陳 宏，張韌仁，蘇 余，文 靜，劉 萍

國(guó)外運(yùn)動(dòng)干預(yù)改善唐氏綜合征患者身心障礙研究

陳 宏，張韌仁，蘇 余，文 靜，劉 萍

四川師范大學(xué)體育學(xué)院，四川 成都，610101。

采用文獻(xiàn)資料法系統(tǒng)綜述了國(guó)外有關(guān)唐氏綜合征（DS）患者身心特點(diǎn)與運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征患者身心障礙的影響，探討對(duì)我國(guó)的思考與啟示。結(jié)果表明：運(yùn)動(dòng)干預(yù)是改善DS患者身心障礙的有效措施之一；運(yùn)動(dòng)干預(yù)方式以綜合訓(xùn)練、阻力訓(xùn)練、有氧訓(xùn)練為主，但技心能主導(dǎo)類、技戰(zhàn)能主導(dǎo)類項(xiàng)目較少；運(yùn)動(dòng)強(qiáng)度為中等強(qiáng)度，且不宜進(jìn)行大強(qiáng)度的急性運(yùn)動(dòng)；干預(yù)時(shí)長(zhǎng)12周居多，最少8周。提示：未來研究可探討多維度、多項(xiàng)目干預(yù)方式的聯(lián)動(dòng)效應(yīng)，建立多樣化干預(yù)方案、多場(chǎng)域聯(lián)合互動(dòng)機(jī)制；驗(yàn)證不同運(yùn)動(dòng)強(qiáng)度對(duì)不同年齡段DS患者的劑量效應(yīng)；運(yùn)用不同的研究方法評(píng)估運(yùn)動(dòng)干預(yù)效果；注重運(yùn)動(dòng)干預(yù)對(duì)DS患者心理因素的影響。

唐氏綜合征；運(yùn)動(dòng)；身心障礙；運(yùn)動(dòng)干預(yù)

1866年英國(guó)醫(yī)生John Langdon Down是最先描述唐氏綜合征（DS）病情的人[1]，1970年被世界衛(wèi)生組織制定為“唐氏綜合征”，一直延續(xù)至今[2]。唐氏綜合征是由額外的21號(hào)染色體引起的，這種染色體疾病會(huì)導(dǎo)致唐氏綜合征患者出現(xiàn)心臟缺陷，肺部面積減少，腸道缺陷，韌帶松弛，肥胖，肌肉張力低[3]；腦重量減少，額葉和顳葉體積比例減少，前庭異常，認(rèn)知能力差，智商低下，視力差[4]等問題。這些身心問題會(huì)引起白血病，甲狀腺疾病，阻塞性睡眠呼吸暫停，癲癇和阿爾茨海默癥等并發(fā)癥的發(fā)生。在全世界范圍內(nèi)1000名兒童中約有1名兒童患有唐氏綜合征[5]，由此可見 DS患兒的患病率非常高。2016年10月25日中共中央、國(guó)務(wù)院出臺(tái)的《“健康中國(guó)2030”規(guī)劃綱要》明確指出要解決殘疾人群健康問題，并且要覆蓋全生命周期，針對(duì)生命不同階段的主要健康問題及主要影響因素，確立若干有效干預(yù)[6]。運(yùn)動(dòng)干預(yù)是改善DS患者身心障礙的有效方法[3]。國(guó)內(nèi)相關(guān)研究起步較晚，研究體系不夠成熟，研究深度還不夠深入[7]，相較而言，國(guó)外對(duì)DS患者的身心健康研究起步較早，研究更為成熟與深入。隨著國(guó)內(nèi)外學(xué)者對(duì)DS患者身心健康的研究日益增多，研究表明運(yùn)動(dòng)干預(yù)對(duì)DS患者的身心障礙效果的改善非常有效[8][9]。基于《“健康中國(guó)2030”規(guī)劃綱要》的背景下，通過搜集大量國(guó)內(nèi)外文獻(xiàn)，以（Elsevier，EBSCO，CNKI）為核心數(shù)據(jù)庫(kù)進(jìn)行檢索；為盡可能檢索出契合主題的文章，確定以主題為檢索項(xiàng)。檢索方式主要以Down's syndrome，Exercise，Physical education，Body movement，唐氏綜合征，運(yùn)動(dòng)，為核心關(guān)鍵詞進(jìn)行查找，為了突出研究重點(diǎn)與熱點(diǎn)，同時(shí)采用了多種形式的組合進(jìn)行檢索，共選取其中近10年相關(guān)文章104篇；隨后對(duì)未明確交代有關(guān)結(jié)果、墻報(bào)類、重復(fù)類文獻(xiàn)進(jìn)行排除，根據(jù)文章契合度，選取其中具有代表性的36篇文獻(xiàn)。對(duì)國(guó)外DS患者的身心特點(diǎn)及運(yùn)動(dòng)干預(yù)影響DS患者身心特點(diǎn)相關(guān)的研究成果進(jìn)行梳理與歸納，并探討對(duì)我國(guó)運(yùn)動(dòng)干預(yù)改善唐氏綜合征患者身心障礙的思考與啟示，為制訂運(yùn)動(dòng)干預(yù)改善DS患者身心障礙康復(fù)方案提供理論參考，進(jìn)一步推動(dòng)全民健身戰(zhàn)略的實(shí)施。

