Award Date


Degree Type

Doctoral Project

Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy

First Committee Member

Jenny Kent

Second Committee Member

Daniel Young

Third Committee Member

Merrill Landers

Number of Pages



Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals with Ds. Our previous work has shown that a 12-week remote exercise program effectively improves home-based balance measures in adults with Ds. Therefore, the purpose of this study is to determine the extent to which lab-based balance measures in adults with Ds are different from adults without Ds, and if their balance can be improved with a remote exercise program. Number of Subjects Six adults (female=4, mean age=24.0, SD=4.1yrs) without Ds (No-Ds control group) nine adults (female=6, mean age=25.8, SD=4.3yrs) with Ds randomized to the intervention (Dsexercise group), and nine adults (female=5, mean age=26.2, SD=4.4yrs) with Ds randomized to the usual care condition (Ds-control group). Materials and Methods Baseline measurements were taken for all three groups. Post-test measurements were taken only for individuals with Ds. The intervention group completed a 12-week remote exercise program consisting of 1-hour sessions 3x/week. The program, Mann Method PT, focuses on functional movement, cardiovascular endurance, hip strengthening, and visual/vestibular training. Balance was evaluated using Timed Up and Go Test (TUG), Stair Climb Test (SCT), iv Functional Reach Test (FRT), and Bertec Balance Measures (Limits of Stability (LOS), Motor Control Test (MCT) and Sensory Organization test (SOT)). Baseline measurements were compared using a two-tailed independent T-test and Levene’s test for equality of variances. The difference between the pre-test and post-test balance measurements were calculated for both the Ds-exercise and Ds-control group, then the two groups were compared using an IndependentSamples Mann-Whitney U Test. Results Participants without Ds performed significantly better in the TUG, SCT, LOS, and SOT compared to participants with Ds (p= <.001, p= <.001, p=.002, p=.004, respectively). When comparing the pre-post differences of the Ds-control group with the Ds-exercise group, there were no significant differences. Conclusions The results show that individuals with Ds have poor balance performance when compared to matched controls without Ds. However, as data collection is still in progress, our data sample is currently too small to draw conclusions on the effects of remote exercise programming on balance performance. Clinical Relevance Balance exercises aimed at improving functional activity are encouraged. Although the current dataset is still underpowered, our telehealth program has been shown to be effective in a previous study. The providers working with individuals with Ds may benefit from understanding how to incorporate balance training into their typical routines for promotion of safe functional activities and recreational participation.


Physical Therapy; Down Syndrome; Adults with Down Syndrome; Balance; Remote Exercise Program; BERTEC


Physical Therapy

File Format


File Size

5647 KB

Degree Grantor

University of Nevada, Las Vegas




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