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Effects of Physical Exercise on Motor Skills in Children With Autism Spectrum Disorder: A Systematic Review and
Zhuoling Lei1,2, Linrui Jia1,2, Qianping Tan1,2
1School of Physical Education, Southwest University, Chongqing, 400715, China.
Insights
Physical exercise significantly enhances motor skills in children with autism spectrum disorder (ASD). Increased exercise frequency benefits balance, while longer durations may yield diminishing returns.
Area of Science:
- Pediatric Rehabilitation
- Developmental Neuroscience
- Autism Spectrum Disorder Research
Background:
- Children with autism spectrum disorder (ASD) often exhibit motor skill deficits.
- Developing effective interventions to improve motor function in children with ASD is crucial for their overall development and participation in daily activities.
Purpose of the Study:
- To systematically review and meta-analyze the impact of physical exercise interventions on the motor skills of children diagnosed with ASD.
- To identify key intervention characteristics that may influence motor skill outcomes in this population.
Main Methods:
- A comprehensive systematic literature search was conducted across six major databases following PRISMA guidelines.
- Included studies were randomized controlled trials (RCTs) involving children aged 12 years or younger with ASD, focusing on physical exercise interventions and standardized motor skill assessments.
- Data extraction, risk of bias assessment (Cochrane ROB 2.0), and evidence quality evaluation (GRADE) were performed by two independent reviewers, with meta-analysis using random-effects models.
Main Results:
- Ten RCTs comprising 256 children with ASD were analyzed, revealing significant improvements in total motor skills, locomotion, object control, and balance.
- Meta-regression indicated that higher intervention frequency positively influenced balance improvements, whereas extended intervention duration showed reduced efficacy.
- Publication bias was noted for total motor skills and balance outcomes.
Conclusions:
- Physical exercise is a highly effective intervention for improving diverse motor skills in children with ASD.
- Optimizing intervention frequency is key for maximizing balance gains, with attention to duration to avoid adaptation plateaus.
- The findings support the integration of tailored physical exercise programs into therapeutic strategies for children with ASD.
Purpose:
To examine the impact of physical exercise on motor skills in children with autism spectrum disorders (ASD).
Methods:
This study followed PRISMA guidelines (PROSPERO: CRD42024600538). Six databases (Embase, Engineering Village, OVID, PubMed, Scopus, and Web of Science) were searched through October 30, 2025.
Inclusion Criteria:
children ≤ 12 years with ASD; randomized controlled trials (RCTs); physical exercise interventions; motor skills outcomes measured via standardized instruments (BOT-2, TGMD-2, PDMS-2, ADS-3, MABC). Two independent reviewers performed study selection and data extraction. Risk of bias was assessed using Cochrane ROB 2.0; evidence quality via GRADE. Statistical analysis used R 4.4.3, calculating standardized mean differences (SMDs) with 95% confidence intervals (CIs). Random-effects models were applied when I² ≥ 50%.
Results:
Ten RCTs (256 children; mean age 6.91 ± 2.51 years) were included. Physical exercise significantly improved total motor skills (SMD = 1.58, 95%CI: 1.15-2.00, p < 0.0000), locomotion (SMD = 1.34, 95%CI: 0.98-1.70, p < 0.00001), object control (SMD = 1.37, 95%CI: 1.02-1.72, p < 0.00001), and balance (SMD = 1.73, 95%CI: 0.82-2.65, p = 0.0002). Publication bias was detected for total motor skills and balance. Meta-regression showed that intervention frequency positively correlated with balance improvement (p = 0.022), while duration negatively correlated (p = 0.002).
Conclusion:
Physical exercise significantly improves motor skills in children with ASD. Meta-regression indicates that frequency is a positive moderator for balance gains, but prolonged duration shows diminishing returns due to adaptation plateaus. Age and session length did not affect the protocol, so it remained flexible.
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