Impact of physical exercise on health outcomes in people with Down Syndrome: a systematic review and meta-analysis of randomized controlled trials.

Introduction: Down syndrome (DS), caused by an extra chromosome 21, leads to physical and cognitive challenges. Physical activity is underutilized as a therapeutic approach. This study reviews the effectiveness of physical exercise in improving body composition and health outcomes in individuals with DS.

Evidence acquisition: Following PRISMA guidelines, this review was registered on PROSPERO (CRD42024561407). A systematic search across six databases identified randomized controlled trials (RCTs) involving physical activity interventions in DS populations compared to controls. Data were analyzed using a random-effects model, with heterogeneity assessed through REML, Q-test, and I². Risk of bias was evaluated using RoB 2.

Evidence synthesis: From 245 records, 13 RCTs (447 participants from eight countries) met inclusion criteria. Interventions lasted 6 to 43 weeks, with 1 to 5 sessions per week. Body mass decreased significantly (SMD: -0.2099, 95% CI: -0.3539 to -0.0658). BMI and body fat also reduced significantly (SMD: -0.2369 and -0.4255, respectively). Waist circumference showed no significant changes, but favorable trends were noted. Muscle strength improvements in chest and leg press were positive but not statistically significant.

Conclusions: Physical exercise significantly improves body composition in individuals with DS, notably reducing body mass, BMI, and body fat. These findings highlight the value of structured physical activity as part of DS management to improve health and quality of life.