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A literature search (PROSPERO CRD42022309560) was performed (18 July 2023) using the following databases: PubMed, CINAHL, APA PsycINFO, Web of Science, Embase and SPORTDiscus. For articles to be included, they had to be peer\u2010reviewed pubications, reporting VO<jats:sub>2<\/jats:sub>peak or VO<jats:sub>2<\/jats:sub>max for individuals with DS separately, with a sample of <jats:italic>n<\/jats:italic>\u00a0\u2265\u00a05 and a mean age \u226518 years. Systematic reviews and meta\u2010analyses were excluded but their reference lists were searched for additional papers to include. Studies were evaluated for risk of bias following the guidelines of Kmet <jats:italic>et al<\/jats:italic>. The results were summarised with frequency statistics. Forty\u2010three studies were included in this systematic review. Sample sizes of included adults with DS ranged from <jats:italic>n<\/jats:italic>\u00a0=\u00a04\u2013226, with a total of <jats:italic>n<\/jats:italic>\u00a0=\u00a01498 adults with DS being included. Most studies (29\/43) used the same standardised maximal exercise treadmill protocol to measure VO<jats:sub>2<\/jats:sub>peak in adults with DS, and 33 out of 43 studies used at least one objective criterion to determine a valid maximal effort. Participants were predominantly male, under 40\u00a0years old, and overweight or obese. Additionally, the diversity of study samples was lacking or not reported. The most widely used, standardised, maximal exercise test treadmill protocol is recommended for future use in research and practice, including objective criteria to determine valid maximal effort. The current study samples are not representative of the population of adults with DS in terms of sex, age and diverse backgrounds and therefore likely overestimate VO<jats:sub>2<\/jats:sub>peak of this population.<\/jats:p>","DOI":"10.1111\/jir.13137","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T04:23:46Z","timestamp":1712809426000},"page":"893-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Measurement protocols and determinants of peak oxygen consumption in adults with Down syndrome: a systematic review"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9882-163X","authenticated-orcid":false,"given":"T. I. 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