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Persons with Down syndrome (DS) suffer from prefrontal cortex dysfunction and deficits in executive functions. The current study examined the effects assisted cycling therapy (ACT) on short-term (STM) and working memory (WM) in adolescents with DS. During ACT, the cadence of participants on a stationary bicycle was augmented with an electrical motor to 180% of the voluntary cadence. Participants completed eight weeks of ACT (n = 17), eight weeks of voluntary cycling (VC) at their own preferred cadence (n = 16), or eight weeks of no cycling (np ≥ .149) and working memory improved only in the ACT group (Hedge’s g = 1.66; p = .003). The results indicate that assisted high-cadence cycling (i.e. ACT) produces superior neural benefits in the dorsolateral prefrontal cortex compared to VC.

Background Reports of positive effects of aerobic exercise on cognitive function in persons with Down syndrome are extremely limited. However, a novel exercise intervention, termed assisted cycling therapy (ACT), has resulted in acutely improved cognitive planning ability and reaction times as well as improved cognitive planning after 8 weeks of ACT in adolescents and young adults with Down syndrome. Here, we report the effects of 8 weeks of ACT on reaction time, set-shifting, inhibition and language fluency in adolescents with Down syndrome. Methods Adolescents with Down syndrome (age: ~18 years) were randomly assigned to 8 weeks of ACT (n = 17) or voluntary cycling (VC: n = 16), and a convenience sample (n = 11) was assigned to be an inactive comparison group (NC: n = 11). During ACT, the cycling cadence of the participants was augmented to an average cadence that was 80% faster than the voluntary cadence of the VC group. The increase in cadence was achieved with an electric motor in the stationary bicycle. Reaction time, set-shifting, inhibition and language fluency were assessed before and after 8 weeks of intervention. Results Power output and heart rates of the ACT and VC groups were almost identical, but the ACT cadence was significantly faster. The ACT group, but not the VC or NC groups, showed significantly improved reactions times (Hedges' g = −0.42) and inhibitory control (g = 0.18). Only the VC group showed improved set-shifting ability (g = 0.57). The ACT and VC groups displayed improved semantic language fluency (g = 0.25, g = 0.22, respectively). Discussions These and previous results support the hypothesis of increased neuroplasticity and prefrontal cortex function following ACT and, to a smaller extent, following VC. Both ACT and VC appear to be associated with cortical benefits, but based on current and previous results, ACT seems to maximize the benefits.

The present study used a synchronization-continuation paradigm during continuous bimanual drumming with different cues in 17 persons with Down syndrome, eight typical persons with similar mental age and eight typical persons with similar chronological age. The task required participants to hit two drums with their hands at the same time following music (e.g., a tune with various decibel drum beats), auditory (e.g., sound of drumbeat), verbal (e.g., voice saying “drum”), and visual (e.g., video of both hands moving up and down and hitting the drums together) cues for 10 seconds, then continue drumming in the absence of cues for another 10 seconds. In general, when all groups were following the music cues their movements were faster as compared with their movements in the auditory, verbal, and visual conditions. In addition, when following visual cues all groups produced more accurate and consistently coordinated movements than with the other cue types. Further, participants with Down syndrome often stopped moving when the pacing cues were eliminated indicating a need for continuous cues for continuous movements.

Background Research on unimanual tasks suggested that motor asymmetries between hands may be reduced in people with Down syndrome. Our study examined handedness (as assessed by hand performance) and perceptual–motor integration effects on bimanual coordination. Methods Adults with Down syndrome (13 non-right-handed, 22 right-handed), along with comparison groups of adults (16 non-right-handed, 21 right-handed) and children (15 non-right-handed, 22 right-handed) without Down syndrome, drummed with auditory, verbal and visual instructions. Results In contrast to handedness effects in the children and adults without Down syndrome, right-handed participants with Down syndrome led more with the left hand, and had lower coordination stability than non-right-handed participants with Down syndrome. Conclusions The reversed handedness effect during bimanual coordination suggests a complex relationship between handedness and task requirements in adults with Down syndrome.

Perception of affordances research in children with developmental disabilities has only examined well practiced skills. Ten toddlers with Down syndrome and 10 with typical development walked across a GAITRite mat, with and without an obstacle. We coded the toddlers' behaviors after 1 and 3 months of walking experience when they encountered the obstacle (avoid, crawl, error, and walk successfully) and calculated gait parameters (step length, width, and velocity). Both groups actively explored their affordances. Despite similar decreases in step length and velocity when approaching the obstacle, toddlers with Down syndrome were more likely to select successful but conservative crawling strategies that minimized balance requirements and reduced risk of falling. Group differences were due to risk management rather than difficulty perceiving affordances.

To date, there are few, if any, behavioral or exercise interventions that have been shown effective in improving cognitive functioning in adolescents with Down syndrome (DS). Exercise is a logical answer because it has been repeatedly shown to improve cognitive and physical and mental health in typical populations. However, current exercise recommendations for persons with DS vary greatly. Recommendations are often nonspecific in terms of the type or intensity of exercise, and results on improvement of cognitive functioning are equivocal. This chapter will report on preliminary data of an 8 week intervention of assisted versus voluntary cycling exercise on cognitive and health functions in adolescents with DS. Assisted Cycling Therapy (ACT) is innova‐ tive and important because it is predicted to enhance neurogenesis, which in turn may improve multiple central nervous system functions related comorbid conditions in adolescents with DS.

The authors' aim was to understand how persons with Down syndrome (DS) perform different tasks and to assess if there were any differences in performance based on the type of instructions. This is important because of neurological differences in persons with DS and neurological demands for performing different types of tasks. Twenty right-handed participants with DS, 20 chronological age-matched (CA), and 20 mental age-matched (MA) performed unimanual, bimanual, discrete, and continuous drumming following visual, auditory, and verbal instructions. Overall, discrete drumming was performed with shorter movement times than continuous drumming and unimanual drumming was performed with shorter movement amplitude than bimanual drumming. With respect to instructions, persons with DS performed with smaller amplitudes, thus more efficient movements, following the visual instructions than auditory and verbal instructions for all types of tasks, whereas CA performed similarly with all instructions and MA performed with smaller amplitudes with visual instructions than auditory instructions. These results suggest that visual instruction provides the best information for people with DS to aid in performance of many different types of movements.