Feasibility of a school-based exercise intervention for children with intellectual disability to reduce cardio-metabolic risk.


Journal

Journal of intellectual disability research : JIDR
ISSN: 1365-2788
Titre abrégé: J Intellect Disabil Res
Pays: England
ID NLM: 9206090

Informations de publication

Date de publication:
01 2020
Historique:
received: 15 01 2018
revised: 28 08 2019
accepted: 30 08 2019
pubmed: 19 10 2019
medline: 2 6 2021
entrez: 19 10 2019
Statut: ppublish

Résumé

People with intellectual disabilities (ID) are at increased risk of secondary health conditions, reduced quality of life and life expectancy. Children with ID demonstrate low levels of physical activity in association with a higher prevalence of obesity, a modifiable risk factor associated with secondary health conditions including type 2 diabetes and cardiovascular disease. Despite this, physical activity interventions addressing weight and weight-related complications in this population are limited. This study aimed to establish the feasibility of a school-based group exercise intervention for children with moderate to severe ID. A single-arm intervention study was used to establish the feasibility of a 16-week exercise intervention. Children attending a School for Specific Purposes in Sydney, Australia, participated in two 30-min exercise sessions per week across the intervention period in addition to their regular physical education class. Each exercise session was 60% aerobically based, 20% strength based and 20% targeted towards fundamental movement skill development. We used two facilitation strategies to assist the delivery of the intervention, including the implementation of a variety of communication resources and promotion of social interaction. Feasibility was assessed through recruitment rates, program retention, adverse effects, attendance, group size feasibility and non-compliance. Anthropometric measures included height (m), weight (kg) and waist circumference (cm; umbilicus), with body mass index (BMI) and waist-to-height ratios (WtHR) used to determine cardio-metabolic risk. Aerobic capacity was assessed using the submaximal 6-min walk test (6-MWT). Intensity of physical activity sessions was measured through the use of tri-axial accelerometers and compared to physical activity recommendations. Ten children aged between 9 and 13 years completed the 16-week intervention, with a 55% recruitment rate, 91% program retention, 86% attendance and with no adverse effects reported. Sessions commenced as 1:1 supervisor to child ratios before progressing to established small groups of 2:7 (supervisor : child). Children spent 38.4% (11.5 min) of each session in moderate to vigorous physical activity (MVPA), equating to 20% of their MVPA recommended daily physical activity levels (twice per week). There was a significant change in weight across the intervention period, with a trend towards increased weight between mid-intervention and 3-month follow-up time points. There were no significant changes in child BMI, WtHR or aerobic capacity. A school-based group exercise intervention for children with moderate to severe ID is feasible and safe, with high retention rates and physical activity participation. No significant improvements in body composition or aerobic capacity were determined. The present study demonstrates that engaging children with moderate-severe ID in school-based group exercise is feasible to assist in physical activity participation.

Sections du résumé

BACKGROUND
People with intellectual disabilities (ID) are at increased risk of secondary health conditions, reduced quality of life and life expectancy. Children with ID demonstrate low levels of physical activity in association with a higher prevalence of obesity, a modifiable risk factor associated with secondary health conditions including type 2 diabetes and cardiovascular disease. Despite this, physical activity interventions addressing weight and weight-related complications in this population are limited. This study aimed to establish the feasibility of a school-based group exercise intervention for children with moderate to severe ID.
METHODS
A single-arm intervention study was used to establish the feasibility of a 16-week exercise intervention. Children attending a School for Specific Purposes in Sydney, Australia, participated in two 30-min exercise sessions per week across the intervention period in addition to their regular physical education class. Each exercise session was 60% aerobically based, 20% strength based and 20% targeted towards fundamental movement skill development. We used two facilitation strategies to assist the delivery of the intervention, including the implementation of a variety of communication resources and promotion of social interaction. Feasibility was assessed through recruitment rates, program retention, adverse effects, attendance, group size feasibility and non-compliance. Anthropometric measures included height (m), weight (kg) and waist circumference (cm; umbilicus), with body mass index (BMI) and waist-to-height ratios (WtHR) used to determine cardio-metabolic risk. Aerobic capacity was assessed using the submaximal 6-min walk test (6-MWT). Intensity of physical activity sessions was measured through the use of tri-axial accelerometers and compared to physical activity recommendations.
RESULTS
Ten children aged between 9 and 13 years completed the 16-week intervention, with a 55% recruitment rate, 91% program retention, 86% attendance and with no adverse effects reported. Sessions commenced as 1:1 supervisor to child ratios before progressing to established small groups of 2:7 (supervisor : child). Children spent 38.4% (11.5 min) of each session in moderate to vigorous physical activity (MVPA), equating to 20% of their MVPA recommended daily physical activity levels (twice per week). There was a significant change in weight across the intervention period, with a trend towards increased weight between mid-intervention and 3-month follow-up time points. There were no significant changes in child BMI, WtHR or aerobic capacity.
CONCLUSIONS
A school-based group exercise intervention for children with moderate to severe ID is feasible and safe, with high retention rates and physical activity participation. No significant improvements in body composition or aerobic capacity were determined. The present study demonstrates that engaging children with moderate-severe ID in school-based group exercise is feasible to assist in physical activity participation.

