SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Autism
Effects of Exercise on Anxiety and Psychiatric Comorbidities in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Xizang Minzu University, Xianyang, China
- 2Shaanxi Institute of International Trade & Commerce, Xi'an, China
- 3East China Normal University, Shanghai, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Anxiety disorders affect nearly 40-50% of children with Autism Spectrum Disorder (ASD). While exercise benefits motor skills, its efficacy in modulating affective symptoms remains under-synthesized. This meta-analysis evaluated the effects of exercise on anxiety and co-occurring symptoms in pediatric autism spectrum disorder (ASD). Methods: We analyzed data from 12 randomized controlled trials (RCTs) involving 482 participants. A three-level random-effects model was utilized to account for effect size dependencies. Subgroup analyses examined exercise modality and intensity. Results: Exercise significantly reduced comorbid anxiety (Hedges' g = -0.68, p<0.001). Notably, aerobic exercise demonstrated the most substantial anxiolytic effect (g = -1.18), outperforming other modalities. Improvements were also observed in core ASD symptoms (g=-0.56) and ADHD-related attention deficits (g=-0.48). Effects on sleep were inconclusive due to heterogeneity. Conclusions: Exercise, particularly aerobic interventions, serves as a potent non-pharmacological strategy for managing anxiety and affective dysregulation in children with ASD. These findings support integrating aerobic exercise into clinical treatment plans to improve emotional well-being.
Keywords: aerobic training, Anxiety, Autism Spectrum Disorder, Exercise, Meta-analysis
Received: 06 Dec 2025; Accepted: 22 Jan 2026.
Copyright: © 2026 Zhang, Song, Gao and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenkun Song
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.