Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial

Abstract

Background Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers. Objective The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population. Methods The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game–based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG. Results This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021. Conclusions The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability. Trial Registration ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355 International Registered Report Identifier (IRRID) PRR1-10.2196/25838

Effects of a Floor Hockey Intervention on Motor Proficiency, Physical Fitness, and Adaptive Development in Youths with Mild Intellectual Disabilities

“…Youths with IDs in the present study were discovered to have significant improvements in physical fitness components, namely cardiorespiratory fitness and abdominal strength and endurance, after the 12-week floor hockey intervention ( Table 4 and Figure 2 ). Findings accord with several intervention studies on youths with IDs and typically developing youths that have revealed positive effects of PA interventions on several physical fitness outcomes in this population [ 13 , 37 , 38 , 60 , 63 , 64 ]. These improvements in the physical fitness of the participants with IDs may be attributable to improvements in motor proficiency due to increases in PA (i.e., floor hockey training).…”

“…Two studies conducted in Asia on samples of more than 400 youths with IDs identified significant correlations of motor proficiency with muscular strength and endurance and cardiorespiratory fitness [ 65 , 66 ]. The positive findings of the current study echo those of early studies [ 13 , 37 , 38 , 60 , 63 ], synthesizing evidence regarding the effects of PA training on physical fitness levels in youths with IDs. Our results also extend the findings of these early studies by indicating that floor hockey practice can improve not only physical fitness but also other motor proficiency and adaptive functioning outcomes among youths with IDs.…”

“…Regarding physical fitness, some intervention studies of youths with IDs have reported global changes in health-related physical fitness components [ 13 , 37 , 38 , 60 , 63 ]. Youths with IDs in the present study were discovered to have significant improvements in physical fitness components, namely cardiorespiratory fitness and abdominal strength and endurance, after the 12-week floor hockey intervention ( Table 4 and Figure 2 ).…”

“…Research has indicated that youths with IDs, especially those in secondary schools, engage in significantly less physical activity (PA) than do their counterparts in the general population [ 9 ]. Youths with IDs also exhibit low levels of physical fitness [ 10 , 11 ] and high rates of obesity [ 12 , 13 , 14 ], and experience substantial health disparities [ 9 , 15 , 16 ]. The global prevalence of overweight and obesity in youths with IDs is 30% to 33% [ 17 ], and the risk of developing overweight and obesity is 1.54 to 1.80 times higher among youths with IDs (aged 12 to 18 years) than among their typically developing peers [ 18 ].…”

“…To date, data on the effects of PA intervention addressing physical fitness for youths with IDs are promising. Wang et al [ 13 ] conducted a randomized controlled trial to examine the effect of a 12-week (2 days per week, 60 min per day) school-based PA intervention and to evaluate sustainable effects of the intervention on physical fitness of 48 youths with IDs (aged 12–18 years). This study is ongoing, and the results of improving physical fitness levels in youths with IDs are expected at the end of 2021.…”