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Meta-Analysis
. 2010 May 12;2010(5):CD005176.
doi: 10.1002/14651858.CD005176.pub4.

Aerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome

Régis B Andriolo  1 , Regina P El Dib, Luis Ramos, Alvaro N Atallah, Edina Mk da Silva
Affiliations
Meta-Analysis

Aerobic exercise training programmes for improving physical and psychosocial health in adults with Down syndrome

Régis B Andriolo et al. Cochrane Database Syst Rev. .

Abstract

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 and included participants with a broad age range (17 to 65 years). They were conducted in the 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 measured in this review including, oxidative stress and body composition variables, 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 there is improvement in physical or psychosocial outcomes of aerobic exercise in adults with Down syndrome. 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.

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Conflict of interest statement

None known.

Figures

1
1
Cumulative relative frequency of studies retrieved with a sensitive search strategy used across all databases (from their inception to August/2009). The oldest study observed was published in 1930 (Travis 1930).
2
2
Flow chart of studies retrieved by the sensitive search strategy. Numbers in parentheses indicate secondary references and how many times they are repeated.
3
3
Methodological quality graph: review authors' judgements about each item of risk of bias presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 1 Peak VO2 (mL·Kg ‐1·min‐1).
1.2
1.2. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 2 Peak heart rate (beats per minute).
1.3
1.3. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 3 Respiratory exchange ratio (VCO2/VO2).
1.4
1.4. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 4 Pulmonary ventilation (L·min‐1).
1.5
1.5. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 5 Maximal treadmill grade (%).
1.6
1.6. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 6 Maximal test time (minutes).
1.7
1.7. Analysis
Comparison 1 Aerobic exercise training programmes versus no intervention (data collection on treadmill test), Outcome 7 Maximal distance (meters).
2.1
2.1. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 1 Peak VO2 (mL·Kg ‐1·min‐1).
2.2
2.2. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 2 Peak heart rate (beats per minute).
2.3
2.3. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 3 Respiratory exchange ratio (VCO2/VO2).
2.4
2.4. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 4 Pulmonary ventilation (L·min‐1).
2.5
2.5. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 5 Maximal test time (minutes).
2.6
2.6. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 6 Distance (total turns of fan wheel divided by 100).
2.7
2.7. Analysis
Comparison 2 Aerobic exercise training programmes versus no intervention (data collection on rowing ergometer test), Outcome 7 Resistance (Kg).
3.1
3.1. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 1 Weight (Kg).
3.2
3.2. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 2 Body fat (%).
3.3
3.3. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 3 Lean mass (Kg).
3.4
3.4. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 4 Fat mass (Kg).
3.5
3.5. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 5 Bone content mineral (Kg).
3.6
3.6. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 6 Red blood cells magnesium (mg/L).
3.7
3.7. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 7 Red blood cells selenium (mg/L).
3.8
3.8. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 8 Red blood cells copper (microgram/L).
3.9
3.9. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 9 Red blood cells zinc (mg/L).
3.10
3.10. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 10 Plasma magnesium (mg/L).
3.11
3.11. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 11 Plasma selenium (microgram/L).
3.12
3.12. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 12 Plasma copper (mg/L).
3.13
3.13. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 13 Plasma zinc (mg/L).
3.14
3.14. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 14 Red blood cells superoxide dismutase (U/mg Hb).
3.15
3.15. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 15 Red blood cells reduced glutatione (microgram/g Hb).
3.16
3.16. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 16 Red blood cells oxidized glutathione (microgram/g Hb).
3.17
3.17. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 17 Plasma reduced glutathione (microgram/g prot/10).
3.18
3.18. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 18 Plasma oxidized glutathione (microgram/g prot).
3.19
3.19. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 19 Plasma thiobarbituric acid reactive substances (mM).
3.20
3.20. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 20 Average power for Knee extension (watts/Kg‐angular velocity at 60/°s).
3.21
3.21. Analysis
Comparison 3 Aerobic exercise training programmes versus no intervention (data collection at rest), Outcome 21 Average power for Knee flexion (watts/Kg‐angular velocity at 60/°s).
4.1
4.1. Analysis
Comparison 4 Aerobic exercise training programmes versus no intervention (data collection on medical isokinetic system), Outcome 1 Average power for Knee extension (watts/Kg‐angular velocity at 60/°s).
4.2
4.2. Analysis
Comparison 4 Aerobic exercise training programmes versus no intervention (data collection on medical isokinetic system), Outcome 2 Average power for Knee flexion (watts/Kg‐angular velocity at 60/°s).
5.1
5.1. Analysis
Comparison 5 Aerobic exercise training programmes versus no intervention (data collection on Timed‐up and go test (s)), Outcome 1 Timed‐up and go test (s).
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Update of

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