Systematic Review of Studies on the Effect of Exercise Interventions on Cognitive Process in Autism Spectrum Disorder

Abstract

The aim of this review is to compile studies on the effects of exercise on cognitive functions in children with Autism Spectrum Disorder (ASD) and the content of exercise programs applied to children with ASD. This study was organized based on the Prisma Flow Diagram developed by Moher et al. (2009). According to the findings obtained from the 13 articles in the review, it was concluded that the articles were conducted using quantitative research methods, generally in China and in 2022, the studies were mostly conducted with the 3-6 age group as the sample group, and mini basketball activities had positive effects in this group. However, virtual reality activities were found to be the most commonly used exercise intervention in children with ASD. It was observed that exercise durations generally varied between 8 and 12 weeks, at least 2 and at most 3 days a week, at least 30 minutes and at most 60 minutes. Scales and questionnaires were used in the articles to determine the effects of the interventions and it was concluded that studies using direct measurement tools such as imaging were very limited. As a result of this systematic review, it was concluded that game content such as basketball and football, exercise programs that provide coordinative development, and virtual reality activities adapted with these programs support cognitive development in children and adolescents with ASD.

Keywords

• Autism Spectrum Disorder
• Cognitive Development
• Exercise

Egzersiz Müdahalelerinin Otizm Spektrum Bozukluğunda Bilişsel Sürece Etkisi İle İlgili Yapılmış Çalışmaların Sistematik Derlemesi

Öz

Bu derlemenin amacı Otizm Spektrum Bozukluğuna (OSB) sahip çocuklarda egzersizin bilişsel işlevler üzerindeki etkileri ve OSB’li çocuklara uygulanan egzersiz programlarının içerikleri ile ilgili yapılan çalışmaların derlenmesidir. Bu çalışma Moher ve diğerleri (2009) tarafından geliştirilen Prisma Akış Diyagramı temel alınarak düzenlenmiştir. Derlemedeki 13 makaleden elde edilen bulgulara göre makalelerin nicel araştırma yöntemleri kullanılarak, genellikle Çin’de ve 2022 yılında yapıldığı, örneklem grubu olarak en fazla 3-6 yaş grubu ile çalışmaların gerçekleştirildiği ve bu grupta mini basketbol etkinliklerinin olumlu etkileri olduğu sonucuna ulaşılmıştır. Bununla birlikte sanal gerçeklik etkinlikleri OSB’li çocuklarda en fazla kullanılan egzersiz müdahalesi olarak tespit edilmiştir. Egzersiz sürelerinin genel olarak 8 ile 12 hafta arasında değiştiği, haftada en az 2 en fazla 3 gün, en az 30 dakika en fazla 60 dakika olduğu görülmüştür. Müdahalelerin etkilerini belirlemek için makalelerde ölçek ve anketlerden yararlanılmış ve görüntüleme gibi doğrudan ölçen ölçüm araçlarını kullanan çalışmaların oldukça sınırlı olduğu sonucuna varılmıştır. Bu sistematik derleme sonucunda basketbol ve futbol gibi oyun içerikleri koordinatif gelişim sağlayan egzersiz programları ve bu programlar ile birlikte uyarlanan sanal gerçeklik etkinliklerinin OSB’li çocuklarda ve ergenlerde bilişsel gelişimi desteklediği sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Otizm Spektrum Bozukluğu
• Bilişsel Gelişim
• Egzersiz