Identifiants

pubmed: 31625658
doi: 10.1111/jir.12690
doi:

Types de publication

Clinical Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7-17

Informations de copyright

© 2019 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Références

Alesi M. & Pepi A. (2017) Physical activity engagement in young people with Down syndrome: investigating parental beliefs. Journal of Applied Research in Intellectual Disabilities 30, 71-83.
Barnett L., Van Beurden E., Morgan P., Brooks L. & Beard J. (2009) Childhood motor skill proficiency as a predictor of adolescent physical activity. Journal of Adolescent Health 44, 252-259.
Barr M. & Shields N. (2011) Identifying the barriers and facilitators to participation in physical activity for children with Down syndrome. J Journal of Intellectual Disability Research 55, 1020-1033.
Cole T. J., Bellizzi M. C., Flegal K. M. & Dietz W. H. (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240-1243.
Columna, L. (2007). Perceived benefits, constraints, and patterns of physical recreation of hispanic families with children with disabilities. Texas Woman's University.
Curtin C., Anderson S. E., Must A. & Bandini L. (2010) The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children's Health. BMC Pediatrics 10, 11, 1-5.
Department of Health (2004) At least five a week: Evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer, Department of Health London.
Downs S. J., Boddy L. M., Knowles Z. R., Fairclough S. J. & Stratton G. (2013) Exploring opportunities available and perceived barriers to physical activity engagement in children and young people with Down syndrome. European Journal of Special Needs Education 28, 270-287.
Draheim C. C. (2006) Cardiovascular disease prevalence and risk factors of persons with mental retardation. Mental Retardation and Developmental Disabilities Research Reviews 12, 3-12.
Einarsson I. O., Olafsson A., Hinriksdóttir G., Jóhannsson E., Daly D. & Arngrímsson S. A. (2015) Differences in physical activity among youth with and without intellectual disability. Medicine and Science in Sports and Exercise 47, 411-418.
Garnett S. P., Baur L. A. & Cowell C. T. (2008) Waist-to-height ratio: a simple option for determining excess central adiposity in young people. International Journal of Obesity 32, 1028-1030.
Grandisson M., Tétreault S. & Freeman A. R. (2012) Enabling integration in sports for adolescents with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities 25, 217-230.
Hayakawa K. & Kobayashi K. (2011) Physical and motor skill training for children with intellectual disabilities. Perceptual and Motor Skills 112, 573-580.
Heller T., Hsieh K. & Rimmer J. (2003) Barriers and supports for exercise participation among adults with Down syndrome. Journal of Gerontological Social Work 38, 161-178.
Heller T., Ying Gs G. S., Rimmer J. H. & Marks B. A. (2002) Determinants of exercise in adults with cerebral palsy. Public Health Nursing 19, 223-231.
Hilgenkamp T. I., Van Wijck R. & Evenhuis H. M. (2012) Low physical fitness levels in older adults with ID: results of the HA-ID study. Research in Developmental Disabilities 33, 1048-1058.
Hinckson E. & Curtis A. (2013) Measuring physical activity in children and youth living with intellectual disabilities: a systematic review. Research in Developmental Disabilities 34, 72-86.
Hinckson E., Dickinson A., Water T., Sands M. & Penman L. (2013) Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism. Research in Developmental Disabilities 34, 1170-1178.
Janicki M., Davidson P., Henderson C., Mccallion P., Taets J., Force L. et al. (2002) Health characteristics and health services utilization in older adults with intellectual disability living in community residences. Journal of Intellectual Disability Research 46, 287-298.
Jones D. B. (2003) “Denied from a lot of places” barriers to participation in community recreation programs encountered by children with disabilities in Maine: perspectives of parents. Leisure 28, 49-69.
Katzmarzyk P. T., Barreira T. V., Broyles S. T., Champagne C. M., Chaput J. P., Fogelholm M. et al. (2015) Physical Activity, Sedentary Time, and Obesity in an International Sample of Children. Medicine and Science in Sports and Exercise 47, 2062-2069.
Katzmarzyk P. T., Baur L. A., Blair S. N., Lambert E. V., Oppert J. M. & Riddoch C. (2008) Expert panel report from the International Conference on Physical Activity and Obesity in Children, 24-27 June 2007, Toronto, Ontario: summary statement and recommendations. Applied Physiology, Nutrition, and Metabolism 33, 371-388.
Lassale C., Tzoulaki I., Moons K. G. M., Sweeting M., Boer J., Johnson L. et al. (2017) Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis. European Heart Journal 39, 397-406.
Leung W., Siebert E. A. & Yun J. (2017) Measuring physical activity with accelerometers for individuals with intellectual disability: a systematic review. Research in Developmental Disabilities 67, 60-70.
Levinson L. & Reid G. (1991) Patterns of physical activity among youngsters with developmental disabilities. Journal of the Canadian Association for Health, Physical Education and Recreation 57, 24-28.
