The Effect of Physical Activity in Children with Autism Spectrum Disorders: A Systematic Review of Randomized Controlled Trials

Background: Children with Autism Spectrum Disorders (ASDs) are generally more sedentary than their typically developing (TD) peers, resulting in a negative impact on their physical and cognitive development. Moreover, children with ASD are less involved in physical activity and sports. This systematic review aimed to investigate the effectiveness of physical activity in children with ASD. Methods: As data sources, PubMed (NML), Web of Science—Core Collection (Clarivate), Web of Science—MedLine (Clarivate), and Scopus were searched for relevant studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The literature search was performed in March 2024, and a supplementary search was conducted in October 2024. Eligibility criteria: The included studies were randomized controlled trials (RCTs) evaluating the effect of physical activity in children with ASD. Results: Sixteen studies were included following the PRISMA guidelines, involving a total of 465 participants. Intervention varied by type (land-based vs. aquatic), duration (7 weeks–one year), frequency (2–4 sessions/week) and session length (25–60 min). Evidence shows that physical activity interventions can positively influence motor coordination, with 81.2% of studies reporting beneficial effects, particularly in balance, motor coordination and overall motor proficiency. Land-based physical activity interventions may be an effective strategy for children with ASD, primarily due to their feasibility and accessibility. Conclusion: Physical activity intervention can improve motor coordination in children with ASD, with land-based programs generally being more accessible and aquatic program offering additional sensory–motor benefits for children with greater impairments. The current systematic review highlights the benefits of implementing physical activity in children with ASD, including extracurricular and school-based programs, to significantly enhance their functional outcomes, well-being, and overall quality of life.