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Recent studies have emphasized that regular exercise should be encouraged as a key part of care and support for people with Down syndrome (DS). However, muscle hypotonia has traditionally been considered a major barrier to resistance training (RT) in people with DS. The main objective of this study was to analyze the impact of circuit RT on markers of muscle damage. The secondary objective was to assess the influence of a RT program on body composition and work task performance. Thirty-six men with DS were recruited and randomly assigned to perform a circuit RT program with six stations 3 days/week for 12 weeks (n = 18) or to a control group (n = 18). Body composition was assessed by bioelectrical impedance analysis. Serum markers of muscle damage (creatine kinase, myoglobin, and lactate dehydrogenase) were determined at baseline and at the end of training weeks 1, 6, and 12. Work task performance was assessed using the weighted pail-carry test. RT did not induce significant changes in markers of muscle damage during the intervention. Furthermore, muscle mass and work task performance were significantly improved in the exercise group. These findings suggest that circuit RT can be used safely to increase muscle mass and work task performance in young adults with DS. Muscle hypotonia should not be considered a major barrier to exercise in people with DS, provided that qualified staff design and supervise all training sessions.

Previous studies have found aerobic training improved oxidative damage in people with Down syndrome (DS). However, there is a lack of information regarding the influence of resistance training on redox imbalance in this population. Accordingly, this study was conducted to determine the effect of resistance training (RT) on antioxidant defence system in sedentary adults with DS. Thirty-six male adults with DS were recruited through different community support groups. Eighteen were randomly assigned to perform a circuit RT program with 6 stations, 3 days/week for 12 weeks. Plasma total antioxidant status (TAS), reduced glutathione (GHS), ascorbate, serum α -tocopherol, and erythrocyte glutathione reductase activity were assessed. Plasma malondialdehyde (MDA) and carbonyl groups (CG) were assessed as markers of oxidative damage. Muscle strength was also measured. Dynamic torque of knee extensors and flexors as well as maximal handgrip strength was significantly improved after the completion of the training program. Plasma levels of TAS and erythrocyte glutathione reductase (GR) activity were significantly increased. Conversely, MDA and CG levels were significantly reduced. It was concluded RT improved antioxidant defence system and reduced oxidative damage in adults with DS. Further, long-term studies are required to determine whether the increased antioxidant system may improve clinical outcomes of adults with DS., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 M. Rosety-Rodriguez et al.)

Background: Previous studies have reported that obese people with trisomy 21 suffer from low-grade systemic inflammation. A recent study has found that aerobic training reduced inflammation in obese women with Down syndrome. To the best of our knowledge, the study reported in this paper is the first to determine for how long these effects were maintained after completion of the programme., Methods: Twenty premenopausal obese women (18-30 years old) with Down syndrome volunteered for this study. Eleven were randomly assigned to the intervention group and performed a 10-week aerobic training programme, 3 sessions per week, consisting of warming-up followed by treadmill exercise (30-40 min) at a work intensity of 55-65% of peak heart rate and a cooling-down period. The control group included 9, age, sex and BMI matched women with Down syndrome that did not perform any training programme. Fat mass percentage and distribution were measured. Plasma level of IL-6 and high-sensitive C-reactive protein (hs-CRP) were monitored. Time-course changes for these outcomes were assessed at pre- and post-intervention. Further, they were re-evaluated at 1, 3 and 6 months after completion of the programme., Results: Three months after completion of the programme, plasma levels of IL-6 and hs-CRP were significantly increased. Up to 6 months later, both fat mass percentage and waist circumference (WC) were significantly increased. Furthermore, physical fitness was also impaired in the intervention group. No changes were observed in the control group., Conclusion: A 3-month detraining period significantly impaired chronic inflammation in obese women with DS., (© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: Obesity is a major health problem in people with intellectual disabilities. It is also widely accepted that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. Fortunately, physical activity has shown to improve inflammation in people with metabolic syndrome and type 2 diabetes. Accordingly, we assessed the influence of aerobic training on pro-inflammatory cytokines and acute phase proteins in women with Down syndrome., Methods: To achieve this outcome, 20 premenopausal obese young women with Down syndrome volunteered for this study. Eleven were randomly assigned to the intervention group and performed a 10-week aerobic training programme, three sessions per week, consisting of a warm-up then a 30- to 40-min treadmill exercise at a work intensity of 55-65% of peak heart rate followed by a cooling-down period. The control group included nine age-, sex- and body mass index-matched women with Down syndrome. Fat mass percentage and fat distribution were measured. Plasmatic levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and fibrinogen were assessed by commercial enzyme-linked immunosorbent assay kits. C-reactive protein (CRP) was assessed by nephelometry., Results: Plasmatic levels of TNF-α (11.7 ± 1.6 vs. 9.2 ± 1.3 pg/ml; P = 0.022), IL-6 (8.2 ± 1.1 vs. 6.1 ± 0.9 pg/ml; P = 0.014) and high sensitive CRP (0.62 ± 0.11 vs. 0.53 ± 0.09 mg/dl; P = 0.009) were significantly reduced in the intervention group. Further, significant correlations between plasmatic and anthropometric parameters were found., Conclusion: A 10-week training programme reduced pro-inflammatory cytokines and acute phase proteins in obese young women with Down syndrome. Long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with trisomy 21., (© 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

