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Purpose <p>To examine the impact of physical exercise on motor skills in children with autism spectrum disorders (ASD).</p> Methods <p>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%.</p> Results <p>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, <i>p</i> &lt; 0.0000), locomotion (SMD = 1.34, 95%CI: 0.98–1.70, <i>p</i> &lt; 0.00001), object control (SMD = 1.37, 95%CI: 1.02–1.72, <i>p</i> &lt; 0.00001), and balance (SMD = 1.73, 95%CI: 0.82–2.65, <i>p</i> = 0.0002). Publication bias was detected for total motor skills and balance. Meta-regression showed that intervention frequency positively correlated with balance improvement (<i>p</i> = 0.022), while duration negatively correlated (<i>p</i> = 0.002).</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2026年6月24日

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  • Zhuoling Lei,
  • Linrui Jia,
  • Qianping Tan,
  • Tingzhang Xie,
  • Eng Wah Teo,
  • Mehdi Duyan,
  • Mehmet Ilkim,
  • Fatma Özoğlu,
  • Jindong Chang

摘要

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.