Improvements in physical fitness in adults with Down syndrome

The effectiveness of an exercise training program for 52 adults with Down syndrome (M age = 39.4 years) was evaluated. The training program consisted of cardiovascular (30 minutes) and strength exercise (15 minutes) for 12 weeks, 3 days a week for 45-minutes per session. Compared to control subjects, the training group improved significantly in cardiovascular fitness and muscular strength and endurance and had a slight but significant reduction in body weight. Greater effort must be made to promote increases in physical activity participation among persons with Down syndrome and developmental disabilities in order to reduce the potential health risks associated with low fitness and sedentary behavior.     

Attitudinal and psychosocial outcomes of a fitness and health education program on adults with down syndrome

Attitudinal and psychosocial outcomes of a fitness and health education program for adults with Down syndrome were examined. Participants were 53 adults with Down syndrome ages 30 years and older (29 females, 24 males, M age = 39.72 years) who were randomized into a training (n = 32) or control group (n = 21). The training group participated in a 12-week, 3 days per week, exercise and health education program. Outcome measures included attitudes towards exercise (cognitive-emotional barriers, outcomes expectations, and performance self-efficacy) and psychosocial well-being (community integration, depression, and life satisfaction). Compared to controls, the training group showed significant changes in attitudes towards exercise, including increased exercise self-efficacy, more positive expected outcomes, fewer cognitive-emotional barriers, improved life satisfaction, and marginally lower depression.     

A 21-week bone deposition promoting exercise programme increases bone mass in young people with Down syndrome

Aim To determine whether the bone mass of young people with Down syndrome may increase, following a 21‐week conditioning training programme including plyometric jumps. Method Twenty‐eight participants with Down syndrome (13 females, 15 males) aged 10 to 19 years were divided into exercise (DS‐E; n=14; eight females, six males mean age 13y 8mo, SD 2y 6mo) and non‐exercise (DS‐NE; n=14; five females, nine males mean age 15y 5mo, SD 2y 6mo) groups. Total and regional (hip and lumbar spine [L1–L4]) bone mineral content (BMC) and total lean mass were assessed by dual energy X‐ray absorptiometry at baseline and after a 25‐minute training session performed twice a week. Repeated‐measures analyses of variation were applied to test differences between pre‐ and posttraining values for BMC and total lean mass. Differences between increments were studied with the Student’s t‐test. Linear regression models were fitted to test independent relationships. Results After the intervention, higher increments in total and hip BMC, and total lean mass, were observed in the DS‐E group (all p<0.05). A time×exercise interaction was found for total lean mass (p<0.05). The increment in total lean mass, height, and Tanner stage accounted for almost for 60% in the increment in total BMC in the DS‐NE group (p<0.05). Interpretation Twenty‐one weeks of training have a positive effect on the acquisition of bone mass in young people with Down syndrome.     

踏车锻炼对慢性阻塞性肺疾病患者运动耐力和中枢驱动的影响

目的 探讨踏车锻炼对慢性阻塞性肺疾病(COPD)患者运动耐力和中枢驱动的影响.方法 选择南方医科大学珠江医院呼吸内科自2009年10月至2010年10月收治的中、重度COPD缓解期COPD患者22例,其中康复组(12例)接受12周中等强度踏车运动训练,对照组(10例)不接受训练.在训练前后分别进行常规肺通气功能、弥散功能和肺容量测定以及运动心肺功能测试及高强度持续恒定功率运动试验,监测运动过程中呼吸流量、容量和膈肌肌电的变化.比较患者试验前后运动耐力和呼吸困难评分的变化.结果 康复组患者锻炼后运动时间比锻炼前延长,峰运动功率增加,差异均有统计学意义(P＜0.05);等时间点呼吸频率(RR)、分钟通气量(VE)、平均吸气流速(VT/Ti)、膈肌电电压的均方根(RMS)、Borg评分较锻炼前下降,差异均有统计学意义(P＜0.05); COPD患者△Borg分别与△VE、△VT/Ti、△RMS呈正相关关系(P＜0.05).结论 下肢运动训练可显著改善COPD患者的运动耐力,降低COPD患者在相同运动强度下的通气需求和中枢驱动,改变了COPD患者的呼吸应答方式,从而减轻了COPD患者呼吸困难的主观感觉.     

Effect of a six-month aerobic exercise training program on cardiovascular responsivity in healthy middle-aged adults.