References

1. Akşit, S. (2023). Otizm spektrum bozukluğu tanısı konmuş çocuklarda fiziksel aktivite müdahalesinin beyin ve bilişsel gelişim üzerindeki etkileri: Bir EEG çalışması. Yayımlanmamış Doktora Tezi, Pamukkale Üniversitesi Eğitim Bilimleri Enstitüsü Beden Eğitimi ve Spor Öğretimi, Denizli.
2. Barendse, E. M., Hendriks, M. P., Jansen, J. F., Backes, W. H., Hofman, P. A., Thoonen, G., Kessels, R. P., ve Aldenkamp, A. P. (2013). Working memory deficits in high-functioning adolescents with autism spectrum disorders: Neuropsychological and neuroimaging correlates. J Neurodev Disord., 5, 14.
3. Baribeau, D., Vorstman, J., ve Anagnostou, E., (2022). Novel treatments in autism spectrum disorder. Current Opinion in Psychiatry, 35(2), 101-110.
4. Barneveld, P. S., Swaab, H., van Engeland, H., ve de Sonneville, L. (2014). Cross‐Sectional Evidence for a Decrease in Cognitive Function With Age in Children With Autism Spectrum Disorders?. Autism Research, 7(5), 527-534.
5. Barrios-Fernández, S., Carlos-Vivas, J., Muñoz-Bermejo, L., Mendoza-Muñoz, M., Apolo-Arenas, M. D., García-Gómez, A., ... ve Adsuar, J. C. (2022, February). Effects of square-stepping exercise on motor and cognitive skills in autism spectrum disorder children and adolescents: a study protocol. In Healthcare, 10(3), 450. MDPI.
6. Bradshaw, J., Schwichtenberg, A. J., ve Iverson, J. M. (2022). Capturing the complexity of autism: Applying a developmental cascades framework. Child Development Perspectives, 16(1), 18-26.
7. Cai, K., Yu, Q., Herold, F., Liu, Z., Wang, J., Zhu, L., ve Zou, L. (2020). Mini-basketball training program improves social communication and white matter integrity in children with autism. Brain Sciences, 10(11), 803.
8. Chen, Z., Lan, W., Yang, G., Li, Y., Ji, X., Chen, L., ve Li, S. (2020). Exercise intervention in treatment of neuropsychological diseases: A review. Frontiers in Psychology, 11, 569206.

