Author(s): PENG, C., SHI, X., HE, J., ZHANG, L., Institution: SHANGHAI UNIVERSITY OF SPORTS, Country: CHINA, Abstract-ID: 1333

INTRODUCTION:
Exercise interventions have shown positive effects on mental health. With increasing attention to the health of children with neurodevelopmental disorders (NDDs), numerous meta-analyses have examined these outcomes in this population; however, conclusions remain inconsistent. This study aimed to summarize and evaluate the strength and reliability of existing evidence regarding the effects of exercise interventions on mental health outcomes in children with NDDs.
METHODS:
PubMed, Web of Science, the Cochrane Library, Embase, and PsycINFO were systematically searched from inception to December 2025. Eligibility criteria were defined according to the PICOS framework, and meta-analyses of randomized controlled trials were included. The methodological quality of reviews was assessed using the AMSTAR-2 tool, and the certainty of evidence was evaluated using the GRADE approach. All outcomes were synthesized using random-effects models, and effect sizes were reported as standardized mean differences with corresponding 95% confidence intervals. Subgroup analyses were conducted according to disorder type.
RESULTS:
Forty-nine meta-analyses comprising 826 randomized controlled trials (40,018 participants) were included, yielding 147 associations between exercise interventions and mental health outcomes. AMSTAR-2 assessments indicated that the methodological quality of the included reviews ranged from moderate to high. GRADE ratings showed that most associations were supported by evidence of moderate certainty. Pooled analyses demonstrated that exercise interventions significantly improved cognitive function in children with NDDs (SMD = 0.45), including executive function (SMD = 0.61), memory (SMD = 0.46), and attention (SMD = 0.33). In addition, exercise interventions significantly improved social functioning (SMD = 0.43) and emotional regulation (SMD = 0.67), primarily reflected in reduced anxiety, depressive symptoms, and social interaction difficulties. Subgroup analyses indicated that children with attention-deficit/hyperactivity disorder showed greater improvements in cognitive function than other NDD subtypes, whereas children with autism spectrum disorder showed greater benefits in social functioning following intervention.
CONCLUSION:
Exercise interventions significantly improve mental health outcomes in children with NDDs and play a pivotal role in enhancing cognitive function, promoting social participation, and supporting emotional regulation. In addition, this study provides strong evidence for differential intervention effects among NDD subgroups. Future studies should optimize intervention design and strengthen long-term follow-up to facilitate the precise implementation and dissemination of exercise interventions for children with NDDs.