Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial.

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 randomised controlled trial (RCT) will be conducted. Ninety adults with ID aged 18-55 will be randomly 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 objectively 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: ISRCTN77889248 (18 April 2012).

Work engagement and job burnout within the disability support worker population.

The aim of this study was to explore work engagement and job burnout within the disability support worker (DSW) population, using the job demands-resources (JD-R) model as a guiding theory. The research measured a set of work-related demands and resources related to working within the disability sector in order to assess which demands/resources account for a significant portion of unique variance when used to model DSW engagement and burnout. This study sampled 258 DSWs from across Australia who completed an online or paper questionnaire that included measures of engagement, burnout and the demands/resources of interest. With regard to demands, role ambiguity was significantly associated with the three engagement scores and the three burnout scores. It also accounted for the most unique variance in the three engagement scores (vigour [VI], dedication [DE] and absorption [AB]), and the personal accomplishment (PA) burnout score. With regard to resources, job feedback was significantly associated with two of the engagement scores (VI and DE) and all three burnout scores. It accounted for the most unique variance in VI and DE, and PA. In conclusion, this research adds to the existing disability workforce literature as it represents one of the first comprehensive investigations of work engagement within this population. Improved job descriptions, on-the-job feedback and the creation of specialist support workers are offered as recommendations to improve the psychosocial health of DSWs.

An initial evaluation of a long-term, sustainable, integrated community-based physical activity program for adults with intellectual disability.

BACKGROUND: Physical activity (PA) programs for adults with intellectual disability (ID) have positive impacts, at least in the short term. No research has been reported on the effect of long-term engagement in PA programs for adults with ID. This paper explores the physical and psychosocial benefits gained by two individuals with mild ID who participated in a long-term PA program. METHOD: Accelerometery was used to collect PA data during the program and for 7-day periods outside of the program. To explore the psychosocial outcomes gained from participating in the program, participants and their caregivers were interviewed about their participation experiences. RESULTS: Across time, a decrease in the amount of light activity engaged in during sessions was found, with participants gradually increasing their moderate to vigorous activity. Psychosocial benefits, including meeting new people and gaining social acknowledgement were reported by participants and caregivers. CONCLUSIONS: Long-term, sustainable, low cost PA programs (such as the one under investigation) can minimise barriers to physical activity for people with ID.

Energy expended by adults with and without intellectual disabilities during activities of daily living.

The aims of this study were to (1) determine the energy expenditure of adults with and without intellectual disabilities during common activities of daily living (ADL), (2) use these values to evaluate the accuracy of equivalent activity values reported in the Compendium of Physical Activities (CPA), and (3) identify ADL that may confer a health benefit for adults with intellectual disabilities when undertaken regularly. Energy expenditure was measured for adults with intellectual disabilities (N=31; 29.0±8.6 yr) and adults without intellectual disabilities (N=15; 30.4±9.6 yr) while undertaking each of seven ADL: sitting quietly (SitQ); sitting watching television (SitTV); sitting and standing while completing an assembly task (SitAT, StaAT); and walking at a slow (WalkS, 3.0 km h(-1)), quick (WalkQ, 6.0 km h(-1)) and fast (WalkF, 9.0 km h(-1)) speed, under laboratory conditions. Adults with intellectual disabilities were found to expend significantly more energy than adults without intellectual disabilities for SitQ, WalkS, WalkQ and WalkF (p<0.05). Energy expended by both populations was significantly more than CPA values for SitQ, SitTV, SitAT, WalkS, and WalkQ (p<0.02) and significantly less for WalkF (p<0.01). Walking at the speed of 3.0 km h(-1) (50 m min(-1)) was found to be sufficient to achieve moderate-intensity energy expenditure, surpassing the intensity threshold for conferring a health benefit. Energy expenditure inaccuracies of the CPA have important consequences when estimating prevalence of engagement in health enhancing physical activities among population sub-groups. The identification of slow walking as a moderate-intensity physical activity offers significant health promotion opportunities for adults with intellectual disabilities through active transport and leisure.