Network Meta-Analysis of Physical Activity Interventions On Cognitive Functions In Children With Autism Spectrum Disorder: A Protocol of Randomized Controlled Trials
Abstract Background: Autism spectrum disorder (ASD) symptoms are usually observed by the age of 2 years. However, the mechanism of ASD is still encompassed in a block box and no identified cure exists. Based on accumulating evidence, intensive early treatment such as physical activity or exercise can make a significant difference in the cognitive control and development in children with ASD. This study aims to update the knowledge on extant literature and explore the efficacy of physical activity intervention strategies (PAIS) on cognitive functions in children with ASD. Methods: A systematic review and network meta-analysis will be conducted following the preferred reporting items for systematic review and meta-analysis protocols for Network Meta-Analyses (PRISMA-NMA). Nine bibliographic databases (APA PsycInfo, Cochrane Central Register of Controlled Trials, Dimensions, ERIC, MEDLINE Complete, PubMed, Scopus, SPORTDiscus, Web of Science) will be systematically searched to screen eligible articles based on a series of inclusion and exclusion criteria. A study will be considered for inclusion if the study: (a) is not classified as a systematic review with or without meta-analysis; (b) is published from inception to date; (c) includes children aged 0-12 years with ASD; (d) quantitively measures cognitive outcomes; (e) treatment includes at least one PAIS. The internal validity and quality of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Statistical analyses will be produced in RStudio 3.6 with the BUGSnet package and Comprehensive Meta-Analysis 3.3. Discussion: This study will provide an updated review of the extant literature by using an appropriate network meta-analytic model and address the questions regarding efficacy of PAIS that significantly impact cognitive functions in children with ASD with implications for future decision making. Systematic review registration: PROSPERO CRD42021279054.