Exercise interventions to improve balance for young people with intellectual disabilities : a systematic review and meta-analysis

Aim: To conduct a systematic review and meta-analysis of the effects of exercise interventions designed to improve balance in young people with intellectual disabilities. Method: A systematic literature search was performed on 10 databases. Studies in press or published in English in a peer-reviewed journal were included if: (1) participants were young people with intellectual disabilities; (2) exercise interventions were designed to improve balance; and (3) they used quasi-experimental or experimental designs. Studies focusing only on a specific subpopulation of young people with intellectual disabilities or having a specific physical characteristic were excluded. Risk of bias was assessed for randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. Results: The search strategy identified 937 articles and 15 studies, published between 1991 and 2017, that met the inclusion criteria. Exercise intervention groups showed a significant and larger improvement in static (pooled effect size, Hedges’ g=0.98) and dynamic (g=1.34) balance compared with the control groups. However, although the pooled improvement of static–dynamic balance was large (g=2.80), the result was non-significant. None of the subgroup analyses were significant, except for the improvement in: (1) static balance (higher in quasi-experimental than in experimental studies); and (2) dynamic balance (higher in young people with a mild vs a mild–moderate intellectual disability). Interpretation: The reviewed exercise interventions seem to represent an effective means for improving the static and dynamic balance of young people with intellectual disabilities. However, the present findings should be considered as preliminary given the small number of studies and their limitations. What this paper adds: Exercise intervention results in large and significant improvements in static and dynamic balance in young people with intellectual disabilities. Exercise intervention results in a large but non-significant improvement in static–dynamic balance. Static balance improvement was significantly higher in quasi-experimental versus experimental studies. Dynamic balance improvement was significantly higher in young people with mild versus mild–moderate intellectual disability. No significant differences related to age group, balance measures, and components of exercise intervention were found.