Research project The overall purpose of this research project is to support adults with intellectual disability (ID) in training their balance and muscle strength. In this research project, we are developing and evaluating a digital exercise application “BalansPeppen” in co-creation with adults with ID and researchers from Umeå University and the municipality of Östersund.
Impaired balance is a common among persons with ID, often starting at an early age and leading to an increased risk of falls and fall-related injuries. Balance and muscle strengthening exercises can reduce the risk of falls, but participation in exercises is generally low among adult with ID. People with ID often experience barriers to participating in exercise activities, such as lack of adapted exercises and dependence on support from staff. BalansPeppen is a digital exercise application developed by and for adults with ID to support participation in balance exercises.
Fall accidents are one of the most common causes for injury in Sweden and is primarily prevalent among the older populations. For persons living with ID, the risk of falling is greater than compared to age-matched non-disabled peers, with falls estimated to occur twice as often among people with ID. This higher fall risk is not limited to older persons with ID, but also children and young individuals in this group often have impaired balance. Furthermore, fractures, which can partly be caused by falls, are more common among people with ID.
Balance and muscle strengthening exercises are known methods to reduce fall risk and are especially important for vulnerable groups. Despite this, few adults with ID participate in regular exercise and physical activity. Instead, they often experience barriers such as limited opportunities for adapted exercises, dependency on support from staff, and concerns about falling, which hinder their opportunities and willingness to exercise. Therefore, there is a great need to develop evidence-based exercise opportunities that are adapted to the needs of the target group to facilitate regular balance exercise for adults with ID.
BalansPeppen is a digital exercise application developed in co-creation between researchers at Umeå University and the municipality of Östersund, as well as adults living with ID. The application’s interface and functions are designed to meet the needs of the end users and include a video library of 18 exercise programmes. The programmes are structured according to three time-lengths and difficulties to challenge users with different balance abilities. To provide support and motivate exercise progression and behaviour change, completed exercise sessions are logged in a “exercise world”, where users earn rewards and points for completed sessions.
The BalansPeppen research project follows the guidelines for complex interventions and is divided into three phases, 1) design and application development, 2) feasibility study, and 3) process- and effectiveness evaluation. The first phase has been completed and resulted in a functional prototype of BalansPeppen. The second phase is ongoing, where 40 adults with ID and their support staff have the opportunity to exercise with the application for six weeks. The feasibility of exercising with BalansPeppen is being evaluated through focus-group interviews with adults with ID and their support staff who participated in the exercising, as well as through the evaluation of physical function.
The next phase of the research project is to evaluate the feasibility study and continue the development of the BalansPeppen application with the aim of preparing for the third phase of the project, process- and effectiveness evaluation.
RESEARCH OBJECTIVES
The aim of the current phase is to investigate the feasibility for adults with ID receiving support within LSS-care to use the exercise application BalansPeppen to train their balance and muscle strength to prevent falls. A secondary aim is to evaluate any effects of the training on balance muscle strength, physical activity, and concerns about falling.
METHODS
Our approach involves a study of the strategies used by users with ID and their support staff to integrate exercising with BalansPeppen into daily activities. This includes mapping potential barriers to participation and strategies used to overcome them, as well as improvements and changes to the BalansPeppen application to better suit the target group. In connection with this, the feasibility study has been structured to enable the evaluation of different methods for measuring physical function in adults with ID. The evaluation involves testing the suitability of various measurement methods for balance, muscle strength, and concerns about falling, including modifications to test protocols to improve suitability.
