Open Access Open Access  Restricted Access Subscription or Fee Access

A systematic review of the effect of physical activity on cognitive performance in youth with Down syndrome

Vincenzo G. Nocera, MS, Angela J. Wozencroft, PhD, Dawn P. Coe, PhD, FACSM


This systematic review of the literature examined the impact of physical activity on cognitive performance in youth with Down syndrome (DS). A comprehensive search resulted in the identification of 20 articles that were screened with five studies included in the qualitative analysis. In the studies analyzed, both acute and chronic moderate intensity physical activity protocols were utilized as well as a variety of cognitive assessments evaluating different components of cognitive function (ie, reaction time, inhibition, planning, working memory, and manual dexterity). Overall, this review found a positive relationship between acute and chronic physical activity and cognitive function. These relationships are consistent with the literature in typically developing youth. The findings of this review show promising results that consistent participation in moderate levels of physical activity may lead to higher levels of cognition function in youth with DS. Practical implications and future research are discussed in the article.


Down syndrome, physical activity, cognition, moderate, pediatric

Full Text:



Presson AP, Paryka G, Jensen KM, et al.: Current estimates of Down syndrome population prevalence in the United States. J Pediatr. 2013; 163(4): 1163-1168.

de Graaf G, Buckley F, Skotko BG: Estimation of the number of people with Down syndrome in the United States. Genet Med. 2017; 19(4): 439-447.

Pueschel SM: Down syndrome. In Parker S, Zuckerman B (ed.): Behavioral and Developmental Pediatrics. New York, NY: Little Brown, 1994.

Roizen NJ: Down syndrome. In Batshaw ML (ed.): Children with Disabilities. 5th ed. Baltimore, MD: Brookes, 2002: 361-376.

Wee SA, Pitetti KH, Goulopoulou S, et al.: Impact of obesity and Down syndrome on peak heart rate and aerobic capacity in youth and adults. Res Dev Disabil. 2015; 36: 198-206.

Wei M, Kampert JB, Barlow CE, et al.: Relationship between low cardiorespiratory fitness and morality in normal-weight, overweight and obese men. JAMA. 1999; 282(16): 1547-1553.

Pastore E, Marino B, Calzolari A, et al.: Clinical and cardiorespiratory assessment in children with Down syndrome without congenital heart disease. Arch Pediatr Adolesc Med. 2000; 154(4): 154-408.

Physical Activity Guidelines Advisory Committee: Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC: US Department of Health and Human Services, 2008.

Angenvaren M, Aufdemkampe G, Verhaar HJ, et al.: Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008; 16(3): 1-37.

Chomitz VR, Slining MM, McGowan RJ, et al.: Is there a relationship between physical fitness and academic achievement? Positive results from public school children in the Northeastern United States. J Sch Health. 2009; 9(1): 30-37.

Lott IT, Dierssen M: Cognitive deficits and associated neurological complications in individuals with Down’s syndrome. Lancet Neurol. 2010; 9(6): 623-633.

Silverman W: Down syndrome: Cognitive phenotype. Ment Retard Dev Disabil Res Rev. 2007; 13(3): 228-236.

Tomoporowski PD, Davis CL, Miller PH, et al.: Exercise and children’s intelligence, cognition, and academic achievement. Educ Psychol Rev. 2008; 20(2): 111-131.

McMorris T, Hale B: Differential effects of differing intensities of acute exercise on speed and accuracy of cognition: A meta-analytical investigation. Brain Cogn. 2012; 80(3): 338-351.

Tan BWZ, Pooley JA, Speelman CP: A meta-analytic review of the efficacy of physical exercise interventions on cognition in individuals with Autism Spectrum Disorder and ADHD. J Autism Dev Disord. 2016; 46(9): 3126-3143.

Verburgh L, Königs M, Scherder EJ, et al.: Physical exercise and executive functions in preadolescent children, adolescents and young adults: A meta-analysis. Br J Sports Med. 2013; 48(12): 973-979.

McMorris T, Hale B: Is there an acute exercise-induced physiological/biochemical threshold which triggers increased speed of cognitive function? A meta-analytic investigation. J Sport Health Sci. 2015; 4(1): 4-13.

Ridgel AL, Vitek JL, Alberts JL: Forced, not voluntary, exercise improves motor function in Parkinson’s disease patients. Neurorehabil Neural Repair. 2009; 23(6): 600-608.

Zigman WB, Lott IR: Alzheimer’s disease and Down syndrome: Neurobiology and risk. Dev Disabil Res Rev. 2007; 13(3): 237-246.

Liberati A, Altman DG, Tetzlaff J, et al.: The PRISMA statement for reporting systematic reviews and metaanalysis of studies the evaluate health care interventions: Explanation and elaboration. J Clin Epidemiol. 2009; 62(10): e1-e34.

Alesi M, Battaglia G, Roccella M, et al.: Improvement of gross motor and cognitive abilities by an exercise training program: Three case reports. Neuropsychiatr Dis Treat. 2014; 10: 479-485.

Chen CC, Ringenbach SDR, Crews D, et al.: The association between a single bout of moderate physical activity and executive function in young adults with Down syndrome: A preliminary study. J Intellect Disabil Res. 2015; 59(7): 598-598.

Thompson PD, Crouse SF, Goodpaster B, et al.: The acute versus the chronic response to exercise. Med Sci Sports Exerc. 2001; 33(6 suppl): S438-S435.

Ringenbach SDR, Albert AR, Chen CC, et al.: Acute bouts of assisted cycling improves cognitive and upper extremity movement functions in adolescents with Down syndrome. Intellect Dev Disabil. 2014; 52(2): 124-135.

Pastula RM, Stopka CB, Delisle AT, et al.: Effect of moderate-intensity exercise training on the cognitive function of young adults with intellectual disabilities. J Strength Cond Res. 2012; 26(12): 3441-3448.

Holzapfel SD, Ringebach SDR, Mulvey GM, et al.: Improvements in manual dexterity relate to improvements in cognitive planning after assisted cycling therapy (ACT) in adolescents with down syndrome. Res Dev Disabil. 2015; 45-46: 261-270.

Hillman CH, Kamijo K, Scudder M: A review of chronic and acute physical activity participation on neuroelectric measures of brain health and cognition during childhood. Prev Med. 2011; 52(1 suppl): S21-S28.

Kamijo K, Nishihria Y, Hatta A, et al.: Differential influences of exercise intensity on information processing in the central nervous system. Eur J Appl Physiol. 2004; 92(3): 305-311.

Kamijo K, Nishihria Y, Higashiura T, et al.: The interactive effect of exercise intensity and task difficulty on human cognitive processing. Int J Psychophysiol. 2007; 65(2): 114-121.

Donchin E, Coles MGH: Is the P300 component a manifestation of context updating? Behav Brain Sci. 1988; 11(3): 357-427.

Bhambhani Y, Malik R, Mookerjee S: Cerebral oxygenation declines at exercise intensities above the respiratory compensation threshold. Respir Physiol Neurobiol. 2007; 156(2): 196-202.

Caterino MC, Polak ED: Effects of two types of activity on performance of second-, third-, and fourth-grade students on a test of concentration. Percept Mot Skills. 1999; 89(1): 245-248.

Austin DR: A call for training in physical activity. In Austin DR, Dattilo J, McCormick (eds.): Conceptual Foundations for Therapeutic Recreation. State College, PA: Venture, 2002: 225-234.

Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001.



  • There are currently no refbacks.