The health benefits of exercise therapy for patients with Down syndrome: A systematic review

Abstract

BackgroundMany patients with Down syndrome (PWDS) have poor cardiometabolic risk profiles, aerobic capacities and weak hypotonic muscles, primarily because of physical inactivity and poor diet.ObjectivesThis study discusses the benefits of exercise therapy on body composition, aerobic capacity, muscle strength, proprioception and cardiometabolic profiles of PWDS.MethodsA literature review using the Crossref metadatabase, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), focusing on the period 2007-2018, was undertaken. Each record was judged adopting the modified Downs and Black Appraisal Scale. The literature investigation identified 15 701 records. Records were excluded if they were published before 2007, pertained to the impact of exercise on intellectual disabilities beyond Down syndrome or the impact of medical, pharmaceutical, nutrition and psychological interventions among PWDS and were published in languages besides English. Nineteen articles were synthesised into this commentary.ResultsPWDS have a heightened cardiometabolic risk profile and high oxidative stress associated with elevated insulin resistance, poor insulin sensitivity, atherosclerosis and hypertension. PWDS have low aerobic capacity (VO2max), peak heart rates, muscle strength, agility and balance. Regular physical activity is beneficial to improve their VO2max and muscle strength. Moreover, regular physical activity reduces lipid peroxidation and arterial cell wall damage, the pathogenesis of atheroma is limited.ConclusionExercise therapy compliance seems to have a positive impact on the cardiometabolic risk profile, muscle strength and aerobic work capacity of PWDS. Nonetheless, additional vigorous experimental investigations are necessary to better understand the effect of exercise therapy on the aerobic, strength, proprioception and cardiometabolic risk profile of PWDS.

Prospective Associations of Physical Activity and Health-Related Physical Fitness in Adolescents with Down Syndrome: The UP&DOWN Longitudinal Study

“…The benefits of increased aerobic work capacity and body composition help reduce the cardiometabolic risk profile of this population. However, more randomized controlled trials of longer duration than the present study are needed to determine the dose-response to exercise and to validate these preliminary empirical findings [ 34 ]. One possible solution to the results obtained in the sample of adolescents with SD could be the development of physical activity programs that target neuromuscular deficits before young people re-deal with exercise as with the non-disabled population [ 35 ].…”

“…One possible solution to the results obtained in the sample of adolescents with SD could be the development of physical activity programs that target neuromuscular deficits before young people re-deal with exercise as with the non-disabled population [ 35 ]. These programmes should focus on the development of strength, endurance, and FMS at an early age as these components are now understood to play an important role in the development of other capacities such as cardiorespiratory, agility or balance [ 34 ]. It has even been shown that strength can play an important role throughout the lives of people with DS as low levels of strength have been associated in lower extremities with an increased risk of falls [ 36 ].…”

Metabolic Diseases and Down Syndrome: How Are They Linked Together?

“…Exercise programs have been tested in DS individuals. These studies suggest health benefits for patients, with improved cardiometabolic risk profile, muscle strength, aerobic capacity, proprioception, and postural stability [ 60 ]. However, another study reported no efficacy of exercise to achieve weight loss in people with DS [ 61 ].…”

Ações contra a Covid-19 na População com Síndrome de Down

“…Também devem ser incluídos nessa rotina exercícios de força envolvendo diferentes grupos musculares (utilizando acessórios alternativos como faixas elásticas, garrafas pet como halteres, e até mesmo o peso do próprio corpo), com pelo menos 8-12 repetições (intensidade moderada), 2 vezes por semana. 10,11 As atividades da vida diária, tais como limpar a casa ou o quintal, subir escadas ou brincar com um animal de estimação também são importantes para manter as pessoas com SD fisicamente ativas e integradas. As atividades físicas devem ser realizadas preferencialmente em um espaço seguro e ventilado.…”