Positive effects of physical activity in autism spectrum disorder: how influences behavior, metabolic disorder and gut microbiota
Open accessAbstract
Autism spectrum disorder is a neurodevelopmental disorder characterized by social interactions and communication skills impairments that include intellectual disabilities, communication delays and self-injurious behaviors; often are present systemic comorbidities such as gastrointestinal disorders, obesity and cardiovascular disease. Moreover, in recent years has emerged a link between alterations in the intestinal microbiota and neurobehavioral symptoms in children with autism spectrum disorder. Recently, physical activity and exercise interventions are known to be beneficial for improving communication and social interaction and the composition of microbiota. In our review we intend to highlight how different types of sports can help to improve communication and social behaviors in children with autism and also show positive effects on gut microbiota composition.
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Activities like swimming, horseback riding, and structured group exercises significantly improve social skills, communication, and motor coordination.
“Research has shown that activities like swimming, horseback riding, and structured group exercises significantly improve social skills, communication, and motor coordination [179].”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [179]
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“Among different sports activities, hydrotherapy stimulate several sensory pathways through water temperature modulation, weight relief and vestibular input (42).”
BackgroundAssessment of BDNF serum levels as a diagnostic marker in children with autism spectrum disorder
Barbosa, A. G., Pratesi, R., Paz, G. S. C., dos Santos, M. A. A. L., Uenishi, R. H., Nakano, E. Y., Gandolfi, L., & Pratesi, C. B. (2020) · Scientific Reports · doi:10.1038/s41598-020-74239-x · Cited by 65 · cited 1× · see citing works
“Several studies suggest BDNF as a mediator of the relationship between exercise and associated cognitive benefits, indeed, BDNF is upregulated up to 7 days after exercise (59) and the inhibition of BDNF receptors showed the reduction of the cognitive benefits associated with physical exercise (60).”
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MethodWeight Gain and Antipsychotic Medication
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“Several studies have highlighted an altered cholesterol metabolism in patients with ASD (36, 37).”
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Brain-derived neurotrophic factor levels in acute stroke and its clinical implications
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“The relation between BDNF alteration and neurological disorders suggest that BDNF could be consider a valid biomarker and therapeutic factor (58).”
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“In the last years, the gut microbiota acquired an important asset for healthy status acquisition (76); as a consequence, it has been claimed as a contributor for the development of a large number of diseases (77–79).”
BackgroundSelf-citationOropharyngeal microbiome evaluation highlights Neisseria abundance in active celiac patients
Iaffaldano, L., Granata, I., Pagliuca, C., Esposito, M. V., Casaburi, G., Salerno, G., Colicchio, R., Piccirillo, M., Ciacci, C., Blanco, G. D. V., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-29443-1 · Cited by 44 · cited 1× · see citing works
“In the last years, the gut microbiota acquired an important asset for healthy status acquisition (76); as a consequence, it has been claimed as a contributor for the development of a large number of diseases (77–79).”
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“Several studies have highlighted an altered cholesterol metabolism in patients with ASD (36, 37).”
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“Cholesterol is also responsible for the correct function of neurotransmitter, and an its impaired metabolism could cause brain dysfunction (38).”
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Self-citationEffect of Karate on Neurocognitive Physiology
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“Several studies show that karate techniques develop postural motor functions, spatial orientations, and impact vestibular signaling patterns that challenge the hippocampus and enhance neurogenesis through the secretion of neurotrophins such as BDNF (54–56).”
BackgroundIossa, S., Costa, V., Corvino, V., Auletta, G., Barruffo, L., Cappellani, S., Ceglia, C., Cennamo, G., D’Adamo, P., D’Amico, A., et al. (2015) · Molecular Cytogenetics · doi:10.1186/s13039-015-0120-0 · Cited by 22 · see citing works
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Childhood obesity: an overview of laboratory medicine, exercise and microbiome
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“Since 2019, it has been estimated that over 150 million children in the world are obese and that this will increase to 206 million by 2025 (16, 17).”
BackgroundSelf-citationSochaczewska, D., Ziętek, M., Dołęgowska, B., Kordek, A., & Szczuko, M. (2022) · Nutrients · doi:10.3390/nu14112224 · Cited by 21 · see citing works
Could Candida Overgrowth Be Involved in the Pathophysiology of Autism?
Herman, A., & Herman, A. P. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11020442 · Cited by 16 · cited 1× · see citing works
“In particular, Candida albicans , a bacteria that produces toxic molecules as ammonia and other are associated with autism-related behavior, and Saccharomyces cerevisiae were most represented in autistic children gut compared to healthy controls (93, 94).”
