Physical Activity of Adults with Intellectual Disabilities: Feasibility and validity of measuring physical activity and physical activity intention and their relationship to the spectrum of Adults with Intellectual Disabilities

In comparison to the wider population people with intellectual disabilities (ID) experience higher rates of morbidity and mortality associated with inactive lifestyles, however little is known about the pattern of their physical activity (PA). To address the inadequacies that currently exist around PA and those with ID, we need to better understand their PA levels to identify those who are inactive and the related factors. The four-part studies in this thesis aimed to establish PA levels of adults with intellectual disabilities (awID) across the spectrum. It also aimed to investigate the readiness to change PA behaviour in this population. The first study, a systematic review of evidence for PA levels among awID found that in 15 eligible studies, comprising 3159 subjects, only 9% achieved PA guidelines. ID severity, living in care, gender, and age were independently significantly correlated with PA levels, the strongest predictor being ID severity (Beta 0.63, p<0.001). These findings were limited in context; none objectively measured PA in people with profound ID. This informed the second feasibility study, investigating assessment of PA across the spectrum using wrist-worn, 7-day accelerometers and the short form of the International Physical Activity Questionnaire (IPAQ-s). This revealed the difficulty in recruiting subjects across the full spectrum, and a difference in response rates between homes (16%) and residential-homes (4%): χ2 (1) = 7.7, p <0.05. Nonetheless, 20 participants were recruited, and both PA measures were used across the ID spectrum, including in those with profound ID (n=5). The third study investigated concurrent validity between the two PA measures; suggesting a substantial agreement between the accelerometer and IPAQ-s (k= 0.6, n = 16, p < .05) in identifying active participants, and a significant positive correlation between the sedentary time by the IPAQ-s and accelerometer (r = 0.50, n = 17, p = 0.04). This has implications both clinically and in the research environment as the study showed for the first time that the IPAQ-s could be used effectively to identify those that are active and measure sedentary behaviour across ID spectrum. In the final study, PA levels measured across the spectrum using the IPAQ-s suggested low PA (39% active) and high sedentary behaviour (82% sedentary >3 hours/day) among awID (n=82). Multiple linear regression revealed that high ID severity is a significant predictor of low PA (Beta -0.28, p<0.05) and high sedentary behaviour (Beta 0.41, p<0.001). To investigate readiness to change PA behaviour in this group, the author developed a single-item PA intention measure (SPAIM). The construct validity and test-retest reliability of the SPAIM were examined, and the relationship between PA intention and PA levels. The SPAIM was a reliable measure of the PA intention, with a strong, positive correlation between first and repeated measure (rs =0.78, n=35, p<0.001). Additionally, linear regression revealed that PA intention significantly predicts daily sedentary hours (Beta -0.34, p<0.01). This research showed that it is possible to measure PA levels across the ID spectrum, but the choice of measure is a major factor. It also highlighted a need for better engagement with carers and residential-home managers, to improve research participation by those with severe to profound ID. Moreover, although only a minority of participants were active, the majority had a positive PA intention. The amount of time spent being sedentary is the only variable related to PA intention. Overall, the evidence suggests that intervention studies aimed at reducing sedentary behaviour are urgently needed in this group. The sedentary hours/day could be a primary target for public health efforts in this population.

Grantor dc:publisher

Oxford Brookes University

Year dc:date

2017

Author dc:creator

• Dairo, Yetunde Marion

Contributors dc:contributor

• Collett, Johnny
• Dawes, Helen

Statement dc:rights

• All rights reserved

Language dc:language

en

DOI dc:identifier

https://doi.org/10.24384/a8tb-w925

OAI identifier oai:identifier

tle:7a0a9564-8350-4346-83f3-015cfaddb30e:d6bd9758-527a-46cd-bfe2-c433766e8fca:1