Embedding Sustainable Physical Activity into The Everyday Lives of Adults with Intellectual Disability: A Randomised Controlled Trial

Abstract

This thesis sought to increase the physical activity (PA) levels of adults with intellectual disability (ID) by integrating exercise specialists and caregiver training into two interventions: lifestyle PA [LSPA] and structured exercise [STEX]. It evaluated whether the two interventions increased PA participation, improved physical fitness and psychosocial characteristics and offered long-term sustainability.

This randomised controlled trial with three groups was conducted in community settings in Sydney involving 96 adults with ID who led physically inactive lifestyles and randomly assigned to the LSPA, STEX, or usual care (Control) groups. Each 12-week LSPA and STEX intervention involved 150 minutes of moderate-to-vigorous physical activity (MVPA) per week. The Control group continued with their usual care without engaging in additional PA. Accredited exercise specialists delivered 60 minutes of LSPA and 150 minutes of STEX while simultaneously training caregivers. Following the conclusion of the interventions, caregivers continued to support the two interventions for an additional 24 weeks. Outcomes were assessed at baseline, three months (intervention period), and nine months (follow-up). Primary outcomes included PA levels and aerobic fitness. Secondary outcomes included peak muscle strength, body composition, functional walking capacity, self-efficacy for activity, social support for activity, exercise outcome expectation, and participation in domestic activities.

The two interventions substantially increased participation in MVPA among adults with ID, enhanced participants’ abilities and confidence in engaging in MVPA, and quantified the increases in PA levels, enabling clinical practitioners to prescribe PA more accurately. As these findings arose from real-world research, policymakers should consider integrating these interventions into everyday disability services for the daily lives of adults with ID.