The Effects of Cognitive–Motor Dual-Task Exercise and Exergaming on Balance and Functional Mobility in Children with Down Syndrome: A Comparative Randomized Trial

<b>Background/Objectives:</b> Children with Down Syndrome (DS) exhibit difficulties in maintaining balance and coordination in addition to limitations in functional mobility. The Cognitive-Motor Dual-Task Exercise Program (CMDT) has shown the ability to improve balance and functional mobility. This study aimed to compare the effect of CMDT versus exergaming on the balance and functional mobility of children with Down Syndrome aged 8-14 years. <b>Methods:</b> A randomized comparative trial was conducted, dividing participants' children with DS into two intervention groups: CMDT group and exergaming group. Participants were recruited using convenience sampling methods from the Voice of Down Syndrome Association and the Down Syndrome Charitable Association in Riyadh, Saudi Arabia. Both interventions were implemented over a period of six weeks. Outcome measures included the Timed Up and Go (TUG), Four Square Step Test (FSST), and Pediatric Balance Scale (PBS). <b>Results:</b> A total of 23 children with DS participated in the study. A mixed repeated measures ANCOVA shows a significant effect of time across the two groups (<i>p</i> < 0.001) for TUG, FSST, and PBS, indicating improvements in balance and functional mobility. There were no significant differences between the two group interventions. <b>Conclusions:</b> CMDT and exergaming were equally effective in improving balance and functional mobility in children with DS. <b>Trial Registration:</b> Clinicaltrials.gov with ID NCT06146907.