Changes in physical activity across a 6‐month weight loss intervention in adolescents with intellectual and developmental disabilities

Abstract

Background Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate‐to‐vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6‐month multi‐component weight loss intervention. Methods Adolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face‐to‐face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self‐monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face‐to‐face arm was delivered during home‐visits and self‐monitoring of MVPA and daily steps was completed by self‐report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x‐BT). Results Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4–10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate‐ MVPA, or sedentary time across the 6‐month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group‐by‐time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = −0.22, P = 0.30) and change in MVPA across the 6‐month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self‐monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6‐month intervention. Conclusion We observed a non‐significant increase in MVPA (30%), which was not associated with the magnitude of weight l...

A Pilot Study to Examine the Feasibility and Acceptability of a Virtual Adaptation of an In-Person Adolescent Diabetes Prevention Program

“…Although we did not use gaming software or devices in our intervention, we did include interactive games to promote behavior modification. The only other study we could find that included remote education and counseling about lifestyle behaviors through video conferencing focused on adolescents with intellectual disabilities and found no differences in outcomes for participants who received the program in-person or virtually [77,78].…”

Interviews with parents of adolescents with intellectual and developmental disabilities in a weight management study

“…Across the three groups, MVPA at baseline was low (~15 min/day) and the change in MVPA at 6 months did not achieve statistical significance (4.5 min/day) with less than 7% of participants achieving the recommended 60 min/day of MVPA. (Ptomey et al, 2021) However, when parents were asked what they thought about the prescribed amount of physical activity for the study, most parents indicated personalised goal‐setting was helpful and motivated their adolescent to become more active. They especially liked that the health educator encouraged their adolescents to progress slowly and build physical activity into their daily routine.

…build up to it, you know we had some pretty easy goals in the beginning to make sure [adolescent] got in the mindset of tracking his steps and knowing that he needs to get on the treadmill or do whatever it is that his goal is for that week.

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“…Across the three groups, MVPA at baseline was low ($15 min/day) and the change in MVPA at 6 months did not achieve statistical significance (4.5 min/day) with less than 7% of participants achieving the recommended 60 min/day of MVPA (Ptomey et al, 2021). However, when parents were asked what they thought about the prescribed amount of physical activity for the study, most parents indicated personalised goal-setting was helpful and motivated their adolescent to become more active.…”

Physical activity, exercise and fitness

“…Ptomey et al . (2022b) implemented a 6‐month, multi‐component weight loss intervention, which compared different diets and different modes of delivery (in‐person vs. remote) of behavioural counselling to comply with both physical activity and diet goals. Although they did achieve weight loss, which was their primary goal, physical activity did not significantly change in either of the groups and was not related to any changes in body weight in young adults with IDD.…”