Relationship Between Physical Activity and Quality of Life in Children With Autism Spectrum Disorder: A Systematic Review

Background and Purpose: Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders primarily characterized by social communication impairments and restricted and repetitive behaviors. Thus, children with ASD experience reduced interactions with peers and external environment, which may further result in decreased opportunity to engage in physical activity (PA). Current evidence has shown that children with ASD exhibit lower level of PA and spend more time engaging in sedentary behaviors when compared with typically developing children. However, it is unclear whether the PA level may be associated or affect quality of life (QoL) in this population. Methods: Three database including PubMed, Scopus, and Cochrane were used for literature search up to December 2023. Keywords used includes: "autism spectrum disorder", "quality of life", and "physical activity" or "exercise" or "sport". Only articles written in English and with subjects under 18 years old were included in this review. Results: Seven studies were included in this review. Two out of two studies and three out of three studies indicated positive associations between PA and overall QoL and general psychosocial functioning in children with ASD respectively. By assessing the subcategories of QoL, some studies showed positive associations between PA and physical, social, emotional, and school functioning domains of QoL in children with ASD while some studies demonstrated insignificant results. Conclusions: Participating in PA may be associated with positive outcomes in various domains of QoL in children with ASD. However, relevant studies are limited with low quality and frequently with small sample size. Moreover, the causality between PA and QoL in this population has yet been clearly identified. Future studies with prospective longitudinal and more solid study design and larger samples are warranted to enhance the understanding of the relationship between PA and QoL in children with ASD. Clinical Relevance: By providing different benefits, such as the opportunity to interact with others and the enhancement of physical health, facilitating PA with efficacious protocols may serve as an approach to improve QoL and even overall well-being in children with ASD in the long run.