The Impact of Physiotherapy and Physical Activity in Autism: What Current Research Shows

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects not only communication and social interaction, but also motor development. According to research data, up to 83% of children with ASD experience difficulties in performing age-appropriate motor skills. In recent years, physiotherapy and physical activity have increasingly been considered important components of a comprehensive support approach for children with autism.

The aim of this article is to analyse current scientific evidence and evaluate the effectiveness of physiotherapy and structured physical activity programs in ASD.

Physiotherapy and Gross Motor Skills in Autism

One experimental study included 20 children with ASD aged 4–7 years, who were divided into two groups. The experimental group participated in a structured physical exercise program (60 minutes, 3 times per week, for 8 weeks), while the control group received standard physiotherapy.

The results showed that:

• children in the experimental group demonstrated statistically significant improvement in gross motor skills;

• standard physiotherapy also had a positive effect, but to a lesser extent.

These findings confirm that structured and goal-oriented physical activity programs may be more effective than non-specific physiotherapy alone.

Balance, Coordination, and Motivation: The Role of Play-Based Physiotherapy

Another study examined two simple physiotherapy approaches applied to 30 children with ASD aged 4–6 years in a kindergarten setting:

1. sessions in a gym environment;

2. play-based exercises using a smart board with balance platforms and unstable support surfaces.

Both programs lasted 5 weeks and resulted in positive changes in:

• balance,

• coordination,

• overall motor function.

The greatest effects were observed in the group using interactive smart board games. The authors attributed this to higher motivation and engagement among children with ASD. Gym-based sessions were also effective, but required greater psychological effort from the children.

Importantly, both approaches were considered simple and accessible for implementation at home, highlighting the role of parents in supporting their child’s motor development.

Evidence From Systematic Reviews: What Evidence-Based Medicine Shows

A systematic review including 41 studies (2000–2019) with more than 1,100 children with ASD reported:

• improvement in motor skills and participation in activities through physical exercise programs;

• positive effects of hydrotherapy, motor programs, exergaming, and hippotherapy on balance, coordination, and functional abilities;

• greater effectiveness of visual instructions compared to verbal instructions when teaching motor skills.

However, the authors emphasised that the overall quality of evidence remains low, due to small sample sizes and methodological heterogeneity across studies.

Meta-Analysis of RCTs: Impact on Core Autism Symptoms

More comprehensive data are presented in a meta-analysis of 28 randomised controlled trials (1,081 participants) focused on Physical Exercise Therapy (PET).

The main conclusions were:

• significant improvement in motor functions;

• reduction in restricted and repetitive behaviours;

• moderate improvement in social functioning.

At the same time, only three studies were rated as high quality, and the overall risk of bias remains high. Therefore, the authors recommend interpreting the results with caution.

Overall Conclusion

Based on current research, the following conclusions can be drawn:

• Physiotherapy and physical activity are effective in autism, particularly with respect to motor development, balance, and coordination.

• Structured and play-based forms of exercise demonstrate greater effectiveness and engagement among children.

• Physical therapy may have an indirect positive effect on behaviour and social skills.

• Despite promising results, the overall level of evidence remains limited, and larger, higher-quality studies are needed.
  

Practical Significance

Physiotherapy is not a treatment for autism, but it represents an important and safe component of comprehensive care that:

• improves the child’s functional independence;

• enhances quality of life;

• supports better adaptation in daily activities.

For this reason, modern clinical recommendations increasingly include physiotherapy and physical activity as part of support programs for children with ASD.

Discuss a comprehensive support program for your child Physiotherapy and physical activity are part of an integrated medical approach for children with ASD. An individual medical consultation helps determine whether a comprehensive program may be appropriate in your case. Request a medical consultation