9. Cole, E. J., Barraclough, N. E., ve Enticott, P. G. (2018). Investigating mirror system (MS) activity in adults with ASD when inferring others’ intentions using both TMS and EEG. Journal of Autism and Developmental Disorders, 48(7), 2350-2367.
10. Demetriou, E. A., Pepper, K. L., Park, S. H., Pellicano, L., Song, Y. J. C., Naismith, S. L., ... ve Guastella, A. J. (2021). Autism spectrum disorder: An examination of sex differences in neuropsychological and self-report measures of executive and non-executive cognitive function. Autism, 25(8), 2223-2237.
11. Emerson, R.W., Adams, C., Nishino, T., et al., (2017). Functional neuroimaging of high-risk 6-month-old infants predicts a diagnosis of autism at 24 months of age. Sci. Transl. Med., 9(393), 2882.
12. Garcés, P., Baumeister, S., Mason, L., Chatham, C. H., Holiga, S., Dukart, J., ... ve Hipp, J. F. (2022). Resting state EEG power spectrum and functional connectivity in autism: a cross-sectional analysis. Molecular Autism, 13(1), 1-16.
13. Gitimoghaddam, M., Vanderloo, L. M., Hung, R., Ryce, A., McKellin, W., Miller, A., ve Collet, J. P. (2021). Impacts of participation in community-based physical activity programs on cognitive functions of children and youth with neurodevelopmental disabilities: a scoping review. Brain Sciences, 11(2), 195.
14. Greco, G., ve De Ronzi, R. (2020). Effect of karate training on social, emotional, and executive functioning in children with autism spectrum disorder. Journal of Physical Education and Sport, 20(4), 1637-1645.
15. Halpern, D. F. (1998). Teaching critical thinking for transfer across domains: disposition, skills, structure training, and metacognitive monitoring. Am Psychologist, 53(4), 449-455
16. Hazlett, H., C., Gu, H., Munsell, B., C., Kim, S. H., Styner, M., Wolff, J. J., ve Piven, J. (2017). Early brain development in infants at high risk for autism spectrum disorder. Nature, 542(7641), 348-351.
17. Hilton, C., Ratcliff, K., Collins, D., ve Jones, J., (2020). Physiological and Cognitive Effects of Daily Exercise on Adolescents with Autism Spectrum Disorders (ASD). AJOT: American Journal of Occupational Therapy, 74(S1), NA- NA.
18. Heidari, S., Mostafaei, S., Razazian, N., Rajati, M., Saeedi, A., ve Rajati, F. (2021). Correlation between lead exposure and cognitive function in 12-year-old children: a systematic review and meta-analysis. Environmental Science and Pollution Research, 28(32), 43064-43073.
19. Hollander, E., Anagnostou, E., Chaplin, W., Esposito, K., Haznedar, M. M., Licalzi, E., ve Buchsbaum, M. (2005). Striatal volume on magnetic resonance imaging and repetitive behaviors in autism. Biological Psychiatry, 58(3), 226-232.
20. Ji, C., Yang, J., Lin, L., ve Chen, S. (2022). Executive function improvement for children with autism spectrum disorder: A comparative study between virtual training and physical exercise methods. Children, 9(4), 507.
21. Kang, J., Chen, H. Li, X., ve Li, X., (2019). EEG entropy analysis in autistic children, J. Clin. Neurosci., 62(2019), 199–206. https://doi.org/10.1016/j.jocn.2018.11.027
22. Langen, M., Durston, S., Staal, W. G., Palmen, S. J., ve van Engeland, H., (2007). Caudate nucleus is enlarged in high-functioning medication-naive subjects with autism. Biological Psychiatry, 62(3), 262-266.
23. Langen, M., Schnack, H. G., Nederveen, H., Bos, D., Lahuis, B. E., de Jonge, M. V., ve Durston, S. (2009). Changes in the developmental trajectories of striatum in autism. Biological Psychiatry, 66(4), 327-333.
24. Li, L., Wang, A., Fang, Q., ve Moosbrugger, M. E., (2023). Physical activity interventions for improving cognitive functions in children with autism spectrum disorder: Protocol for a network meta-analysis of randomized controlled trials. JMIR Research Protocols, 12(1), e40383.
25. Liang, X., Li, R., Wong, S. H., Sum, R. K., Wang, P., Yang, B., ve Sit, C. H. (2022). The effects of exercise interventions on executive functions in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis. Sports Medicine, 52(1), 75-88.
26. Ludyga, S., Pühse, U., Gerber, M., ve Kamijo, K. (2021). How children with neurodevelopmental disorders can benefit from the neurocognitive effects of exercise. Neuroscience ve Biobehavioral Reviews, 127, 514-519.
27. Luna, B., Doll, S. K., Hegedus, S. J., Minshew, N. J., Sweeney, J. A., (2007). Maturation of executive function in autism. Biol Psychiatry, 61, 474-481.
28. Macoun, S. J., Schneider, I., Bedir, B., Sheehan, J., ve Sung, A. (2021). Pilot study of an attention and executive function cognitive intervention in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 51, 2600-2610.
29. McVoy, M., Lytle, S., Fulchiero, E., Aebi, M. E., Adeleye, O., ve Sajatovic, M. (2019). A systematic review of quantitative EEG as a possible biomarker in child psychiatric disorders. Psychiatry Res., 279, 331–44.
30. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., ve PRISMA Group*. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine, 151(4), 264-269.
