Table 2_The impact of physical play-based games on executive functions and social behaviors in children with autism spectrum disorder: a systematic review and meta-analysis.docx

ObjectiveTo conduct a systematic review and meta-analysis examines the impact of physical play-based games on executive functions and social behaviors in children with Autism Spectrum Disorder (ASD),and to compare the differences in effects across intervention types and dosages through subgroup analysis. To our knowledge, this is the first meta-analysis to concurrently evaluate these two domains in this population.
MethodsSix databases (CNKI, Wanfang, PubMed, Cochrane Library, Web of Science, Embase) were searched from inception to December 20, 2025, for randomized controlled trials (RCTs) and non-RCTs on physical play-based Games interventions for children with ASD. Two researchers independently screened studies, extracted data, and assessed using the Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and the ROBINS-I tool for non-randomized studies. Meta-analysis was performed using STATA 18.0 with a random-effects model. Effect sizes were expressed as standardized mean differences (SMD) with 95% confidence intervals (CI).
ResultsTwelve studies involving 520 children with ASD were included. Meta-analysis showed that physical play-based games significantly improved social behavior in children with ASD (SMD = 0.68, 95% CI [0.49, 0.88], P < 0.001). However, the improvement in executive function did not reach statistical significance (SMD ≈ 0.31, 95% CI [-0.04, 0.67], P > 0.05). Given the limited number of studies (n=4) and the marginal nature of this finding, this result should be interpreted with caution and requires confirmation in future research. Subgroup analysis indicated that traditional physical play-based games, high-frequency (≥4 sessions/week), and longer-duration (≥60 minutes/session) interventions showed numerically larger effect sizes, but the differences between subgroups were not statistically significant.
Conclusionphysical play-based games are an effective intervention for improving social behavior in children with ASD, with a moderate and consistent effect. Structured group-based physical play-based games are recommended in practice, with adjustments based on individual child characteristics. Further high-quality research is needed to verify long-term effects and generalization.

研究目的：本研究旨在开展系统综述与元分析，探讨肢体游戏类干预对自闭症谱系障碍（Autism Spectrum Disorder, ASD）儿童执行功能与社会行为的影响，并通过亚组分析比较不同干预类型及干预剂量下的效应差异。据我们所知，本研究是首个在该人群中同时评估这两个领域的元分析。

研究方法：检索建库至2025年12月20日的CNKI、万方、PubMed、Cochrane Library、Web of Science、Embase共6个数据库，收集关于肢体游戏类干预用于自闭症患儿的随机对照试验（randomized controlled trials, RCT）与非随机对照试验。由2名研究者独立完成文献筛选、数据提取，并分别采用Cochrane偏倚风险评估工具（RoB 2）评估RCT的偏倚风险、ROBINS-I工具评估非随机研究的偏倚风险。采用STATA 18.0软件及随机效应模型进行元分析，效应量以标准化均数差（standardized mean difference, SMD）及95%置信区间（confidence interval, CI）表示。

研究结果：最终纳入12项研究，共涉及520名自闭症患儿。元分析结果显示，肢体游戏类干预可显著改善自闭症患儿的社会行为（SMD=0.68，95%CI[0.49, 0.88]，P<0.001）；但该干预对患儿执行功能的提升未达到统计学显著性（SMD≈0.31，95%CI[-0.04, 0.67]，P>0.05）。鉴于相关研究数量较少（n=4）且该结果仅存在边际显著性，解读该结果时需谨慎，后续仍需更多研究加以验证。亚组分析显示，传统肢体游戏干预、高频率（≥4次/周）及长时长（≥60分钟/次）的干预方案效应量数值更大，但亚组间差异未达到统计学显著性。

研究结论：肢体游戏类干预是改善自闭症患儿社会行为的有效手段，效应量中等且结果稳定。临床实践中推荐采用结构化的团体肢体游戏干预，并可根据患儿个体特征进行调整。未来仍需开展高质量研究以验证其长期效应与推广性。