Review: Physical exercise in Tourette syndrome - a systematic review

Tourette syndrome (TS) is a common neuropsychiatric disorder which, in addition to the core symptoms of motor and vocal tics, includes a high association with co-existing mental health disorders. Physical exercise is increasingly being recommended as part of management for children and young people with mental health problems. However, there is a lack of guidance regarding the role of physical exercise in the management of TS in children.

EMBASE, MEDLINE, PsycINFO, SportDiscus, Google scholar and Cochrane register of controlled trials (CENTRAL) databases were searched. Studies investigating interventions aimed at reducing core symptoms of TS and comorbidities and exploring the relationship between physical exercise and tic severity were included.

Seven studies were identified. Five focused on physical exercise interventions and two were observational studies investigating the relationship between tic severity and physical activity. There was some evidence indicating that physical exercise reduces tic severity in the short term and some evidence regarding the benefit of physical exercise on associated co-occurring symptoms, such as anxiety. However, none of the intervention studies involved randomisation and interventions varied in terms of content and duration.

There was some evidence of a short-term improvement in tic expression as a result of physical exercise interventions, but there is a lack of methodologically robust studies. Thus, conclusions about the impact of exercise on TS symptoms or comorbidities cannot be drawn at this stage. There is a clear need for well-designed methodologically robust studies, including prospective observational studies and randomised controlled designs.