Walking with a Purpose - Encouraging Physical Activity in People with Disabilities Presenter: Dr. Keiba Shaw, PT, DPT, EdD Nova Southeastern University College of HealthCare Sciences Department of Physical Therapy
Overarching Objective! To assist people with disabilities to achieve levels of physical activities that will benefit their health, wellness and physical functioning.
Introduction! People with intellectual and developmental disabilities have! poorer overall health! less access to healthcare and! lead sedentary lifestyles (Centers for Disease Control [CDC], 2014).
Introduction (cont.)! Adults with developmental disabilities have! higher rates of chronic disease including diabetes and heart disease than those without developmental disabilities.
Study Methods / Description - Levels
Study Methods / Description! Baseline measures, follow-up measures taken at 12 weeks, 24 weeks and 32 weeks and 40 weeks following achievement of the specific Levels in the Program.! Data collected from the subjects include: Demographic information (age, gender, ethnicity) Height and weight; BMI calculated Heart rate (HR), respiratory rate (RR), blood pressure (BP) A subjective rating of exercise-related exertion Questionnaire about knowledge, skills, and behaviors related to physical activity.
Methods / Data Analysis! Each participant was assigned a subject number! An Excel spreadsheet was created for data entry and management! Descriptive statistics were calculated for all demographic data and measurements.! Data distributions will be examined! For normally distributed data, tests such as repeated analysis of variance will be used to examine changes over time and by group.
Methods / Data Analysis! Data collected from the ActiGraph includes percentages of time spent in various types of physical activity: % in sedentary % in light % in moderate % in vigorous % in very vigorous % in moderate to vigorous physical activity (MVPA)
Table 1. Anthropometrics Baseline 12 Weeks 24 Weeks 32 Weeks Subjects (n) 21 21 18 16 Weight (lbs) Mean (sd) 162.3 (45.1) 160.4 (41.0) 161 (44.0) 156.8 (40.3) Median 163.3 154.6 151.7 152.4 BMI Mean (sd) 29.2 (7.6) 28.9 (7.1) 24.5 (12.3) 23.4 (13.4) Median 33.7 29.2 26.0 25.7 Waist (in) Mean (sd) 65.6 (28.2) 36.5 (5.5) 36 (6.2) 34.3 (5.5) Median 42.3 35.0 35.0 33.5 Hip (in) Mean (sd) 73.8 (30.0) 40.8 (5.1) 40.8 (5.7) 39.7 (5.4) Median 46.5 39.5 39.3 38.0 WHR Mean (sd) 0.89 (0.09) 0.89 (0.05) 0.88 (0.08) 0.86 (0.05) Median 0.91 0.89 0.90 0.88
Study Implications/Discussion! Preliminary data on:! how to implement a walking and rolling program for people with intellectual and physical disabilities! Exercise program prescription dosage (shorter vs. longer program)! Effectiveness of walking and rolling program on physical characteristics! Amount of time spent in sedentary, moderate and vigorous intensity exercise
Summary! Implementation of a walking program that is consistent with meeting the recommended levels of exercise can lead to improvements in! anthropometrics such as BMI, waist and hip size, WHR and overall weight loss
Summary (cont.)! Identifying how much time is spent in sedentary or light intensity physical activity can help in the development of effective programs targeting this population
Limitations Lessons Learned! Participant attrition due to various reasons such as! Moving out of study area! Lost actigraph! Forgetting to wear the device! Checking monitor pouches for actual device! Wearing in pool
Limitations Lessons Learned (cont.)! Checking monitor pouches for actual device! Other activities (e.g. swimming)
Recommendations for Future Research! Identify monitors that are more user friendly and unobtrusive! Identify monitors that are water resistant! Take snapshots of activity to decrease data load
References 1. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman. 2. Centers for Disease Control and Prevention. (2014). Steps to Wellness: A guide to implementing the 2008 Physical Activity Guidelines for Americans in the Workplace: Atlanta, GA: U.S. Department of Health and Human Services. 3. Johnson, C.C. (2009). The Benefits of physical activity for youth with developmental disabilities: A systematic review. American Journal of Health Promotion: January/February 2009, Vol. 23, No. 3, pp. 157-167. http://dx.doi.org/10.4278/ajhp.070930103 4. Ellemberg, D., & St-Louis-Deschênes, M. (2010). The effect of acute physical exercise on cognitive function during development. Psychology of Sport and Exercise, 11 (2), 122-126 http://dx.doi: 10.1016/ j.psychsport.2009.09.006 5. Heller, T., McCubbin, J., Drum, C., & Peterson, J. (2011). Physical activity and nutrition health promotion interventions: What is working for people with intellectual disabilities? American Association on Intellectual and Developmental Disabilities. 49, 26-36.