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. 2024 May 9:15:1360434.
doi: 10.3389/fneur.2024.1360434. eCollection 2024.

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

Lili Li #  1 , Shuqi Jia #  2 , Peng Wang  2 , Shufan Li  2 , Xing Wang  2 , Xiaoyi Zhu  3
Affiliations

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

Lili Li et al. Front Neurol. .

Abstract

Objective: To compare the effects of various sports exercise programs on the core symptoms of patients with autism spectrum disorder (ASD).

Methods: We searched the China National Knowledge Infrastructure, VIP databases, Wanfang databases, Cochrane Library, PubMed, EMBASE, and Web of Science databases from their inception to February 2023 for randomized controlled trial that investigated the effect of sports exercise on the core symptoms of ASD. The overall risk of bias in the included literature was summarized using the revised Cochrane Randomized Trial Risk of Bias Tool (ROB2), and network meta-analysis was used to compare the intervention effects.

Results: A total of 30 studies involving 1,375 participants were included. The results showed that sports exercise programs, including 8-12 weeks of ball sports (SMD = -5.35, 95%CI: -7.57, -3.23), horse riding (SMD = -3.71, 95%CI: -6.18, -1.13), 8-12 weeks of comprehensive sports exercise (SMD = -2.17, 95%CI: -3.99, -0.44), and more than 12 weeks of comprehensive sports exercise (SMD = -3.75, 95%CI: -6.33, -1.24), significantly improved social interaction disorders. Furthermore, 8-12 weeks of ball sports (SMD = -4.36, 95%CI: 2.04, 6.73) and more than 12 weeks of comprehensive sports exercise (SMD = 3.65, 95%CI: 1.40, 6.08) significantly improved repetitive behaviors and restricted interests.

Conclusion: Sports exercise can improve the core symptoms of ASD patients, and different symptoms show a selective response to different exercise elements.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023455806.

Keywords: autism spectrum disorder; core symptoms; motor intervention; network meta-analysis; physical activity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature selection and inclusion.
Figure 2
Figure 2
Assessment of methodological quality included in the study.
Figure 3
Figure 3
(A, B) The evidence network diagram of physical exercise intervention in core symptoms of patients with autism spectrum disorders. “0” Represented the control group (routine interventions, daily activities, educational intervention and no intervention). A: ball games for 8–12 weeks; D: comprehensive physical exercise for 8–12 weeks; E: comprehensive physical exercise for 12 weeks, O: control group (no exercise intervention).
Figure 4
Figure 4
(A, B) Probability ranking diagram on intervention effect of each outcome index. “O” represented the control group (routine intervention, daily activities, educational intervention and no intervention). A ball: games for 8–12 weeks; B: equestrain exercise for 8–12 weeks; C: comprehensive physical activities for 8–12 weeks; O: control group (no exercise intervention).
Figure 5
Figure 5
The inverted funnel diagram of exercise improving the repetition of the stereotyped behavior in patients with autism spectrum disorder.
See this image and copyright information in PMC

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