Resistance training and Down Syndrome: A narrative review on considerations for exercise prescription and safety

Abstract

The current manuscript reviews the literature on the health effects of resistance training (RT) for individuals with Down syndrome (DS), focusing on this training modality’s methodology, application, and safety. The literature has mentioned that early aging in this population is associated with loss of muscle strength, lower lean and bone mass, and increased obesity. It is necessary to propose non-pharmacological measures for prevention and health promotion. Thus, this review suggests a current research-based RT guide for individuals with DS. This review is divided into three sections: Section 2 briefly reviews DS and the effects on structural and functional decline and how exercise and physical activity can influence health aspects in this population; Section 3 summarizes the evidence for RT prescription; Section 4 briefly reviews the health and potential benefits of RT in individuals with DS. The findings from this review suggest that most individuals with DS should engage in moderate-intensity RT at least 2 days a week and perform RT on the major muscle groups and include balance training. The RT program should be modified and adapted according to individuals’ characteristics and limitations. RT promotes positive, health-related benefits such as increasing strength, improving body composition, improving functional capacity and balance, reducing inflammatory status and oxidative stress, and improving the immune system. The RT protocols summarized in this current review provide guidance, critical conclusions, and novel research settings, which could be useful to coaches, clinicians, and researchers to effectively design RT program for individuals with DS.

Effects of exercise, physical activity, and sports on physical fitness in adults with Down syndrome: A systematic review

“…The results mention significant effects on strength, specifically in the hand grip, knee extension torque, and the number of repetitions in bench press, shoulder press, leg press, modified curl-up, and isometric push-ups [49] , [53] , [56] , [57] , [59] , important indicators since strength is a marker of physical condition, general health, and prevention of mortality from all causes [74] , in addition, the development of strength is a protective factor against sarcopenia [75] , a risk factor in this population. These results corroborate what was mentioned by Melo et al [12] and Sugimoto et al [76] and confirm that strength training is safe in this population. These significant changes could be justified due to neural adaptations (intramuscular and intermuscular coordination) and muscular adaptations (hypertrophy) [77] or by an increase in the activation rate of motor units [78] .…”

“…These results corroborate the importance of promoting exercise, physical activity, and sport in this population, given that the level of physical fitness is a fundamental factor that promotes well-being and a better quality of life [86] , [87] . Although there are reviews that declare improvements in aspects of strength and functional capacity from some types of physical activity, such as exergaming [88] , and suggestions of at least two days of resistance training per week for health benefits in this population [12] , there is confusion about cardiorespiratory fitness and body fat percentage [62] .…”

“…Adults with Down syndrome tend to have negative alterations in health indicators and generally have higher rates of obesity than their typically developing peers [11] . They also have impaired physical fitness, expressed in lower strength [12] and aerobic capacity [13] compared to adults without Down syndrome. Furthermore, it has been reported that a large part of adults with DS are sedentary, and it is estimated that less than 10% of this population reaches the minimum recommendation for physical activity [14] – [17] .…”

Heart Rate Variability During Physical Effort in Patients With Metastatic Ovarian Cancer and Concomitant Obesity

“…Відомо, що ЧСС регулюється складною взаємодією між симпатичною та парасимпатичною активністю, яка змінена у пацієнтів із ожирінням і не повністю зрозуміла [15]. Також описано зниження відповіді на симпатичні стимули, незалежно від базального симпатичного тонусу [16]. Ми припустили, що ожиріння певною мірою знижує реакцію ЧСС на фізичні вправи, що, у свою чергу, може вплинути на адаптацію до фізичних навантажень.…”

The benefit of a four-week range of motion exercise on hand muscle strength in children with Down Syndrome

“…Movement difficulties linked with Down syndrome can lead to a more sedentary lifestyle and decreased physical fitness, with adults having poorer aerobic capacity than healthy people [11,12]. In addition, children with Down syndrome consistently show decreased upper and lower body muscle strength compared to children with normal conditions [13]. Overall motor performance parameters can be known from muscle strength [14].…”