Effects of exercise on anxiety and psychiatric comorbidities in children with autism spectrum disorder: a systematic review and meta-analysis
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 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.
Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251157119.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 482 participants or records.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.