BACKGROUND: Children with Down syndrome clinically show a diminished activity limit at all ages due to muscle weakness and respiratory problems. PURPOSE: To compare the effect of strength exercises to lower limb muscles and effect of chest physical therapy treatment program on pulmonary functions in Down syndrome children. METHODS: Thirty Down syndrome children of both sexes (24 boys and 6 girls) were selected from outpatient clinic of the National Research Center For Motor Disabilities In Children At Cairo, Egypt. Children were selected to be ranged in age from 10 to 14 years and to be free from any innate heart deformities. They were randomly divided into two groups of equal numbers (group A and group B). Group A received chest physiotherapy, and group B received strength training program for hip, knee and ankle muscles by utilizing universal exercise unit 3 times/week for 12 weeks. Ergospirometry system was utilized to evaluate the pulmonary functions (forced vital capacity, forced expiratory volume in 1 s, maximum voluntary ventilation, and peak expiratory flow) that were measured before and after the proposed treatment period. RESULTS: Post treatment results of FVC and PEFR showed a statistically significant difference in each group while no significant difference was recorded between both groups. Post treatment results of FEV1 and MVV showed significant distinction between both groups in favor to group (A). CONCLUSION: Strength exercises to lower limb muscles are not effective as chest physical therapy on improving pulmonary functions in children with Down syndrome.

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