The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of neuromuscular exercise on balance, muscle strength and flexibility specifying the parameters and characteristics of effective interventions in children between 6 and 12 years and adolescent between 13 and 18 years with Down Syndrome. The present study is a systematic review of effectiveness outcomes balance, muscle strength and flexibility in this population. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from May to December 2021. We recruited randomized controlled trials (RCTs) which met the inclusion criteria in our study. Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from 3 to 5 days a week, and the duration of each session was between six and 15 min. The frequency was between two and three times a week for 6 and 12 weeks and the intensity were between 60 and 80% of maximal voluntary contraction. Neuromuscular exercise in different modes of application was associated with increases in chest and lower limb muscle strength mean 8.51, CI [2.35–14.67] kg and (21.54 [1.64, 41.43]) kg. Balance also improved when the mode of application was isokinetic training and core stability exercises (− 0.20 [− 0.29, − 0.12]) evaluated with stability index. Neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years. No evidence was found in children under 8 years.

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Background Therapeutic exercise exerts positive effects by mitigating or reducing the motor or cognitive changes that people with Down syndrome undergo throughout their life. There are no updated systematic reviews that integrate the evidence available in way that facilitates decision-making for physical rehabilitation teams. This study aimed to assess the effect of different types of physical exercise on the motor function of adults with Down syndrome. Methods We conducted a systematic review and meta-analysis of randomized clinical trials and quasi-experimental studies. The literature search was performed between September 2020 and June 2021 using the PubMed, SCIELO, Epistemonikos, and Lilacs databases. Studies were selected according to pre-determined inclusion and exclusion criteria. The risk-of-bias assessment was performed using the risk-of-bias rating tool. Risk-of-bias assessment and meta-analyses were performed using the RevMan software package. Results Water aerobic exercise significantly increased isometric push-up strength time (mean difference MD = 24.00 [95% CI = 2.66–45.35]; P = 0.03), while combined exercise significantly increased muscle strength both in the upper limbs (MD = 11.93 [95% CI = 4.72–19.14]; P = 0.001) and lower limbs (MD = 18.47 [95% CI = 2.34–34.60]; P = 0.02). Aerobic exercise improved spatiotemporal gait parameters. Aerobic exercise in an aquatic environment and continuous and interval training improved six-minute walk (MD = 43.21 [95% CI = 0.84–85.57]; P = 0.05). The certainty assessment revealed low certainty for all outcomes. Conclusions There was low certainty of evidence for the outcomes proposed in this review. However, therapeutic exercise was shown to be effective in improving muscle strength and gait functionality.

Background: Manual Muscle Testing (MMT) is a useful tool to evaluate ventilatory mechanics in adults with asthma. However, in the reviewed literature, there are few studies that report psychometric features of this test. Therefore, the present study aimed to evaluate MMT reliability and validity in respiratory muscles in adults with asthma.Methods: It was a cross-sectional study. Muscle strength (MMT and static respiratory pressures), sociodemographic and anthropometric variables related to the disease were evaluated. Measurements were carried out by two independent evaluators The reliability of MMT was analyzed with the weighted kappa and the convergent validity was evaluated by comparing the MTT and the respiratory pressure measurements using Pearson's correlation coefficient. The level of significance was p <0.05. Results: Twenty-six adults with stable asthma participated in the study. The intrarater reliability for MMT was between moderate and substantial (kappa=0.45-0.88) for all evaluated muscles while the interrater reliability was slight and fair for intercostal muscles (kappa=0.07-0.24), and fair and substantial (kappa=0.36-0.75) for other muscles. The convergent validity of MMT and respiratory pressures was low (r=0.20-0.48).Conclusions: MMT is a reliable measurement that can be used to evaluate respiratory muscle strength in adults with asthma. This study support MMT application for respiratory muscles at clinical settings when more objective measures such as MIP and MEP are not available. Considering that the MMT is a useful, practical, low-cost tool commonly used by physiotherapists, future studies could evaluate the convergent validity compared with dynamometry or electromyography of the respiratory muscles.