An increased ability to generate force in the major muscles of the lower limb may be important for adolescents with Down

syndrome, whose vocational roles may be influenced by their physical capacity. Although no corresponding changes in physical function were found, the observed SMDs for these variables (0.3 for the Grocery Shelving task and 0.5 for the timed stairs test) indicated a moderate observed effect size. Effect sizes of this magnitude are encouraging and are similar to those reported among adults with Down syndrome (Shields et DAPT order al 2008). If these SMD results were confirmed on a larger sample, then it is possible progressive resistance training might have clinically significant effects on the physical functioning of adolescents with Down syndrome. The SMDs for the physical functional measures were

smaller than for the muscle strength measures. This is expected as muscle strength is only one component required for these functional tasks; that is, there was less specificity of training for these functional tasks. Consistent with this, there are some data in people with Down syndrome to suggest that muscle strength is an important but not the only variable important in completing functional tasks (Cowley et al 2010). An innovative aspect of this trial was that the progressive resistance training intervention was led by physiotherapy student-mentors. This feature provided the supervision and the social interaction needed to encourage Antidiabetic Compound Library solubility dmso the adolescents to exercise. Choosing physiotherapy students to act as mentors was advantageous as they had an understanding of the principles of exercise training, and were also close in age to the adolescents so that the social interaction between the pair was meaningful. An additional benefit was that the

physiotherapy students had the opportunity to gain a unique experience of disability, something that they may not necessarily have gained from their professional training due to a lack of appropriate clinical placements. Progressive resistance training is a program typical of those that members of the community might undertake if they attended a community gym. The model developed and implemented in this study has the potential to become part of the on-going clinical experience ADAMTS5 of physiotherapy students and therefore could be an avenue for the long term sustainability of this type of community-based exercise program. It could also provide on-going opportunities for people with Down syndrome and those with other disabilities who require a high level of support to exercise. It is anticipated that, like with all novices, after a period of supervised exercise it may be possible for adolescents with Down syndrome to continue with the program with a lesser degree of supervision such as with a family member.