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

Area of Science:

• Exercise Physiology
• Human Genetics
• Clinical Medicine

Background:

• Individuals with Down syndrome (DS) exhibit significantly lower peak and submaximal exercise capacity compared to the general population.
• Ambulation is a critical predictor of survival in adults with DS, highlighting the importance of understanding and managing exercise limitations.

Purpose of the Study:

• To review current knowledge on the causes, effects, and management of reduced exercise capacity in persons with Down syndrome.
• To emphasize the clinical significance of addressing low physical fitness for maintaining health and productivity in adults with DS.

Main Methods:

• Review of existing literature on acute and chronic responses to submaximal and peak exercise in individuals with DS.
• Analysis of data concerning peak oxygen uptake (VO(2peak)), exercise economy, and contributing factors like chronotropic incompetence, joint laxity, and muscle hypotonia.

Main Results:

• Reduced exercise capacity in DS is attributed to an interplay between low VO(2peak) and poor exercise economy.
• Chronotropic incompetence is identified as the primary driver of low VO(2peak), while disturbed gait kinetics and kinematics contribute to poor exercise economy.
• Low physical fitness, including reduced exercise capacity and muscle strength, impairs the ability of adults with DS to perform daily living tasks.

Conclusions:

• Clinical management of reduced exercise capacity is crucial for the long-term health and productivity of individuals with DS.
• Available evidence suggests that structured exercise training is beneficial for enhancing exercise capacity and physiological function in persons with DS.