The impact of physical activity on the balance ability of children and adolescents with intellectual disabilities: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to evaluate the overall intervention effect of physical activity on balance ability in children and adolescents with intellectual disabilities, systematically compare the intervention differences among various types of physical activities, and explore the optimal dose-response relationship for improving balance ability. Randomized controlled trials investigating the effects of physical activity on balance ability were retrieved from six electronic databases: Web of Science, Cochrane Library, PubMed, CNKI, Wanfang, and VIP. The Cochrane Handbook 5.1.0 was used for risk of bias assessment, and data analysis was performed using Review Manager 5.4 and Stata 17.0. A total of 16 studies involving 554 participants were included. (1) Physical activity significantly improved balance ability in children and adolescents with intellectual disabilities (SMD = 1.19, 95 %CI 0.87, 1.51, p < 0.01). (2) Subgroup analysis revealed that strength training had the most significant improvement effect. (3) The optimal dose parameters were: single session duration of 30–45 min (SMD = 1.38, 95 %CI 0.51, 2.26, p = 0.002), twice per week (SMD = 1.45, 95 %CI 0.79, 2.10, p < 0.001), and an intervention duration of 8–10 weeks (SMD = 1.51, 95 %CI 0.89, 2.14, p < 0.001). (1) Physical activity can significantly improve balance ability in children and adolescents with intellectual disabilities, with consistent benefits observed in both children and adolescent groups. (2) Based on current evidence, to achieve significant balance improvement in a relatively short time, intervention programs focusing on strength training should be prioritized. Specifically, the recommended implementation parameters are 30–45 min per session, twice weekly, for 8–10 weeks to obtain optimal benefits. • For youth with intellectual disabilities, physical activity significantly improves balance, particularly dynamic balance. • Optimal balance gains come from 30 to 45 min strength training sessions, twice weekly for 8 to 10 weeks. • Shorter, more frequent exercise sessions are more effective for improving balance than longer, less frequent ones. • Strength training improves balance more than aerobic or balance training by building lower limb and core strength.