Heidi I. Stanish

Physical activity of adults with mental retardation: review and research needs.

OBJECTIVEnTo characterize physical activity levels of adults with mental retardation and identify limitations in published research.nnnDATA SOURCESnKey word searches for mental retardation, intellectual disability, learning disability, or developmental disability combined with physical activity or habitual exercise identified articles from MEDLINE, Academic Search Elite, Psych Articles, Health Source, and SPORT Discus. This produced a total of 801 citations.nnnSTUDY INCLUSION AND EXCLUSION CRITERIAnPublished English-language literature that quantitatively measured physical activity levels of adults with mental retardation was included in this review. Fourteen articles met this criterion.nnnDATA EXTRACTIONnCharacteristics of participants, study design, outcome measures, methods of analyses, and findings in terms of percentages, step counts, and accelerometer output were extracted.nnnDATA SYNTHESISnData were synthesized to identify the percentage of adults with mental retardation who met published health-related physical activity criteria and compare them with adults without mental retardation and to examine study limitations.nnnRESULTSnThe studies with the greatest rigor indicate that one-third of adults or fewer with mental retardation were sufficiently active to achieve health benefits. However, data are insufficient to determine whether adults with mental retardation are less active than the general community.nnnCONCLUSIONSnFuture research would be enhanced by including appropriately powered representative samples, by including comparison groups, by validating physical activity questionnaires, and by determining the accuracy of proxy respondents.

Dietary intake of adults with mental retardation who reside in community settings.

The dietary intake of adults with mental retardation among three different community residential settings was described and compared. Two dietary screeners were administered to 325 adults. The womens Fruit and Vegetable Screener scores from group homes were significantly higher than scores from those with family members and in semi-independent settings. No significant differences were found in dietary intake across residences for men. Overall, 0% to 6% of the participants consumed the recommended 5 or more fruits and vegetables per day, and 15% to 30% consumed the recommended<or=30% or less of calories from fat. Results suggest that regardless of residential setting, men and women do not consume enough fruits and vegetables and consume too much dietary fat.

Walking Habits of Adults With Mental Retardation

The walking activity of men and women with mental retardation residing in community settings was described. Participants were 38 women (M age=.7, SD=9.5) and 65 men (M age=35.9, SD=11.2). They wore pedometers for 7 days. A 2 x 2 factorial ANOVA indicated no significant gender differences in total step counts or between participants with and those without Down syndrome. A post-hoc analysis revealed that participants walked less on Saturday than during the weekdays. Only 21.1% of the women and 21.5% of the men with mental retardation accumulated the recommended 10,000 steps per day.

Pedometer-Measured Physical Activity of Adults With Intellectual Disability: Predicting Weekly Step Counts

Pedometers are objective, inexpensive, valid, and reliable measures of physical activity. The minimum number of days of pedometer monitoring needed to estimate average weekly step counts was investigated. Seven days of pedometer data were collected from 154 ambulatory men and women (ns = 88 and 66, respectively) with intellectual disability. Correlations between average weekly steps and 3-day combinations ranged from .80 to .94, and adjusted R(2) for 3 days of monitoring was .886. Results suggest that 3 days of pedometer wear is sufficient to predict average weekly steps among ambulatory adults with intellectual disability. This finding will allow researchers to reduce participant burden and study costs, may guide measurement procedures, and inform missing data protocols.

Promotion of physical activity in individuals with intellectual disability

This paper provides an overview of strategies that have been used to promote physical activity in individuals with intellectual disability. Several different approaches are discussed and the strengths and limitations of each are presented. Some determinants of physical activity for individuals with intellectual disability are also reported in an effort to better understand the factors that influence participation that could be targeted in future interventions. Recommendations for programming are provided.

Efficacy of a Peer-Guided Exercise Programme for Adolescents with Intellectual Disability

BACKGROUNDnPeer support is strongly associated with physical activity of adolescents. This study examined the efficacy of a YMCA-based, peer-guided exercise training programme for increasing health-related physical fitness among adolescents with intellectual disabilities.nnnMATERIALS AND METHODSnAdolescents with intellectual disabilities and typically developing peer partners provided reciprocal support during 1-h exercise sessions that included aerobic exercise, weight training and stretching activities. The programme was conducted 2 days/week for 15 weeks and pre- and post-test fitness testing was conducted.nnnRESULTSnParticipants demonstrated significant improvements in curl-ups, 6-min walk and BMI. Exercise session attendance was high and participants typically completed all of the prescribed aerobic and stretching exercises, whereas weight training exercises were completed less consistently.nnnCONCLUSIONSnThis peer-guided model integrates social and instructional support for adolescents with intellectual disabilities and may encourage exercise participation in community settings.

