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

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

Open Access
|Jan 2023

Figures & Tables

Fig. 1.

Diagram of the PRISMA flow of the articles included in the review and meta-analysis

Fig. 2.

Forest plot of the effects of exercise programs on balance of individuals with Down syndrome

Fig. 3.

Forest plot of the effects of exercise programs on Biodex Balance Index (overall, anteroposterior, mediolateral) of individuals with DS

Fig. 4.

Forest plot of the effects of exercise programs on BOTMP of individuals with DS

Results from the meta-analysis utilizing a random effects model

Number of studiesI2P-value−95%CIEffect size+95%CITau2
1575.14<0.000010.951.241.530.50

Effect sizes by subgroup: frequency, length of sessions, age

SubgroupCategoriesEffect size−95% CI+95% CI
Duration≤101.190.611.77
≥121.150.761.53
Frequency2 per week0.840.321.36
3 per week1.440.891.98
>3 per week0.48−0.281.25
Session length<450.800.201.40
45–601.420.901.94
>600.510.110.91
Age5–131.390.861.92
14–180.590.051.14
>180.860.131.59

Descriptions of the interventions, controls, and balancing measurements of the studies included in the meta-analysis

Study (country)PEDro scaleDesignEffect sizeParticipants (Female and male %)Age range (Mean) years oldInterventionSession Duration, in min (Frequency/wk.)Total Duration (wk.)Assessment (Method)
Abdel Rahman et al. [27]5RCTs1.61
  • IG: 15 (40% males)

  • CG: 15 (47% males)

  • IG: 10–12 (10.9) age

  • CG: 11–13 (11.6) age

Wii Fit balance game training60(2)6Static balance (OLS: EC + EO), dynamic balance (BOTMP)
Ulrich et al.[28]5RCTs0.27
  • IG: 19 (47% males)

  • CG: 27 (41% males)

  • IG: 8–15 (12.4) age

  • CG: 8–15 (12) age

Bicycle intervention75 (5 consecutive days)5 daysStanding Balance (right leg and left leg)
Eid [29]9RCTs0.91
  • IG: 15 (53% males)

  • CG: 15 (60% males)

  • IG: 8–10 (8.9) age

  • CG: 8–10 (9.3) age

Physical therapy + whole–body vibration80–90(3)24Dynamic balance (DLE:EO) (Biodex Balance System
Eid et al. [30]8RCTs1.55
  • IG: 15 (53% males)

  • CG: 16 (56% males)

  • IG: 9–12 (10.3) age

  • CG: 9–12 (10.1) age

Physical therapy + isokinetic training60(3)12Dynamic balance (DLE:EO) (Biodex Balance System
Gupta et al. [17]7RCTs1.20
  • IG: 12 (67% males)

  • CG: 11 (55% males)

  • IG: 11–14 (13.5) age

  • CG: 10–14 (13) age

Strength and Balance exercisesNM(3)6Static balance (OLS: EC + EO), dynamic balance (BOTMP)
Jankowicz-Szymanska et al. [31]3RCTs0.25
  • IG: 20 (NM)

  • CG: 20 (NM)

  • IG: 16–18 (NM) age

  • CG: 16–18 (NM) age

Training program targeting balance capacities45(2)12Static balance (OLS: EC + EO), (Pressure platform)
Naczk [32]5RCTs0.51
  • IG: 11 (64% males)

  • CG: 11 (64% males)

  • IG: NA (14.9) age

  • CG: NA (14.4) age

water–based exercise and a swimming program90(2)33Flamingo balance test which is a single leg balance test
Perrot et al. [33]6RCTs1.96
  • IG: 6 (NA)

  • CG: 6 (NA)

  • IG: 35–64 (49.3) age

  • CG: 35–64 (51.4) age

Exergaming(Wii–based program)60(2)12Timed Up and Go Test and Timed Up and Down Stairs Test
Raghupathy et al. [23]8RCTs0.25
  • IG: 18 (61% males)

  • CG: 18 (56% males)

  • IG: 6–10 (7.8) age

  • CG: 6–10 (8.4) age

Traditional Indian Dance60(3)6Paediatric balance scale
Alsakhawi et al. [19]5RCTs2.36
  • IG(A): 15 (NA)

  • IG(B): 15 (NA)

  • IG(C): 15 (NA)

  • IG(A): 4–6 (4.6) age

  • IG(B): 4–6 (4.6) age

  • IG(C): 4–6 (4.6) age

Core Stability Exercises and Treadmill Training60(3)8Berg balance scale and the Biodex Balance System
el-Meniawy et al. [34]4RCTs2.03
  • IG(A): 15 (NA)

  • IG(B): 15 (NA)

  • IG(A): 8–10 (9.34) age

  • IG(B): 8–10 (9.34) age

suspension therapy and treadmill training60(3)12Biodex instrument system
Boer [35]6RCTs0.48
  • IG: 13 (50% males)

  • CG: 13 (50% males)

  • IG: 18–45 (34.2) age

  • CG: 18–45 (30.3) age

freestyle swim training40(4)8Standing on one leg and WOBB
Silva et al. [36]8RCTs0.64
  • IG: 12 (NA)

  • CG: 13 (NA)

  • IG: 18–60 (NA) age

  • CG: 18–60 (NA) age

Wii–basedexercise program60(3)8Flamingo Balance Test and TUG
Azab et al. [37]7RCTs1.10
  • IG: 16 (56.3% males)

  • CG: 15 (73.3% males)

  • IG: 7–9 (9.19) age

  • CG: 7–9 (8.60) age

trampoline–based stretch–shortening cycle exercises10–15(2)12Balance Biodex System
Aly et al. [20]5RCTs1.41
  • IG: 15 (73% males)

  • CG: 15 (66% males)

  • IG: 6–10 (8.11) age

  • CG: 6–10 (8.34) age

Core stability exercises45–60(3)8Dynamic balance (DLE:EO) (Biodex Balance System
Language: English
Page range: 12 - 22
Submitted on: Nov 1, 2022
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Accepted on: Jan 9, 2023
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Published on: Jan 16, 2023
In partnership with: Paradigm Publishing Services

© 2023 Saeid Bahiraei, Ebrahim Mohammad Ali Nasab Firouzjah, Aazam Abbaszadeh, published by University of Physical Education in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License.