Effects of Physical Exercise on Motor Skills in Children With Autism Spectrum Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Forfatter(e)
Lei, Z., Jia, L., Tan, Q., Xie, T., Teo, E. W., Duyan, M., Ilkim, M., Ozoglu, F., Chang, J.
År
2026
DOI
10.1007/s10803-026-07403-3
Tidsskrift
Journal of Autism & Developmental Disorders
Volum
24
Sider
24
Kategori(er)
Autismespekter Språk og motorikk
Tiltakstype(r)
Fysisk aktivitet
Abstract

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.