Exercise training to improve balance ability for individuals with Down Syndrome: A systematic review and meta-analysis

Saeid Bahiraei; Ebrahim Mohammad Ali Nasab Firouzjah; Aazam Abbaszadeh

doi:10.5114/areh.2023.124256

Abstract

Down syndrome (DS) is associated with exhibit specific balance problems due to inter alia deficits in the postural control system and hypotonia. One approach to reducing balance impairments in this population is exercise training. This study presents a systematic review and meta-analysis of the effects of exercise training designed to improve balance ability in people with DS.

A search for relevant articles was carried out on seven electronic databases: MEDLINE, PubMed, Cochrane Library, Google Scholar, Scopus, PEDro, and Web of Science. This systematic review was carried out between 2010 and 2022. Utilizing a set of predetermined inclusion and exclusion criteria, the studies were selected and their methodology was assessed using the PEDro scale. Data analyses were performed using the CMA v3 random effects model.

In total, 514 articles were screened, and the data from 15 randomized controlled trials (RCTs) involving individuals with DS were subjected to a meta-analysis. The results showed that exercise training was effective in improving balance (ES: 1.20, 95% CIs: 0.95 to 1.53, p = 0.00).

Despite the small number of studies, the findings suggest that exercise training might improve balance in children and young people with DS. In conclusion, exercise training is highly recommended for people with DS, to improve their balance and prevent falling risk.