This study was designed to assess the influence of resistance training on salivary immunoglobulin A (IgA) levels and hormone profile in sedentary adults with Down syndrome (DS). A total of 40 male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities. All participants had medical approval for participation in physical activity. Twenty-four adults were randomly assigned to perform resistance training in a circuit with six stations, 3 days per week for 12 weeks. Training intensity was based on functioning in the eight-repetition maximum (8RM) test for each exercise. The control group included 16 age-, gender-, and BMI-matched adults with DS. Salivary IgA, testosterone, and cortisol levels were measured by ELISA. Work task performance was assessed using the repetitive weighted-box-stacking test. Resistance training significantly increased salivary IgA concentration (P=0.0120; d=0.94) and testosterone levels (P=0.0088; d=1.57) in the exercising group. Furthermore, it also improved work task performance. No changes were seen in the controls who had not exercised. In conclusion, a short-term resistance training protocol improved mucosal immunity response as well as salivary testosterone levels in sedentary adults with DS.

Background: It is widely accepted that muscle strength plays a key role on functional tasks of daily living and employability in individuals with Down syndrome (DS). Recent studies have also reported resistance training may improve chronic inflammation in other clinical situations. This is the first study conducted to determine the effect of resistance circuit training on low-grade systemic inflammation in adults with DS., Material/methods: A total of 40 young male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities and their families. They had medical approval for physical activity participation. Twenty-four were randomly assigned to perform resistance circuit training with 6 stations, 3 days per week for 12 weeks. Exercise intensity was based on function of the 8RM assessments. The control group included 16 age-, sex-, and BMI-matched adults with Down syndrome. Plasma levels of leptin, adiponectin, and TNF-a were assessed by commercial ELISA kits. C-reactive protein (CRP) was assessed by nephelometry. Body composition was also determined, measuring fat-free mass percentage and waist circumference (WC). This protocol was approved by our Institutional Ethics Committee., Results: Plasma levels of leptin, TNF-a, and IL-6 were significantly decreased after the completion of the training program, as were fat-free mass and WC. No sports-related injuries or withdrawals from the program were reported during the entire study period. No changes were observed in the control group., Conclusions: Resistance circuit training improved low-grade systemic inflammation in male sedentary adults with DS.

Recent studies have reported that obese young people with Down syndrome suffer from low-grade systemic inflammation. Whereas this condition may be improved in the general population by regular exercise, the problem has received no attention in the case of people with intellectual disability. Therefore, the authors' aim was to assess the influence of aerobic training on plasma adipokines in obese women with Down syndrome. Twenty obese young women with Down syndrome volunteered for this study, 11 of whom were randomly assigned to a 10-wk aerobic-training program. They attended 3 sessions/wk, which consisted of warm-up exercises followed by the main activity on a treadmill (30-40 min) at a work intensity of 55-65% of peak heart rate and ended with a cooling-down period. The control group included 9 women with Down syndrome matched for age, sex, and body-mass index. Fat-mass percentage and distribution were measured, and plasma adipokine levels (leptin and adiponectin) were assessed. In addition, each participant performed a maximal graded continuous treadmill exercise test. These parameters were assessed pre- and postintervention. Aerobic training produced a significant increase in participants' maximal oxygen uptake (20.2 ± 5.8 vs.23.7 ± 6.3 ml · kg-1 · min-1; p < .001), and plasma leptin levels were significantly reduced in the intervention group (54.2 ± 6.7 vs.45.7 ± 6.1 ng/ml; p = .026). Further significant correlations between plasma leptin and indices of obesity were found. In contrast, no significant changes were found in adiponectin levels (p > .05). None of the tested parameters changed in the control group. In conclusion, a 10-week training program reduced leptin levels in obese young women with Down syndrome.

