Physical Activity and Quality of Life in Autism Spectrum Disorder: A Systematic Review

This registration documents the protocol for a systematic review that will synthesise the available evidence on the relationship between physical activity (PA) and quality of life (QOL) outcomes in individuals diagnosed with autism spectrum disorder (ASD) across the lifespan. Individuals with ASD experience disproportionate physical and mental health comorbidities, a high prevalence of motor impairment, and levels of physical activity that fall consistently below population recommendations — a combination that places them at elevated risk of secondary health conditions and reduced quality of life. Although a substantial body of primary research has examined exercise and physical activity in this population, the majority of existing syntheses have focused on core autism symptomatology, motor proficiency, or physical fitness rather than on multi-domain quality of life as a primary outcome, and evidence remains fragmented across age groups, intervention modalities, and measurement instruments. The review will address three questions structured using the PICO framework, concerning (a) the effect of physical activity participation relative to sedentary behaviour or control conditions on QOL outcomes, (b) which types of physical activity intervention are most effective for enhancing QOL, and (c) how PA dose parameters — frequency, intensity, and duration — influence QOL outcomes. Studies of any design that report a physical activity exposure or intervention alongside a quality of life or well-being outcome in an ASD-specific population will be eligible. Because substantial clinical and methodological heterogeneity is anticipated across populations, intervention modalities, and outcome instruments, findings will be synthesised narratively rather than through meta-analysis, in accordance with the SWiM reporting guideline. Expected outputs are a PRISMA 2020 flow diagram, tables of study and intervention characteristics, a structured quality appraisal, and an integrated narrative synthesis organised by QOL domain and by life stage, together with an explicit mapping of evidence gaps to inform future trial design.