Effects of a Physical Exercise Program (PEP-Aut) on Autistic Children's Stereotyped Behavior, Metabolic and Physical Activity Profiles, Physical Fitness, and Health-Related Quality of Life: A Study Protocol.

José Pedro Ferreira,Mauro Gomes Barros,Chrystiane Vasconcelos Andrade Toscano,Guilherme Eustaquio Furtado,Aristides Machado Rodrigues,Rildo Souza Wanderley,Humberto Moreira Carvalho

doi:10.3389/fpubh.2018.00047

Abstract

Physical exercise has shown positive effects on symptomatology and on the reduction of comorbidities in population with autism spectrum disorder (ASD). However, there is still no consensus about the most appropriate exercise intervention model for children with ASD. The physical exercise program for children with autism (PEP-Aut) protocol designed allow us to (i) examine the multivariate associations between ASD symptoms, metabolic profile, physical activity level, physical fitness, and health-related quality of life of children with ASD; (ii) assess the effects of a 40-week exercise program on all these aspects of children with ASD. The impact of the exercise program will be assessed based on the sequence of the two phases. Phase 1 is a 12-week cross-sectional study assessing the symptomatology, metabolic profile, physical fitness and physical activity levels, socioeconomic status profile, and health-related quality of life of participants. This phase is the baseline of the following phase. Phase 2 is a 48-week intervention study with a 40-week intervention with exercise that will take place in a specialized center for children with ASD in the city of Maceió-Alagoas, Brazil. The primary outcomes will be change in the symptomatic profile and the level of physical activity of children. Secondary outcomes will be anthropometric and metabolic profiles, aerobic function, grip strength, socioeconomic status, and health-related quality of life. The study will provide critical information on the efficacy of exercise for children with ASD and help guide design and delivery of future programs.

Highlights

Autism spectrum disorder (ASD) refers to a complex category of the neurobiological development disorders, which is typically diagnosed during childhood [1]
The specialized education centers (SEC-Aut) will be selected using the following eligibility criteria: (i) availability to participate in all phases of the study during a total period of 22 months; (ii) potential for signing up the largest number of participants eligible for the study; (iii) existence of an indoor and outdoor area with appropriate conditions to implement physical exercise program for children with autism (PEP-Aut) sessions; (iv) adequate professional and family support to implement and monitor the PEP-Aut sessions in children with ASD; and (v) willingness to work with the research team on adjustments and improvements in the intervention protocol
The eligibility criteria for ASD participants include the following: (i) to have a certified medical diagnosis of Asperger’s syndrome, autism, or developmental disorder without specification, in accordance with the standards established in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) [1]; (ii) to present a recent history of non-participation in Physical exercise (PE) programs or similar physical motor activities; (iii) initial medical checkup to determine fitness to participate in PE program; and (iv) the absence of other syndromes and motor impairment conditions associated with ASD

Summary

INTRODUCTION

Autism spectrum disorder (ASD) refers to a complex category of the neurobiological development disorders, which is typically diagnosed during childhood [1]. There is evidence that children with ASD have higher risk of comorbidities [15, 16], sleep disturbance [17, 18], metabolic disorders [19], hyperactivity [20, 21], motor activity disorders [22], obesity [23,24,25,26], and lower health-related quality of life for children and their families [5, 12]. Detailed information provided in these papers on the specifics of exercise interventions for children with ASD, such as exercise intensity, volume, and frequency, has largely been absent [41] This has made replication difficult, and the identification of effective exercise components has not been possible [42]. AIMS OF THE STUDY (a) To examine the multivariate associations among ASD symptoms, metabolic profile, PA level, physical fitness, and health-related quality of life of children with ASDs. (b) To assess the effects of a 40-week exercise program on the metabolic profile, PA level, physical fitness, and healthrelated quality of life of children with ASD

INITIAL PROCEDURES

Participants with ASD Eligibility Criteria

METHODS/DESIGN

DISCUSSION

Findings

ETHICS STATEMENT