The purpose of this study was to determine the effects of a six month aerobic exercise training regimen on cardiovascular responsivity to mental arithmetic in healthy middle-aged men and women. Subjects were randomly assigned to a moderate intensity exercise intervention or to an assessment-only control group. Before and after the intervention subjects' heart rates and blood pressures were measured doing a mental arithmetic task (N = 83). Other physiological and psychosocial measures included the Type A structured interview and a maximal exercise treadmill test. Validated adherence to the exercise regimen exceeded 75% and there were significant increases in aerobic capacity in those subjects receiving exercise training. Exercise did not significantly reduce cardiovascular responsivity to the stress task. Type A behavior did not interact with reactivity across exercisers or controls nor was it significantly correlated with adherence. The results are discussed with respect to factors that have been previously reported to potentially influence the exercise/reactivity relationship.     

Lateral asymmetries in finger-tapping by adolescents and young adults with Down syndrome

Lateral asymmetries in finger-tapping were compared in right-handed adolescents and young adults with and without Down syndrome in order to examine cerebral specialization in the Down syndrome group. Finger-tapping data revealed that subjects with Down syndrome performed more slowly than did control subjects and failed to show a right-hand tapping advantage. Although the latter finding suggests that individuals with Down syndrome are less lateralized for sequential processing, they exhibited the same pattern of tapping variability as did control subjects; i.e., they were more variable when finger-tapping with their left hands.     

The impact of sleep disruption on executive function in Down syndrome

The high prevalence of sleep disorders, particularly obstructive sleep apnea, is well established in children with Down syndrome. However, only a few studies have focused on older children and young adults in this population. Given the presence of sleep disorders and the early emergence of Alzheimer's disease, more work is needed to examine the relationship between sleep and cognition in Down syndrome. Twenty-nine adolescents and young adults with Down syndrome participated in the present study. Parents reported on their sleep difficulties using a well-validated measure of sleep problems in intellectual disabilities. Based on theoretical models linking obstructive sleep apnea to prefrontal cortex dysfunction, we tested components of executive functions that have been shown to be impaired in previous studies of Down syndrome. First, results indicate that participants with Down syndrome with higher body mass index also had increased caregiver reports of sleep apnea symptoms. Individuals with high ratings of sleep disruption also showed greater difficulties with executive function. These results suggest that sleep disruption may place this set of functions at risk in young adults. Future work should examine if this risk may result in earlier onset of dementia or steeper decline with Alzheimer's disease. Further, additional studies are needed to investigate the effect of exercise interventions and weight reduction on sleep disorders in this population.     

Face processing and facial emotion recognition in adults with Down syndrome

Face processing and facial expression recognition was investigated in 17 adults with Down syndrome, and results were compared with those of a child control group matched for receptive vocabulary. On the tasks involving faces without emotional content, the adults with Down syndrome performed significantly worse than did the controls. However, their performance was good on the tests with complete faces. On the facial expression tasks, participants with Down syndrome exhibited particular difficulties with the neutral and surprised expressions. Analysis of their error pattern suggest they had a tendency to judge faces more positively than did the controls. Finally, there were significant relationships among emotional processing, receptive vocabulary, and inhibition measures; nonverbal reasoning ability was not related to any of the tasks.     

An exploratory study of the association between physical activity,cardiovascular fitness and body size in children with Down syndrome

Objective: To explore the association between physical activity, cardiovascular fitness and body size among children with Down syndrome. Method: Physical activity, cardiovascular fitness and body size were measured by accelerometry, maximal fitness test and anthropometric measurements (BMI, waist circumference), respectively. Results: Fourteen children with Down syndrome (8 boys, 6 girls; mean age 12.9 years) participated. There was no significant correlation between physical activity and cardiovascular fitness or physical activity and body size. Children with Down syndrome who were fitter, had lower BMIs (r?=??0.77, 95% confidence interval (CI) ?0.41 to ?0.93) and smaller waist circumference (r?=??0.75, 95% CI ?0.36 to ?0.92). Conclusion: Preliminary evidence suggests physical activity may not be associated with either body size or fitness in children with Down syndrome. Body size appears to be inversely related to fitness in children with Down syndrome.     

