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The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

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Abstract

Background

Both chronic and acute exercise interventions have reported positive effects on executive functions (EFs) in general populations. However, data on changes in EFs in children and adolescents with autism spectrum disorder (ASD) in response to exercise interventions are still unclear.

Objective

This systematic review and meta-analysis aimed to synthesize available empirical studies concerning the effects of exercise interventions on EFs in children and adolescents with ASD.

Methods

In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the electronic databases CINAHL Complete (via EBSCOhost), SPORTDiscus with Full Text (via EBSCOhost), MEDLINE (via EBSCOhost), Web of Science, ProQuest, and Education Resources Information Center (ERIC; via EBSCOhost) were searched from inception to January 2021. Two authors independently extracted data and conducted a risk-of-bias analysis using the Physiotherapy Evidence Database scale. Randomized controlled trials/quasi-experimental designs that used acute or chronic exercise interventions and assessed EFs through neurocognitive tasks or questionnaires among children and adolescents with ASD were included. In total, 259 articles were identified, of which 15 full texts were independently assessed for eligibility by two authors. In total, 14 articles underwent systematic review, and seven were selected for meta-analysis.

Results

Overall, chronic exercise interventions had a small to moderate positive effect on overall EFs in children and adolescents with ASD (g = 0.342; 95% confidence interval [CI] 0.084–0.600; p < 0.01). Regarding domain-specific EFs, chronic exercise interventions had a small to moderate positive effect on cognitive flexibility (g = 0.312; 95% CI 0.053–0.570; p < 0.01) and inhibitory control (g = 0.492; 95% CI 0.188–0.796; p < 0.01). However, our review found a non-significant effect size (g = 0.212; 95% CI − 0.088 to 0.512) on working memory.

Conclusions

Chronic exercise interventions appear to have beneficial effects on overall EFs in children and adolescents with ASD, particularly in relation to cognitive flexibility and inhibitory control.

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Authors and Affiliations

  1. Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China

    Xiao Liang, Stephen H. S. Wong, Raymond K. W. Sum & Cindy H. P. Sit

  2. The Faculty of Physical Education, Shenzhen University, Shenzhen, China

    Ru Li

  3. Cardiac Rehabilitation Center, Fuwai Hospital, CAMS&PUMC, Beijing, China

    Peng Wang

  4. Shenzhen Children’s Hospital, Shenzhen, China

    Binrang Yang

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  1. Xiao Liang
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  2. Ru Li
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  7. Cindy H. P. Sit
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Corresponding author

Correspondence to Cindy H. P. Sit.

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No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Xiao Liang, Ru Li, Stephen H. S. Wong, Raymond K.W. Sum, Peng Wang, Bingrang Yang and Cindy H.P. Sit have no conflicts of interest that are directly relevant to the content of this article.

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All data generated or analyzed during this systematic review and meta-analysis were included in the article.

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Author contributions

XL and CHPS were responsible for the conceptualization, investigation, and hypothesis of the research. XL and RL conducted the systematic search, data extraction, and assessment of risk of bias and completed all statistical analyses. CHPS, SHSW, RKWS, PW, and BY reviewed and edited the initial draft and its revisions. All authors read and approved the final manuscript.

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Liang, X., Li, R., Wong, S.H.S. et al. The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis. Sports Med 52, 75–88 (2022). https://doi.org/10.1007/s40279-021-01545-3

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