Abstract
This systematic review aimed to evaluate the effectiveness of major types of mind-body exercises (MBEs) on health-related outcomes in children and adolescents with autism spectrum disorder (ASD). Seven major electronic databases were systematically searched from inception to January 3, 2023. Fifteen studies consisting of ten randomized controlled trials and five controlled clinical trials with a total 651 participants aged 3–17 years were identified. While there was some evidence supporting the positive effects of MBE on behavioral problems in children and adolescents with ASD, there was limited evidence supporting their efficacy on other health-related outcomes such as social communication and cognitive functions. Larger and more robust trials with longer follow-up periods are needed to draw more definitive conclusions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
Data will be made available upon request to the corresponding author.
References
Álvarez-Bueno, C., Pesce, C., Cavero-Redondo, I., Sánchez-López, M., Martínez-Hortelano, J. A., & Martínez-Vizcaíno, V. (2017). The effect of physical activity interventions on children’s cognition and metacognition: A systematic review and meta-analysis. Journal of the American Academy of Child Adolescent Psychiatry, 56(9), 729–738. https://doi.org/10.1016/j.jaac.2017.06.012.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Armijo-Olivo, S., da Costa, B. R., Cummings, G. G., Ha, C., Fuentes, J., Saltaji, H., & Egger, M. (2015). PEDro or Cochrane to assess the quality of clinical trials? A meta-epidemiological study. PLoS One, 10(7), e0132634. https://doi.org/10.1371/journal.pone.0132634.
Bhat, A. N. (2020). Is motor impairment in autism spectrum disorder distinct from developmental coordination disorder? A report from the SPARK study. Physcial Therapy, 100(4), 633–644. https://doi.org/10.1093/ptj/pzz190.
Bhat, A. N. (2021). Motor impairment increases in children with autism spectrum disorder as a function of social communication, cognitive and functional impairment, repetitive behavior severity, and comorbid diagnoses: A SPARK study report. Autism Research, 14(1), 202–219. https://doi.org/10.1002/aur.2453.
Black, L. I., Barnes, P. M., Clarke, T. C., Stussman, B. J., & Nahin, R. L. (2018). Use of Yoga, meditation, and chiropractors among U.S. children aged 4–17 years. Nchs Data Brief, 324, 1–8.
Bremer, E., Crozier, M., & Lloyd, M. (2016). A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism, 20(8), 899–915. https://doi.org/10.1177/1362361315616002.
Chan, A. S., Sze, S. L., Siu, N. Y., Lau, E. M., & Cheung, M. C. (2013). A Chinese mind-body exercise improves self-control of children with autism: A randomized controlled trial. PLoS One, 8(7), e68184. https://doi.org/10.1371/journal.pone.0068184.
Chan, A. S., Han, Y. M., Sze, S. L., & Lau, E. M. (2015). Neuroenhancement of memory for children with autism by a mind-body exercise. Frontiers in Psychology, 6, 1893. https://doi.org/10.3389/fpsyg.2015.01893.
Chan, J. S. Y., Deng, K., Wu, J., & Yan, J. H. (2019). Effects of meditation and mind-body exercises on older adults’ cognitive performance: A meta-analysis. The Gerontologist, 59(6), e782–e790. https://doi.org/10.1093/geront/gnz022.
Chan, J. S., Deng, K., & Yan, J. H. (2021). The effectiveness of physical activity interventions on communication and social functioning in autistic children and adolescents: A meta-analysis of controlled trials. Autism, 25(4), 874–886. https://doi.org/10.1177/1362361320977645.
Clifford, P., Gevers, C., Jonkman, K. M., Boer, F., & Begeer, S. (2022). The effectiveness of an attention-based intervention for school-aged autistic children with anger regulating problems: A randomized controlled trial. Autism Research, 15(10), 1971–1984. https://doi.org/10.1002/aur.2800.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.).). Erlbaum.
de Morton, N. A. (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study. The Australian Journal Physiotherapy, 55(2), 129–133. https://doi.org/10.1016/s0004-9514(09)70043-1.
