Immersive reality training for gross motor outcomes in children with Down syndrome

Gross motor delays are common in children with Down syndrome (DS) and may limit participation. Immersive reality-based training may support motor learning through interactive, task-oriented practice and multisensory feedback, but evidence in children with DS remains limited.

In this pilot randomized study, 10 children with DS were allocated to immersive reality-based training (n = 5) or conventional training (n = 5). All participants were 10 years old, with varying cognitive ages. Both groups received supervised motor training twice weekly for 6 weeks. Standardized gross motor outcomes were assessed using the Test of Gross Motor Development-2 at baseline, during intervention, post-intervention, and follow-up.

All participants completed the intervention and follow-up, with 100% session attendance and no adverse events. Gross Motor Quotient improved in both groups, from 52.60 ± 4.93 to 75.40 ± 4.93 in the immersive reality group and from 61.60 ± 5.77 to 75.40 ± 2.51 in the conventional group. Gross Motor Quotient change was greater in the immersive reality group.

Immersive reality-based training was feasible, well tolerated, and associated with improved standardized gross motor outcomes. Findings require cautious interpretation because of the small sample size and baseline imbalance.

Immersive reality-based training was feasible and well tolerated in children with Down syndrome, with complete session attendance and no adverse events. Both immersive reality-based and conventional training were associated with improvements in standardized TGMD-2 outcomes over time. The immersive reality group showed greater absolute improvement in Gross Motor Quotient, although findings should be interpreted cautiously because of the small sample size and baseline imbalance. This pilot randomized study supports larger trials evaluating immersive reality-based training as a complementary modality in pediatric motor rehabilitation.