Table 4 Physical activity interventions

Rimmer 2004 [23] USA Community Quasi-experimental study with a control group

(a) Exercise group n = 30 Weight status: 13% normal, 23%overweight, 64% obese Gender: 53% females, 47% males Age (years)^a: 38.6 (6.2) ID: all Down syndrome

Duration: 12 weeks of 3 exercise group sessions per week (45 min each) led by physiologists and assistants. (a) Activity: 30 to 45 min of cardiovascular exercise and 15 to 20 min of muscular strength and endurance.Maintenance: none reported

12 weeks

(a) Mean weight change, kg: -1^b

(b) Control group n = 22 Weight status: 14% normal weight, 9% overweight, 77% obese Gender: 59% females, 41% malesAge (years)^a: 40.6 (6.5) ID: all Down syndromeAttrition/drop out: none

(b) Mean weight change, kg: + 1.7 Significant between group difference (p < 0.01)

Moss 2009 [24] South Africa Community Uncontrolled quasi-experimental study

Total n = 100Weight status, BMI^a: 29.3 (6.8) for females, 29 (8.5) for males Gender: 53 females, 47 males Age (years)^a: 37.1 (10.1) for females, 39.2 (8.9) for males ID: Intellectually aged between 4-12 yr oldAttrition/drop out: none reported

Duration: 12 weeks of 3 days per week exercise group sessions.Activity: 20 min walking the first 4 weeks and completing 30 min of walking the final 4 weeks.Maintenance: none reported

3 months

Females: Mean BMI change, kg/m²: -2.74^b Males: Mean BMI change, kg/m²: -3.1

Wu 2010 [25] Taiwan Institution Uncontrolled quasi-experimental study

Total n = 146 weight status: 31% obese, 16.9% overweight, 45.8% normal weight, 6.3% underweight Gender: Age (years): 19-67 ID: 3.4% mild, 30.8%, moderate, 33.6% severe, 32.2% profound Attrition/drop out: none

Duration: 6 months of 4 times per week exercise group sessions (40 min each) led by institutional caregivers.Activity: Exercise sessions included sports acrobatics, jogging, dancing, and walking.Maintenance: none reported

6 months

Mean weight change, kg: -1.86 (p < 0.001)^b Mean BMI change, kg/m²: - 0.84 (p < 0.001)

Mendonca 2011 [26] Portugal Community Quasi-experimental study with a comparison group

(a) Down Syndrome n = 13 Weight status, BMI^a: 29.3 (3.7)Gender: 3 females, 10 malesAge (years): 27-50 ID: Down syndrome, mild -moderate ID

Duration: 12 weeks of 3 days per week exercise group sessions led by physiologist and assistants. Activity: 2 days combined training separated by one day of endurance training (30 min): treadmill walking or running, dynamic exercises: leg press, chest press, vertical traction, shoulder press, lower back, leg extension, biceps curl, and triceps pushdown, abdominal curls Maintenance: none reported

12 weeks

(a) Mean BMI change, kg/m²:-0.4^b

(b) No Down syndrome n = 12 Weight status, BMI^a: 26.6 (4.5)Gender: 3 females, 9 malesAge (years): 27-50 ID: No IDAttrition/drop out: none

(b) Mean BMI change, kg/m²: 0No significant difference between (a) and (b)