The functional fitness capacity of adults with Down syndrome in South Africa

Background It is well established that there is a relationship between physical inactivity and increased risk for diseases of lifestyle. Persons with Down syndrome (DS) are especially at risk because of physical and health impairments, as well as perceived and real barriers to participation in exercise. The purpose of the study was to establish the functional fitness capacity and predictors of performance of DS adults. Methods Data were collected at various intellectual disability centres and private homes in seven provinces of South Africa. Three hundred and seventy‐one DS individuals (199 men and 172 women) from 18 to 66 years were tested for balance, flexibility, coordination, muscular strength and endurance, aerobic capacity and functional ability. Data were categorised according to gender and age groups (18–25, 26–35, 36–45, and >45 years). Multiple regression analysis was performed to determine the relationship between the functional task and physical test items. Results Down syndrome men performed significantly better on all but two tests compared with the women (P < 0.05). DS women performed better on the sit‐and‐reach flexibility item and the chair stand test; however, differences were not statistically significant from the men. Significant differences across age groups were observed for nine of the 13 functional fitness tests (P < 0.05). Muscular strength items, especially leg strength, significantly predicted functional performance in DS men and women. Aerobic capacity only predicted functional performance in DS men and sit‐and‐reach flexibility and dynamic balance only in DS women. Conclusions Findings of this study provide important information on the functional capacity of DS adults and show which physical attributes contribute to functional performance. Consequently appropriate training programmes can be tailored for this population whom is known to have poor functional fitness.     

Maximal exercise response of paraplegic wheelchair road racers.

The maximal metabolic responses of 11 paraplegic wheelchair road racers were evaluated with 2 wheelchair exercise protocols: increasing speed and increasing resistance. The maximal heart rates, minute ventilations and oxygen uptakes were similar for the 2 tests, indicating that either protocol is suitable for maximal wheelchair dynamometer exercise tests for groups. The resulting data were then compared to published data on maximal arm exercise by athletic and non athletic paraplegics and ambulatory males of the same age group. The combined mean values for both exercise tests of maximal oxygen consumption rate (VO2max = 37.4 ml/kg/min), minute ventilation (VE = 109.4 l/min), respiratory exchange quotient (RQmax = 1.18) and heart rate (187 beats/min) are in the mid range of reported data on wheelchair athletes. The mean RQ and heart rate values were similar to those achieved by ambulatory individuals performing maximal exercise tests. The mean VO2max of 37.4 ml/kg/min in our subjects is comparable to that achieved by sedentary ambulatory males of this age group. The data and the comparison to published data suggest several conclusions: in some parameters elite male paraplegic road racers have maximal values similar to those of ambulatory males, and in others they have maximal values substantially lower than might be expected; there is considerable variability among paraplegics in the metabolic responses to maximal exercise, most likely related to differences in cardiovascular fitness; and paraplegics can improve their cardiovascular fitness by training.     

Improving functional skills and physical fitness in children with Rett syndrome

Background To investigate the feasibility of a physical exercise programme with treadmill for persons with Rett syndrome (RS) in order to promote fitness and health. Methods A daily training programme on a treadmill was designed for four females with RS over a period of 2 months with tests performed in three intervals, at time 1, 2 and 3, 2 months apart with intervention taking place between tests 2 and 3. Participants were four girls with RS aged 8.5–11 years (mean: 10 years) attending the educational facility Beit Issie Shapiro, Raanana, Israel, all with independent mobility and with typical characteristics of RS stage III. The training took place at the educational facility, on a 1400 model treadmill (Trimline, capable of very low speeds < 0.5 k/h), with very long side rails. Special low side rails were adapted to the treadmill in order to fit the height of the children and velcro straps were added to assist in safely placing the hands. Pulse was monitored constantly during exercise by an A3 polar pulse belt. Pulse measurements at rest during training were considered as evaluators of aerobic physical condition. Functional measurement was based on a scale specially established for the present study. The scale was a 31‐item motor‐functioning tool that measures the ability of participants to knee walk and knee stand, to get up to a standing position, duration of walking different paths, and to go up and down stairs and slopes. Results The study showed that physical fitness of the children at the end of the training programme had improved considerably (P < 0.05). Tests showed that general functional abilities had improved considerably (P < 0.0001). Although all items of the functional ability measure showed impressive positive change, some of the 31 items on it showed statistically significant improvement (knee walking, going up and down stairs and speed of walking for 25 m. Pearson correlation showed high linkage (r = ?0.76) between functional improvement and change in physical fitness. Conclusions Physical fitness programme executed on a daily basis is capable of improving functional ability of children with RS. Nonprofessional personnel can execute such a programme under supervision of a qualified physical therapist.     