BackgroundMennitti, C., Ranieri, A., Nigro, E., Tripodi, L., Brancaccio, M., Ulisse, J., Gentile, L., Fimiani, F., Cesaro, A., D’Alicandro, G., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010602 · Cited by 12 · see citing works
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Self-citationInfluence of swimming on sensory functioning, quality of life and behavior of children with autism
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Peripartum Antibiotics Exposure and the Risk of Autoimmune and Autism Disorders in the Offspring
Almasri, J., Barazi, A., King, K. S., Walther-Antonio, M. R. S., Wang, Z., Murad, M. H., Murray, J. A., & Absah, I. (2021) · Avicenna Journal of Medicine · doi:10.1055/s-0041-1732485 · Cited by 8 · see citing works
Exercise Changes Gut Microbiota: A New Idea to Explain that Exercise Improves Autism
Xue, Y.-Q., An, S., Qiu, W., Zhang, W., Fu, L.-M., & Zhen, Z.-P. (2022) · International Journal of Sports Medicine · doi:10.1055/a-2018-2477 · Cited by 8 · see citing works
Cerebellar Pathology in Autism
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“Further studies have shown that the cerebellum is a key brain region involved in motor function such as coordination and balance (63, 64).”
BackgroundFalcone, N., Ranieri, A., Vitale, A., Pastore, L., & Lombardo, B. (2022) · Medicina · doi:10.3390/medicina58040524 · Cited by 7 · see citing works
Self-citationSwimming exercise is a promising early intervention for autism‐like behavior in Shank3 deletion rats
Xu, D., Meng, Y., An, S., Meng, W., Li, H., Zhang, W., Xue, Y., Lan, X., Wang, X., Li, M., et al. (2022) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.13920 · Cited by 7 · cited 1× · see citing works
“However, a study conducted by Xu et al. on Shank3 knockout mice that had deficits in social memory, spatial memory, and object recognition showed that a swimming program improves learning and memory, hippocampal neural development, and plasticity in Shank3 knockout mice (50).”
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“…physical activity can lead to a decrease in microbial diversity, an increase in the quantity of Helicobacter pylori, and the onset of heightened permeability in the intestines, allowing bacteria and their harmful substances to enter the bloodstream, triggering widespread inflammation [175,176].”
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“99 [104] and a very strong correlation with the GM-FCS ( − 0.85 r − 0.89) [105].”
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“Previous research highlighted the effectiveness of team sports-based mini-basketball in improving SCI in individuals with ASD [17].”
BackgroundMetabolomic changes in children with autism
Al‐Beltagi, M., Saeed, N. K., Bediwy, A. S., & Elbeltagi, R. M. (2024) · World Journal of Clinical Pediatrics · doi:10.5409/wjcp.v13.i2.92737 · Cited by 15 · see citing works
Dysregulation of Immune Mediators and Synaptic Plasticity in Central Nervous System Disorders
Imbriani, P., D’Ambra, C., Mori, R. D., Ionta, M., Renna, A., & Bonsi, P. (2026) · Cells · doi:10.3390/cells15020201 · Cited by 15 · see citing works
“Systematic reviews and meta-analyses indicate that physical activity and exercise interventions benefit communication, social interaction, stereotyped behaviors, cognitive flexibility and inhibitory control in children and adolescents with ASD [290,291].”
Li, L., Jia, S., Peng, W. A. N. G., Li, S., Wang, X., & Zhu, X. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1360434 · Cited by 12 · see citing works
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Shaban, A. M., Ameen, O., Omar, M., Derbaly, S. A. E., Omara, H. R., Bayomi, A. I., Latif, A. A. A., Elakabawy, Z. I., & Khodir, S. A. (2025) · Scientific Reports · doi:10.1038/s41598-025-09089-6 · Cited by 3 · see citing works
“This result was consistent with other studies 62 .”
Firouzjah, M. H., Pourazar, M., Kakvandi, S. N., & Dalasm, R. A. (2025) · Early Human Development · doi:10.1016/j.earlhumdev.2025.106350 · Cited by 3 · see citing works
Rouphael, M., Sacre, Y., Bitar, T., Andres, C. R., & Hleihel, W. (2024) · Nutrients · doi:10.3390/nu16060847 · Cited by 3 · see citing works
“2 microdeletions, may also be prevalent among children diagnosed with ASD [62].”
BackgroundTargeting exercise triggered irisin for therapeutic intervention of autism-associated social anxiety
Tatode, A., Gupta, T., Qutub, M., Umekar, M. J., Taksande, B. G., & Premchandani, T. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.11.027 · Cited by 2 · see citing works
Okon, I. A., Nwachukwu, D. C., Udoeyop, F. A., Uko, B. R., Umoren, E. B., Kolawole, T. A., Amadi, N. G., Owaji-Teleyem, D. M., & Owu, D. U. (2024) · Obesity Medicine · doi:10.1016/j.obmed.2024.100559 · Cited by 2 · see citing works
Ebrahimi, A., Sabaghi, A., Nedaei, S. E., & Yousofvand, N. (2025) · Journal of Science in Sport and Exercise · doi:10.1007/s42978-024-00323-7 · Cited by 2 · see citing works
“While existing studies support the favorable effects of HIIT on autism [36, 47], no specific research has yet addressed the benefits of HIIT on autism-like behaviors induced by HFD.”
