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Effect of Aquatic Training Versus Land Exercises on Motor Function in Children With Autism Spectrum Disorder: A Randomized Controlled Trial

Physiother Res Int. 2026 Apr;31(2):e70220. doi: 10.1002/pri.70220.

ABSTRACT

BACKGROUND: Autism Spectrum disorder (ASD) is a neurodevelopmental condition characterized by intensely repetitive and limited behaviors as well as deficiencies in perceptuo-motor processing and interpersonal interaction capabilities.

OBJECTIVES: The objective of this paper is to evaluate the effectiveness of aquatic training (AT) versus land-based exercises (LBE) on the quality of life (QoL), motor function, and autistic traits in children with ASD.

METHODS: Fifty children with ASD diagnoses of both sexes, aged from three to five years, were assigned to two groups at random (n = 25 each). AT was given to the AT group, whereas LBE was given to the LE group for 45 min three times a week for three successive months. Before and after the recommended intervention period, the Childhood Autism Rating Scale (CARS-2), Peabody Developmental Motor Scale (PDMS-2), and Arabic version of the Pediatric QoL generic core scale (PedsQL) were used to measure autistic features, motor skills, and QoL, respectively.

RESULTS: Within-group comparison showed significant improvement in PedsQL, PDMS-2 and CARS-2 scores (p < 0.001). Additionally, between-group comparison reveled significant improvement in CARS-2 and PedsQL and PDMS-2 (stationery and locomotion age equivalent and gross motor quotient) of the AT group compared with that of the LE group posttreatment (p < 0.001).

CONCLUSION: AT demonstrated higher efficacy than LBE, yielding greater improvements in motor development and QoL, as well as more pronounced enhancements in sensory integration among young children with ASD. Thereupon, it is worthwhile for physical rehabilitation practitioners to include the AT in the intervention plans for children with ASD.

TRIAL REGISTRATION: The clinical trial registration number of the current study is as follows: Registry submission date 11/5/2021 URL: https://www.

CLINICALTRIALS: gov/study/NCT05123066?tab=table; ID number: NCT05123066.

PMID:41988871 | DOI:10.1002/pri.70220