Fang, Q., Aiken, C. A., Fang, C., & Pan, Z. (2019). Effects of exergaming on physical and cognitive functions in individuals with autism spectrum disorder: A systematic review. Games for Health Journal, 8(2), 74–84. https://doi.org/10.1089/g4h.2018.0032.
Farahani, M. A., Soleimanpour, S., Mayo, S. J., Myers, J. S., Panesar, P., & Ameri, F. (2022). The effect of mind-body exercise on cognitive function in cancer survivors: A systematic review. Canadian Oncology Nursing Journal, 32(1), 38–48. https://doi.org/10.5737/236880763213848.
Healy, S., Nacario, A., Braithwaite, R. E., & Hopper, C. (2018). The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Autism Research, 11(6), 818–833. https://doi.org/10.1002/aur.1955.
Hourston, S., & Atchley, R. (2017). Autism and mind-body therapies: A systematic review. Journal of Alternative and Complementary Medicine, 23(5), 331–339. https://doi.org/10.1089/acm.2016.0336.
Huang, J., Wang, D., & Wang, J. (2021a). Clinical evidence of Tai Chi exercise prescriptions: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2021, 5558805. https://doi.org/10.1155/2021/5558805.
Huang, Y., Yu, S., Wilson, G., Park, J., Cheng, M., Kong, X., Lu, T., & Kong, J. (2021b). Altered extended locus coeruleus and ventral tegmental area networks in boys with autism spectrum disorders: A resting-state functional connectivity study. Neuropsychiatric Disease Treatment, 17, 1207–1216. https://doi.org/10.2147/ndt.S301106.
Hynes, J., & Block, M. (2022). Effects of physical activity on social, behavioral, and cognitive skills in children and young adults with autism spectrum disorder: A systematic review of the literature. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-022-00319-5.
Kaur, M., & Bhat, A. (2019). Creative Yoga intervention improves motor and imitation skills of children with autism spectrum disorder. Physical Thearapy, 99(11), 1520–1534. https://doi.org/10.1093/ptj/pzz115.
Kaur, M., Eigsti, I. M., & Bhat, A. (2021). Effects of a creative Yoga intervention on the joint attention and social communication skills, as well as affective states of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 88. https://doi.org/10.1016/j.rasd.2021.101860.
Ke, X., Song, W., Yang, M., Li, J., & Liu, W. (2022). Effectiveness of music therapy in children with autism spectrum disorder: A systematic review and meta-analysis. Frontiers in Psychiatry, 13, 905113. https://doi.org/10.3389/fpsyt.2022.905113.
Kim, S., Dede, A. J., Hopkins, R. O., & Squire, L. R. (2015). Memory, scene construction, and the human hippocampus. Proceedings of the National Academy of Science the United States of America, 112(15), 4767–4772. https://doi.org/10.1073/pnas.1503863112.
Kodak, T., & Bergmann, S. (2020). Autism spectrum disorder: Characteristics, associated behaviors, and early intervention. Pediatric Clinics of North America, 67(3), 525–535. https://doi.org/10.1016/j.pcl.2020.02.007.
Koenig, K. P., Buckley-Reen, A., & Garg, S. (2012). Efficacy of the get ready to learn Yoga program among children with autism spectrum disorders: A pretest-posttest control group design. The American Journal of Occupational Therapy, 66(5), 538–546. https://doi.org/10.5014/ajot.2012.004390.
Lai, C. L. E., Lau, Z., Lui, S. S. Y., Lok, E., Tam, V., Chan, Q., Cheng, K. M., Lam, S. M., & Cheung, E. F. C. (2017). Meta-analysis of neuropsychological measures of executive functioning in children and adolescents with high-functioning autism spectrum disorder. Autism Research, 10(5), 911–939. https://doi.org/10.1002/aur.1723.
Liu, Z., Wu, Y., Li, L., & Guo, X. (2018). Functional connectivity within the executive control network mediates the effects of long-term Tai Chi exercise on elders’ emotion regulation. Frontiers in Aging Neuroscience, 10, 315. https://doi.org/10.3389/fnagi.2018.00315.