Effects of Sensory Integration to Manage Behavior Problems of Children with Autism Spectrum Disorder
Samad, A. R., Aslam, F. M., Khan, H. A., & Tabassum, S. M. (2024) · Allied Medical Research Journal · doi:10.59564/amrj/02.01/023 · Cited by 2 · see citing works
İnce, G., Gönen, A., & Ünveren, Y. (2025) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2025.2530565 · Cited by 1 · see citing works
“The literature includes many studies on the effects of physical activity on individuals with ASD (Casta ~ no et al. 2024; Ranieri et al. 2023; Sansi, Nalbant, and Ozer 2021; Shahane, Kilyk, and Srinivasan 2024).”
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Effectiveness of Brain Training Exercises on Visual and Auditory Memory in Students with Dyslexia
Kalantari, A. V., Marashian, F. S., Bozorgi, Z. D., & Hafezi, F. (2024) · Educational research in medical sciences · doi:10.5812/ermsj-151747
Socialization of children with autism spectrum disorder complicated by concomitant disorders
Rymbekovna, R. A., Turebayeva, K., Muratovna, R. A., Olexyuk, Z., Valeryevna, Y. I., & Жусупбекова, З. Д. (2025) · Journal Of Advanced Pharmacy Education And Research · doi:10.51847/8cqntpyjyg
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Isroyati, Laksono, K., & Mintowati (2025) · Multidisciplinary Science Journal · doi:10.31893/multiscience.2026300
“Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impairments in social communication and interaction, as well as restricted and repetitive behaviors (Maurya & Khan, 2022; Ranieri et al., 2023).”
Gökhan, İ., & Elmas, Ö. F. (2025) · Herkes için Spor ve Rekreasyon Dergisi · doi:10.56639/jsar.1804873
Complementary and Alternative Treatments for Autism Spectrum Disorder: A Comprehensive Review
Demir, M. H. B. (2026) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1616996
Laurenti, F., Presta, V., Compiani, M., Zobbi, G., Ilari, B., Picchi, M. P., Maré, E., Severini, F., Guarnieri, A., Mazzei, S., et al. (2026) · Sports · doi:10.3390/sports14020080
“However, physical activity has emerged as a promising non-pharmacological intervention for children with ASD, with evidence supporting its effectiveness in enhancing both motor skills and social functioning [12,13].”
Dastamooz, S., Boroujeni, S. T., Zou, L., Farahani, M. H. D., Hasani, M., Dastamouz, S., Sarahian, N., Hosseini, S. A., & Kordnayej, M. (2026) · Research in Autism · doi:10.1016/j.reia.2026.202879
Egwu, E. O., Chukwuemeka, E. K., Napoleon, T., Oyedele, T. J., Ogheneruona, D. O., Christopher, U. N., Solomon, A. O., Onwurah, C. B., Obodoeze, A. E., Ogungbemi, E. F., et al. (2026) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-026-07435-9
Chen, L., Mei, Z., Cai, C., Yin, T., & Xiang, Y. (2026) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2026.105362
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“Beyond the genome, exploring how alterations in the gut microbiota further influence neurobehavioral symptoms may offer critical insights into the multifaceted clinical heterogeneity of patients with ASD [50].”
Self-citationBalance of Life: Exercise as a Vehicle for the Soul and Mind
Ernandini, E., & Trinita, D. C. (2026) · IntechOpen eBooks · doi:10.5772/intechopen.1017545
Goncalo, A. K. (2026) · Journal of Alzheimer s Disease · doi:10.1177/13872877261491809
- Authors
- Ranieri, A., Mennitti, C., Falcone, N., La Monica, I., Di Iorio, M. R., Tripodi, L., Gentile, A., Vitale, M., Pero, R., Pastore, L., D’Argenio, V., Scudiero, O., & Lombardo, B.
- Affiliations
- CEINGE Biotecnologie Avanzate Franco Salvatore (Italy) (IT)
- University of Naples Federico II (IT)
- San Raffaele University of Rome (IT)
- Corresponding author
- Scudiero, Olga
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2023-10-10
- Volume
- 14
- Pages
- 1238797-1238797
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC10681626
- OpenAlex
- W4387498738
- Cited by
- 32
- References
- 130
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 10
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, physical activity, exercise intervention, gut microbiota, metabolic disorders, gastrointestinal diseases, obesity, cardiovascular disease, social behavior, communication, children
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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