Award Date

5-15-2026

Degree Type

Doctoral Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Committee Member

Thessa Hilgenkamp

Second Committee Member

Daniel Young

Third Committee Member

Kai-Yu Ho

Number of Pages

50

Abstract

Purpose/Hypothesis: Down syndrome (Ds) is a complex genetic condition that can impact multiple systems of the body, including functional balance. Ds-specific impairments such as muscle hypotonia, ligamentous laxity, and decreased muscle strength, coupled with a sedentary lifestyle can result in poor motor control, altered proprioceptive function, static and dynamic instability. Visual and vestibular impairments are also common in this population, increasing fall risk and fear of falling, and discouraging participation in physical activity. The aim of this study is to analyze the impact of a physical therapy-based exercise program on the functional balance of adults with Ds.

Number of Subjects: Forty low-active participants with Down syndrome between 18-35 years without any major health conditions.

Materials and Methods: This study was a randomized controlled trial with participants completing a 12-week exercise condition or a 12-week control condition. After informed consent, participants were randomly assigned to the control group (n=20) or to the exercise group (n=20). The exercise group completed the 12-week remote Mann Method Physical Therapy-Based Exercise Program, consisting of 1 hour of supervised aerobic and resistance training exercises 3 days/week, while the control group continued their usual activities. Participants completed balance assessments pre and post using the following outcome measures: Timed Up and Go (TUG) test, Stair Climb test (SCT), Functional Reach test (FRT), and Computerized Dynamic Posturography tests: Sensory Organization Test (SOT, 6 conditions), Motor Control Test (MCT), and Limits of Stability test (LOS), and Short Falls Efficacy Scale-1. Two-way mixed ANOVA (group x time) was used to examine the changes over time η 2 between the groups.

Results: Due to dropout and non-compliance, the data of n=16 participants of the exercise group and n=17 participants of the control group were included in this analysis. Medium to large effect sizes were found for the interaction effects of time by condition for the SOT overall (partial = 0.076), combined somatic portion of the SOT (partial η 2 =0.076), SOT Condition 3 (eyes open, moving virtual reality (VR) environment, fixed support surface) (partial η 2 =0.079), SOT condition 4 (eyes open, fixed VR environment, moving support surface) (partial η 2 =0.115), the MCT medium forward left and right leg latency (partial η 2 =0.062; partial η 2 =0.083) and DCL of the LOS (partial η 2 =0.091). No significant differences were found for the main effect of time, condition, or the interaction of time-by-condition for the SCT, TUG, FRT, SOT, MCT, or LOS (p< 0.05).

Conclusion: A 12-week remote physical therapy based exercise program showed non-significant results but medium to large effect sizes of the interaction effect for various functional balance measures of adults with DS, mostly the SOT, which are suggestive of a modest improvement in balance due to the exercise program. Clinical Relevance: The effect sizes are suggestive of a modest change in balance outcomes following an exercise program. Further investigation into the impact of exercise on balance of adults with DS, using a larger sample size to account for the large variability in this population, is warranted.

Keywords

Down syndrome; Exercise; Balance; Adults with Down syndrome; Falls; Physical Therapy; Physical activity; Vestibular; Vision; Proprioception

Disciplines

Physical Therapy

File Format

PDF

File Size

475 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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