The impact of exercise interventions on postural control in individuals with Down syndrome: a systematic review and meta-analysis.

Abstract

Background: Individuals with Down syndrome have severe difficulties maintaining proper postural control when standing upright. Therefore, the goal of the present review and meta-analysis was to examine the effects of exercise interventions on improving postural control in individuals with Down syndrome.

Methods: This systematic review was reported following the PRISMA guidelines; while Cochrane guidelines were adopted for methodological guidance. Reports were searched in PubMed, Science Direct, Physiotherapy Evidence Database scale (PEDro), EMBASE, Web of Science (WOS), Scopus and Google Scholar from 2000 to January 2025. Randomized clinical trials and quasi-experimental studies were assessed in English. Review, meta-analysis, and descriptive studies were excluded from the study. Two researchers screened and evaluated data based on PEO criteria and the quality of studies was assessed using the PEDro scale.

Results: Among between 374 studies, Six articles were included in the present review and meta-analysis. Four studies showed that exercise interventions improve postural control in individuals with Down syndrome. However, the results of 2 studies indicated that exercise interventions do not improve postural control in these individuals. Ultimately, after analyzing the studies, the statistical results showed a significant difference between the intervention group and the control group (p = 0.001), indicating the effectiveness of exercise interventions and subsequent improvement in postural control in individuals with Down syndrome. According to PEDro scale, four studies were low quality, and two were high quality. Also, applying GRADE criteria, there is a "Low" certainty of evidence observed. The mean effect size of the exercises in the 6 included studies in the present review was 0.67, indicating a small effect size.

Conclusions: The exercise interventions improve postural control in individuals with Down syndrome. In addition, Due to the small sample size and the small number of studies included, to deal with the risk of bias in the studies, a new randomized controlled trial with a stronger methodology and large sample size comparing exercises and other strategies or different types of exercises is recommended.