Down syndrome: strength, balance and physical activity

Understanding Down syndrome: strength, balance and physical activity

People may seek physiotherapy support when disability affects movement, balance, strength, transfers, physical capacity or participation. Physiotherapy planning should be based on the participant's functional needs and goals, not the diagnosis alone.

The diagnosis is only one part of the picture. The participant’s preferences, current abilities, environment, support network and individual goals all shape a useful physiotherapy plan.

Function and physiotherapy assessment

Assessment builds a clear picture of current function, the activities the participant wants to improve or maintain, and any safety, equipment or health factors that affect the plan.

• Current mobility, transfers, balance, strength and endurance
• The participant’s own goals at home and in the community
• Falls risk, equipment, environment and support needs
• Simple outcome measures that can show meaningful functional change

Physiotherapy planning and early priorities

The first priorities are chosen with the participant. The program should be accessible, safe, relevant to everyday life and realistic to practise between appointments.

• Agree on practical, participant-led functional goals
• Choose accessible exercises and functional practice
• Address safety, fatigue, pain and falls risk
• Involve family, carers or support workers with consent where this improves carry-over

A staged rehabilitation plan

Rehabilitation progresses from settling the current problem to rebuilding the physical qualities the person needs. Exercises are selected and adjusted according to response rather than copied from a one-size-fits-all list.

Typical functional milestones are individual and may include safer transfers, improved walking tolerance, fewer falls, greater confidence, better access to community activities or maintaining an existing level of independence.

• Practise walking, transfers, stairs or floor recovery as relevant
• Progress strength, balance and cardiovascular capacity
• Build a program that can be used in everyday settings
• Review mobility aids or assistive technology when within physiotherapy scope

Working towards everyday goals

Progress is measured against the participant’s individual goals—such as safer transfers, walking further, joining an activity or maintaining independence. Supports and funding always depend on the person’s plan and circumstances.

The plan is reviewed using observations and outcome measures that make sense for the goal. Progress may mean improvement, greater consistency, safer support or maintaining function over time.

When medical review is important

New or rapidly changing weakness, sudden loss of function, unexplained falls, breathing difficulty, chest pain, acute neurological symptoms or significant health changes require prompt medical assessment.

If the diagnosis is uncertain or progress is not following the expected pattern, the plan should be reviewed and referral arranged where appropriate.