Improving body composition and social function through combined exercise program in children with intellectual disabilities: a single-arm pre-post intervention study

[Purpose] Although children with intellectual disabilities (ID) face a heightened risk of physical inactivity, psychiatric comorbidities such as ADHD, and delayed social development –which collectively impair their physical, cognitive, and emotional well-beingâ€" and structured physical activity (PA) has been proposed as a multidimensional intervention, few studies have rigorously examined the integrated effects of a combined exercise program on the physical health, behavioral symptoms, and social functioning of this population. This study aimed to evaluate the effects of a 16-week combined exercise program –incorporating aerobic and resistance trainingâ€" on body composition, ADHD-related behavioral symptoms, and social functioning in children with ID. [Methods] A total of 30 children with mild ID (mean age: 10.4 â± 1.3 years) participated in a structured intervention comprising three 60-min exercise sessions per week over 16 weeks. The exercise intensity progressively increased across three phases (50â€"80% HRR). Body composition (including BMI, body fat, and muscle mass) was assessed using validated anthropometric and bioelectrical impedance methods. ADHD symptoms were evaluated using the ADHD Rating Scale-IV, and social functioning was assessed using the Social Maturity Scale, which were rated by both parents and teachers. Paired t-tests were conducted to assess pre-post differences, with significance set at p < 0.05. [Results] Postintervention results revealed significant improvements in children’s body composition: reductions in weight (â'3.1%, p = 0.031), BMI (â'3.3%, p = 0.028), body fat (â'6.3%, p = 0.015), waist circumference (â'2.6%, p = 0.040), hip circumference (â'1.4%, p = 0.048), and WHR (â'1.1%, p = 0.045), along with an increase in muscle mass (+5.9%, p = 0.022). ADHD-related symptoms significantly decreased: inattention (â'20.0%, p = 0.012), hyperactivity/impulsivity (â'20.5%, p = 0.014), and task incompletion (â'20.7%, p = 0.010). Social indicators also improved, including reductions in both social interaction difficulties (â'20.3%, p = 0.020) and repetitive behavior (â'20.0%, p = 0.025). [Conclusion] The 16-week combined exercise program produced meaningful improvements in the physical health, attentional control, and social functioning of children with ID. These findings underscore the utility of integrated PA as a nonpharmacological, multidomain intervention to enhance the well-being of neurodiverse children. Future studies should explore the underlying neurobiological mechanisms and assess the longterm sustainability of these outcomes.