1 唐氏綜合征的身心特點(diǎn)

Bertapelli等[10]發(fā)現(xiàn)DS患者比健全人的肥胖患病率高，其中女性患病率高于男性，患病率高低與年齡和低的身體活動(dòng)量有關(guān)[11]。另外兩項(xiàng)研究證實(shí)了這一觀點(diǎn)，低的身體活動(dòng)量使得下肢肌肉張力和力量減弱、下肢骨量減少，其中男性腰椎骨密度低于正常人群25%，容易患上骨質(zhì)疏松癥[12]，骨骼缺陷可能是肌肉張力引起的。Silva等[13]同樣發(fā)現(xiàn)DS患者的骨密度量低，甚至比智障人群的骨密度量都要低（<0.001），隨著年齡的增加DS患者衰老會(huì)加快，其肌肉質(zhì)量和身體成分也會(huì)有所下降，DS患者會(huì)出現(xiàn)過早的肌肉減少癥狀[14]。

DS患者比同齡健全人靜態(tài)姿勢(shì)控制更差，一項(xiàng)測(cè)試中DS兒童在位移距離上其反應(yīng)時(shí)間也顯著長(zhǎng)于健全兒童[15]，不管是睜眼還是閉眼測(cè)試DS患者姿勢(shì)控制的值比普通大學(xué)生的都要低[16]，特別是單腳閉眼站立姿勢(shì)靜態(tài)平衡控制差異極為顯著[17]。其原因可能是隨著年齡的增加DS患者的視力會(huì)變得越來越差，需要更加依賴軀體感覺，所以早期干預(yù)對(duì)于DS患者的平衡能力發(fā)展非常重要的[18]。

DS患者會(huì)發(fā)生心臟異常發(fā)育，包括心臟、大血管和肺部等結(jié)構(gòu)異常。隨著年齡的增長(zhǎng)心血管疾病發(fā)病率會(huì)越來越高，這些問題與DS患者的年齡與脂代謝是相關(guān)的[19]。Draheim等[20]對(duì)52名DS患者與健全人進(jìn)行身體測(cè)量對(duì)比發(fā)現(xiàn)DS患者收縮壓、舒張壓更低，甘油三酯和總體脂肪更高。DS患者的肺部會(huì)呈現(xiàn)除肺表面積減少，肺泡發(fā)育異常，肺血管生長(zhǎng)異常，肺泡數(shù)量減少。肺部異常會(huì)導(dǎo)致DS患者易患甲狀腺功能亢進(jìn)、甲狀腺功能減退癥。發(fā)生甲狀腺功能減退癥，血清促甲狀腺激素濃度和正常甲狀腺素濃度略有升高，會(huì)降低心肌收縮力和心輸出量[21]。Angulo等[22]發(fā)現(xiàn)DS兒童的瞳孔比同心理年齡的正常兒童大266-1066ms，DS兒童的瞳孔潛伏期有更大延遲，注意力反應(yīng)時(shí)間比同心理年齡的正常兒童慢。另一項(xiàng)研究Saly等[23]發(fā)現(xiàn)DS兒童認(rèn)知功能和粗大運(yùn)動(dòng)功能受損，這些能力的缺失會(huì)影響DS患者的生活水平，并且可能會(huì)導(dǎo)致其他心理問題的出現(xiàn)。