Obesity in children with developmental and/or physical disabilities

Children with developmental or physical disabilities, many of whom face serious health-related conditions, also are affected by the current obesity crisis. Although evidence indicates that children with disabilities have a higher prevalence of obesity than do children without disabilities, little is known of the actual magnitude of the problem in this population. To address this concern, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) held a conference on obesity in children with intellectual, developmental, or physical disabilities, bringing together scientists and practitioners in the fields of obesity and disability to foster collaboration, identify barriers to healthy weight status in populations with disabilities, propose avenues to solutions through research and practice, and develop a research agenda to address the problem. This article describes current knowledge about prevalence of obesity in this population, discusses factors influencing obesity risk, and summarizes recommendations for research presented at the conference.

The feasibility of using a peer-guided model to enhance participation in community-based physical activity for youth with intellectual disability

We examined the feasibility of a using a peer-guided model to foster participation of youth with intellectual disability in community-based exercise. The intervention was designed to address personal barriers to exercise commonly faced by individuals with intellectual disability. Twenty adolescents with mild–moderate intellectual disability and 14 typically developing peers exercised in groups of two or three, 2 days per week for 15 weeks at YMCAs. Each dyad or triad provided reciprocal support during structured, individualized exercise sessions led by certified fitness trainers. Adherence to the program was high and youth with intellectual disability showed a significant reduction in personal barriers. They also felt they had learned new skills and made new friends. Typically developing youth were also positive about their experience as a volunteer. Our findings suggest that a peer-guided exercise model is useful for enhancing participation in community-based exercise.

Intellectual disability is associated with increased risk for obesity in a nationally representative sample of U.S. children.

BACKGROUNDnData on obesity prevalence in children with intellectual disability (ID) are scarce.nnnOBJECTIVEnWe estimated rates of obesity among children aged 10-17 years with and without ID in a nationally representative dataset that included measures of child weight and ID status, as well as family meal frequency, physical activity, and sedentary behavior.nnnMETHODSnChi-square tests compared prevalence of obesity, demographic and behavioral characteristics between children with and without ID as reported in the 2011 National Survey of Childrens Health. Tests for interaction in logistic regression models determined whether associations between obesity and behavioral characteristics were different between children with/without ID.nnnRESULTSnObesity prevalence for children with ID was 28.9% and 15.5% for children without ID. After adjusting for age, sex, race/ethnicity and poverty level, the odds ratio was significantly 1.89 times greater among children with ID than among those without ID (95% CI: 1.14 to 3.12). Among children with ID, 49.8% ate at least one meal with family members every day compared to 35.0% without ID (pxa0<xa00.002), and 49.5% with ID participated in frequent physical activity compared to 62.9% (pxa0<xa00.005). Prevalence of obesity was higher among all children who ate family meals every day compared to fewer days per week, and the effect was significantly more pronounced among those with ID (pxa0=xa00.05).nnnCONCLUSIONSnPrevalence of obesity among youth with ID was almost double that of the general population. Prospective studies are needed in this population to examine the impact of consistent family mealtimes and infrequent physical activity.

Enjoyment, barriers, and beliefs about physical activity in adolescents with and without autism spectrum disorder.

The authors compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy between adolescents with autism spectrum disorder (ASD) and typically developing (TD) adolescents. A questionnaire was verbally administered to 35 adolescents with ASD and 60 TD adolescents. Compared with TD adolescents, fewer adolescents with ASD enjoyed team sports (65% vs. 95%, p < .001) and physical education (84% vs. 98%, p = .02). A greater proportion of adolescents with ASD perceived that physical activities were too hard to learn (16% vs. 0%, p < .01), and fewer believed that physical activity was a way to make friends (68% vs. 97%, p < .001). Fewer adolescents with ASD preferred to do physical activity in their free time (25% vs. 58%, p < .01). Most adolescents with ASD felt that physical activity is fun (84%), but the proportion was lower than in TD adolescents (98%, p = .03). Some perceptions about physical activity were similar between the 2 groups, but differences identified may inform program development.