Fractal scaling properties of heart rate dynamics in persons with Down syndrome

It has been shown that the fractal scaling properties of heart rate dynamics, in healthy aging, differ from that seen in heart disease and this favors the use of fluctuation measures as diagnostic tools. The purpose of this study was to evaluate the fractal heart rate dynamics in adults with Down syndrome (DS) under different physiological conditions (rest, exercise and post-exercise recovery) and compare their responses with those of nondisabled individuals. Fourteen participants (10 males; and 4 females) with DS and 13 nondisabled (9 males, and 4 females) controls performed maximal and submaximal treadmill tests with metabolic and heart rate measurements. Detrended fluctuation analysis was performed on the last 256 consecutive R-R intervals obtained under the following conditions: (1) standing rest, (2) submaximal treadmill exercise and (3) standing post-exercise recovery. Participants with DS presented lower chronotropic response than controls to peak and submaximal exercise (p<0.05). The short-term scaling exponent (α(1)) was greater in the DS group at rest (1.29±0.06 vs 1.07±0.08), during exercise (1.24±0.09 vs 0.99±0.08) and recovery (1.31±0.06 vs 1.21±0.06) (p<0.05). Furthermore, the fractal scaling distance score (I1-α(1)I) of participants with DS was also greater than that of controls under each physiological condition (p<0.05). This confirmed their greater fractal distance from the healthy value of 1.0. In conclusion, adults with DS show a breakdown of scale-invariant organization in heart rate dynamics towards Brownian noise and this is similar to that described in healthy aging.     

Structured exercise does not stabilize cognitive function in individuals with mild cognitive impairment residing in a structured living facility

Exercise has been shown to have positive effects on the brain and cognition in healthy older adults, though no study has directly examined possible cognitive benefits of formal exercise programs in persons with mild cognitive impairment (MCI) living in structured facilities. Thirty-one participants completed neuropsychological testing and measures of cardiovascular fitness at baseline and after 6 months of a structured exercise program that included aerobic and resistance training. While exercise improved cardiovascular fitness in persons with MCI, there was no improvement in cognitive function. Rather, MCI patients in this sample declined in performance on several tests sensitive to Alzheimer's disease. Examined in the context of past work, it appears exercise may be beneficial prior to the onset of MCI, though less helpful after its onset.     

Assessment protocols of maximum oxygen consumption in young people with Down syndrome – A review

Maximum oxygen consumption is considered the gold standard measure of cardiorespiratory fitness. Young people with Down syndrome (DS) present low values of this indicator compared to their peers without disabilities and to young people with an intellectual disability but without DS. The use of reliable and valid assessment methods provides more reliable results for the diagnosis of cardiorespiratory fitness and the response of this variable to exercise. The aim of the present study was to review the literature on the assessment protocols used to measure maximum oxygen consumption in children and adolescents with Down syndrome giving emphasis to the protocols used, the validation process and their feasibility. The search was carried out in eight electronic databases – Scopus, Medline-Pubmed, Web of science, SportDiscus, Cinhal, Academic Search Premier, Scielo, and Lilacs. The inclusion criteria were: (a) articles which assessed VO2peak and/or VO2max (independent of the validation method), (b) samples composed of children and/or adolescents with Down syndrome, (c) participants of up to 20 years old, and (d) studies performed after 1990. Fifteen studies were selected and, of these, 11 measured the VO2peak using tests performed in a laboratory, 2 used field tests and the remaining 2 used both laboratory and field tests. The majority of the selected studies used maximal tests and conducted familiarization sessions. All the studies took into account the clinical conditions that could hamper testing or endanger the individuals. However, a large number of studies used tests which had not been specifically validated for the evaluated population. Finally, the search emphasized the small number of studies which use field tests to evaluate oxygen consumption.     