Liu, J., Tao, J., Xia, R., Li, M., Huang, M., Li, S., Chen, X., Wilson, G., Park, J., Zheng, G., Chen, L., & Kong, J. (2021). Mind-body exercise modulates locus coeruleus and ventral tegmental area functional connectivity in individuals with mild cognitive impairment. Frontiers in Aging Neuroscience, 13, 646807. https://doi.org/10.3389/fnagi.2021.646807.
Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83(8), 713–721.
Narasingharao, K., Pradhan, B., & Navaneetham, J. (2017). Efficacy of structured Yoga intervention for sleep, gastrointestinal and behaviour problems of ASD children: An exploratory study. Journal of Clinical Diagnostic Research, 11(3), Vc01–vc06. https://doi.org/10.7860/jcdr/2017/25894.9502.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71.
Ramassamy, E., Gajula Shivashankarappa, P., Adimoulame, S., Meena, R., Elangovan, H., & Govindasamy, E. (2019). Yoga therapy as an adjunct to traditional tooth brushing training methods in children with autism spectrum disorder. Special Care in Dentistry, 39(6), 551–556. https://doi.org/10.1111/scd.12422.
Rodrigues, J. M., Mestre, M., & Fredes, L. I. (2019). Qigong in the treatment of children with autism spectrum disorder: A systematic review. Journal of Integrative Medicine, 17(4), 250–260. https://doi.org/10.1016/j.joim.2019.04.003.
Sankhala, S. S., & Deepeshwar, N. H. R. S (2021). Changes in bioenergy field of children with autism following non-pharmacological interventions: A randomized controlled study. International Journal of Medicine and Public Health, 11(1), 57–62.
Sarabzadeh, M., Azari, B. B., & Helalizadeh, M. (2019). The effect of six weeks of Tai Chi Chuan training on the motor skills of children with autism spectrum disorder. Journal of Bodywork and Movement Therapies, 23(2), 284–290. https://doi.org/10.1016/j.jbmt.2019.01.007.
Semple, R. J. (2019). Review: Yoga and mindfulness for youth with autism spectrum disorder: Review of the current evidence. Child Adolescent and Mental Health, 24(1), 12–18. https://doi.org/10.1111/camh.12295.
Shanker, S., & Pradhan, B. (2022a). Effect of Yoga on children with autism spectrum disorder in special schools. Industrial Psychiatry Journal, 31(2), 367–369. https://doi.org/10.4103/ipj.ipj_212_21.
Shanker, S., & Pradhan, B. (2022b). Effect of Yoga on the motor proficiency of children with autism spectrum disorder and the feasibility of its inclusion in special school environments. Adapted Physical Activity Quarterly, 39(2), 247–267. https://doi.org/10.1123/apaq.2021-0108.
Sharma, S. R., Gonda, X., & Tarazi, F. I. (2018). Autism spectrum disorder: Classification, diagnosis and therapy. Pharmacol & Therapeutics, 190, 91–104. https://doi.org/10.1016/j.pharmthera.2018.05.007.
Sivaramakrishnan, D., Fitzsimons, C., Kelly, P., Ludwig, K., Mutrie, N., Saunders, D. H., & Baker, G. (2019). The effects of Yoga compared to active and inactive controls on physical function and health related quality of life in older adults- systematic review and meta-analysis of randomised controlled trials. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 33. https://doi.org/10.1186/s12966-019-0789-2.
Song, R., Grabowska, W., Park, M., Osypiuk, K., Vergara-Diaz, G. P., Bonato, P., Hausdorff, J. M., Fox, M., Sudarsky, L. R., Macklin, E., & Wayne, P. M. (2017). The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson’s Disease: A systematic review and meta-analysis. Parkinsonism & Related Disorders, 41, 3–13. https://doi.org/10.1016/j.parkreldis.2017.05.019.