2 運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征患者身心特點(diǎn)的影響

2.1 運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征身體成分的影響

González等[24]對(duì)26名DS患者進(jìn)行21周的綜合訓(xùn)練（垂直跳躍、墻上俯臥撐、站立拋接球、彈力帶拉伸）后發(fā)現(xiàn)DS患者的上下肢的瘦體重顯著增加（<0.05），但是DS患者的脂肪量沒有變化，其原因是運(yùn)動(dòng)干預(yù)中對(duì)飲食攝入、身體活動(dòng)水平或久坐時(shí)間等因素的控制不夠。研究表明瘦體重與心血管健康是有相關(guān)性的，未來研究可通過實(shí)證研究驗(yàn)證運(yùn)動(dòng)干預(yù)降低脂肪量、增加瘦體重改善心血管疾病的作用。Ferry等[25]對(duì)42名DS患者進(jìn)行一年的體育游戲活動(dòng)（跳躍運(yùn)動(dòng)、健美操運(yùn)動(dòng)、速度賽、障礙滑雪、體操運(yùn)動(dòng)）干預(yù)后DS患者的體重、BMI、都有所降低，其中腰部的骨礦物質(zhì)含量提高了7；全髖骨礦物質(zhì)含量提高了10；腰椎的骨密度提高了4。Shields等[26]運(yùn)用單盲法對(duì)不同年齡段的DS患者進(jìn)行漸進(jìn)阻力訓(xùn)練（坐式器械臥推、坐式腿部彎舉）后發(fā)現(xiàn)上下肢力量都得到增強(qiáng)，特別是上肢力量增加了21%。運(yùn)動(dòng)干預(yù)可以減少脂肪量，增加瘦體重、骨密度，但在干預(yù)過程中要控制好無關(guān)變量。

2.2 運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征患者平衡能力和姿勢(shì)控制的影響

DS兒童平衡能力差的原因可能是身體活動(dòng)量低，通過不同類型的體育鍛煉計(jì)劃DS患者的平衡能力得到了改善[15]。El-Meniawy等[27]對(duì)30名DS患者進(jìn)行12周跑步機(jī)和懸浮訓(xùn)練均能改善DS患者的平衡能力，其中懸浮訓(xùn)練的改善效果更佳顯著，其原因可能是跑步機(jī)傾斜的不夠。研究表明10%傾斜角度導(dǎo)致DS兒童的步態(tài)更接近正常發(fā)育兒童的步態(tài)，對(duì)DS兒童的步態(tài)有非常好的康復(fù)效果[28]。況且進(jìn)行懸浮訓(xùn)練時(shí)頭部位置變化刺激耳石器官，在重力影響下喚起階段性和強(qiáng)直性前庭脊柱反射并作用于頭部和四肢保持姿勢(shì)。

González等[29]對(duì)30名DS青少年進(jìn)行20周全身振動(dòng)訓(xùn)練后，顯著改善了DS青少年的靜態(tài)平衡，進(jìn)行全身振動(dòng)訓(xùn)練時(shí)DS患者在運(yùn)動(dòng)過程中會(huì)募集更多的神經(jīng)元細(xì)胞去調(diào)節(jié)身體位置和集中注意力，并產(chǎn)生多模式的感覺輸入耦合，通過減少身體的搖擺保持平衡。

