyweight x 1 rep
Hinge: Bodyweight + 50% of Bodyweight x 1 rep
Female Standards (Reduce respectively for age)
Vertical Pull: Bodyweight x 1 repetitions
Horizontal Push: 50-70% of Bodyweight x 1 rep
Squat: 75%-100% of Bodyweight x 1 rep
Hinge: Bodyweight + 25% of Bodyweight x 1 rep

7 Primary Movements of the Human Body

Push: (Vertical/Horizontal)
Pull: (Vertical/Horizontal)
Squat
Hinge
Lunge
Rotation
Walking Gait

If these Primary Movement Patterns are regularly enforced and improved upon, the likelihood of an individual with autism in suffering with obesity issues, joint issues or other health issues decreases.

Each Joint’s Primary Need through the lens of Mobility & Stability

Gleno-humeral– Mobility
Scapula – Stability
Thoracic Spine–Mobility

Lumbar Spine – Stability

Hip – Mobility (multi-planar)

Knee – Stability

Ankle –Mobility (sagittal)

Mike Boyle & Gray Cook’s Joint by Joint Approach

Firstly, when addressing issues such as obesity, mobility, stability and muscle mass, it is important to keep in mind the hierarchical nature of differing training disciplines when training for general health and fitness, alongside optimum mobility, posture and bio-mechanics.

Some forms of training are more beneficial for those with autism than others.

However, by creating an objective, scientific and physiological lens to analyse the benefit of different disciplines of training, we can confirm that resistance/weight training is of most benefit to those with Autism for Mobility, Posture and Bio-Mechanics.

Motor Unit Recruitment & Full Range of Motion

Dr John Rusin argues that loading the body’s joints through their full range of motion (RoM) produces the most optimal muscular reaction within the body.

This hypothesis can be analysed through the use of an Electromyography Assessment (EMG), which calculates the Motor Unit Recruitment (MUR) (the muscle mass utilised during any given motion).

François Billaut of the Victoria University, Australia subsequently tested and confirmed this hypothesis which proved that both high intensity exercises, utilising the body’s full range of motions through each respective joint, produced the largest muscular reaction in the body.

Taking Rusin & Billaut’s work into account, in conjunction with Brad Schoenfeld’s research which highlighted that “intensity (i.e. load)… is arguably the most important exercise variable for stimulating muscle growth’’, we can confirm that it is far more difficult for someone with mobility issues to successfully manage excess body fat, maintain joint integrity and adequate muscle mass standards.

Why Resistance Training to address Mobility, Postural or Bio-Mechanical Issues?

Because intelligently programmed resistance training, which values each joints Range of Motion (ROM) above all else, results in free

mobility,
postural and
bio-mechanical developments
unlike many other popular forms of physical training such as:

Yoga/Pilates
Cycling
Running
Aerobics
Martial Arts

The Hierarchical Lens of Physical Training gives 1 point to each different discipline of training if the training provides the participant with the following physiological result:

Joint Mobility - 1 Point
Joint Stability - 1 Point
Muscle Mass - 1 Point
Cardiovascular Health - 1 Point
Pain Prevention/Management/Alleviation - 1 Point
Mental Health Benefits - 1 Point

Benefits of Different Forms of Exercise

Strength training and dynamic movements are superior to static stretching for improving mobility, posture and bio-mechanics according to numerous scientific studies:

In 2005, Hess et al. subjected a group of octogenarians to a resistance training program at 80% of 1RM, three times per week; after 10 weeks of training, participants improved their performance on the TUG test (Mobility Test) by 15.7%.
Fiatarone et al. demonstrated that resistance training raised functional mobility even in people over 90 years old.
In 2006, Holviala etal. proved that both muscle power and strength are important determinants of mobility, and that resistance training is a powerful tool to induce specific neuromuscular adaptations that translate into improved mobility in healthy older adults.
Greek researchers looked at a group of men who trained with loads at 40, 60, or 80% of their 1RM or one-rep max. The results showed that higher intensities were linked with greater improvements in mobility/flexibility. That is, the men who trained at 80% of their 1RM were the ones who saw the greatest improvements.

Deadlifts Vs Sun Salutations

Take deadlifting, correctly performed, as an example:

With each rep you’ll stretch your hamstrings, loaded with your additional weight of the bar or dumbbells, to its full range of motion.
Not only will you perform this hinge many more times in a weightlifting session than a yoga or stretching session, but it will be much heavier and more beneficial than simply hinging and touching your ever elusive toes.
With deadlifting you will build muscle, burn calories, improve posture, strengthen your bones and joints and reduce your risk of injury by a staggering amount and your toes will come ever closer to you when you do choose to drop in for a quick yoga session.

So the question arises, why salute the sun if you can just deadlift twice a month. It seems that in this instance, deadlifting can improve the length of your hamstring, but yoga doesn’t seem to help your deadlift?

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