Therapeutic effects of exercise interventions for children and adolescents with Autism: An umbrella meta-analysis.

AIM: To evaluate the therapeutic effects of exercise interventions in children and adolescents with autism spectrum disorder (ASD) using an umbrella meta-analysis.

METHOD: We systematically searched Embase, CINAHL, the Cochrane Library, Web of Science, PubMed, SinoMed, CNKI, Wanfang, and VIP for systematic reviews and meta-analyses of exercise-based interventions in ASD. Two reviewers independently assessed methodological quality and extracted data. We included 20 systematic reviews and meta-analyses comprising 14,245 participants.

RESULTS

Exercise interventions were associated with enhanced social skills (SMD = 0.52; 95% CI 0.28-0.76; P < 0.001), improvements in repetitive stereotyped behaviors (SMD = 0.49; 95% CI 0.29-0.69; P < 0.001), and improved motor skills (SMD = 1.16; 95% CI 0.64-1.68; P < 0.001) in individuals with ASD.

CONCLUSIONS

Exercise interventions are associated with improvements in social skills, repetitive stereotyped behaviors, and motor skills in children and adolescents with ASD. However, the overall certainty of evidence is low, and substantial heterogeneity and moderate-to-high overlap across meta-analyses warrant cautious interpretation. Exercise may represent a scalable, low-cost neuromodulatory adjunct within neurodevelopmental rehabilitation; future high-quality trials with long-term follow-up and clearly defined intensity and dose-response relationships are needed.