Aerobic exercise training programmes for adults with Down syndrome

Andriolo RB, El Dib RP, Ramos L, Atallah ÁN, da Silva EMK

Published Online:

January 19, 2011

Many people with Down syndrome have poor strength, poor muscle mass, and high body fat percentage and so are disposed to cardiovascular health problems. Although physical fitness has been suggested to improve physical and psychosocial health for a variety of healthy patient populations, information about the safety and effectiveness of aerobic exercise for adults with Down syndrome is lacking. This review identified only three small randomized trials. The results showed that only aspects of work performance (for example, maximal test time, maximal distance at the end of the exercise test) were improved after aerobic exercise training programs. Further well-designed research on larger population samples is required to evaluate potential benefits for psychosocial aspects in adults with Down syndrome.

Abstract (click to read)

Background:

Although physical fitness has been suggested to improve physical and psychosocial health for a variety of population profiles, there is a lack of information about the safety and effectiveness of aerobic exercise for adults with Down syndrome.

Objectives:

To evaluate the effectiveness and safety of aerobic exercise training programmes for physiological and psychosocial outcomes in adults with Down syndrome.

Search strategy:

The following electronic databases were searched: The Cochrane Central Register of Controlled Trials (CENTRAL) (2009, Issue 1); MEDLINE (1966 to August 2009); EMBASE (1980 to August 2009); CINAHL (1982 to August 2009); LILACS (1982 to August 2009); PsycINFO (1887 to August 2009); ERIC (1966 to August 2009); Current Controlled Trials (August 2009); and Campbell Collaboration's Social, Psychological, Educational and Criminological Register (C2-SPECTR) (to August 2009). Information about ongoing clinical trials was sought by searching ClinicalTrials.gov (http://clinicaltrials.gov) (accessed August 2009), and the National Research Register (NRR) (2009 Issue 1).

Selection criteria:

Randomised or quasi-randomised controlled trials using supervised aerobic exercise training programmes with behavioral components accepted as co-interventions.

Data collection and analysis:

Two reviewers selected relevant trials, assessed methodological quality and extracted data. Where appropriate, data were pooled using meta-analysis with a random-effects model. Positive values favour the intervention group, while negative values favour the control group.

Main results:

Three studies included in this systematic review used different kinds of aerobic activity: walking/jogging and rowing training for participants from 17 to 65 years old (from USA, Portugal and Israel). In the meta-analyses, only maximal treadmill grade was improved after aerobic exercise training programmes (4.26 grades (%) [95% CI 2.06, 6.45]). Other variables relative to work performance that could not be combined in a meta-analysis were also improved in the intervention group: maximal test time (P=0.0003), total turns of fan wheel (P=0.02), resistance of ergometer (p=0.003), power knee extension and flexion (p<0.00001), and timed up and go test (p=0.008). Thirty other outcomes including, oxidative stress and body composition, could not be combined in the meta-analysis. Apart from work performance, trials reported no statistically significant improvements.

Authors' conclusions:

There is insufficient evidence to demonstrate that aerobic exercise in adults with Down syndrome improves physical or psychosocial outcomes . Although evidence exists to support improvements in physiological and psychological aspects from strategies using mixed physical activity programmes, well-conducted research examining long-term physical outcomes, adverse effects, psychosocial outcomes and costs is required before informed practice decisions can be made.

This record should be cited as:

Andriolo RB, El Dib RP, Ramos L, Atallah ÁN, da Silva EMK. Aerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.: CD005176. DOI: 10.1002/14651858.CD005176.pub4

Assessed as up to date:

February 19, 2010

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Primary Review Group:

Developmental, Psychosocial and Learning Problems Group

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Aerobic exercise training programmes for adults with Down syndrome

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