Physical Activity-Based Interventions and Emotional Regulation in Individuals with Autism Spectrum Disorder: A Systematic Review

Background: Difficulties in emotional regulation are highly prevalent in individuals with autism spectrum disorder (ASD) and are closely associated with anxiety and reduced quality of life. Physical activity has been proposed as a complementary, non-pharmacological intervention to support emotional functioning in this population. Objective: This systematic review examined the effects of physical activity-based interventions on emotional regulation in individuals with ASD, with anxiety considered as a related but secondary outcome. Methods: The review followed PRISMA guidelines. Searches were conducted in PubMed and Web of Science. Randomized controlled trials published in English or Spanish that evaluated physical activity interventions and reported outcomes related to emotional regulation or anxiety were included. Cochrane RoB 2 was used to assess the risk of bias. Results: Six trials involving 389 participants, including children and adults with ASD, were included. Interventions comprised aerobic exercise, motor skill and balance training, aquatic programs, and technology-assisted interventions, with durations of 5–10 weeks. Overall, intervention groups showed improvements in emotional regulation and reductions in anxiety compared with control conditions, although methodological limitations and risk of bias were present. Conclusions: Physical activity-based interventions may support emotional regulation in individuals with ASD; however, heterogeneity across studies and methodological concerns warrant cautious interpretation.