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Understanding the benefits of inclusive fitness

A $3.5 million NIH grant will help begin to measure the impact of inclusive fitness efforts

With a $3.5 million grant from the National Institutes of Health (NIH), UNC School of Education faculty member Kara Hume, Ph.D., and adjunct faculty member Brianne Tomaszewski, Ph.D., will lead research that aims to increase the physical activity of adults with intellectual disabilities in an effort to support their physical and mental health and promote healthy aging.

The R01 grant, called the PACE program, or Physical Activity and Community EmPOWERment, will fund pilot testing of two multi-level physical activity programs — Step It Up and Power Hour — to understand the feasibility, acceptability, and fidelity of each. Tomaszewski, also an assistant professor at the UNC TEACCH Autism Program in the Department of Psychiatry, is the grant’s lead principal investigator. Hume, the Richard “Dick” Coop Faculty Scholar in Education, and Melissa Savage, Ph.D., an assistant professor at the University of North Texas, are co-principal investigators.

Research has shown physical activity can contribute to a variety of positive outcomes in areas that include academics and adaptive behavior and can provide health benefits, including protective factors that help to mitigate Alzheimer’s disease and related dementias. Research has also shown that it can be difficult for adults with intellectual disability to engage in physical activity and thus, they experience higher rates of early-onset dementias and age-related conditions.

“Physical activity is critically important for everyone, but often individuals with intellectual and developmental disabilities are left out of exercise-related opportunities and spaces,” said Hume, a foremost autism researcher who has long studied educational interventions for autistic children and adolescents. “There are so few inclusive, adaptive fitness offerings for these populations. This grant can help us to really understand the impact of community fitness programs on the quality of life for the participants — those with and without disabilities.

“And while this will be very preliminary work, Brianne, Melissa, and I are curious if this type of regular exercise may slow down cognitive decline as individuals, particularly those with intellectual disabilities, age.”

Fitness programs focused on inclusivity

The PACE program builds upon a 16-week at-home walking program for adults with intellectual disabilities called Step It Up, providing them with self-management strategies, including goal setting and self-monitoring. Within this study, participants will also engage in weekly group walking classes.

Power Hour is an inclusive, adaptive fitness class for people with intellectual disabilities, which focuses on developing strength, balance, mobility, and endurance. Hume, who holds CrossFit Level 1 coaching certification, leads Power Hour at Chapel Hill CrossFit.

The study will assess the feasibility of each by measuring recruitment, attendance, and completion rates of program participants. Focus groups and interviews will augment quantitative findings and provide feedback on participant acceptability.

The findings from this project will lay essential groundwork for a future large-scale physical activity intervention, which will help the research team understand the efficacy of the programs.

Removing barriers to physical fitness

People with intellectual disabilities often face barriers to participating in physical activity, including a lack of inclusive exercise-related opportunities, limited access to community exercise facilities, and fewer exercise professionals with expertise in adapting movements.

Drawing on a 30-year career serving autistic people in a variety of capacities and a love of physical fitness, Hume began co-facilitating Power Hour in 2019 to create a more inclusive physical health community. She said she seeks to understand how exercise can enhance mental health and self-determination for all.

“Developing improved strategies and programs that promote physical activity for people with intellectual disabilities is critical, as is training the workforce of exercise professionals to meet this need” she said. “Power Hour is a model of a truly inclusive exercise program, where there are health and social benefits for all of us who participate.”

Since its launch, Power Hour has grown to include more than 25 regular participants, both with and without disabilities.

Power Hour meets regularly on Sunday afternoons at 4 p.m., and is free to all, thanks to the generosity of Chapel Hill CrossFit. As part of this new grant, Hume and team also plan to expand Power Hour across the Triangle area in the year ahead.

The Richard “Dick” Coop Faculty Scholar in Education Fund provided support in the development in this grant application.