Effects of Exergame-Based Interventions on Executive Functions and Motor Skills in Children with Autism Spectrum...

Children with Autism Spectrum Disorder (ASD) frequently present impairments in executive functions and motor skills, which can negatively affect academic performance, adaptive behavior, and daily functioning. Exergames have emerged as a potentially engaging cognitive-motor intervention. The objective of this systematic review was to analyze the effects of exergame-based interventions on executive function components (particularly inhibitory control and cognitive flexibility) and motor skills in children with ASD. A systematic review was conducted in accordance with PRISMA guidelines, with the protocol registered in PROSPERO. Electronic searches were performed in PubMed, Scopus, Web of Science, and ERIC. Intervention studies published within the last five years and assessing exergame-based interventions in children with ASD were included. Methodological quality was evaluated using the PEDro scale. Six studies met the inclusion criteria. Exergame-based interventions were associated with improvements in executive functions, particularly inhibitory control (reported in two studies using Stroop- and Flanker-type tasks) and cognitive flexibility (assessed in two studies using the Wisconsin Card Sorting Test), although results varied depending on intervention duration and design. Acute interventions (single-session) primarily influenced inhibitory control, whereas longer-term programs showed broader cognitive and motor adaptations. Improvements in motor outcomes, including gross motor development, coordination, and fundamental motor skills, were reported in four studies. Methodological quality ranged from 4 to 6 points on the PEDro scale, indicating fair to good quality. Considerable heterogeneity was observed in intervention protocols, duration, and outcome measures. Exergame-based interventions may represent a potentially promising approach for targeting executive functions and motor skills in children with ASD; however, the current evidence is limited and heterogeneous. Not all included studies assessed both cognitive and motor outcomes, and findings should therefore be interpreted with caution. Further high-quality randomized controlled trials are needed to confirm these effects and establish optimal intervention parameters.