Functional Training Plus Sensory Rehabilitation Tops Motor Gains in Intellectual Disability

Children and adolescents with intellectual disability often struggle with balance and coordination, deficits that ripple through nearly every part of daily life, from walking safely on uneven ground to participating in sports and classroom activities. A new systematic review and network meta-analysis published in the Journal of Autism and Developmental Disorders offers one of the most comprehensive answers yet to a practical question that parents, therapists, and adapted physical education teachers have long asked: which type of exercise intervention actually works best? The answer, according to the analysis of 25 randomized controlled trials involving 897 participants, is that functional training combined with sensory rehabilitation programs shows relatively favorable effects on both balance and coordination.

The research team, led by Meng Chen and Mengzhi Li of Hanyang University in South Korea, conducted an exhaustive search of both English-language and Chinese databases, including PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, Embase, CNKI, Wanfang, VIP, and CBM, covering all literature from database inception through 23 December 2025. This bilingual search strategy is significant because it captured a substantial body of intervention research conducted in China that conventional English-only reviews frequently miss, broadening the evidence base considerably beyond what most prior meta-analyses on the topic have been able to include.

Network meta-analysis is a statistical technique that goes beyond traditional pairwise comparisons. Instead of only pooling studies that directly compare one intervention against a control group, it builds a network of all treatments across all trials, allowing both direct and indirect comparisons between interventions that may never have been tested head to head. This matters in a field where a given trial might compare balance training with trampoline exercise, while another compares core stabilization with hippotherapy, leaving clinicians with fragmentary and seemingly contradictory findings. By integrating the entire network of evidence, the method can rank interventions by their probability of being the most effective.

The interventions evaluated in the included trials spanned a remarkable range. They included conventional balance training, core stabilization and core strength programs, functional training, sensory integration and sensory rehabilitation approaches, trampoline and jumping exercises, rope skipping, hippotherapy, aquatic exercise, virtual reality training, floor hockey and floorball, fun athletics programs, hemsball, simplified boxing routines, and combined aerobic and resistance exercise programs. Outcome measures focused on static and dynamic balance as well as motor coordination, the twin pillars of gross motor function that determine how confidently and capably young people move through their environments.

Based on the ranking probabilities generated by the network model, functional training delivered alongside sensory rehabilitation programs emerged at the top for both balance and coordination outcomes. Functional training emphasizes movements that mimic real-world tasks such as squatting, reaching, stepping, and weight shifting, which may explain its advantage: rather than isolating a single physical capacity, it trains the integrated postural control system that children must deploy in everyday situations. Pairing it with sensory rehabilitation, which targets the vestibular, proprioceptive, and visual inputs that feed postural control, appears to attack the balance problem from both the musculoskeletal and the sensory-processing sides simultaneously.

The findings arrive at a moment of growing concern about motor development in this population. Previous research has documented that children and adolescents with intellectual disability show measurably poorer postural sway, slower reactive balance, and weaker functional strength than typically developing peers, and that sedentary periods, including those caused by pandemic-related inactivity, further erode motor skills. Poor balance is not merely an athletic limitation; it is a fall risk factor and a barrier to social participation, independence, and the physical fitness that underpins long-term health. An evidence-based hierarchy of interventions therefore has consequences well beyond the gymnasium.

The study followed rigorous methodological standards, adhering to the PRISMA 2020 reporting guidelines and its extension for network meta-analyses, and assessing the risk of bias in the included randomized trials with the revised Cochrane RoB 2 tool. The authors reported no funding source for the study and declared no competing financial interests. The work was conducted by researchers at the Department of Sports Science at Hanyang University ERICA and the Department of Dance at Hanyang University, with Meng Chen and Mengzhi Li contributing equally as co-first authors and Zhenping Jiang serving as corresponding author.

For practitioners, the practical message is encouraging. Exercise interventions of many kinds appear to improve motor function in young people with intellectual disability, meaning that almost any structured physical activity is likely better than none. But when resources are limited and choices must be made, the evidence now points toward programs that combine functional, task-oriented movement with deliberate sensory challenge. The authors caution that the findings represent ranking probabilities across a heterogeneous trial network rather than a definitive prescription, and they call for further high-quality trials to refine dosing, duration, and intensity recommendations. Still, for a population too often excluded from the benefits of exercise science, this analysis provides a clear, evidence-based starting point for building stronger, steadier, more capable movers.

Subject of Research: Effects of non-pharmacological exercise interventions on balance and coordination in children and adolescents with intellectual disability

Article Title: Effects of Non-Pharmacological Interventions on Motor Function in Children and Adolescents With Intellectual Disability: Systematic Review and Network Meta-Analysis

Article References: Chen, M., Li, M., Hua, X., & Jiang, Z. (2026). Effects of Non-Pharmacological Interventions on Motor Function in Children and Adolescents With Intellectual Disability: Systematic Review and Network Meta-Analysis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-026-07522-x

Image Credits: AI Generated

DOI: 10.1007/s10803-026-07522-x

Keywords: intellectual disability, balance, coordination, functional training, sensory rehabilitation, network meta-analysis, physical activity, motor function, randomized controlled trials, pediatric rehabilitation, Effects, Non-Pharmacological