The impact of a 9month walking program on the exercise capacity and weight reduction for adolescents with severe autism.
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Slide 1 :
Efficacy of a 9-Month Treadmill Walking Program for Adolescents with Severe Autism Ken Pitetti, Andrew Rendoff, & Travis Grover Wichita State University
Slide 2 :
Autism: A Spectrum of Developmental Disorders Twelve major criteria for autistic behaviors (DSM-IV-TR manual) Lack of varied, spontaneous, make-believe play or social imitative play appropriate to developmental level preoccupation with one or more stereotyped and restricted patterns (staring at lights, hand-flapping) adherence to specific, non-functional routines or rituals (tapping ears, snapping fingers, making vocal sounds) Stereotyped and repetitive motor mannerisms (rocking)
Slide 3 :
Children, adolescents, and adults with mild to moderate mental retardation demonstrate fair to poor physical fitness levels (Fernhall, Pitetti, and Colleagues) This is also true of youth with severe developmental disabilities, including youth with autism, living in a residential/school treatment facility (Pitetti et al., 1999)
Slide 4 :
The best predictor of early mortality and morbidity in individuals with developmental disabilities is lack of mobility (Hayden, 1993). Therefore, it appears that physical activity is an important contributor to health in populations with developmental disabilities
Slide 5 :
The impact of brief (10-25 min) antecedent exercise programs on behavioral outcomes for adolescents with autism has been studied However, no studies to determine whether a long-term exercise program (> 2 months) could be performed
Slide 6 :
Purpose Efficacy (effectiveness) incorporating a 9 month treadmill-walking program into the academic curriculum of youth with severe autism Efficacy was defined as a significant progression in treadmill walking: frequency, speed, time, elevation , and monthly calories consumed. Secondary, changes in Body Mass Index
Slide 7 :
Participants Ten adolescents/young adults (6 male and 4 female; 17.0+1.5 yrs) were clients of treatment facility for people with severe developmental disabilities. Identified by staff (from 46 clients) as able to follow instructions to perform treadmill walking without assistance or holding rails.
Slide 8 :
Procedure Control (3M, 2F) 30 minutes of “leisure activity”, 3-X/wk, at the campus gym shooting, dribbling, passing basketball jumping rope, roller skating, Scooter-Board activities Exercise (3M,2F) 30 min MWF of treadmill walking, “leisure activities” if time, campus gym T-Th available for treadmill walking
Slide 9 :
Treadmill Walking Protocol initial frequency of 2-X/wk, progression of one day every two weeks to a peak frequency of 5-X/wk initial duration of 8 min/session, a progression of 1-2 min/wk to a peak duration of 20 min/session initial treadmill speed ranged from 2.4 to 3.5 mph, progression of .1 to .3 mph/wk
Slide 10 :
Caloric Expenditure VO2 (ml•kg-1•min-1) = 0.1 (TM speed) + 1.8 (TM speed) (%grade) + 3.5 (ACSM, 2005) net VO2 then converted to METS by dividing net VO2 by 3.5 ml•kg-1•min-1 kcal.min-1 = (METs x 3.5 x body weight in kg)/(200).
Slide 11 :
Caloric Expenditure Daily logs of caloric expenditure were added to obtain the sum of each week’s caloric expenditure. Mean monthly caloric expenditures were determined from weekly caloric expenditure. Body weight was measured weekly and used for weekly caloric expenditure calculations.
Slide 12 :
Treadmill ProgressionPre- to Post-Treatment Frequency (d/wk) 2.5+0.8 to 4.1+0.4 * Time (mins) 16.6+4.8 to 17.9+1.7 Calories/Month 168.4+74.1 to 914.6+233.4 * Speed (mph) 2.9+0.42 to 3.9+0.12 * Elevation (%) .05+.07 to 1.7+0.28 * * = p<.05
Slide 13 :
BMI and Body MassPre- to Post-Treatment Control Weight (kg) 93.0+32.3 to 91.2+30.9 BMI 30.9+8.5 to 30.0+7.4 Exercise Weight (kg) 98.0+18.3 to 92.9+15.5 BMI 33.7+7.8 to 30.0+7.4 *
Slide 14 :
Exercise Group vs. Control Group BMI and Body Weight Body Weight (lbs)
Slide 15 :
Mean Body Mass Index (BMI) vs Mean Average Caloric Expenditure Per Month
Slide 16 :
CONCLUSION Positively impacted the treadmill walking capacity with significant increases in frequency, speed, grade, and calories expended. Positively impacted BMI
Slide 17 :
Of Interest:Risperdal (Risperidone) Resperidone has been shown to have efficacy for treating aggression, self-injury, and property destruction (APA, 2000). Significant weight gain was a limiting side effect (Hellings et al, 2001) Two participants in the exercise group were taking resperidone In one: no change (204 lbs, BMI of 28.6) Another: (212 lbs to 188 lbs) and BMI (30 to 25.6)
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