A comprehensive exercise program for a young adult male with Down syndrome who experienced a stroke.

PURPOSE: Individuals with Down syndrome (DS) may be at heightened risk for stroke due to a combination of physiological conditions and lifestyle choices. There remains a lack of information regarding the effectiveness of exercise training on individuals with DS post-stroke. This case report describes the effects of a comprehensive exercise program on an individual with DS who had sustained a stroke.

METHOD: A 20-year-old male with DS recovering from a left hemorrhagic stroke 18 months previous underwent a 12-week land and water-based program 60 minutes/session, 5 sessions/week. Exercise sessions addressed specific limitations, including cardiorespiratory fitness, generalized muscle weakness, balance deficits, and reduced ambulatory ability in terms of speed, gait pattern and walking tolerance.

RESULTS: Between the baseline and 6-month follow-up assessments improvements were noted in peak oxygen consumption (VO2peak, 8% increase), one-repetition maximum (51%), community balance and mobility scale (54%), comfortable walking speed (42%), six-minute walk test (28%) and daily step count (21%).

CONCLUSION: Improved cardiorespiratory fitness, strength, balance and mobility provide preliminary evidence of the trainability of individuals with both DS and stroke. Future studies are warranted to investigate the role of exercise in risk factor reduction for primary and secondary prevention of stroke in people with DS. Implications for Rehabilitation Individuals with Down syndrome (DS) may be at heightened risk of stroke due to a combination of physiological conditions and lifestyle choices which contribute to reduced exercise capacity, accelerated aging patterns, moyamoya syndrome and physical inactivity as well as high rates of obesity and related conditions. More intensive fitness programs may be particularly important for people with both DS and stroke. Participation in a comprehensive exercise program can be safe and effective in regaining pre-stroke levels of cardiorespiratory fitness, functional mobility and goal attainment. RESULTS suggest that a more intensive physical therapy regimen may be recommendable during out-patient rehabilitation for individuals with DS post-stroke.