A 12-week exercise programme has a positive effect on everyday executive function in young people with Down syndrome: a pilot non-randomised controlled trial.
N Shields, N Mizzi, K Buhlert-Smith and 3 others
PMID 36101998WHAT IT FOUND
Most executive function measures showed no exercise-group advantage in young people with Down syndrome, but one familiar-person rating scale reported less everyday executive dysfunction after 12 weeks of community exercise with mentor support.
Key findings
01A familiar-person rating of global executive behaviour favoured the exercise group, with a mean difference of -4.77 units (95% CI -9.30 to -0.25) on a scale where higher scores mean more everyday executive dysfunction.
02No differences between the exercise and control groups were found for the Down syndrome-specific everyday cognitive scale, the two familiar-person behaviour indexes, or direct tests of planning, inhibition, attention shifting, working memory, and reaction time.
03Participants in the exercise group attended 177 of 192 scheduled sessions, with an attendance rate of 92% and SD 12%, and no major adverse events were reported.
STILL TO COME
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What it does not show
The study was a pilot non-randomised controlled trial with a convenience sample of 20 participants, so it cannot support firm conclusions about treatment effects. No sample size calculation was completed before the study. Participants and assessors were not blind to group allocation, so bias in familiar-person reports cannot be ruled out. The exercise group had slightly lower baseline adaptive functioning in the socialisation domain, which may confound comparisons. The intervention combined exercise with student-mentor social support, so the study cannot separate the contribution of any single component. There was no follow-up after the 12-week programme, so it is unknown whether any effects persisted. The study did not determine the optimal exercise dose. Missing outcome data were reported for several measures, including questionnaires not returned, fatigue, iPad malfunction and refusal.
Declared interests
The study was funded by an internal La Trobe University grant. DH was supported by a Discovery Early Career Researcher Award. Some participants were recruited through a larger trial supported by the Australian National Health and Medical Research Council and seven partners, including government, local council and disability organisations. The NHMRC had no role in design, conduct, analysis, interpretation, report writing or publication decision. Funding statements also name the Australian Research Council, Victorian Department of Health and Human Services and La Trobe University. No author declared conflicts of interest.
The easy way to misread this
Do not conclude that exercise alone improves everyday executive function in young people with Down syndrome. The study was a small non-randomised pilot with no blinding, the intervention combined exercise and student-mentor social support, and one familiar-person global rating scale favoured the exercise group while other familiar-person and direct test outcomes showed no difference.