Exercise for a Healthier Life: Encouraging Physical Activity in Children with Down Syndrome

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Trisomy 21 Update

Obesity is a national epidemic, affecting all segments of society — including children and adults with trisomy 21 (Down syndrome).

According to the U.S. Centers for Disease Control and Prevention, about 20 percent of all American adolescents and teenagers are obese. Poor dietary choices and a low level of physical activity are major contributing factors to the childhood obesity epidemic in the United States.

Children with Down syndrome have been reported to participate in less physical activity than other children, including children with developmental delays and intellectual disabilities without Down syndrome. This lack of physical activity likely contributes to the higher numbers of overweight and obese children and adults with Down syndrome.

Adolescents with developmental disabilities who are overweight or obese are at an increased risk for obesity-related secondary conditions such as joint pain, decreased endurance and diabetes. One way to address weight issues is to begin an exercise program.

Barriers to physical activity

If your child doesn’t exercise regularly, you may want to start by identifying the reasons behind the inactivity. What barriers are getting in the way of your child’s physical activity?

Barriers can be:

  • Physical, such as no access to sidewalks or a park for safe exercise
  • Interest-related, such as your child showing an interest in soccer, but only baseball is available in your area
  • Psychological, including a lack of confidence in sports skill, or a fear of trying new things

Reflect on the barriers to physical activity in your child’s life and think about how you might address these limitations to help your child. Are neighborhood or community programs accessible? Is there a therapist or physical educator in your child’s school who can help?

Identifying actual and perceived barriers is often the first step to finding solutions.

Facilitating exercise

On the flip side of barriers are facilitators — the people and processes that help make exercise happen.

Similar to barriers, these facilitators can be:

  • Physical, such as a sibling who can help teach your child learn to play basketball, or a car to transport a young adult to a bowling program
  • Emotional, such as your child knowing she’s a skilled dancer, or has an interest in running

Family members can be excellent facilitators of exercise. They can help a child or adult with Down syndrome carry out an exercise program that includes the components described below.

Components of an effective exercise program

Adolescents and young adults with DS should strive to include the following components in an exercise program.


The goal of muscle strengthening is to overload the muscle so it becomes stronger over time. This can be performed through the use of weights, gym equipment, resistance bands or a person’s own body weight, depending on the starting point of the individual.

Aim to strengthen all parts of the body — arms, legs and core. Consider a formal exercise program developed by a physical therapist or exercise physiologist, or look to resources such as a physical education teacher or an adaptive physical education class to develop an exercise plan.

Cardiovascular exercise

While the response to exercise in individuals with Down syndrome is being studied from a research perspective, the benefits of exercise are easily apparent. For example, cardiovascular exercise can contribute to increased ease of walking throughout the school day without requiring rest breaks, the ability to climb a hill and play without shortness of breath, and improved performance in sports activities.

There are many ways to incorporate cardiovascular exercise into your child’s routine, including:

  • Participation in a swimming program
  • Use of exercise equipment, such as a treadmill, recumbent bike or elliptical machine (under supervision when appropriate)
  • Recreational activities, such a walking, biking and jogging

If your child with Down syndrome is not currently exercising, he should start slowly. For example, encourage your child to walk for five minutes, then gradually increase the time or distance. Individuals with Down syndrome who are followed by a cardiologist should consult with their physician prior to starting a formal endurance exercise program.

Balance activities

Balance tasks are often the most enjoyable portion of the exercise plan and can contribute to improved skill with sports activities or better mobility in the community.

Encourage your child to practice:

  • Stationary activities, such as balancing on one leg with hands on the hips, and progress to doing this with eyes closed when it becomes easy.
  • Dynamic tasks that challenge coordination and motor planning, such as skipping, hopscotch or walking across a balance beam. Yoga activities, martial arts and dance classes are also more formal ways to build your balance.

60 minutes a day

Help your child aim for 60 minutes of exercise each day. This can be a combination of strengthening, cardiovascular and balance activities, and does not need to be completed in one continuous cycle. For example, your child’s activity may include a 10-minute walk to school, 20 minutes of basketball during recess, and a 30-minute yoga session after dinner.

Considerations for long-term success

Any physical activity program should include enjoyable activities that are meaningful to the participant.

When helping your child with Down syndrome develop an exercise program, consider what activities he enjoys. Does he like group activities and music? Maybe a dance class will be motivating and elevate his heart rate while the minutes fly by.

Does your child enjoy the water? Consider signing her up for swimming lessons or getting involved in a Special Olympics program. These actions may provide the skills needed for a lifetime of aquatic exercise.

Does your family find it hard to spend time together during the week due to school and work obligations? Schedule an hour for a family bike ride or hike each weekend in the summer and fall. Find activities that are most meaningful to you or your child and try to incorporate them into your daily life to promote ongoing interest in physical activity.

Consult with a physician prior to initiating an exercise program if your child has any exercise restrictions. Consider community resources and programs and consult with a physical therapist if you need assistance with initiating an exercise program.