Physical exercise in the prevention and rehabilitation of Osteopenia in premature infants and children with Down Syndrome: a systematic review

Abstract

Introduction: Osteopenia is a systemic metabolic disease derived from decreased bone formation and/or increased resorption without compromising microarchitecture, causing increased fragility and susceptibility to fractures, which can affect growth in childhood and adolescence. Objective: Identify which interventions through physical exercise can help in the treatment and prevention of osteopenia/osteoporosis in premature infants and children with Down Syndrome. Methods: The searches were conducted in specific databases in Health Sciences, structured in the form PICOS, including randomized clinical trials related to physical exercise against osteopenia in premature children and with Down Syndrome from 0 to 12, using the Health Sciences Descriptors to identify the keywords. Studies with high methodological quality were eligible for meta-analysis in the random effects model. Results: Of the 15 articles analyzed, it was observed that both infants, children, and adolescents in the experimental groups, who performed physical exercise, showed statistically significant differences in at least one of the biomarkers of bone formation or bone resorption and, in the same way, showed statistical differences in densitometry and ultrasound measurements. The meta-analysis performed with the studies in preterm infants showed statistically significant mean differences of 0.77 and 0.61 for bone formation in the intervention group and 1.07 for the intensity of 10 repetitions in the Moyer and Mileur protocol. Conclusion: Physical exercise contributes to greater bone formation and reduction of bone resorption, effectively treating and preventing metabolic diseases of osteo in premature infants and children with Down Syndrome.

Keywords

• Physiotherapy
• Exercise
• Osteometabolic diseases
• Bone formation
• Prematurity
• Pediatrics