Effects of a tele-coaching exercise program on motor performance in youth with Down syndrome

Down syndrome (DS), caused by trisomy 21, is characterized by physical and cognitive impairments. Physical exercise represents a valuable strategy to address these challenges and promote improvements in overall health. In particular, eHealth solutions enable the implementation of exercise interventions through tele-coaching provided via online platforms, which help individuals with DS to overcome barriers related to accessibility, continuity of care, and supervision of exercise practice. This pilot study aimed to evaluate the feasibility and the effectiveness of an eHealth-based tele-coaching program designed to improve muscular strength and balance in children and adolescents with DS. Eighteen children and adolescents with DS, aged 9-17 years, were enrolled in the study. Participants completed a remotely supervised exercise intervention delivered through a dedicated eHealth platform (e-gym). The program consisted of training sessions performed 3 times per week over a 15-week period. The intervention consisted of interactive and playful digital content aimed at improving upper and lower limb strength and balance. Exercise intervention was supported by real-time tele-coaching, continuous monitoring, and individualized feedback. Post-intervention analysis demonstrated a significant improvement in systolic blood pressure (p=0.04) and balance performance (p=0.002). Although adiposity-related measures showed positive trends, including body weight, body mass index (BMI), BMI z-score, waist circumference, and waist-to-height ratio, no statistically significant changes were found. The study supported the feasibility and potential effectiveness of eHealth-based exercise interventions for individuals with DS. Digital platforms such as tele-coaching represent scalable tools to promote motor performance and health-related outcomes. The integration of digital health approaches into community and healthcare services enhances access to adapted exercise programs and supports long-term engagement.