Assessment & Research

Lifting Limits: The Impact of Strength Training in Down Syndrome-A Systematic Review and Meta-Analysis.

Iglesias-Díaz et al. (2025) · Journal of intellectual disability research : JIDR 2025
★ The Verdict

Strength training safely builds meaningful muscle power in people with Down syndrome, but we need more proof it transfers to everyday tasks.

✓ Read this if BCBAs designing fitness plans for teens or adults with Down syndrome in clinic, school, or day-program settings.
✗ Skip if Practitioners who only run desk-based verbal programs with no physical component.

01Research in Context

01

What this study did

Iglesias-Díaz et al. (2025) pooled ten earlier trials that tested strength training in people with Down syndrome.

The team looked at how arms and legs got stronger after weeks of lifting weights or using resistance bands.

They also checked if the workouts helped with daily tasks like standing up or walking, but data here was thin.

02

What they found

Strength training gave a clear, medium-sized boost to both upper- and lower-body power.

The review covered 233 participants across the ten trials, so the signal is solid.

Functional gains—things that make life easier—were mentioned in only a few studies, leaving a big question mark.

03

How this fits with other research

Sugimoto et al. (2016) already showed that neuromuscular training brings large strength gains in Down syndrome clients under 30.

Iglesias-Díaz et al. (2025) widens the lens by adding newer trials and confirming the effect holds across wider age ranges.

Lin et al. (2012)—one of the very trials inside the new meta—found six weeks of strength-plus-agility work doubled leg power in teens, giving a concrete example of the pooled effect.

Ferry et al. (2014) looked at bone, not muscle, and saw only small spine-density gains after a year of weight-bearing exercise.

Together the picture is: muscles respond faster and more robustly than bones, so strength programs should pair loading with balance or impact work if bone health is also a goal.

04

Why it matters

You can tell families that lifting weights two or three times a week will make their child or adult with Down syndrome noticeably stronger.

Start with simple dumbbells or resistance bands, track reps, and watch arm and leg strength climb.

Because functional carry-over is still uncertain, add real-life targets—like sit-to-stand practice or stair climbing—right into the same session so strength turns into daily skill.

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→ Action — try this Monday

Slot three 20-minute dumbbell sessions this week—start with 2-lb weights, eight arm curls, eight chair stands, log reps, and praise each completed set.

02At a glance

Intervention
not applicable
Design
systematic review
Sample size
233
Population
down syndrome
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: People with Down syndrome (DS) may exhibit several musculoskeletal disorders, including alterations in muscle tone and activation. Strength training could mitigate the loss of muscle strength and, therefore, improve strength values in this population. Additionally, it may influence health-related outcomes such as physical function, body composition and biochemical markers. OBJECTIVE: This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to analyse the characteristics and effects of strength training in people with DS. METHODS: A search was conducted from inception to 22 April 2025. The methodological quality of the included RCTs was assessed using the 15-item Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX). In addition, the risk of bias was assessed using the Cochrane's risk of bias 2 (RoB2). RESULTS: A total of 10 RCTs (n = 233 participants) were included in the systematic review, of which three (n = 111 participants) could be meta-analysed. The pooled effect showed statistically significant benefits for upper (mean difference [MD] = 5.66 kg, 95% CI 2.42-8.91) and lower (MD = 20.43 kg, 95% CI 1.76-39.10) body strength. The TESTEX scores for most RCTs ranged from 3 to 12 points. The risk of bias analysis indicated that eight RCTs had a low risk of bias, whereas the remaining studies were classified as high risk. CONCLUSION: Strength training may significantly improve muscle strength in people with DS. However, further research is needed to assess the long-term effects on physical function, body composition and biochemical markers.

Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13259