Effect of physical activity interventions on restricted and repetitive behaviors in children with autism spectrum disorder: a systematic review

Objectives In recent years, physical activity (PA) interventions, primarily characterized by sport-based activities, have garnered growing attention for their potential to reduce restricted and repetitive behaviours (RRBs) in children with autism spectrum disorder (ASD). Therefore, this study aims to systematically review the impact of PA interventions on RRBs in children with ASD.Methods This study was conducted in accordance with the PRISMA guidelines. Relevant studies published between 1st January 2010 and 1st September 2025 examining the effects of PA interventions on RRBs in children with ASD were retrieved from the Web of Science, PubMed, Scopus, PsycINFO, and CNKI databases. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).Results Twenty-two studies from seven countries were included, comprising eleven randomized controlled trials, six quasi-experimental designs, three single-group experimental designs, and two single-subject experimental designs, involving 735 participants in total. Intervention settings primarily involved schools, rehabilitation centres, and sports facilities. PA modalities included specialized sports, comprehensive physical training and sport-based games. Intervention duration ranged from 10 to 90 min, with frequencies varying from one to five sessions per week and total intervention periods of 1 to 40 wk. Most interventions were implemented with moderate intensity. Overall, PA interventions demonstrated beneficial effects in reducing RRBs among children with ASD.Conclusions Physical activity interventions show potential as a treatment approach for alleviating RRBs in children with ASD. However, the dose-response relationships and the underlying neural mechanisms remain insufficiently understood and warrant further investigation.