The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of neuromuscular exercise on balance, muscle strength and flexibility specifying the parameters and characteristics of effective interventions in children between 6 and 12 years and adolescent between 13 and 18 years with Down Syndrome. The present study is a systematic review of effectiveness outcomes balance, muscle strength and flexibility in this population. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from May to December 2021. We recruited randomized controlled trials (RCTs) which met the inclusion criteria in our study. Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from 3 to 5 days a week, and the duration of each session was between six and 15 min. The frequency was between two and three times a week for 6 and 12 weeks and the intensity were between 60 and 80% of maximal voluntary contraction. Neuromuscular exercise in different modes of application was associated with increases in chest and lower limb muscle strength mean 8.51, CI [2.35–14.67] kg and (21.54 [1.64, 41.43]) kg. Balance also improved when the mode of application was isokinetic training and core stability exercises (− 0.20 [− 0.29, − 0.12]) evaluated with stability index. Neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years. No evidence was found in children under 8 years.

Objective: To determine the effect of therapeutic exercises on the motor function of children with Down syndrome (DS) aged 0 to 3 years.Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library without publication date restrictions for the terms.Study Selection: The search yielded 1384 eligible articles, which were screened by 2 reviewers. RCTs that would have evaluated the effectiveness of therapeutic exercise were selected, and that would have reported the effectiveness in the outcomes.Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Six studies were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. A therapeutic aerobic exercise was performed using the treadmill, while a neuromuscular exercise was done using unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. Conclusion: There is moderate to high evidence to support that therapeutic exercise promotes the occurrence of motor patterns such as gait patterns and enhances the motor skills of children with DS aged 0 to 3 years.

Objective to evaluate the effects of neuromuscular exercise, specifying the parameters and characteristics of effective interventions to improve balance, muscle strength and flexibility in children with DS between the ages of 4 and 18 years. Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library. Study Selection: The search yielded 1384 eligible articles. Randomized clinical trials were selected, and that would have reported the effectiveness in the outcomes. Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. The frequency was between two and three times a week for 6 and 12 weeks and the intensity was between 60% and 80% of maximum resistance (MR). Conclusion neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years of age.

The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (− 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (− 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6–8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.