A network meta-analysis of the effect of physical exercise on core symptoms in patients with autism spectrum disorders.

Overview

• This study analyzed multiple types of physical exercise programs to determine their effects on core symptoms in patients with autism spectrum disorder (ASD).
• The research conducted a network meta-analysis of randomized controlled trials to compare how different sports exercises impact social interaction difficulties and repetitive behaviors typically seen in ASD.

Purpose of the Study

• The aim was to compare effects of various sports exercise programs on core symptoms of ASD—specifically social interaction disorders and repetitive, restricted behaviors.
• The study sought to understand which types and durations of physical activities are most beneficial for different ASD symptoms.

Methodology

• Researchers performed a systematic search of multiple databases including China National Knowledge Infrastructure, VIP, Wanfang, Cochrane Library, PubMed, EMBASE, and Web of Science.
• The search included all randomized controlled trials (RCTs) studying physical exercise interventions for ASD from database inception through February 2023.
• Risk of bias in included studies was assessed using the revised Cochrane Randomized Trial Risk of Bias Tool (ROB2).
• A network meta-analysis was utilized to synthesize data and compare intervention effects across multiple exercise programs.
• A total of 30 RCTs with 1,375 participants were included in the final analysis.

Key Findings

• Sports exercise programs significantly improved social interaction disorders in ASD patients, including:
  • 8-12 weeks of ball sports (Standardized Mean Difference [SMD]: -5.35, indicating a strong positive effect)
  • Horse riding programs (SMD: -3.71)
  • 8-12 weeks of comprehensive sports exercise combining multiple activities (SMD: -2.17)
  • More than 12 weeks of comprehensive sports exercise (SMD: -3.75)
• For repetitive behaviors and restricted interests, significant improvements were seen with:
  • 8-12 weeks of ball sports (SMD: -4.36)
  • More than 12 weeks of comprehensive sports exercise (SMD: -3.65)
• Differing core symptoms appear to respond selectively to different types and durations of physical exercise.

Implications

• Physical exercise is confirmed as a promising intervention for improving core ASD symptoms.
• Tailoring exercise programs by type and duration may optimize symptom-specific benefits, such as targeting social skills or reducing repetitive behaviors.
• Ball sports and comprehensive multi-sport programs demonstrated particularly strong effects, suggesting multi-faceted physical engagement is beneficial.
• Horse riding also offers significant social interaction benefits, highlighting the value of diverse and potentially therapeutic exercise forms.

Study Registration

• The meta-analysis was registered with PROSPERO, an international prospective register of systematic reviews, under the identifier CRD42023455806.