Abstract
BACKGROUND: Exercise interventions have a positive impact on executive functioning in children and adolescents with autism spectrum disorders (ASD), but the efficacy of inhibitory control (IC) following exercise interventions is unclear. The aim was to investigate the effects of an exercise intervention on IC function in children and adolescents with ASD and to explore the underlying mechanisms. METHODS: We searched 8 English (Web of Science, PubMed, Scopus, Embase, MEDLINE, SPORTDiscus, Cochrane Library, and APA PsycINFO) and 2 Chinese databases (China Biomedical and CNKI) up to November 2024. Two authors independently extracted data, assessed bias with Cochrane Risk of Bias 2 tool, and graded evidence with Grading of Recommendations, Assessment, Development and Evaluation. Eighteen studies were included, of which 8 entered the meta-analysis. RESULTS: Overall, the combined effect of exercise intervention on IC in children and adolescents with ASD was statistically significant in the intervention group compared to the control group (standardized mean difference = -0.49, 95% confidence interval [-0.72 to -0.26], Z = 4.16, P < .0001), with no heterogeneity (I2 = 0%), and no publication bias was found by funnel plots and Egger test, sensitivity analysis revealed no publication bias, and the findings were stable. Subgroup analysis revealed that, in terms of movement patterns, martial arts interventions appeared to be more effective in enhancing IC, while ball sports and combined sports did not show significant effects. Interventions with shorter session durations (≤45 minutes), more frequent weekly sessions (>2), and shorter intervention cycles (≤4 weeks) tended to demonstrate slightly better outcomes, although not all subgroup differences reached statistical significance. CONCLUSIONS: Exercise interventions have a significant impact on IC in children and adolescents with ASD. Martial arts interventions may be more beneficial for improving IC in children and adolescents with ASD. Similarly, shorter sessions, higher weekly frequency, and shorter overall intervention cycles tended to yield somewhat better effects. However, given the variation in the number and quality of included studies, these findings must be further validated by more scientifically objective randomized controlled trials.