Individuals with Down syndrome have been generally described as having high levels of oxidative stress, which have been associated to an increased morbidity. Fortunately, recent studies have reported that aerobic training may upregulate antioxidant defence system both in general population and individuals with trisomy 21. Accordingly, the present study was conducted to ascertain the effectiveness of aerobic training in reducing protein oxidation. To achieve this goal, 31 adolescents with Down syndrome performed a 12-week training program on a treadmill with 3 days/week, consisting of warm-up (15 min), main part (20-35 min) at a work intensity of 60-75% of peak heart rate (HR(max) =194.5-[0.56 age]) and cool-down (10 min). A control group included seven age-, sex- and BMI-matched adolescents with trisomy 21 that did not perform any training program. Plasma carbonyl content was determined by means of a slightly modified Levine method. Pre- and post-training carbonyl contents were 1.98 ± 0.2 [95% confidence intervals (95% CI): 1.94-2.02] nmol/mg protein and 1.16 ± 0.1 (95% CI: 1.14-1.18) nmol/mg protein, respectively. When compared with baseline values, it was decreased significantly (1.98 ± 0.2 vs 1.16 ± 0.1; P<0.001). It was concluded that 12-week exercise program significantly reduced protein oxidation in adolescents with Down syndrome. Further long-term follow-up studies are required to determine whether correction of this oxidant imbalance improves clinical outcomes of individuals with trisomy 21., (© 2010 John Wiley & Sons A/S.)

Objective: To assess the influence of a 12-week training programme on plasmatic levels of allantoin, an in vivo marker for oxidative stress, in adolescents with Down syndrome. This finding would be of great interest, since oxidative damage has been proposed as a pathogenic mechanism of several pathologies in this population., Materials: To reach this goal, 31 male adolescents with Down syndrome (16.3 (1.1) years; 155.2 (5.7) cm; 70.8 (4.5) kg) performed a 12-week training programme, three sessions per week, consisting of warm-up (15 min) followed by a main part (20-35 min (increasing 5 min each 3 weeks)) at a work intensity of 60-75% of peak heart rate (increasing by 5% each 3 weeks) and then a cool-down period (10 min). According to previous studies, it should be emphasised that the maximal heart rate for individuals with Down syndrome was predicted by the equation HRmax = 194.5-(0.56 age). The control group included seven age-, sex- and BMI-matched adolescents with trisomy 21 that did not perform any training programme. The levels uric acid and allantoin were assayed in plasma by HPLC. This protocol was approved by an institutional ethics committee., Results: When compared with baseline, plasmatic levels of allantoin were decreased significantly (22.09 (1.62) vs 18.74 (1.38) micromol/l; p<0.001) after being exercised. Furthermore, the allantoin/uric acid ratio was decreased significantly (0.071 (0.006) vs 0.059 (0.004); p<0.05). On the contrary, no changes were reported in controls., Conclusion: A 12-week aerobic programme significantly reduced oxidative damage expressed in terms of plasmatic allantoin content in adolescents with Down syndrome. Further studies on this topic are required.

This study was designed to assess the influence of resistance training on salivary immunoglobulin A (IgA) levels and hormone profile in sedentary adults with Down syndrome (DS). A total of 40 male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities. All participants had medical approval for participation in physical activity. Twenty-four adults were randomly assigned to perform resistance training in a circuit with six stations, 3 days per week for 12 weeks. Training intensity was based on functioning in the eight-repetition maximum (8RM) test for each exercise. The control group included 16 age-, gender-, and BMI-matched adults with DS. Salivary IgA, testosterone, and cortisol levels were measured by ELISA. Work task performance was assessed using the repetitive weighted-box-stacking test. Resistance training significantly increased salivary IgA concentration (P=0.0120; d=0.94) and testosterone levels (P=0.0088; d=1.57) in the exercising group. Furthermore, it also improved work task performance. No changes were seen in the controls who had not exercised. In conclusion, a short-term resistance training protocol improved mucosal immunity response as well as salivary testosterone levels in sedentary adults with DS.