Effect of Aerobic Training on Anxiety, Activities of Daily Living and Visual Motor Skills Performance in Children with Autism: A Randomised Controlled Trial

Introduction: The prevalence of Autism Spectrum Disorder (ASD) has significantly increased over the past 20 years. Characterised by impairments in communication skills and the presence of stereotypical behaviours, individuals with ASD often experience difficulties in performing Activities of Daily Living (ADLs), abnormalities in visual processing and anxiety disorders. Structured exercise programs can serve as an effective complementary therapy for individuals with ASD by reducing symptoms and maximising abilities. Aim: To study the effect of aerobic exercise on anxiety, ADLs and visual motor skills performance in children with mild to moderate ASD. Materials and Methods: This randomised controlled trial was conducted at the SGT Medical College Hospital and Research Institute in Gurugram, Haryana and Holy Heart Special School in Dwarka Mor, Delhi, India from January 2023 to May 2023. Thirty-eight children aged between 7 and 13 years with mild to moderate ASD who met the selection criteria were included and randomly assigned to two groups. Group A (n=19) received aerobic training, while Group B (n=19), the control group, received an ASD awareness lecture along with other students to help them understand this disorder, which may decrease anxiety and improve the performance of children with ASD. Data were collected at baseline and at the end of the 8th week of the study. The outcome measures used were the Screen for Child Anxiety Related Disorders (SCARED), the Functional Independence Measure (FIM) and the mirror drawing apparatus. Data were statistically analysed using the Shapiro-Wilk normality test and the Mann-Whitney test. Results: Group A and Group B had respective median ages of 11 (8-13) years and 8 (7-12) years, with a similar gender distribution (F=1, M=18) in both groups. There was a significant reduction in the SCARED scores in Group A compared to Group B (p-value=0.004) after aerobic exercises. FIM scores were significantly higher in Group A than in Group B after the aerobic exercise intervention (p-value=0.009). Similarly, in Group A, the amount of time needed to draw the figure and the errors made with both the right and left hands decreased significantly for the mirror drawing score following aerobic exercises, indicating improvements in anxiety, ADLs and visual motor skills after the treatment. Conclusion: The results indicated that incorporating aerobic activities for children with mild to moderate autism improves ADLs, visual motor abilities and reduces anxiety.