Exercise dose and multidimensional motor function in young people with Down syndrome: a Bayesian network...

This study utilizes Bayesian network dose-response meta-analysis (MBNMA) to assess the effects of total exercise dose on balance, stability, motor skills, functional mobility, and coordination in children and adolescents with Down syndrome.

RCTs were identified from Cochrane Library, Web of Science, PubMed, Embase, and SPORTDiscus. Analyses were conducted in R (4.4.2); exercise dose was standardized as METs·min/week, and Bayesian network dose-response models were fitted using the MBNMAdose package. Study quality was assessed with the PEDro scale.

A total of 23 studies were included. The analysis revealed significant positive dose-response relationships between overall exercise dose and balance, motor skills, and coordination, particularly in the moderate to high dose range (around 750 METs/week). Optimal improvements in balance occurred at 440 METs/week, while motor skills and coordination showed maximum effects at 750 METs/week. No statistically significant improvements were observed for stability and functional mobility, indicating that these outcomes may not be reliant on increased exercise dose.

This study quantifies exercise dose optimization in children and adolescents with Down syndrome using a continuous network dose-response framework, revealing outcome-specific effects. The findings support goal-oriented exercise design and highlight transparent dose reporting, standardized outcomes, and long-term follow-up for rehabilitation decision-making.

This study used a Bayesian network dose-response meta-analysis to quantify the association between total exercise dose and multidimensional motor outcomes in children and adolescents with Down syndrome. Dose-response patterns were outcome-specific rather than linear. Balance was optimized at 440 METs/week, whereas motor skill and motor coordination improved beyond a higher-dose threshold and peaked at 750 METs/week. These findings define functional dose boundaries and support goal-oriented exercise prescription for children and adolescents with Down syndrome across clinical, school, and community settings.