Reduced exercise capacity in persons with Down syndrome: cause, effect, and management

Abstract

Persons with Down syndrome (DS) have reduced peak and submaximal exercise capacity. Because ambulation is one predictor of survival among adults with DS, a review of the current knowledge of the causes, effects, and management of reduced exercise capacity in these individuals would be important. Available data suggest that reduced exercise capacity in persons with DS results from an interaction between low peak oxygen uptake (VO2peak) and poor exercise economy. Of several possible explanations, chronotropic incompetence has been shown to be the primary cause of low VO2peak in DS. In contrast, poor exercise economy is apparently dependent on disturbed gait kinetics and kinematics resulting from joint laxity and muscle hypotonia. Importantly, there is enough evidence to suggest that such low levels of physical fitness (reduced exercise capacity and muscle strength) limit the ability of adults with DS to perform functional tasks of daily living. Consequently, clinical management of reduced exercise capacity in DS seems important to ensure that these individuals remain productive and healthy throughout their lives. However, few prospective studies have examined the effects of structured exercise training in this population. Existent data suggest that exercise training is beneficial for improving exercise capacity and physiological function in persons with DS. This article reviews the current knowledge of the causes, effects, and management of reduced exercise capacity in DS. This review is limited to the acute and chronic responses to submaximal and peak exercise intensities because data on supramaximal exercise capacity of persons with DS have been shown to be unreliable.

Impact of Pulmonary Rehabilitation Program on Respiratory Function and Exercise Tolerance in Subjects with Down Syndrome

“…The same therapist and technique before the study and after 2 months of the study measured all the parameters of evaluation. It was reported that, subjects with DS have reduced peak and sub-maximal exercise capacity [23]. Our results proved that VC, MVV, SaO 2 and RR significantly improved at the end of the study because of the pulmonary rehabilitation program and these results are in agreement with some previous studies as well.…”

Impact of obesity and Down syndrome on peak heart rate and aerobic capacity in youth and adults

“…While lack of motivation and understanding do not explain low work capacities achieved among individuals with DS when appropriate testing and familiarization protocols are followed (Fernhall et al, 2013), physical activity levels do not further explain this phenomenon either with activity being similar to the general population (Mendonca, Pereira, & Fernhall, 2010). With mortality in ID commonly associated with a low intelligence quotient and poor self-care skills, it is important to point out that low aerobic capacity has also been strongly linked to morbidity and mortality among individuals with ID (Fernhall et al, 2001;Hayden, 1998).…”

Effects of aerobic and resistance training on the cardiorespiratory fitness of young people with Down Syndrome

“…Still on the cardiorespiratory adaptations to training, the findings of this study showed a significant increase in pulmonary ventilation (VE) for young people who participated in the training program, whether aerobic or resistance. The increased maximum pulmonary ventilation in this population is interesting because due to the restricted size of airways, the small nasal passage and large tongue can obstruct breathing during exercise 11 .…”

“…At the end of intervention, the authors 14 found a reduction in heart rate in all stages of submaximal exercise. Other studies 11,21 , involving adults with DS found improvements in motion economy, expressed by reduction of oxygen uptake during submaximal exercise.…”

“…As poor cardiorespiratory fitness at an early age tends to persist in adulthood, it is important to initiate the practice of exercise in this phase of life. Furthermore, the literature indicates reduced maximal and submaximal exercise capacity among people with DS 11 .…”