Chronic Physical Activity for ADHD and/or Autism Spectrum Disorder in Children: A Meta-Analysis of Randomized Controlled Trials

Chronic Physical Activity for Attention Deficit Hyperactivity Disorder and/or Autism Spectrum Disorder in Children: A Meta-Analysis of Randomized Controlled Trials

Zhang M, Liu Z, Ma H, Smith DM.

Front Behav Neurosci. 2020 Oct 22;14:564886.

doi: 10.3389/fnbeh.2020.564886.


Commentary* by Dr. Margaret Weiss: Perhaps clinicians need to pay more attention to assessment and prescription of exercise in the management of neurodevelopmental disorders.



Purpose: To explore the effects of physical activity (PA) intervention on executive function (EF) and motor skills (MS) among children with attention deficit hyperactivity disorder and/or autism spectrum disorder (ASD).


Methods: Relevant studies were sourced from PubMed, Web of Science, EMBASE, Cochrane Library, CNKI and Wanfang Data. Only randomized controlled trials (RCT) were included based upon the following criteria: (1) participants were children and clinically diagnosed with ADHD/ASD, (2) intervention strategies were identified as chronic physical activity, and (3) EF (e.g., cognitive flexibility) and/or MS (e.g., gross motor skills) were measured at baseline and post-intervention and compared with an eligible control group.


Results: Eleven studies involving 346 participants were finally identified. PA elicited significant improvements in EF and MS in children with ADHD/ASD. Regarding changes in the EF of participants, PA showed a great improvement in overall EF [standardized mean difference (SMD): 0.90, 95% confidence interval (CI) 0.49-1.30, p < 0.00001], inhibitory control (SMD: 1.30, 95% CI 0.58-2.02, p = 0.0004) and cognitive flexibility (SMD: 0.85, 95% CI 0.42-1.29, p = 0.0001), but no significant improvement in working memory (SMD: 0.28, 95% CI -0.15-0.71, p = 0.20). Significant improvements were also found with respect to gross motor skills (SMD: 0.80, 95% CI 0.30-1.30, p = 0.002), but no significant changes were found in fine motor skills (SMD: 0.30, 95% CI -0.91-1.52, p = 0.62).


Conclusion: Chronic PA interventions may promote EF and MS in children with ADHD/ASD, especially in inhibitory control, cognitive flexibility, and gross motor skills. However, PA interventions seemed to have insignificant effects on working memory and fine motor skills to children with ADHD/ASD.


* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion.  It is not approved or necessarily representative of the CADDRA board.



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