Feasibility of a school‐based exercise intervention for children with intellectual disability to reduce cardio‐metabolic risk
Authors: Bellamy J. , Broderick C. , Hardy L. L. , Simar D. , Puusepp‐Benazzouz H. , Ong N. , Silove N. 
Published: October 2019

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.