Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Chronic exercise interventions had a small to moderate positive effect on executive function overall in children and adolescents with autism spectrum disorder; particularly in cognitive flexibility and inhibitory control.

2. Chronic exercise intervention was shown to have a non-significant effect on working memory.

Evidence Rating Level: 1 (Excellent)

Youth with autism spectrum disorder (ASD) are known to have difficulties in social communication and restricted interests. However, many studies have also indicated that they are at risk of developing executive dysfunction which is a fundamental cognitive skill required for improved overall health. Current literature suggests that exercise can play a positive role in positively affecting cognitive function. In response to a current gap in knowledge, this systematic review and meta-analysis sought to examine the effect of exercise interventions on executive function in children and adolescents with ASD.

From 259 screened records, 14 articles underwent systematic review and 7 were selected for meta-analysis from 2011-2021. Included studies had to investigate the effect of any type of exercise on executive function on children aged 5-17 with a diagnosis of ASD. In addition, studies had to measure cognitive outcomes with validated instruments.

In total, there were 310 children and adolescents with ASD aged 6-18. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of each included study. The results of this study demonstrated that exercise intervention had a positive, small-to-moderate effect on overall executive function. With respect to domain-specific executive function, chronic exercise interventions had a small-to-moderate positive effect on cognitive flexibility and inhibitory control. In contrast, this study found a non-significant effect of exercise on working memory amongst this population. However, this study was limited by the heterogeneity in measurement of executive function which made the synthesis of results more difficult. Nonetheless, this study provided early evidence for future studies to investigate the influence of variables such as age and intensity of physical activity.

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