title: Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial A single-blind, pilot randomised trial of a weight management intervention for adults with intellectual disabilities and obesity: study protocol Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial An efficacy trial of ‘Steps to Your Health’, a health promotion programme for adults with intellectual disability Disparities in diabetes prevalence and preventable hospitalizations in people with intellectual and developmental disability: a population-based study. Daily physical activity in adults with mild and moderate learning disabilities: is there enough?
abstract: Background Walking interventions have been shown to have a positive impact on physical activity ( PA ) levels , health and wellbeing for adult and older adult population s. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities . This paper will provide details of the Walk Well intervention , design ed for adults with intellectual disabilities , and a r and omised controlled trial ( RCT ) to test its effectiveness . Methods / design This study will adopt a RCT design , with participants allocated to the walking intervention group or a waiting list control group . The intervention consists of three PA consultations ( baseline , six weeks and 12 weeks ) and an individualised 12 week walking programme . A range of measures will be completed by participants at baseline , post intervention ( three months from baseline ) and at follow up ( three months post intervention and six months from baseline ) . All outcome measures will be collected by a research er who will be blinded to the study groups . The primary outcome will be steps walked per day , measured using accelerometers . Secondary outcome measures will include time spent in PA per day ( across various intensity levels ) , time spent in sedentary behaviour per day , quality of life , self-efficacy and anthropometric measures to monitor weight change . Discussion Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities , this RCT will examine if a walking intervention can successfully increase PA , health and wellbeing of adults with intellectual disabilities . Trial registration IS RCT N : IS RCT Background Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups . The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities . Methods We used a cluster r and omised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations . Assessment s were carried out blind to allocation . Clusters of participants were r and omly allocated to the Walk Well program or a 12-week waiting list control . Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques , written re sources for participants and carers , and an individualised , structured walking programme . The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks . Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity ( MVPA ) , body mass index ( BMI ) , and subjective well being . Results One hundred two participants in 50 clusters were r and omised . 82 ( 80.4 % ) participants completed the primary outcome . 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation . At baseline , participants walked 4780 ( st and ard deviation 2432 ) steps per day , spent 65.5 % ( st and ard deviation 10.9 ) of time sedentary and 59 % percent had a body mass in the obesity range . After the walking programme , the difference between mean counts of the Walk Well and control group was 69.5 steps per day [ 95 % confidence interval ( CI ) -1054 to 1193.3 ] . There were no significant between group differences in percentage time sedentary 1.6 % ( 95 % CI −2.984 to 6.102 ) , percentage time in MVPA 0.3 % ( 95 % CI −0.7 to 1.3 ) , BMI −0.2 kg/m2 ( 95 % CI −0.8 to 0.4 ) or subjective well-being 0.3 ( 95 % CI −0.9 to 1.5 ) . Conclusions This is the first published trial of a walking program for adults with intellectual disabilities . Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities . Since participants spent the majority of their time sedentary , home-based programmes to reduce sitting time may be a viable health improvement approach . Trial registration Current Controlled Trials IS RCT Background The prevalence of obesity in adults with intellectual disabilities has consistently been reported to be higher than the general population . Despite the negative impact of obesity on health , there is little evidence of the effectiveness of weight management interventions for adults with intellectual disabilities and obesity . Preliminary results from a single-str and ed feasibility study of a multi-component weight management intervention specifically design ed for adults with intellectual disabilities and obesity ( TAKE 5 ) and that satisfied clinical recommendations reported that it was acceptable to adults with intellectual disabilities and their carers . This study aims to determine the feasibility of a full-scale clinical trial of TAKE 5 . Methods This study will follow a pilot r and omised trial design . Sixty-six obese participants ( body mass index ( BMI ) ≥30 kg/m2 ) will be r and omly allocated to the TAKE 5 multi-component weight management intervention or a health education ‘ active ’ control intervention ( Waist Winners Too ( WWToo ) ) . Both interventions will be delivered over a 12-month period . Participants ’ anthropometric measures ( body weight , BMI , waist circumference , percentage body fat ) ; indicators of activity ( levels of physical activity and sedentary behaviour ) and well-being will be measured at three time points : baseline , 6 and 12 months . The research er collecting outcome measures will be blind to study group allocation . Conclusions The data from this study will generate pilot data on the acceptability of r and omisation , attrition rates and the estimates of patient-centred outcomes of TAKE 5 , which will help inform future research and the development of a full-scale r and omised clinical trial . Trial registration IS RCT N52903778 Background Adults with intellectual disability ( ID ) are physically very inactive . This study will compare two approaches to increasing physical activity in adults with ID : a lifestyle physical activity ( light-moderate intensity ) approach and a structured exercise ( moderate-vigorous intensity ) approach . The trial will compare the short-term ( 3-month ) and long-term ( 9-month ) outcomes and sustainability of each approach with a usual-care control group . Methods / Design A three-arm