长期身体活动对孤独症谱系障碍儿童执行功能效果的系统综述

doi:10.3969/j.issn.1006-9771.2024.05.006

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (5): 535-542.doi: 10.3969/j.issn.1006-9771.2024.05.006

长期身体活动对孤独症谱系障碍儿童执行功能效果的系统综述

钟晓珂¹^,², 王琦³, 昌思琴², 蒋长好⁴()

1.福建师范大学体育科学学院，福建福州市 350108
2.首都体育学院运动科学与健康学院，北京市 100191
3.首都体育学院体育人工智能研究院，北京市 100191
4.首都体育学院运动脑成像研究中心，北京市 100089

收稿日期:2024-04-18 出版日期:2024-05-25 发布日期:2024-06-12
通讯作者: 蒋长好(1966-)，男，汉族，安徽巢湖市人，博士，教授，主要研究方向：脑科学与运动认知。E-mail： jiangchanghao@cupes.edu.cn
作者简介:钟晓珂(1996-)，女，汉族，河南濮阳市人，博士研究生，主要研究方向：脑科学与运动认知。
基金资助:
1.国家自然科学基金项目(32371132);2.北京市社会科学基金项目(19YTA001);3.首都体育学院体育医学工程学新兴交叉学科平台研究项目(20230929)

Effect of long-term physical activity on executive function of children with autism spectrum disorder: a systematic review

ZHONG Xiaoke¹^,², WANG Qi³, CHANG Siqin², JIANG Changhao⁴()

1. School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian 350108, China
2. School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
3. Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing 100191, China
4. The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100089, China

Received:2024-04-18 Published:2024-05-25 Online:2024-06-12
Contact: JIANG Changhao, E-mail: jiangchanghao@cupes.edu.cn
Supported by:
National Natural Science Foundation of China(32371132);Beijing Key Project of Philosophy and Social Sciences(19YTA001);Capital University of Physical Education and Sports Emerging Interdisciplinary Platform for Medicine and Engineering in Sports(20230929)

摘要/Abstract

摘要：

目的根据《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法，建立孤独症谱系障碍(ASD)儿童身体活动的范畴和结构，系统评价长期身体活动对ASD儿童执行功能的影响。

方法检索万方数据库、中国知网、PubMed、Web of Science和ProQuest等数据库，收集2014年至2023年公开发表的身体活动与ASD儿童执行功能相关的文献，根据文献的纳入和排除标准纳入文献，采用PRISMA指南对纳入文献进行系统综述，采用物理治疗证据数据库(PEDro)量表对文献质量进行评价。

结果最终纳入10篇文献，包括9项随机对照试验和1项非随机对照试验，共351例ASD儿童，年龄3~18岁；来自意大利、加拿大、韩国、中国、美国5个国家；发表时间集中在2016年之后。ASD儿童的身体活动主要包括运动项目类活动(如棒球、篮球、乒乓球、马术辅助活动)、技能类活动(如自行车、认知运动训练、运动式游戏)、体能类活动(SPARK)，以及格斗类项目(格斗和空手道)。干预频率每次30~70 min，以每次45 min居多；每周1~5次，以每周2次居多；持续2~24周，以12周居多。长期身体活动可以改善ASD儿童的抑制控制和认知灵活性，对工作记忆的改善效果存在不一致现象。

结论长期身体活动对ASD儿童执行功能的改善具有选择性影响，可以改善ASD儿童的抑制控制和认知灵活性，对工作记忆的改善还存在一定分歧。

关键词: 孤独症谱系障碍, 儿童, 身体活动, 执行功能, 系统综述

Abstract:

Objective To establish the categories and structure of physical activity in children with autism spectrum disorder (ASD), and systematically evaluate the long-term effect of physical activity on the executive function of children with ASD, based on the theoretical and methodological framework of the International Classification of Functioning, Disability, and Health-Children and Youth version (ICF-CY).

Methods A search was conducted in databases such as Wanfang data, CNKI, PubMed, Web of Science and ProQuest, to collect literatures about long-term physical activity for executive function of children with ASD published from 2014 to 2023. The literatures were reviewed based on inclusion and exclusion criteria, following PRISMA guidelines for systematic review, and the quality of the included literatures were assessed with the Physiotherapy Evidence Database (PEDro) scale.

Results Totally, ten articles were included, consisting of nine randomized controlled trials (RCTs) and one non-randomized controlled trial, with a total of 351 children diagnosed as ASD, aged three to 18 years, came from Italy, Canada, South Korea, China and the United States, published mainly after 2016. Physical activity primarily included sports activities (such as baseball, basketball, table tennis and equine-assisted activities), skill-based activities (such as cycling, cognitive-motor training and active gaming), physical fitness activities (SPARK), as well as combat-related activities (martial arts and karate); 30 to 70 minutes a time (mainly 45 minutes), one to five times a week (mainly twice a week), for two to 24 weeks (mainly twelve weeks). Long-term physical activities had been found to improve inhibitory control and cognitive flexibility in children with ASD, although the effect on working memory was inconsistent.