2.3 運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征患者心肺功能的影響

Mendonca等[30]對(duì)DS成年男人進(jìn)行12周的有氧和阻力相結(jié)合的跑步機(jī)訓(xùn)練后，DS患者在攝氧量提高的同時(shí)心臟自主神經(jīng)功能也得到改善，值得關(guān)注的是DS患者在運(yùn)動(dòng)干預(yù)后1min心率恢復(fù)得到顯著改善（<0.05），但是大強(qiáng)度運(yùn)動(dòng)干預(yù)不利于DS患者身心障礙的改善，對(duì)DS患者進(jìn)行一次最大有氧運(yùn)動(dòng)后發(fā)現(xiàn)DS患者的動(dòng)脈僵硬反應(yīng)減弱，減少了血管儲(chǔ)備，急性最大有氧運(yùn)動(dòng)立即增加了DS患者的動(dòng)脈僵硬度[31]。研究發(fā)現(xiàn)中等強(qiáng)度的身體活動(dòng)量與肌肉健康和心肺健康（<0.05）呈正相關(guān)，中等強(qiáng)度對(duì)DS患者的肌肉健康和心肺健康有益[32]。由此可見通過中等強(qiáng)度的運(yùn)動(dòng)干預(yù)可以降低DS患者的脂肪量來改善心臟的自主神經(jīng)功能和心血管功能是可行的。Zeinab等[33]對(duì)30名DS兒童進(jìn)行12周的下肢肌力訓(xùn)練與胸部物理治療后發(fā)現(xiàn)胸部物理治療組的最大肺活量，1s后最大呼氣量顯著改善；呼氣峰值流速和最大通氣量沒有得到改善。力量訓(xùn)練組的最大肺活量和呼氣峰值流速得到顯著改善，1s后最大呼氣量和最大通氣量沒有得到改善。運(yùn)動(dòng)干預(yù)雖然不改變肺的形態(tài)，但它可以提高肺部對(duì)氧氣的運(yùn)輸能力。

2.4 運(yùn)動(dòng)干預(yù)對(duì)唐氏綜合征患者認(rèn)知功能影響

Ptomey等[34]對(duì)27名DS患者進(jìn)行12周的中等強(qiáng)度有氧運(yùn)動(dòng)（步行、慢跑、跳舞）與力量訓(xùn)練（垂直跳躍、俯臥撐練和深蹲）后發(fā)現(xiàn)配對(duì)關(guān)聯(lián)學(xué)習(xí)、注意轉(zhuǎn)換任務(wù)、反應(yīng)時(shí)間都有很大提升，特別是配對(duì)關(guān)聯(lián)學(xué)習(xí)提升最大。一些大腦區(qū)域，如尾狀核和前額皮質(zhì)對(duì)運(yùn)動(dòng)控制和認(rèn)知功能起著非常重要的作用[35]。增加身體活動(dòng)量可以使其作用于腦部維持認(rèn)知功能包括注意力、記憶。Holzapfel等[36]對(duì)46名DS青少年進(jìn)行8周的固定自行車變速訓(xùn)練后DS患者的雙手靈活性顯著提高。運(yùn)動(dòng)干預(yù)能有效地改善DS患者的認(rèn)知計(jì)劃能力與精細(xì)運(yùn)動(dòng)控制，并且激活了運(yùn)動(dòng)感知皮層和小腦控制中樞。

3 小結(jié)與展望

（1）運(yùn)動(dòng)干預(yù)是改善DS患者的身心障礙有效措施之一，對(duì)其進(jìn)行長(zhǎng)期的、科學(xué)有效的運(yùn)動(dòng)干預(yù)，可產(chǎn)生積極的影響作用。

（2）運(yùn)動(dòng)干預(yù)方式包括綜合訓(xùn)練（體育游戲活動(dòng)、垂直跳躍+墻上俯臥撐+站立拋接球+彈力帶拉伸）、阻力訓(xùn)練（坐式器械臥推、坐式腿部彎舉）、有氧訓(xùn)練（步行、慢跑和跳舞）、力量訓(xùn)練（垂直跳躍、俯臥撐和深蹲）、懸浮訓(xùn)練、全身振動(dòng)訓(xùn)練、跑步機(jī)訓(xùn)練、固定自行車變速訓(xùn)練；目前主要以綜合訓(xùn)練、阻力訓(xùn)練、有氧訓(xùn)練三類干預(yù)為主，且運(yùn)動(dòng)干預(yù)項(xiàng)目具體且豐富，可惜的是其技心能主導(dǎo)類、技戰(zhàn)能主導(dǎo)類項(xiàng)目較少。當(dāng)然有氧訓(xùn)練與力量訓(xùn)練、有氧訓(xùn)練與阻力訓(xùn)練一樣具有改善DS患者的身心障礙的作用，甚至，有氧訓(xùn)練與阻力訓(xùn)練相結(jié)合比單純的有氧訓(xùn)練改善效果更佳。未來可通過實(shí)證研究探討多維度、多項(xiàng)目干預(yù)方式的聯(lián)動(dòng)效應(yīng)，建立多樣化干預(yù)方案、多場(chǎng)域聯(lián)合互動(dòng)機(jī)制，找到更加有效、更加科學(xué)的運(yùn)動(dòng)干預(yù)方案。