A comparison between older persons with down syndrome and a control group: clinical characteristics, functional status and sensorimotor function

The increase in life expectancy within the general population has resulted in an increasing number of elderly adults with intellectual disability, and this is reflected in the increased life expectancy in persons with Down syndrome, currently about 56 years. The aim of this study was to study the clinical characteristics, the functional status and sensori-motor function of 10 older persons with Down syndrome (mean age 59 years), 13 younger persons with Down syndrome (mean age 44 years) and compare them with 38 adults with intellectual disability without Down syndrome and a control group of people without intellectual disability. All the persons with Down syndrome and intellectual disability resided in two residential living centres in Israel, while the 31 older persons without intellectual disability (mean age 75 years), who served as the control group, lived in an independent living facility. The study considered demographic data, medical backgrounds, physical and functional tests. The results showed that the older persons with Down syndrome in the study were more obese, shorter and had more medical problems than both the older persons with intellectual disability and the control group. The functional performance of the older adults with Down syndrome was more impaired in comparison with both other groups. It is postulated that their slower responses may be explained by a less physically active lifestyle, that may accelerate the onset of disease, resulting in symptoms associated with aging that are detrimental to health.     

Aerobic endurance exercise benefits memory and affect in young adults

Exercise seems a simple and widely practised behaviour that activates molecular and cellular signalling cascades involved in various central nervous system processes. Despite impressive results obtained in animal studies, fitness interventions have produced less reliable effects in humans, particularly in young adults. In the present study we tested the hypothesis that an individually adapted exercise training consisting of three running sessions of 30 minutes per week for 6 weeks, has the potential to improve visuospatial and verbal memory, concentration performance, and affect in young and healthy adults. Twenty-eight students participated and underwent a graded fitness test to assess individual fitness. The experimental group took part in an aerobic running programme, whereas the control group were asked not to vary their everyday activities. We found a significant increase in visuospatial memory performance and a significant increase in positive affect on a .05 alpha level of significance. However, we observed no effects of running training on concentration performance and verbal memory. We conclude that physical activity can possibly serve as a means to improve positively valenced aspects of affect and benefit visuospatial but not verbal memory in young adults.     

Aerobic endurance exercise benefits memory and affect in young adults

Exercise seems a simple and widely practised behaviour that activates molecular and cellular signalling cascades involved in various central nervous system processes. Despite impressive results obtained in animal studies, fitness interventions have produced less reliable effects in humans, particularly in young adults. In the present study we tested the hypothesis that an individually adapted exercise training consisting of three running sessions of 30 minutes per week for 6 weeks, has the potential to improve visuospatial and verbal memory, concentration performance, and affect in young and healthy adults. Twenty-eight students participated and underwent a graded fitness test to assess individual fitness. The experimental group took part in an aerobic running programme, whereas the control group were asked not to vary their everyday activities. We found a significant increase in visuospatial memory performance and a significant increase in positive affect on a .05 alpha level of significance. However, we observed no effects of running training on concentration performance and verbal memory. We conclude that physical activity can possibly serve as a means to improve positively valenced aspects of affect and benefit visuospatial but not verbal memory in young adults.     

Strength and agility training in adolescents with Down syndrome: A randomized controlled trial

The purpose of this study was to investigate the effects of a proposed strength and agility training program of adolescents with Down syndrome. Ninety-two adolescents were recruited and evenly randomized to two intervention groups (exercise group vs. control group). The mean age for the exercise and the control group was 10.6±3.2 and 11.2±3.5 respectively. The exercise training program consisted of a 5-min treadmill exercise and one 20-min virtual-reality based activity administered three times a week for 6 weeks. Pre- and post-test measures were taken for muscle strength and agility performance. The measured muscle included hip extensor, hip flexor, knee extensor, knee flexors, hip abductors, and ankle plantarflexor. A handheld dynamometer was used to measure the lower extremities muscle strength, and agility performance was assessed by the strength and agility subtests of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition. The exercise group had significant improvements in agility (p=0.02, d=0.80) and muscle strength of all muscle group (all p's<0.05, d=0.51-0.89) assessed in comparison to the control group after the 6-week intervention. Knee muscle groups including both flexors and extensors had the greatest gains among all the muscles measured. A short-term exercise training program used in this study is capable of improving muscle strength and agility performance of adolescents with DS.     

Numerical skills in children with Down syndrome. Can they be improved?

The present study aims to explore the impact of a numerical skills training program on the basic mathematical skills and logical thinking in children with Down syndrome (DS). The training program was built specifically for children with DS, bearing the strengths and weaknesses of their particular cognitive profile in mind. Two groups of children with DS took part in the study. All children were tested before and after the training on measures of numerical skills and logical thinking. One group of 27 children was trained in numerical skills twice a week for 2 months, for about 30 min per session. A control group of 9 children was not involved in any training session. After training, children in the intervention group performed better in numerical tests, while those in the control group did not. These results suggest that our training program is both feasible and effective for children with Down syndrome.