Conclusion Long-term physical activity may positively impact on executive function in children with ASD, especially inhibitory control and cognitive flexibility. However, the effect on working memory need more researches.

Key words: autism spectrum disorder, children, physical activity, executive function, systematic review

中图分类号:

R749.93

钟晓珂, 王琦, 昌思琴, 蒋长好. 长期身体活动对孤独症谱系障碍儿童执行功能效果的系统综述[J]. 《中国康复理论与实践》, 2024, 30(5): 535-542.

ZHONG Xiaoke, WANG Qi, CHANG Siqin, JIANG Changhao. Effect of long-term physical activity on executive function of children with autism spectrum disorder: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 535-542.

图/表 4

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率≤15%	意向性分析	组间统计比较	变异性测量	总分
Borgi等^[26](2016)	√	√		√		√	√	√	√	√	√	8
Greco等^[27](2020)	√	√	√	√	√	√	√	√	√	√	√	10
Macoun等^[28](2021)	√	√		√	√	√	√	√	√	√	√	9
Nekar等^[29](2022)	√	√		√				√	√	√	√	6
Pan等^[30](2017)	√	√		√				√	√	√	√	6
Phung等^[31](2019)	√	√	√	√	√	√	√	√	√	√	√	10
Rafiei等^[32](2021)	√	√		√				√	√	√	√	6
Tse等^[33](2019)	√	√		√	√	√	√	√	√	√	√	9
Tse等^[34](2021)	√	√		√	√	√	√	√	√	√	√	9
Wang等^[35](2020)	√			√	√			√	√	√	√	6

纳入文献	国家	年龄/岁	样本量	设计	干预方式	干预时间	ASD诊断标准	结局指标	测量工具
Borgi等^[26](2016)	意大利	6~12	试验组(n = 15) 对照组(n = 13)	RCT	马术活动	每次60 min，每周1次，共24周	未说明	执行功能	TOL
Greco等^[27](2020)	意大利	8~11	试验组(n = 14) 对照组(n = 14)	RCT	空手道训练	每次45 min，每周2次，共24周	AODS-2	执行功能	BRIEF-P
Macoun等^[28] (2021)	加拿大	6~12	试验组(n = 9) 对照组(n = 11)	RCT	认知运动训练	每次30 min，每周3次，共8周	DSM-IV	工作记忆	WISC-IV
Nekar等^[29](2022)	韩国	6~18	试验组(n = 12) 对照组(n = 12)	RCT	认知运动训练	每次45 min，每周2次，共12周	未说明	抑制控制工作记忆认知灵活性	SCWT、FDS、WCST
Pan等^[30] (2017)	中国	6~12	试验组(n = 11) 对照组(n = 11)	RCT	乒乓球	每次70 min，每周2次，共12周	DSM-IV	认知灵活性	WCST
Phung等^[31](2019)	美国	8~11	试验组(n = 14) 对照组(n = 20)	RCT	格斗训练	每次45 min，每周2次，共13周	AODS-2	抑制控制工作记忆认知灵活性	Hearts & Flowers test、BRIEF-P
Rafiei等^[32](2021)	意大利	6~10	试验组1 (n = 20) 试验组(n = 20) 对照组(n = 20)	RCT	SPARK、游戏运动	每次35 min，每周3次，共8周	AODS-2	认知灵活性	WCST
Tse等^[33] (2019)	中国	8~12	试验组(n = 19) 对照组(n = 21)	RCT	棒球	每次45 min，每周2次，共12周	DSM-5	抑制控制工作记忆	Go/No Go、CBTT、BDS
Tse等^[34] (2021)	中国	8~12	试验组1 (n = 22) 试验组2 (n = 20) 对照组(n = 20)	RCT	自行车	每次60 min，每周5次，共24周	DSM-5 AODS-2	抑制控制工作记忆认知灵活性	Go/No Go、CBTT、FDS、BDS、SCWT、TOL
Wang等^[35](2020)	中国	3~6	试验组(n = 18) 对照组(n = 15)	非RCT	迷你篮球	每次40 min，每周5次，共12周	DSM-5	抑制控制工作记忆认知灵活性	CHEXI

长期身体活动对孤独症谱系障碍儿童执行功能效果的系统综述

Effect of long-term physical activity on executive function of children with autism spectrum disorder: a systematic review

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