r and omised controlled trial ( RCT ) will be conducted . Ninety adults with ID aged 18 - 55 will be r and omly assigned to one of three groups : 1 ) a lifestyle physical activity group ( n = 30 ) , 2 ) a structured exercise group ( n = 30 ) , or 3 ) a usual care control group ( n = 30 ) . Participants in both groups will receive a 12-week intervention delivered by exercise specialists in the community with disability service staff , after which intervention will continue for 6 months , delivered by disability service staff only . Primary outcomes are aerobic fitness , 12-hour energy expenditure , and proxy-reported everyday physical activity . Secondary outcomes include objective ly assessed physical activity and sedentary behaviour , intervention compliance , functional walking capacity , participation in domestic activities , muscle strength , body composition , psychosocial outcomes , quality of life and health care costs . Discussion The trial results will determine the effectiveness and sustainability of two approaches to increasing physical activity and exercise among adults with ID.Trial registration IS RCT N77889248 ( 18 April 2012 ) Objective : Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities ( ID ) , r and omized efficacy trials of such interventions are lacking . Design : A r and omized active control intervention trial . Setting : The participants attended the health promotion classes in local disability agency service facilities . Method : We enrolled 443 individuals and r and omly assigned them to one of two eight-week participatory classes . The ‘ Steps to Your Health ’ ( STYH ) classes emphasized moderate to vigorous physical activity ( MVPA ) , healthy eating and  body mass index ( BMI )  reduction . The control intervention focused on hygiene and safety . Results : We did not find a statistically significant difference in mean MVPA or BMI change between completers of the STYH group compared to the control group one year after the intervention was completed . We did find that participation in STYH classes had a non-significant association with odds of reduction in BMI ( odds ratio [ OR ] 2.87 , 95 % confidence interval [ CI ] 0.91–9.11 ) and completers who lived in group homes were more likely than their counterparts who lived with families or in apartments to decrease their BMI ( OR 4.61 ; 95 % CI 1.14–18.64 ) . Conclusions : This trial did not demonstrate a significant effect of STYH participation on change in mean minutes of MVPA or mean BMI 12 months after classes ended , although there was a non-significant association with odds of reduction of BMI ( p = 0.07 ) . This study has implication s for design of intervention studies in people with intellectual disability ( ID ) AIMS To describe and compare population -level aspects of diabetes and diabetes primary care among people with and without intellectual and developmental disabilities . METHODS Administrative health data accessed from the Institute for Clinical Evaluative Sciences was used to identify a cohort of Ontarians with and without intellectual and developmental disabilities between the ages of 30 and 69 years ( n = 28 567 ) . These people were compared with a r and om sample of people without intellectual and developmental disabilities ( n = 2 261 919 ) according to diabetes prevalence , incidence , age , sex , rurality , neighbourhood income and morbidity . To measure diabetes primary care , we also studied hospitalizations for diabetes-related ambulatory care-sensitive conditions . RESULTS Adults with intellectual and developmental disabilities had a consistently higher prevalence and incidence of diabetes than those without intellectual and developmental disabilities . Disparities in prevalence between those with and without intellectual and developmental disabilities were most notable among women , younger adults and those residing in rural or high income neighbourhoods . In terms of hospitalizations for diabetes-related ambulatory care-sensitive conditions , people with intellectual and developmental disabilities were 2.6 times more likely to be hospitalized . CONCLUSIONS Adults with intellectual and developmental disabilities are at high risk of developing and being hospitalized for diabetes . The findings of the present study have a number of important implication s related to the early detection , prevention and proper management of diabetes among adults with intellectual and developmental disabilities PURPOSE Whilst the health benefits associated with regular physical activity are well known , little objective evidence exists regarding the activity profiles of adults with mild and moderate learning disabilities . The aims of the present study were to establish 7 day physical activity profiles for 24 adults with mild and moderate learning disabilities and to compare them with the general population and current Department of Health recommendations for physical activity . METHOD A descriptive study was used , based on interviews with 24 adults with learning disabilities ( mean age 34 years ) triangulated by daytime and residential care workers . Participants volunteered from two residential homes and one social education centre ( SEC ) in a city in the North of Engl and . RESULTS The physical activity profiles show that the participants led sedentary lifestyles that were more exaggerated than those of the general population . Twenty-two participants ( 93 % ) performed significantly less than the minimum daily levels of physical activity recommended by the Department of Health . CONCLUSIONS Few adults with learning disabilities can choose to walk to work , go for a run or visit the local swimming pool without adequate support . This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care setting s to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health . Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity
target: None of the studies reported the reliability and validity of the methods used to measure sedentary behaviour .
background: Supporting positive change in lifestyle behaviours is a priority in tackling the health inequalities experienced by adults with intellectual disabilities .
  In this systematic review , we examine the evidence on the definition , measurement and epidemiology of sedentary behaviour of adults with intellectual disabilities .
  Many research ers do not distinguish between insufficient physical activity and sedentary behaviour .