Hu Baojian, Liang Qingxia, Jiang Huiyi
Department of Pediatrics, Children's Medical Center, The First Hospital of Jilin University, Lequn Branch, Changchun City, Jilin Province, China.
Enping People's Hospital, Enping City, Guangdong Province, China.
Front Child Adolesc Psychiatry. 2025 Sep 4;4:1647280. doi: 10.3389/frcha.2025.1647280. eCollection 2025.
To investigate the effects of exercise doses recommended by the American College of Sports Medicine (ACSM) on motor skills, social interaction, behavioral patterns, and verbal and non-verbal communication domains in children with autism.
A systematic search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library, focusing on the effects of physical activity on children with autism. Randomized controlled trials comparing exercise interventions with no intervention were included, and changes in motor skills, social interaction, behavioral patterns,and communication domains were assessed using standardized mean differences (SMD), 95% confidence intervals (CI), and p-values ( < 0.05).Interventions were categorized based on high or low adherence to exercise prescriptions developed or recommended by ACSM.Studies in which ≥70% of components met ACSM criteria were classified as having high adherence, while those with <70% were classified as having low adherence, based on thresholds established in previous literature. A fixed-effects or random-effects model was applied for meta-analysis, and subgroup comparisons were conducted.
A total of 27 studies (29 exercise interventions) involving 1,012 participants were included. In the motor skills domain,the pooled standardized mean difference (SMD) was 1.35, 95% confidence interval (CI) [0.66,2.03]. Subgroup analysis revealed that the high-adherence group showed an SMD of 1.44, 95% CI [0.51,2.36], while the low-adherence group showed an SMD of 1.26, 95% CI [0.15,2.36]. For the social interaction domain,the overall SMD was -0.22, 95% CI [-0.54,0.99]. The high-adherence subgroup had an SMD of -0.41, 95% CI [-0.62,-0.21], whereas the low-adherence group had an SMD of 0.42, 95% CI [-0.50,1.33]. In the behavioral patterns domain, the overall SMD was -0.79, 95% CI [-1.26,-0.32]. Subgroup analysis indicated an SMD of -0.42, 95% CI [-0.73,-0.11] for the high-adherence group and -2.79, 95% CI [-5.63,0.06] for the low-adherence group.For the verbal and non-verbal communication domain, the overall SMD was 0.33, 95% CI [-0.31,0.97]. Subgroup SMD were 0.21,95% CI [-0.14,0.57] for the high-adherence group and 0.59, 95% CI [-1.67,2.84] for the low-adherence group.
Exercise interventions had a significant positive impact on motor skills and behavioral patterns in children with autism spectrum disorder (ASD). Interventions with high adherence to ACSM-recommended exercise dosages were more effective in improving motor skills, social interaction,and behavioral patterns compared to low-adherence dosages.Future evidence-based exercise prescriptions may be established for children with ASD, optimizing motor-functional outcomes.
PROSPERO, identifier (CRD42024565241).
探讨美国运动医学学会（ACSM）推荐的运动剂量对自闭症儿童运动技能、社交互动、行为模式以及言语和非言语交流领域的影响。
在PubMed、Embase、Web of Science和Cochrane图书馆进行系统检索，重点关注体育活动对自闭症儿童的影响。纳入比较运动干预与无干预的随机对照试验，并使用标准化均数差（SMD）、95%置信区间（CI）和p值（<0.05）评估运动技能、社交互动、行为模式和交流领域的变化。干预措施根据对ACSM制定或推荐的运动处方的高或低依从性进行分类。根据以往文献确定的阈值，≥70%的组成部分符合ACSM标准的研究被归类为高依从性，而<70%的研究被归类为低依从性。采用固定效应或随机效应模型进行荟萃分析，并进行亚组比较。
共纳入27项研究（29项运动干预），涉及1012名参与者。在运动技能领域，合并标准化均数差（SMD）为1.35，95%置信区间（CI）[0.66,2.03]。亚组分析显示，高依从性组的SMD为1.44，95%CI[0.51,2.36]，而低依从性组的SMD为1.26，95%CI[0.15,2.36]。在社交互动领域，总体SMD为-0.22，95%CI[-0.54,0.99]。高依从性子组的SMD为-0.41，95%CI[-0.62,-0.21]，而低依从性组的SMD为0.42，95%CI[-0.50,1.33]。在行为模式领域，总体SMD为-0.79，95%CI[-1.26,-0.32]。亚组分析表明，高依从性组的SMD为-0.42，95%CI[-0.73,-0.11]，低依从性组的SMD为-2.79，95%CI[-5.63,0.06]。在言语和非言语交流领域，总体SMD为0.33，95%CI[-0.31,0.97]。高依从性子组的SMD为0.21，95%CI[-0.14,0.57]，低依从性组的SMD为0.59，95%CI[-1.67,2.84]。
运动干预对自闭症谱系障碍（ASD）儿童的运动技能和行为模式有显著的积极影响。与低依从性剂量相比，高依从性ACSM推荐运动剂量的干预措施在改善运动技能、社交互动和行为模式方面更有效。未来可能为ASD儿童制定基于证据的运动处方，以优化运动功能结果。
PROSPERO，标识符（CRD42024565241）。
