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Effects of exercise on anxiety and psychiatric comorbidities in children with autism spectrum disorder: a systematic review and meta-analysis

Forfatter(e)
Zhang, L. Q., Song, W. K., Gao, H. N., Li, X. Y.
År
2026
DOI
10.3389/fpsyt.2026.1761833
Tidsskrift
Frontiers in Psychiatry
Volum
17
Sider
16
Kategori(er)
Angst og engstelighet (inkl. både vansker og lidelse) Autismespekter
Tiltakstype(r)
Fysisk aktivitet
Abstract

Background

Anxiety disorders affect nearly 40%-50% of children with autism spectrum disorder (ASD). While exercise benefits motor skills, its efficacy in modulating affective symptoms remains under-synthesized. This meta-analysis evaluated the effects of exercise on anxiety and co-occurring symptoms in pediatric ASD.

Methods

We analyzed data from 12 randomized controlled trials (RCTs) involving 482 participants. A three-level random effects model was utilized to account for effect size dependencies. Subgroup analyses examined the exercise modality and intensity.

Results

Exercise significantly reduced comorbid anxiety (Hedges' g = -0.68, p < 0.001). Notably, aerobic exercise demonstrated the most substantial anxiolytic effect (g = -1.18), outperforming other modalities. Improvements were also observed in the core ASD symptoms (g = -0.56) and attention-deficit/hyperactivity disorder (ADHD)-related attention deficits (g = -0.48). The effects on sleep were inconclusive due to heterogeneity.

Conclusions

Exercise, particularly aerobic interventions, serves as a potent non-pharmacological strategy for the management of anxiety and affective dysregulation in children with ASD. These findings support the integration of aerobic exercise into clinical treatment plans to improve emotional wellbeing.