References

Antonarakis SE, Skotko BG, Rafii MS, Strydom A, Pape SE, Bianchi DW, et al. Down syndrome. Nat Rev Dis. 2020; 6(1): 1–20.
Search in Google Scholar Back to article
Ruiz-González L, Lucena-Antón D, Salazar A, Martín-Valero R, Moral-Munoz J. Physical therapy in Down syndrome: systematic review and meta-analysis. J Intellect Disabil Res 2019; 63(8): 1041–67.
Search in Google Scholar Back to article
Malak R, Kostiukow A, Krawczyk-Wasielewska A, Mojs E, Samborski W. Delays in motor development in children with Down syndrome. Med Sci Monit. 2015; 21: 1904.
Search in Google Scholar Back to article
Mendonca G, Pereira F, Morato P, Fernhall B. Walking economy of adults with Down syndrome. Int J Sports Med. 2010; 31(1): 10–5.
Search in Google Scholar Back to article
Villarroya MA, González-Agüero A, Moros-García T, de la Flor Marín M, Moreno LA, Casajús JA. Static standing balance in adolescents with Down syndrome. Res Dev Disabil 2012; 33(4): 1294–300.
Search in Google Scholar Back to article
Connolly BH, Michael BT. Performance of retarded children, with and without Down syndrome, on the Bruininks Oseretsky Test of Motor Proficiency. Phys Ther. 1986; 66(3): 344–8.
Search in Google Scholar Back to article
Galli M, Rigoldi C, Brunner R, Virji-Babul N, Giorgio A. Joint stiffness and gait pattern evaluation in children with Down syndrome. Gait Posture. 2008; 28(3): 502–6.
Search in Google Scholar Back to article
Caird MS, Wills BP, Dormans JP. Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg 2006; 14(11): 610–9.
Search in Google Scholar Back to article
Gámez-Calvo L, Gamonales JM, León K, Muñoz-Jiménez J. Influence of balance on the quality of Life of People with Down syndrome in school and adult ages: A literature review. MHSalud. 2022; 19(1): 71–86.
Search in Google Scholar Back to article
Latash ML, Kang N, Patterson D. Finger coordination in persons with Down syndrome: atypical patterns of coordination and the effects of practice. Exp Brain Res. 2002; 146(3): 345–55.
Search in Google Scholar Back to article
Block ME. Motor development in children with Down syndrome: A review of the literature. Adapt Phys Activ Q 1991; 8(3): 179–209.
Search in Google Scholar Back to article
Wong C, Dwyer J, Holland M. Overcoming weight problems in adults with Down syndrome. Nutr Today. 2014; 49(3): 109–19.
Search in Google Scholar Back to article
Bieć E, Zima J, Wójtowicz D, Wojciechowska-Maszkowska B, Kręcisz K, Kuczyński M. Postural stability in young adults with Down syndrome in challenging conditions. PLoS One. 2014; 9(4): e94247.
Search in Google Scholar Back to article
MacDonald M, Esposito P, Hauck J, Jeong I, Hornyak J, Argento A, et al. Bicycle training for youth with Down syndrome and autism spectrum disorders. Focus Autism Other Dev Disabil. 2012; 27(1): 12–21.
Search in Google Scholar Back to article
Galli M, Rigoldi C, Mainardi L, Tenore N, Onorati P, Albertini G. Postural control in patients with Down syndrome. Disabil Rehabil. 2008; 30(17): 1274–8.
Search in Google Scholar Back to article
Bahiraei S, Daneshmandi, H., Norasteh, A.A., Yahya, S. Balance stability in intellectual disability: Introductory evidence for the balance evaluation systems test (BESTest). Life Span and Disability. 2019; 22(1): 7–28.
Search in Google Scholar Back to article
Gupta S, Rao BK, Kumaran S. Effect of strength and balance training in children with Down's syndrome: a randomized controlled trial. Clin Rehabil. 2011; 25(5): 425–32.
Search in Google Scholar Back to article
Espindula AP, Ribeiro MF, Souza LAPSd, Ferreira AA, Ferraz MLdF, Teixeira VdPA. Effects of hippotherapy on posture in individuals with Down Syndrome. Fisioterapia em Movimento. 2016; 29: 497–506.
Search in Google Scholar Back to article
Alsakhawi RS, Elshafey MA. Effect of core stability exercises and treadmill training on balance in children with Down syndrome: randomized controlled trial. Adv Ther. 2019; 36(9): 2364–73.
Search in Google Scholar Back to article
Aly SM, Abonour AA. Effect of core stability exercise on postural stability in children with Down syndrome. IJMRHS. 2018; 5(10): 213–22.
Search in Google Scholar Back to article
Villarroya MA, González-Agüero A, Moros T, Gómez-Trullén E, Casajús JA. Effects of whole body vibration training on balance in adolescents with and without Down syndrome. Res Dev Disabil 2013; 34(10): 3057–65.
Search in Google Scholar Back to article
Carter K, Sunderman, S., & Burnett, S. W. The effect of vestibular stimulation exercises on balance, coordination, and agility in children with Down syndrome. J Psychiatry Neurosci 2018; 6(2): 28–32.
Search in Google Scholar Back to article
Raghupathy MK, Divya M, Karthikbabu S. Effects of traditional Indian dance on motor skills and balance in children with Down syndrome. J Mot Behav. 2022; 54(2): 212–21.
Search in Google Scholar Back to article
Bahiraei S, Daneshmandi H. The effect and durability of functional exercises on Balance Evaluation Systems Test (BESTest) scores in people with intellectual disabilities: a preliminary report. J Intellect Disabil Res 2022; 66(11): 880–92.
Search in Google Scholar Back to article
Hutton B, Catala-Lopez F, Moher D. The PRISMA statement extension for systematic reviews incorporating network meta-analysis: PRISMA-NMA. Med Clin (Barc). 2016; 147(6): 262–6.
Search in Google Scholar Back to article
Roostaei M, Baharlouei H, Azadi H, Fragala-Pinkham MA. Effects of aquatic intervention on gross motor skills in children with cerebral palsy: a systematic review. Phys Occup Ther Pediatr 2017; 37(5): 496–515.
Search in Google Scholar Back to article
Rahman SA, Rahman A. Efficacy of virtual reality-based therapy on balance in children with Down syndrome. World Appl Sci. 2010; 10(3): 254–61.
Search in Google Scholar Back to article
Ulrich DA, Burghardt AR, Lloyd M, Tiernan C, Hornyak JE. Physical activity benefits of learning to ride a two-wheel bicycle for children with Down syndrome: A randomized trial. Phys Ther. 2011; 91(10): 1463–77.
Search in Google Scholar Back to article
Eid MA. Effect of whole-body vibration training on standing balance and muscle strength in children with Down syndrome. Am J Phys Med Rehabil 2015; 94(8): 633–43.
Search in Google Scholar Back to article
Eid MA, Aly SM, Huneif MA, Ismail DK. Effect of isokinetic training on muscle strength and postural balance in children with Down's syndrome. Int J Rehabil Res 2017; 40(2): 127–33.
Search in Google Scholar Back to article
Jankowicz-Szymanska A, Mikolajczyk E, Wojtanowski W. The effect of physical training on static balance in young people with intellectual disability. Res Dev Disabil 2012; 33(2): 675–81.
Search in Google Scholar Back to article
Naczk A, Gajewska E, Naczk M. Effectiveness of Swimming Program in Adolescents with Down Syndrome. Int J Environ Res Public Health. 2021; 18(14): 7441.
Search in Google Scholar Back to article
Perrot A, Maillot P, Le Foulon A, Rebillat A-S. Effect of exergaming on physical fitness, functional mobility, and cognitive functioning in adults with Down syndrome. Am J Intellect Dev. 2021; 126(1): 34–44.
Search in Google Scholar Back to article
El-Meniawy GH, Kamal HM, Elshemy SA. Role of treadmill training versus suspension therapy on balance in children with Down syndrome. Egypt J Med Hum Genet. 2012; 13(1): 37–43.
Search in Google Scholar Back to article
Boer P. The effect of 8 weeks of freestyle swim training on the functional fitness of adults with Down syndrome. J Intellect Disabil Res 2020; 64(10): 770–81.
Search in Google Scholar Back to article
Silva V, Campos C, Sá A, Cavadas M, Pinto J, Simões P, et al. Wii-based exercise program to improve physical fitness, motor proficiency and functional mobility in adults with Down syndrome. J Intellect Disabil Res 2017; 61(8): 755–65.
Search in Google Scholar Back to article
Azab A, Mahmoud W, Basha M, Hassan S, Morgan E, Elsayed A, et al. Distinct effects of trampoline-based stretch-shortening cycle exercises on muscle strength and postural control in children with Down syndrome: a randomized controlled study. Eur Rev Med Pharmacol. 2022; 26(6): 1952–62.
Search in Google Scholar Back to article
Maïano C, Hue O, Lepage G, Morin AJ, Tracey D, Moullec G. Do exercise interventions improve balance for children and adolescents with Down syndrome? A systematic review. Phys Ther. 2019; 99(5): 507–18.
Search in Google Scholar Back to article

Exercise training to improve balance ability for individuals with Down Syndrome: A systematic review and meta-analysis

Abstract

Paradigm

My account