Effects of physical activity and exercise-based interventions in young adults with autism spectrum disorder: A systematic review

Abstract

Young adults with autism spectrum disorder are an underserved population. Evidence-based guidelines for physical activity programs to address the lifelong needs of this population are presently unavailable. Our systematic review critically appraises the research to date on the effects of physical activity/exercise-based interventions on physical fitness, motor skills, core autism symptoms, and functional participation in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 experimental and quasi-experimental studies that assessed the effects of physical activity/exercise-based interventions in 763 young adults with autism spectrum disorder. Evidence is strongest for improvements of medium-to-large size in physical fitness followed by medium-to-large improvements in motor outcomes, medium-to-large improvements in psychological function, and small-to-large improvements in quality of life. Aerobic, resistance, and movement skill/sport-specific training can improve cardiovascular function and muscular strength/endurance in young adults. Movement/sport training can help improve fundamental motor skills. Finally, holistic interventions combining elements of physical activity, diet, and lifestyle modifications are effective in improving outcomes related to body composition and quality of life in young adults. There is presently insufficient evidence for improvements in physical activity engagement or core autism symptoms following exercise interventions. We provide recommendations for assessment and intervention for clinicians working with young adults with autism spectrum disorder. Lay abstract Young adults with autism spectrum disorder over 18 years of age are an underserved population, and there is presently limited evidence examining the effects of physical activity programs in this population. Our review synthesizes the evidence to date from studies that have assessed the effects of physical activity/exercise programs in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 studies that included a total of 763 young adults with autism spectrum disorder. There is the strongest evidence for improvements in physical fitness, followed by motor skills, psychological function, and quality of life following physical activity interventions in young adults with autism spectrum disorder. Specifically, aerobic and resistance training as well as programs focused on movement skill and sport-specific training lead to improved physical fitness and movement performance. Holistic interventions focusing on physical activity, dietary changes, and lifestyle modifications lead to improvements in body composition and quality of life of young adults with autism spectrum disorder. There is presently limited evidence to support the use of exercise/activity programs to improve physical activity levels and core autism symptoms in young adults with autism spectrum disorder. Based on our review results, we also provide practical recommendations for clinicians working with young adults with autism spectrum disorder.

An exploration of a physical activity intervention in a community fitness setting for adolescents with autism

“…however, this aligns with research that suggests training should be done gradually and progress will be dependent on individual abilities (Shahane et al, 2023). It would be of interest for future research to explore additional behavioral and technologically based interventions that could facilitate 100% independence, particularly, for participants with disabilities seeking to perfect specific exercises or sports skills (e.g., Unified sports athletes).…”

“…were necessary steps to be able to effectively and independently exercise at a community fitness site. Teaching these skills in addition to the physical activities themselves sought to address the known barriers to physical activity for individuals with autism (Shahane et al, 2023). Furthermore, the maintenance of independence across the three measures (physical activity, creating the workout, and navigating the workout) in Phases 2, 3, and 4 as components of the intervention were removed suggests that the training before Phase 1 to create the workouts, the treatment package used in Phase 1 for initial physical activity acquisition, and the workout navigation checklist were effective in teaching the skills.…”

“…It would be of interest for future research to explore additional behavioral and technologically based interventions that could facilitate 100% independence, particularly, for participants with disabilities seeking to perfect specific exercises or sports skills (e.g., Unified sports athletes). Another area for future research would be to explore if additional behavioral intervention strategies (e.g., self-monitoring) increased participants' independence in physical activity (Shahane et al, 2023).…”

“…Taken together, this instructional package and the trainings used may be beneficial to individuals, parents, teachers, and other staff members seeking to increase physical activity in people with autism particularly in community settings. The choice of viewing the video-models in Phase 2 and during generalization provided participants with the opportunity to engage with the workout in a way that they found most meaningful (Shahane et al, 2023). Practitioners wanting to facilitate similar types of opportunities may find the use of the Exercise Buddy app, video-models, and a checklist useful in promoting independence and self-determination during other types of physical activity.…”

Effectiveness of Yoga Training on the Health-related Physical Fitness and Balance in Children with Autism Spectrum Disorder

“…Childhood obesity is linked to adult obesity and cardiovascular diseases. Nonetheless, lifestyle interventions hold promise in improving body composition in ASD youth [20]. Activities like water exercises, horseback riding, and mind-body practices also offer bene ts [21].…”