Background: People with Down syndrome show lower levels of cardiovascular fitness, which can affect physical activities such as working or performing daily tasks. Cardiovascular exercise has been recognized as effective in improving the cardiovascular fitness of individuals with and without disabilities; however, the effect on the cardiovascular fitness of people with Down syndrome is uncertain.
Objectives: To investigate the effects of cardiovascular exercise programs for people with Down syndrome.
Search strategy: The authors searched electronic databases including MEDLINE, EMBASE, AMED, PsychINFO, CINHAL, ERIC, Cochrane library, Digital Dissertation Index, Sportdiscus, and AusSport Med through October 2004 using the following key words: Down syndrome or trisomy 21 in combination with physical fitness, exercise, physical activity, exercise therapy, exercise training, physical training, and aerobic. Hand searches and reference checks for the identified articles were also conducted.
Selection criteria: Included studies were randomized or non-randomized controlled trials that assessed the effects of an aerobic exercise program on the cardiovascular fitness in people with Down syndrome. Aerobic exercise programs were based on the American College of Sports Medicine (ACSM) guidelines. Studies were included that assessed changes in body structure or function, activity limitation, or participation in social activities.
Data collection and analysis: Two reviewers independently assessed the quality of each study using the PEDro scale. Data were extracted on study design, demographic information, outcome measures, adverse effects and other factors. The authors calculated effect sizes with 95% confidence intervals for the comparisons of the outcomes of each study and conducted a meta-analysis to estimate the overall effect of cardiovascular training programs.
Main results: Four studies satisfied the inclusion criteria for this review. The results indicated positive effects of cardiovascular fitness including an increase in peak oxygen consumption, peak minute ventilation, maximum workload, and physical endurance. No changes were found in body weight, and there were no effects on psychosocial functioning. In addition, there were no reports of withdrawals or negative effects.
Conclusions: Although the findings demonstrated large effects for individuals with Down syndrome, more randomized control trials are needed to definitely determine the effects. Moreover, future research should address the adverse effects of vascular exercise.