Daily physical activity in adults with mild and moderate learning disabilities: Is there enough?

Messent, Peter R.; Cooke, Carlton; Long, Jonathan

doi:10.3109/09638289809166104

Cited by 54 publications

(43 citation statements)

References 7 publications

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“…This is despite institutional barriers that have been hypothesised to inhibit physical activity engagement in those with ID. 237 An important finding from this substudy was the difference in activity levels gained from wrist-and waist-worn devices. Although waist-worn devices have been widely used in research over the last decade, with established methods of categorising collected data, which allows for comparisons between studies, wrist-worn devices are newer and lack standardised approaches to data analysis.…”

Section: Discussionmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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Section: Discussionmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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“…All of the studies were published well after these revisions were implemented yet the outdated guidelines were used for data interpretation, leading to potentially unreliable findings. For example, Messent et al [1998aMessent et al [ , 1998b actually discussed both the 30-minute (current) and 20-minute (former) moderate activity guidelines and it was not clear which was used as a criterion. In addition, the Emerson [2005] study was published well after the policy was revised [Prior, 1999] but a physical activity scale based on the old guidelines was used for data collection.…”

Section: Physical Activity Behaviormentioning

confidence: 99%

Health‐promoting physical activity of adults with mental retardation

Stanish

Temple

Frey

2006

Ment. Retard. Dev. Disabil. Res. Rev.

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This literature review describes the physical activity behavior of adults with mental retardation consistent with the U.S. Surgeon General's recommendation of 30 minutes of moderate intensity physical activity on 5 or more days per week. The proportion of participants achieving this criterion ranges from 17.5 to 33%. These data are likely to be generous estimates of activity as individuals included in physical activity studies to date have been relatively young and healthy volunteers with mild to moderate limitations. Major sources of physical activity were walking and cycling for transport, chores and work, dancing, and Special Olympics. There is a pressing need to conduct studies using appropriately powered representative samples and to validate measures that assess physical activity less directly; including methodologies in which proxy respondents are used. Accurate information about existing patterns of behavior will enhance the development of effective strategies to promote physical activity among persons with mental retardation.

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“…36 The activities described were categorized as sedentary behaviours based on energy expenditure using the Compendium of Physical Activities (CPA). 37 Activities like passive transportation, arts and crafts, sewing cushion covers, computer work, snooker, watching TV or videos, reading and writing, cooking, or eating were all defined as sedentary behaviour. Although no quantitative data was reported in this study, this was the only study to measure sedentary behaviour in specific settings, 13 and the only study to highlight the contribution of passive transportation to total sedentary time.…”

Section: Methods Of Measurementmentioning

confidence: 99%

Definitions, measurement and prevalence of sedentary behaviour in adults with intellectual disabilities — A systematic review

Melville

Oppewal

Elinder

et al. 2017

Preventive Medicine

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Daily physical activity in adults with mild and moderate learning disabilities: Is there enough?

Cited by 54 publications

References 7 publications

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Health‐promoting physical activity of adults with mental retardation

Definitions, measurement and prevalence of sedentary behaviour in adults with intellectual disabilities — A systematic review

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