（3）運(yùn)動(dòng)強(qiáng)度以中等強(qiáng)度為主。運(yùn)動(dòng)干預(yù)時(shí)要關(guān)注DS患者心肺功能的適應(yīng)性，不宜進(jìn)行大強(qiáng)度的急性運(yùn)動(dòng)，這對(duì)DS患者的身心障礙改善有負(fù)面效果。未來研究可重視DS患者運(yùn)動(dòng)強(qiáng)度的精確測(cè)量來評(píng)估運(yùn)動(dòng)干預(yù)改善身心障礙效果的有效性，以及驗(yàn)證不同運(yùn)動(dòng)強(qiáng)度對(duì)不同年齡段DS患者的劑量效應(yīng)。

（4）運(yùn)動(dòng)干預(yù)時(shí)長(zhǎng)最少8周，其次12周居多，較長(zhǎng)干預(yù)為1年。當(dāng)前國(guó)外大量研究廣泛使用橫斷面來檢查DS患者的功能與結(jié)果，縱向或交叉順序研究尚少，未來研究可關(guān)注DS患者的整個(gè)生命周期，運(yùn)用不同的研究方法評(píng)估運(yùn)動(dòng)干預(yù)效果。

（5）該研究領(lǐng)域多數(shù)學(xué)者對(duì)運(yùn)動(dòng)干預(yù)的效果研究中主要集中于身體狀態(tài)變化，運(yùn)動(dòng)干預(yù)對(duì)DS患者心理狀態(tài)變化研究甚少。未來研究可拓寬運(yùn)動(dòng)干預(yù)對(duì)DS患者心理狀態(tài)變化的研究范圍。

[1] Ken Pitetti, Tracy Baynard, Stamatis Agiovlasitis. Children and adolescents with Down syndrome, physical fitness and physical activity[J].Journal of Sport and Health Science, 2013, 2(01): 47～57.

[2]Douglas Wahlsten. Chapter 12 - Down Syndrome [M]. America: Academic Press, 2019: 137～147.

[3]Lukowski A F, Milojevich H M, Eales L. Cognitive Functioning in Children with Down Syndrome: Current Knowledge and Future Directions[J]. Advances in child development and behavior, 2019, 56: 257～289.

[4]Lott IT. Neurological phenotypes for Down syndromeacross the life span[J].Progress In Brain Research, 2012, 197: 101～121.

[5] Diamandopoulos K, Green J. Down syndrome: An integrative review[J]. Journal of Neonatal Nursing, 2018, 24(05): 235～241.

[6]中華人民共和國(guó)中央人民政府.中共中央國(guó)務(wù)院印發(fā)《“健康中國(guó)2030”規(guī)劃綱要》[EB/OL].（2016-10-25）[2019-10-08]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.

[7]吳雪萍，張建華.我國(guó)適應(yīng)體育研究的發(fā)展特征與熱點(diǎn)演變[J].上海體育學(xué)院學(xué)報(bào)，2014，38（05）：5～11.

[8] 劉 文，胡日勒.唐氏綜合癥兒童自我控制的發(fā)展和矯正研究綜述[J].中國(guó)特殊教育，2008（09）：23～26.

[9] Siebra C A, Siebra H A. Using computational support in motor ability analysis of individuals with Down syndrome: Literature review[J]. Computer methods and programs in biomedicine, 2018, 157: 145～152.