Sotoodeh, M. S., Arabameri, E., Panahibakhsh, M., Kheiroddin, F., Mirdoozandeh, H., & Ghanizadeh, A. (2017). Effectiveness of Yoga training program on the severity of autism. Complementary Therapies in Clinical Practice, 28, 47–53. https://doi.org/10.1016/j.ctcp.2017.05.001.
Srinivasan, S. M., Eigsti, I. M., Neelly, L., & Bhat, A. N. (2016). The effects of embodied rhythm and robotic interventions on the spontaneous and responsive social attention patterns of children with autism spectrum disorder (ASD): A pilot randomized controlled trial. Research in Autism Spectrum Disorders, 27, 54–72. https://doi.org/10.1016/j.rasd.2016.01.004.
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). Evidence-based medicine: How to practice and teach EBM (3rd ed.). Elsevier Churchill Livingstone.
Su, W. C., Srinivasan, S., Cleffi, C., & Bhat, A. (2021). Short report on research trends during the COVID-19 pandemic and use of telehealth interventions and remote brain research in children with autism spectrum disorder. Autism, 25(6), 1816–1822. https://doi.org/10.1177/13623613211004795.
Tabeshian, R., Nezakat-Alhosseini, M., Movahedi, A., Zehr, E. P., & Faramarzi, S. (2022). The effect of Tai Chi Chuan training on stereotypic behavior of children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 52(5), 2180–2186. https://doi.org/10.1007/s10803-021-05090-w.
Takemura, N., Cheung, D. S. T., Smith, R., Deng, W., Ho, K. Y., Lin, J., Kwok, J. Y. Y., Lam, T. C., & Lin, C. C. (2020). Effectiveness of aerobic exercise and mind-body exercise in cancer patients with poor sleep quality: A systematic review and meta-analysis of randomized controlled trials. Sleep Medicine Reviews, 53, 101334. https://doi.org/10.1016/j.smrv.2020.101334.
Tanksale, R., Sofronoff, K., Sheffield, J., & Gilmour, J. (2021). Evaluating the effects of a Yoga-based program integrated with third-wave cognitive behavioral therapy components on self-regulation in children on the autism spectrum: A pilot randomized controlled trial. Autism, 25(4), 995–1008. https://doi.org/10.1177/1362361320974841.
Tao, J., Liu, J., Liu, W., Huang, J., Xue, X., Chen, X., Wu, J., Zheng, G., Chen, B., Li, M., Sun, S., Jorgenson, K., Lang, C., Hu, K., Chen, S., Chen, L., & Kong, J. (2017). Tai Chi Chuan and Baduanjin increase grey matter volume in older adults: A brain imaging study. Journal of Alzheimers Disease, 60(2), 389–400. https://doi.org/10.3233/jad-170477.
Tse, C. Y. A., Lee, H. P., Chan, K. S. K., Edgar, V. B., Wilkinson-Smith, A., & Lai, W. H. E. (2019). Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: A randomized controlled trial. Autism, 23(7), 1699–1710. https://doi.org/10.1177/1362361318823910.
van Steensel, F. J., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14(3), 302–317. https://doi.org/10.1007/s10567-011-0097-0.
Vidyashree, H. M., Maheshkumar, K., Sundareswaran, L., Sakthivel, G., Partheeban, P. K., & Rajan, R. (2019). Effect of Yoga intervention on short-term heart rate variability in children with autism spectrum disorder. International Journal of Yoga, 12(1), 73–77. https://doi.org/10.4103/ijoy.IJOY_66_17.
Wang, K., Li, K., Zhang, P., Ge, S., Wen, X., Wu, Z., Yao, X., Jiao, B., Sun, P., Lv, P., & Lu, L. (2021). Mind-body exercises for non-motor symptoms of patients with parkinson’s Disease: A systematic review and meta-analysis. Frontiers in Aging Neuroscience, 13, 770920. https://doi.org/10.3389/fnagi.2021.770920.