31. Nakutin, S. N., ve Gutierrez, G. (2019). Effect of physical activity on academic engagement and executive functioning in children with ASD. School Psychology Review, 48(2), 177-184.
32. Nekar, D. M., Lee, D. Y., Hong, J. H., Kim, J. S., Kim, S. G., Seo, Y. G., ve Yu, J. H. (2022). Effects of augmented reality game-based cognitive–motor training on restricted and repetitive behaviors and executive function in patients with autism spectrum disorder. In Healthcare, 10, 10.
33. Newson, J. J., ve Thiagarajan, T. C., (2019). EEG frequency bands in psychiatric disorders: A review of resting state studies. Front Hum Neurosci.12, 521.
34. Petanjek, Z., Sedmak, D., Džaja, D., Hladnik, A., Rašin, M. R., ve Jovanov-Milosevic, N. (2019). The protracted maturation of associative layer IIIC pyramidal neurons in the human prefrontal cortex during childhood: a major role in cognitive development and selective alteration in autism. Frontiers in Psychiatry, 10, 122.
35. Phung, J. N., ve Goldberg, W. A. (2019). Promoting executive functioning in children with autism spectrum disorder through mixed martial arts training. Journal of Autism and Developmental Disorders, 49, 3669-3684.
36. Rafiei Milajerdi, H., Sheikh, M., Najafabadi, M. G., Saghaei, B., Naghdi, N., ve Dewey, D. (2021). The effects of physical activity and exergaming on motor skills and executive functions in children with autism spectrum disorder. Games for Health Journal, 10(1), 33-42.
37. Salimova, K. R., (2022). Neurophysiological correlates of impaired development in autism spectrum disorder (ASD). Biology Bulletin Reviews, 12(2), 140-148.
38. Shen, M. D., Kim, S. H., McKinstry, R. C., Gu, H., Hazlett, H. C., Nordahl, C. W., ... ve Gu, H. (2017). Increased extra-axial cerebrospinal fluid in high-risk infants who later develop autism. Biological psychiatry, 82(3), 186-193.
39. Shewchuk, S., (2021). Investigating the Effect of High-Intensity Aerobic Exercise on Executive Functions: A Scoping Review.
40. Solomon, M., Ozonoff, S. J., Cummings, N., ve Carter, C. S. (2008). Cognitive control in autism spectrum disorders. Int J Dev Neurosci.13;26(2):239-247
41. Stoodley, C. J., D’Mello, A. M., Ellegood, J., Jakkamsetti, V., Liu, P., Nebel, M. B., ve Tsai, P. T., (2017). Altered cerebellar connectivity in autism and cerebellar-mediated rescue of autism-related behaviors in mice. Nature neuroscience, 20(12), 1744-1751.
42. Strofylla, G., Charitou, S., Asonitou, K., ve Koutsouki, D. (2021). Efficacy of 6-Month Adapted Aerobic Program on Motor Proficiency, BMI and Cognitive Abilities of Students with Autism Spectrum Disorder: Three Case Reports. Open Journal of Social Sciences, 9(9), 153-166.
43. Tager-Flusberg, H., ve Joseph, R. M., (2003). Identifying neurocognitive phenotypes in autism. Philosophical transactions of the royal society of London. Series B: Biological Sciences, 358(1430), 303-314.
44. Tse, A. C., Anderson, D. I., Liu, V. H., ve Tsui, S. S. (2021). Improving executive function of children with autism spectrum disorder through cycling skill acquisition. Medicine & Science in Sports & Exercise, 53(7), 1417-1424.
45. Wang, J. G., Cai, K. L., Liu, Z. M., Herold, F., Zou, L., Zhu, L. N., ve Chen, A. G. (2020). Effects of mini-basketball training program on executive functions and core symptoms among preschool children with autism spectrum disorders. Brain sciences, 10(5), 263.
46. Wantzen, P., Clochon, P., Doidy, F., Wallois, F., Mahmoudzadeh, M., Desaunay, P., ve Guillery-Girard, B. (2022). EEG resting-state functional connectivity: evidence for an imbalance of external/internal information integration in autism. Journal of Neurodevelopmental Disorders, 14(1), 1-14.
47. Yang, S., Liu, Z., Xiong, X., Cai, K., Zhu, L., Dong, X., ... ve Chen, A. (2021). Effects of mini-basketball training program on social communication impairment and executive control network in preschool children with autism spectrum disorder. International Journal of Environmental Research and Public Health, 18(10), 5132.
48. Yılmaz, K., (2021). Sosyal bilimlerde ve eğitim bilimlerinde sistematik derleme, meta değerlendirme ve bibliyometrik analizler. Manas Sosyal Araştırmalar Dergisi, 10(2), 1457-1490.
49. Zhang, Z., Peng, P., ve Zhang, D. (2020). Executive function in high-functioning autism spectrum disorder: a meta-analysis of fMRI studies. Journal of Autism and Developmental Disorders, 50, 4022-4038.
50. Zhang, Y., Tian, H., Tao, Y., Li, Y., Wang, D., ve Qin, L. (2023). A study on the effects of three game intervention programs on executive functions of preschool autistic children. International Journal of Developmental Disabilities, 1-11.
51. Zhao, F., Zhang, H., Wang, P., Cui, W., Xu, K., Chen, D., ... ve Wei, S. (2022). Oxytocin and serotonin in the modulation of neural function: Neurobiological underpinnings of autism-related behavior. Frontiers in Neuroscience, 16, 919890.