[10] Bertapelli F, Pitetti K, Agiovlasitis S, et al. Overweight and obesity in children and adolescents with Down syndrome—prevalence, determinants, consequences, and interventions: a literature review[J]. Research in developmental disabilities, 2016, 57: 181～192.

[11]Basil J S, Santoro S L, Martin L J, et al. Retrospective study of obesity in children with Down syndrome[J]. The Journal of pediatrics, 2016, 173: 143～148.

[12] Marta García-Hoyos, José Antonio Riancho, CarmenValero. Bone health in Down syndrome[J].MEDICINA CLINICA,2017, 149(02): 78～82.

[13] Silva V Z M D , Barros J D F, Azevedo M D , et al. Bone mineral density and respiratory muscle strength in male individuals with mental retardation（with and without Down Syndrome）[J]. Research in Developmental Disabilities, 2010, 31(06): 1585～1589.

[14] Hélio José Coelho-Junior,Emanuele Rocco Villani, Riccardo Calvani, AngeloCarfì, Anna Picca, Francesco Landi, Roberto Bernabei, Graziano Onder, Emanuele Marzetti. Sarcopenia-related parameters in adults with Down syndrome: A cross-sectional exploratory study[J]. Experimental Gerontology, 2019, 119: 93～99.

[15] Hao-Ling Chen, Chun-Fu Yeh a, Tsu-Hsin Howe .Postural control during standing reach in children with Down syndrome[J].Research in Developmental Disabilities, 2015, 38: 345～351.

[16] Cabeza-Ruiz R, X García-Massó, Centeno-Prada R A, et al. Time and frequency analysis of the static balance in young adults with Down syndrome[J]. Gait & Posture, 2011, 33(01): 23～28.

[17] E E Guzman-Mu?oz, L B Gutierrez-Navarro, SEMiranda-Diaz. Postural control in children adolescents and adults with Down syndrome[J]. International Medical Review on Down Syndrome, 2017, 21(01): 12～16.

[18] Rigoldi, Chiara, Galli, Manuela, Mainardi Luca, Crivellini Marcello, Albertini, Giorgio. Postural control in children, teenagers and adults with Down syndrome[J]. Research in Developmental Disabilities, 2011, 32: 170～175.

[19] Vis J C, Engelen K V, Bouma B J, et al. Cardiovascular Disorders among Persons with Down Syndrome-Chapter Six[J]. International Review of Research in Mental Retardation, 2010, 39(10): 165～194.

[20] Draheim Christopher C, Geijer Justin R, Dengel Donald R.Comparison of Intima-Media Thickness of the Carotid Artery and Cardiovascular Disease Risk Factors in Adults With Versus Without the Down Syndrome[J].American Journal of Cardiology, 2010, 106(10): 1512～1516.

[21] Liz Marder, RobertTulloh, EmmaPascall. Cardiac problems in Down syndrome[J].Paediatrics and Child Health, 2015, 25(01): 23～29.

[22] Angulo-Chavira A Q, García O, Arias-Trejo N. Pupil response and attention skills in Down syndrome[J]. Research in developmental disabilities, 2017, 70: 40～49.

[23] Saly Said Abd El-Hady,Faten Hassan Abd El-Azim,Hoda Abd El-Aziem Mohamed El-Talawy.Correlation between cognitive function, gross motor skills and health – Related quality of life in children with Down syndrome[J].Egyptian Journal of Medical Human Genetics,2018, 19(02): 97～101.

[24] González Agüero A, VicenteRodríguez G, GómezCabello A, et al. A combined training intervention programme increases lean mass in youths with Down syndrome[J]. Research in Developmental Disabilities, 2011, 32(06): 2383～2388.

[25] Ferry, Béatrice, Gavris M, Tifrea C, et al. The bone tissue of children and adolescents with Down syndrome is sensitive to mechanical stress in certain skeletal locations: A 1-year physical training program study[J]. Research in Developmental Disabilities, 2014, 35(09): 2077～2084.

[26] Shields N, Taylor N F, Wee E, et al. A community-based strength training programme increases muscle strength and physical activity in young people with Down syndrome: A randomised controlled trial[J]. Research in Developmental Disabilities, 2013, 34(12): 4385～4394.

