Children with disabilities spend most of the school day sitting and get very little exercise, even during recess and gym class, suggests a study from Hong Kong.

Physical activity is important for all children’s development, but those with disabilities rarely get the recommended 60 minutes per day of exercise, researchers report in the journal Medicine and Science in Sports and Exercise.

Children with severe intellectual disabilities had the least amount of physical activity, compared with students with other types of disabilities, the study team found.

“Physical inactivity is a serious global health problem and its associations with obesity or obesity-related diseases are well documented,” said lead author Cindy Sit of The Chinese University of Hong Kong.

“Children with disabilities are less physically active, tend to adopt a more sedentary lifestyle, and are at three to six times greater risk for obesity,” Sit told Reuters Health by email.

The U.S. Institute of Medicine recommends that schools provide children with at least half an hour of exercise during gym class.

To determine how much exercise kids with disabilities were getting in school, the study team assessed 259 children aged 6 to 23 years from 13 specialized schools in Hong Kong, collecting data on exercise and time spent sitting throughout the day and particularly during gym class, recess and lunchtime.

The children, whose disabilities included visual and hearing impairments, physical and intellectual disabilities and social development issues, wore accelerometers, devices that track movement.

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Researchers found that what kids did during recess, lunch and gym class was a major determinant of children’s exercise and sitting time totals for the day, with recess having the largest effect on daily activity level.

Overall, children spent 70 percent of their day sitting or not moving. Students spent one quarter of the day doing light physical activity.

The children spent little time doing moderate to intense physical activity, with an average of about 17 minutes per day. Students got more minutes of exercise during gym class, about seven minutes, than during lunch or recess.

Children with severe intellectual disabilities, particularly boys, had especially low levels of physical activity.

Jennifer Ryan, a senior lecturer at Brunel University in London, who wasn't involved in the study, noted that the lack of exercise in gym class suggests that schools are not providing the support students need, whether this is more staff or assistive devices.

In addition to giving students support for more vigorous exercise, schools can also help students reduce the amount of time they spend sitting, Ryan told Reuters Health.

“Breaking up long periods of sitting with standing and walking can have health benefits such as reducing blood pressure and reducing body weight,” she said by email.

“Parents and children should know that it is very important for children with disability to participate in physical activity throughout their lives,” Ryan said.

Parents should not feel discouraged if a child does not like the first activity they try and may need to find an instructor or club that feels supportive, she added.

Sit said parents can encourage schools to provide more opportunities for exercise, but noted, “schools cannot provide all the physical activity that children need for growth, development, and health.”

Sit advised parents to limit children’s screen time and encourage exercise at home, participating in the exercise with their children if possible.