sports, exercise, down syndrome
Over the years, we have witnessed major growth in the awareness and engagement of exercise and healthy lifestyle in people with disabilities. However, studies have shown that physical activity, step totals per day and minutes of vigorous physical activity were all lower, and sedentary time per day was higher in people with Down syndrome (DS). Individuals with DS are significantly more likely to experience co-morbidities and cardio-metabolic conditions than their unaffected counterparts including but not limited to:
- Heart Defects
- Hypotonia (low muscle tone)
- Low bone mineral density
- Spinal issues
- Sleep disorders
- Mental health conditions
Even though this is a pretty intense list, all of the conditions about can be improved or at the very least, managed with physical activity.
lower physical activity levels with people with down syndrome
Individuals with DS have a lower exercise capacity, oxygen capacity, and max heart rate, in part due to abnormal catecholamine response and a sympathovagal imbalance potentially causing exercise to be more challenging or uncomfortable. However, exercise can actually improve these responses to activity. Whitt-Glover et al (2006) demonstrated that sibling groups of at least one child with DS and one sibling without any disabilities showed no significant differences in physical activity levels between children with DS and their unaffected siblings. Therefore, it is more often than not a result of social barriers. Studies repeatedly have shown that exercise elicits great benefits for those with DS, such as:
- Reduced weight
- Increased maximal aerobic power
- Increased respiratory response
- Increased quality of life and mental health
- Increased participation in social activities
- Improved fine and gross motor skills
- Improved balance and gait
- Increased cardiovascular fitness
- Increased strength and neural recruitment
- Increased time to fatigue
- Muscular hypertrophy
- Increase bone strength
- Reduce ‘bad’ and increased ‘good’ cholesterols
best practices for physical activity
Activities that involve continuous movement of large muscle groups to raise the heart and breathing rate. When performed regularly, aerobic exercise helps to build cardiorespiratory fitness. Examples include walking, rowing, swimming, boxing, dancing, cycling and aqua fitness.
- Frequency: 3-7 days/week to maximize caloric expenditure because body weight is usually higher than desired.
- Intensity: 40%-80% of VO2R or HRR
- Time: 30-60 min/day or shorter bouts that equal this time, which would be more desirable
- Type: Walking is preferred but may progress to running. Swimming and stationary cycling are also recommended.
Adequate muscular strength is necessary to perform everyday activities like climbing stairs, getting on and off chairs, and opening jars. In other words, strength training is important for independence! Low muscle tone, or “floppy” muscles, are common in people with Down syndrome, making strength training an important part of any exercise routine. Strength is built through resistance activities that challenge muscles. When performed regularly, resistance training helps muscles grow larger (to a degree) and stronger. Examples include activities performed with resistance bands, dumbbells, body weight, gym equipment, and even household objects such as tins of food.
Research has shown a combination of aerobic and resistance exercises can have beneficial effects for people with Down syndrome, including improvements in memory, exercise capacity and fitness, and in young people aged 10-19, an increase in lean muscle mass.
Balance problems are also common in people living with Down syndrome – in fact we know that high falls risk can be a problem for anyone living with an intellectual disability. Balance exercises are designed to train balance on the spot (static balance) and while moving around (dynamic balance) should both be incorporated to help.
- Frequency: 2-3 days/week
- Intensity: Start at 12 reps at 15-20 RM for 1 or 2 weeks, then progress to 8-12 RM at 75%-80% 1RM
- Time: 2-3 sets with 1-2 min rest
- Type: Use machines for safety purposes. Target major muscle groups.
benefits of exercise for people with down syndrome
People living with an intellectual disability (such as those with Down syndrome) have higher rates of physical and mental health conditions than that of the general population. For example, people with Down syndrome are more likely to have heart defects, low thyroid levels, and to be overweight/obese. Many of these physical and intellectual health conditions and risk factors are treatable, and potentially preventable, with the right lifestyle measures. Regular physical activity can improve muscle strength and aerobic capacity in people with Down syndrome and have a positive impact on cardiovascular disease risk factors. In addition to improving physical fitness, exercise is known to benefit intellectual health. This is important because at least 50% of children and adults with Down syndrome will experience a major intellectual health concern in their lifetime, such as anxiety or depression.