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To determine the effects of a home exercise program of combined aerobic and strength training on fitness with a 10.5-year-old girl with Down syndrome (DS). Measurements included cardiovascular variables, strength, body composition, flexibility, and skill.The subject participated in a home exercise program: 30 to 60 minutes of moderate- to high-intensity exercise five to six days per week for six weeks. The cardiovascular variables monitored were heart rate, respiration rate, and oxygen consumption during a submaximal treadmill stress test. Other measures included 10-repetition maximal strength of selected muscle groups, body mass index, flexibility, Gross Motor Scales of the Bruininks-Oseretsky Test of Motor Proficiency, and anaerobic muscle power.Improvements in submaximal heart and respiration rates, aerobic performance, muscle strength and endurance, gross motor skills, and anaerobic power were observed for this subject. Body weight and flexibility were unchanged.For this subject, a combined aerobic and strength-training program resulted in improved cardiopulmonary functions not observed in previous studies of subjects with DS.