Li A., Yin J., Au J., So H., Tsang T., Wong E. et al. (2007) Standard reference for the six-minute-walk test in healthy children aged 7 to 16 years. American Journal of Respiratory and Critical Care Medicine 176, 174-180.
Lochbaum M. & Crews D. (2003) Viability of cardiorespiratory and muscular strength programs for the adolescent with autism. Complementary Health Practice Review 8, 225-233.
Maffeis C., Banzato C., Talamini G. & Obesity Study Group of the Italian Society of Pediatric, E. & Diabetology (2008) Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. The Journal of Pediatrics 152, 207-213.
Mcgarty A. M. & Melville C. A. (2018) Parental perceptions of facilitators and barriers to physical activity for children with intellectual disabilities: a mixed methods systematic review. Research in Developmental Disabilities 73, 40-57.
Mcgarty A. M., Penpraze V. & Melville C. A. (2016) Calibration and cross-validation of the ActiGraph wGT3X+ accelerometer for the estimation of physical activity intensity in children with intellectual disabilities. PLoS ONE 11, e0164928.
Menear K. (2007) Parents' perceptions of health and physical activity needs of children with Down syndrome. Journal Down Syndrome Research Practice 12, 60-68.
Okely A., Booth M. & Patterson J. (2001) Relationship of physical activity to fundamental movement skills among adolescents. Medicine and Science in Sports and Exercise 33, 1899-1904.
Ozmen T., Ryildirim N. U., Yuktasir B. & Beets M. W. (2007) Effects of school-based cardiovascular-fitness training in children with mental retardation. Pediatric Exercise Science 19, 171-178.
Payne G. & Isaacs L. (2012) Human Motor Development: A Lifespan Approach. McGraw-Hill, NY.
Phillips A. C. & Holland A. J. (2011) Assessment of objectively measured physical activity levels in individuals with intellectual disabilities with and without Down's syndrome. PLoS ONE 6, e28618.
Pitetti K. H., Rendoff A. D., Grover T. & Beets M. W. (2007) The efficacy of a 9-month treadmill walking program on the exercise capacity and weight reduction for adolescents with severe autism. Journal of Autism and Developmental Disorders 37, 997-1006.
Poitras V. J., Gray C. E., Borghese M. M., Carson V., Chaput J.-P., Janssen I. et al. (2016) Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Applied Physiology, Nutrition, Metabolism 41, S197-S239.
Rimmer J. H., Yamaki K., Lowry B. M., Wang E. & Vogel L. C. (2010) Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities. Journal of Intellectual Disability Research 54, 787-794.
Salaun L. & Berthouze-Aranda S. E. (2012) Physical fitness and fatness in adolescents with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities 25, 231-239.
Shields N., Synnot A. J. & Barr M. (2012) Perceived barriers and facilitators to physical activity for children with disability: a systematic review. British Journal of Sports Medicine 46, 989-997.
Sit C., Lindner K. & Sherrill C. (2002) Sport participation of Hong Kong Chinese children with disabilities in special schools. Adapted Physical Activity Quarterly 19, 453-471.
Spanos D., Hankey C., Boyle S., Koshy P., Macmillan S., Matthews L. et al. (2013) Carers' perspectives of a weight loss intervention for adults with intellectual disabilities and obesity: a qualitative study. Journal of Intellectual Disability Research 57, 90-102.
Staples K. & Reid G. (2010) Fundamental movement skills and autism spectrum disorders. Journal of Autism and Developmental Disorders 40, 209-217.
Strong W., Malina R., Blimkie C., Daniels S., Dishman R., Gutin B. et al. (2005) Evidence based physical activity for school-age youth. The Journal of Pediatrics 146, 732-737.
Trost S., Kerr L., Ward D. & Pate R. (2001) Physical activity and determinants of physical activity in obese and non-obese children. International Journal of Obesity and Related Metabolic Disorders 25, 822-829.
Westendorp M., Houwen S., Hartman E. & Visscher C. (2011) Are gross motor skills and sports participation related in children with intellectual disabilities? Research in Developmental Disabilities 32, 1147-1153.
Wouters M., Evenhuis H. & Hilgenkamp T. (2019) Physical activity levels of children and adolescents with moderate-to-severe intellectual disability. Journal of Applied Research in Intellectual Disabilities 32, 131-142.

Auteurs

J Bellamy (J)

Faculty of Medicine, School of Medical Sciences, Department of Exercise Physiology, UNSW Sydney, New South Wales, Australia.
The Children's Hospital at Westmead, New South Wales, Australia.

C Broderick (C)

Faculty of Medicine, School of Medical Sciences, Department of Exercise Physiology, UNSW Sydney, New South Wales, Australia.
The Children's Hospital at Westmead, New South Wales, Australia.

L L Hardy (LL)

Prevention Research Collaboration, The University of Sydney, New South Wales, Australia.

D Simar (D)

Faculty of Medicine, School of Medical Sciences, Department of Exercise Physiology, UNSW Sydney, New South Wales, Australia.

H Puusepp-Benazzouz (H)

The Children's Hospital at Westmead, New South Wales, Australia.

N Ong (N)

The Children's Hospital at Westmead, New South Wales, Australia.

N Silove (N)

The Children's Hospital at Westmead, New South Wales, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH