Wang Hao, Cheng Gong, Li Meng-Meng
Hoseo University, Cheonan, Korea.
School of Physical Education, Shanghai University of Sport, Shanghai, China.
Eur J Pediatr. 2025 Apr 8;184(5):286. doi: 10.1007/s00431-025-06115-7.
This study rigorously examines the efficacy and sustained impact of exercise therapy on enhancing executive function among children and adolescents diagnosed with autism spectrum disorder (ASD). Furthermore, it conducts a comprehensive analysis of five distinct subgroups, categorized by variations in school age, exercise cycles, exercise characteristics, dimensions of executive function, and the administration of medication. A systematic search was conducted across the PubMed, EmBase, Cochrane Library, Web of Science, and SPORTDiscus databases to identify randomized controlled trials published from the inception of the library until October 20, 2024, focusing on the effects of exercise therapy on the enhancement of executive function in children and adolescents with ASD. Sixteen studies were systematically evaluated and included in the meta-analysis, revealing that exercise therapy led to a significant improvement in executive function among children and adolescents with ASD (SMD = 0.41, 95% CI [0.30, 0.52], P = 0.00), along with some evidence of sustained improvement (SMD = 0.74, 95% CI [0.29, 1.20], P = 0.00). Subgroup analyses indicated that exercise did not significantly enhance executive functioning in preschool-aged patients with ASD, and working memory did not exhibit a significant improvement across various dimensions of executive functioning. Furthermore, no differences were observed in analyses of different exercise cycles, exercise characteristics, or the use of medication among subjects.
Exercise interventions improve executive function in children and adolescents with ASD, with sustained post-intervention effects. Limited impact on working memory and observed heterogeneity highlights the need for more precise intervention designs and rigorous research.
• Exercise therapy is widely considered a promising non-pharmacological intervention for improving cognitive functions in children and adolescents with autism spectrum disorder (ASD). • Prior studies suggest exercise benefits executive function in ASD, but evidence on sustained effects and subgroup differences remains limited.
• This meta-analysis confirms that exercise therapy significantly and sustainably improves executive function in children and adolescents with ASD, with greater benefits observed in school-aged participants. • For the first time, subgroup analyses reveal age-dependent effects and confirm that working memory shows limited responsiveness to exercise, regardless of medication use or exercise characteristics.
本研究严格检验了运动疗法对改善自闭症谱系障碍（ASD）儿童和青少年执行功能的疗效及持续影响。此外，还对五个不同亚组进行了全面分析，这些亚组根据学龄、运动周期、运动特征、执行功能维度及药物使用情况进行分类。通过对PubMed、EmBase、Cochrane图书馆、科学网和SPORTDiscus数据库进行系统检索，以识别从各数据库建库之初至2024年10月20日发表的随机对照试验，重点关注运动疗法对ASD儿童和青少年执行功能增强的影响。对16项研究进行了系统评价并纳入荟萃分析，结果显示运动疗法使ASD儿童和青少年的执行功能有显著改善（标准化均数差=0.41，95%置信区间[0.30, 0.52]，P=0.00），并有一些持续改善的证据（标准化均数差=0.74，95%置信区间[0.29, 1.20]，P=0.00）。亚组分析表明，运动对ASD学龄前患者的执行功能没有显著增强作用，且工作记忆在执行功能的各个维度上均未表现出显著改善。此外，在对不同运动周期、运动特征或受试者药物使用情况的分析中未观察到差异。
运动干预可改善ASD儿童和青少年的执行功能，并在干预后产生持续效果。对工作记忆的影响有限且观察到的异质性突出表明需要更精确的干预设计和严谨的研究。
• 运动疗法被广泛认为是一种有前景的非药物干预措施，可改善自闭症谱系障碍（ASD）儿童和青少年的认知功能。• 先前的研究表明运动对ASD患者的执行功能有益，但关于持续效果和亚组差异的证据仍然有限。
• 这项荟萃分析证实，运动疗法能显著且持续地改善ASD儿童和青少年的执行功能，在学龄参与者中观察到更大益处。• 亚组分析首次揭示了年龄依赖性效应，并证实无论药物使用或运动特征如何，工作记忆对运动的反应有限。
