Balance control in children and adolescents with intellectual disability: a systematic review and meta-analysis

To systematically summarise and analyse published research, which assessed balance control deficiencies of children and adolescents with intellectual disability (ID) in various balance domains by comparing their performance with that of typically developing (TD) peers. This study followed PRISMA principles and conducted a systematic search in six electronic databases in May 2025, including PubMed, Web of Science Core Collection, Scopus, EBSCO, LILACS, Cochrane Library, PEDro and Embase. The methodological quality of included studies was assessed using the Scottish Intercollegiate Guidelines Network checklist, and the certainty of the evidence was assessed via the GRADE approach. The meta-analysis was performed via RevMan 5.4. Descriptive analysis was performed if the data were insufficient. Fifteen studies were included and eight of which were pooled for meta-analysis. Children and adolescents with ID had poorer balance control than their TD peers. Specific to the various balance domains, individuals with ID presented substantially more difficulties in sensory orientation (eyes open: SMD = 0.89, 95% CI: 0.69 to 1.09, p < 0.001; eyes closed: SMD = 0.44, 95% CI: 0.26 to 0.62, p < 0.001) and limits of stability (SMD = -0.91, 95% CI: -1.09 to -0.73, p < 0.001). They also encountered more hardships in gait stability (SMD = 0.52, 95% CI: 0.27 to 0.78, p < 0.001). For domain of anticipatory postural adjustments, inconsistent results were obtained. Children and adolescents with ID have deficient balance control ability than their TD peers. More researches are needed to comprehensively assess various domain of balance in this target group, especially those with longitudinal designs.