Effects of virtual reality-based aerobic exercise versus traditional aerobic exercise training on physical fitness, functional capacity, and quality of life in individuals with Down syndrome: DOWNFIT (Down Syndrome Fitness Intervention Trial) randomized controlled trial

Purpose To compare the effects of virtual reality-based aerobic exercise (VR-AE) and traditional aerobic exercise (TAE) on on physical fitness, functional capacity, and quality of life (QoL) in adolescents with Down syndrome (DS).Methods Forty adolescents with DS (mean age 14.45 ± 1.22 years) were randomized to the VR-AE, TAE, or control group (CG). Both intervention groups completed 20 supervised sessions over 10 weeks. VR-AE involved Xbox Kinect-based exergaming, while TAE consisted of treadmill training. Physical fitness, functional capacity, QoL, physical activity, and enjoyment were assessed at baseline and post-intervention.Results Both VR-AE and TAE improved selected anthropometric measures compared with CG (p < 0.05). VR-AE demonstrated greater improvements in flexibility, handgrip strength, and trunk endurance (p < 0.05), whereas TAE produced greater improvements in functional capacity and mobility (p < 0.05). Anthropometric improvements were comparable between intervention groups.Conclusions VR-AE and TAE showed different patterns of short-term improvement in adolescents with DS. Whilst these findings should be interpreted cautiously given the relatively small sample size and 10-week intervention period, they highlight the potential for supervised VR-AE and TAE to serve as practical exercise options that can be tailored to individual rehabilitation goals and preferences.