Wei, G. X., Xu, T., Fan, F. M., Dong, H. M., Jiang, L. L., Li, H. J., Yang, Z., Luo, J., & Zuo, X. N. (2013). Can Taichi reshape the brain? A brain morphometry study. PLoS One, 8(4), e61038. https://doi.org/10.1371/journal.pone.0061038.
Wu, M. T., Tang, P. F., Goh, J. O. S., Chou, T. L., Chang, Y. K., Hsu, Y. C., Chen, Y. J., Chen, N. C., Tseng, W. I., Gau, S. S., Chiu, M. J., & Lan, C. (2018). Task-switching performance improvements after Tai Chi Chuan training are associated with greater prefrontal activation in older adults. Frontiers in Aging Neuroscience, 10, 280. https://doi.org/10.3389/fnagi.2018.00280.
Wu, C., Yi, Q., Zheng, X., Cui, S., Chen, B., Lu, L., & Tang, C. (2019). Effects of mind-body exercises on cognitive function in older adults: A meta-analysis. Jounal of the American Geriatrics Society, 67(4), 749–758. https://doi.org/10.1111/jgs.15714.
Ye, M., Wang, L., Xiong, J., & Zheng, G. (2021). The effect of mind-body exercise on memory in older adults: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 33(5), 1163–1173. https://doi.org/10.1007/s40520-020-01557-5.
Zeidan, J., Fombonne, E., Scorah, J., Ibrahim, A., Durkin, M. S., Saxena, S., Yusuf, A., Shih, A., & Elsabbagh, M. (2022). Global prevalence of autism: A systematic review update. Autism Research, 15(5), 778–790. https://doi.org/10.1002/aur.2696.
Zhang, Y., Li, C., Zou, L., Liu, X., & Song, W. (2018). The effects of mind-body exercise on cognitive performance in elderly: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 15(12), https://doi.org/10.3390/ijerph15122791.
Zhang, M., Liu, Z., Ma, H., & Smith, D. M. (2020). Chronic physical activity for attention deficit hyperactivity disorder and/or autism spectrum disorder in children: A meta-analysis of randomized controlled trials. Frontiers in Behavioral Neuroscience, 14, 564886. https://doi.org/10.3389/fnbeh.2020.564886.
Zhang, X., Zong, B., Zhao, W., & Li, L. (2021). Effects of mind-body exercise on brain structure and function: A systematic review on MRI studies. Brain Sciences, 11(2), https://doi.org/10.3390/brainsci11020205.
Zhong, D., Xiao, Q., Xiao, X., Li, Y., Ye, J., Xia, L., Zhang, C., Li, J., Zheng, H., & Jin, R. (2020). Tai Chi for improving balance and reducing falls: An overview of 14 systematic reviews. Annals of Physical and Rehabilitation Medicine, 63(6), 505–517. https://doi.org/10.1016/j.rehab.2019.12.008.
Zou, L. Y., Xiao, Z. J., Wang, H. R., Wang, C. Y., Hu, X. J., & Shu, Y. K. (2017). Martial arts for health benefits in children and youth with autism spectrum disorder: A systematic review. Archives of Budo, 13, 79–92.
Funding
This research was funded by the National Social Science Fund in China [grant number 22BTY062].
Author information
Authors and Affiliations
Contributions
Conceptualization: Huang, J. and Li, C.; Methodology: Huang, J., Li, X., Chen, Z., Healy, S., Zou, L., Tse, A. C. Y., and Li, C.; Original draft preparation: Huang, J., Li, X., and Chen, Z.; Review and editing: Healy, S., Zou, L., Tse, A. C. Y., and Li, C.; Funding acquisition: Li, C.
Corresponding author
Ethics declarations
Competing Interests
The authors declare that they have no conflict of interest.
Ethics Approval
This is a systematic review and no ethical approval is required.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Huang, J., Li, X., Chen, Z. et al. Effects of Mind-Body Exercises on Health-related Outcomes in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review. Rev J Autism Dev Disord (2023). https://doi.org/10.1007/s40489-023-00412-3
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40489-023-00412-3