[27] El-Meniawy G H, Kamal H M, Elshemy S A. Role of treadmill training versus suspension therapy on balance in children with Down syndrome[J]. Egyptian Journal of Medical Human Genetics, 2012, 13(01): 37～43.

[28] Rodenbusch T L M, Ribeiro T S, Sim O C R , et al. Effects of treadmill inclination onthe gait of children with Down syndrome[J]. Research in Developmental Disabilities, 2013, 34(07): 2185～2190.

[29] González Agüero, Alejandro, Matute-Llorente, ángel, Gómez-Cabello, Alba, et al. Effects of whole body vibration training on body composition in adolescents with Down syndrome[J]. Research in Developmental Disabilities, 2013, 34(05): 1426～1433.

[30] Mendonca G V, Pereira F D, Fernhall B. Heart rate recovery and variability following combined aerobic and resistance exercise training in adults with and without Down syndrome[J]. Research in developmental disabilities, 2013, 34(01): 353～361.

[31] Hu M, Yan H, Ranadive S M, et al. Arterial stiffness response to exercise in persons with and without Down syndrome[J]. Research in developmental disabilities, 2013, 34(10): 3139～3147.

[32] Izquierdo-Gomez Rocío, Martínez-Gómez David, Villagra A, et al. Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study[J]. Research in Developmental Disabilities, 2015, 36: 428～436.

[33] Zeinab Ahmed Hussein.Strength training versus chest physical therapy on pulmonary functions in children with Down syndrome[J]. Egyptian Journal of Medical Human Genetics, 2017, 18(01): 35～39.

[34] Ptomey Lauren T, Szabo Amanda N, Willis Erik A, et al. Changes in cognitive function after a 12-week exercise intervention in adults with Down syndrome[J].Disability and Health Journal, 2018, 11(03): 486～490.

[35] Yuko Yamauchi Sayaka Aoki,Junko Koike Naomi Hanzawa, Keiji Hashimoto. Motor and cognitivedevelopment of children with Down syndrome: The effect of acquisition of walking skills on their cognitive and language abilities[J].Brain and Development, 2019, 41(04): 320～326.

[36] Holzapfel S D, Ringenbach S D R, Mulvey G M, et al. Improvements in manual dexterityrelate to improvements in cognitive planning after assisted cycling therapy (ACT) in adolescents with down syndrome[J]. Research in Developmental Disabilities, 2015, 45～46: 261～270.

Study on Sports Interventions to Improve Physical and Mental Disorders in Patients with Down Syndrome

CHEN Hong, ZHANG Renren, SU Yu, et al

College of Physical Education, Sichuan Normal University, Chengdu Sichuan, 610101, China.

This article systematically reviews the effects of physical and mental characteristics of foreign patients with Down syndrome (DS) and the effects of exercise intervention on physical and mental disorders of Down syndrome patients, and discusses the reflections and enlightenments of China. The results show that: sports intervention is one of the effective measures to improve the physical and mental handicap of DS patients; sports intervention methods are mainly comprehensive training, resistance training, aerobic training, but the technical and mental ability-led and technical-warfare-led projects are few; The intensity is medium intensity, and it is not suitable for high-intensity acute exercise; the duration of intervention is mostly 12 weeks, at least 8 weeks. Tip: Future research can explore the linkage effect of multi-dimensional and multi-project interventions, establish a variety of intervention programs, and a multi-field joint interaction mechanism; verify the dose effect of different exercise intensity on DS patients of different ages; use different research methods to evaluate Effect of exercise intervention; pay attention to the influence of exercise intervention on psychological factors of DS patients.

Down syndrome; Exercise; Physical and mental disorders; Sport intervention

G804.8

A

1007―6891（2021）06―0044―04

10.13932/j.cnki.sctykx.2021.06.11

2020-01-05

2020-04-17

《四川省社會(huì)科學(xué)研究“十三五”規(guī)劃2016年度課題：基于體育消費(fèi)視角的四川殘疾學(xué)生體育需求、行為及援助研究》（項(xiàng)目編號(hào)：SC16B073）。