Scalable physical activity intervention for youth with disability: Burn 2 Learn adapted cluster randomized controlled trial

Background: Youth with disability are less physically active and more likely to have chronic health conditions than their peers without disability. The aim of our study was to assess the effectiveness of a scalable school-based physical activity intervention for youth with disability on functional capacity and a range of secondary outcomes. Methods: We conducted a two-arm cluster randomized controlled trial involving adolescents aged 15–19 years with diagnosed disabilities (N = 255) from 28 secondary schools in New South Wales, Australia. Schools were randomized to the Burn 2 Learn adapted (B2La) intervention, or a wait-list control. The B2La intervention included foundational resistance exercises (e.g., push-ups, bodyweight squats), aerobic exercises (e.g., shuttle runs), and sport skills (e.g., catching, kicking), delivered as classroom activity breaks 2–3 times per week by trained special education teachers. The primary outcome was functional capacity assessed using the 6-min walk or push test. Secondary outcomes were muscular fitness, body mass index, physical activity (accelerometers), resistance training motor competence, motivation for physical activity, high-intensity interval training self-efficacy, quality of life, and externalizing behaviors. Assessments were conducted at baseline, 6-months (primary endpoint), and 9-months (follow-up). Results: At 6-months, the intervention group demonstrated a significant improvement in functional capacity, with a group-by-time effect of 20.3 m (95% CI, 3.1–37.1). At 9-months, the effect was 17.8 m (95% CI, 0.0–35.6). The intervention had a small effect on muscular fitness, resistance training motor competence, and high-intensity interval training self-efficacy. No effects were observed for the other outcomes and no adverse events were recorded. Conclusions: Physical activity breaks delivered by special education teachers during the school day improved functional capacity and a range of secondary outcomes in youth with disability. Activity breaks may need to be longer, more frequent, or more intense to achieve clinically important health effects. Trial registration: Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808; prospectively registered 15th November, 2021.