Fitness for Adolescents With Down Syndrome

SIGNIFICANCE: One of every 691 children born in the United States has Down syndrome (DS). As this population lives longer, health issues not previously identified have become evident. Obesity and limited physical activity affect overall health and may have an impact on other health conditions. Obesity increases the risk of diabetes and heart disease, whereas lack of physical activity increases the risk of obesity, osteoporosis, joint problems, and heart disease. Forty-five percent of males and 56% of females with DS are overweight, and 30% to 50% are estimated to be obese. Higher levels of hormones that affect obesity and eating problems (trouble with chewing, food texture preferences) may be related to obesity in persons who have DS.

Behavior problems (negativity, stubbornness, defiance, and trouble coping) increase with age and create difficulty in getting persons with DS to participate in physical activity and nutrition programs. Physical activity and nutrition management address obesity and thus are important for persons with DS. Although exercise programs exist in the community, programs that are available to persons with DS are difficult to find.

This pilot study sought to combine an exercise and nutrition program to meet the needs of adolescents with DS with the goal of developing a program accessible through the Down Syndrome Alabama organization.

METHOD:A 16-wk program of physical activity and nutrition was implemented with a sample of 9 adolescents with DS who volunteered. Weekly sessions included an hour of structured physical activity and an hour of nutrition activities. Outcome measures were collected pre- and postprogram and included weight, body mass index (BMI), and a series of nine gross motor tasks (tandem walking, walking sideways, one foot balance, throwing and catching a ball, etc.). Physical activity logs were collected weekly and summarized. The physical activity component included physical fitness activities (cardiovascular elements, strength and resistance training, balance) and gross motor activities (throwing, kicking, dribbling, striking and dancing). The program was administered in a group format, which started and ended with a stretching period.

The nutrition plan was a modification of the U.S. Department of Agriculture program ChooseMyPlate, which was to promote the Dietary Guidelines for Americans. A nutrition student from the School of Health Professions Dietetic Internship provided the initial modifications. Some participants were unable to identify foods at the level needed for the initial modification, so the learning modules were further adjusted to fit with students’ skills. Activities included food identification, discussion of the food pyramid, simple food preparation using healthy foods, and discussion of healthy beverages.

RESULTS:Outcomes revealed significant changes in 7 of the 12 gross motor activities. No weight loss, change in BMI, or lean mass were seen. Physical activity logs revealed that the primary exercise that most, but not all, participants received was the weekly program. The results from preassessment to postassessment provide some evidence that a structured exercise program is an effective and important intervention approach for adolescents with DS. Challenges with recruitment and lack of nutritional change suggest that a lifestyle approach available to the larger community of persons with DS is needed. The next year of funding will be used to develop an online exercise and nutrition program accessible through the Down Syndrome Alabama organization.