Physical Capacity in Children with Down Syndrome: A Narrative Review

Abstract

Background:  Down syndrome causes developmental challenges including motor delays and reduced physical capacity, often complicated by congenital heart defects in ~50% of cases. Research on children aged ≤14 years is limited.

Aim: This narrative review synthesizes current evidence on physical capacity in children with Down syndrome aged 14 years and younger, focusing on cardiorespiratory fitness, muscle strength, motor coordination, and executive function. The objective is to identify effective therapeutic interventions and provide recommendations for optimizing functional independence and quality of life in this population.

Material and Methods: Literature search of PubMed and Google Scholar (2021-2025) for studies in children aged ≤14 years. Eight studies met inclusion criteria.

Results: Respiratory training (PNF, IMT) combined with aerobic exercise significantly improves respiratory strength and walking capacity. Children with Down syndrome show markedly reduced walking capacity versus typically developing peers (105.6 m difference in 6-minute walk test), limiting physical and social participation. Motor deficits include impaired sensorimotor integration and dual-task control (motor costs: -57.3% to -167%). Motor and cognitive impairments develop independently. Higher BMI correlates with reduced motor skills (r=-0.729). Sport training improves strength, balance, and core stability.

Conclusions: Physical limitations stem from respiratory weakness, impaired motor-cognitive integration, and weight factors. Effective interventions require respiratory training with aerobic exercise, domain-specific motor-cognitive approaches, and weight management. Sport-based programs enhance functional capacity and quality of life.