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Completed

NCT Number: NCT07410897

Adapted Aquatic Exercise and Behavioral Outcomes, Flexibility, and Handgrip Strength in Children With Autism Spectrum Disorder

This randomized clinical trial studied whether an adapted aquatic exercise program could improve behavior and physical abilities in children with autism spectrum disorder (ASD). Thirty-five boys aged 6 to 12 years with mild ASD participated in the study. Participants were randomly assigned to either an aquatic exercise group or a control group.

The aquatic exercise group took part in a structured, individualized swimming and water-based exercise program twice per week for 16 weeks, while the control group continued their regular academic education without additional exercise. The program focused on water safety, breathing control, and basic swimming movements.

Outcomes were measured before and after the 16-week period. Autism-related behaviors were evaluated using the Autism Behavior Checklist. Physical abilities were assessed using flexibility (sit-and-reach test) and handgrip strength measurements.

The study aimed to determine whether regular participation in adapted aquatic exercise could reduce autism-related behaviors and improve motor skills that are important for daily life activities in children with ASD.

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Key information

Conditions

Autism Spectrum Disorder Child Development Disorders, Pervasive Mental Disorders Neurodevelopmental Disorders

Age range

6 year–12 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Aksaray University

Aksaray, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male children aged 6 to 12 years
  • Clinical diagnosis of mild autism spectrum disorder confirmed by a licensed -child psychiatrist according to DSM-5 criteria
  • Medical clearance for participation in aquatic exercise
  • Ability to follow verbal and visual instructions
  • Ability to imitate fine and gross motor movements
  • Independent in toileting
  • Not participating in structured sports or exercise programs other than standard academic instruction
  • Written informed consent provided by a parent or legal guardian

Exclusion criteria

  • Severe autism spectrum disorder
  • Orthopedic, neurological, or medical conditions that contraindicate participation in aquatic exercise
  • Current participation in structured physical training or sports programs outside of school
  • Inability to safely participate in water-based activities

Treatment and study plan

Adapted Aquatic Exercise Program

Behavioral

A structured adapted aquatic exercise program conducted over 16 weeks, with two 50-minute sessions per week. Sessions were delivered individually by certified adapted swimming instructors and included water familiarization, pool safety, breathing exercises, upper- and lower-limb propulsion, and progressive freestyle swimming skills.

Academic Instruction

Other

Standard academic education provided by the school without participation in structured physical activity or aquatic exercise programs during the study period.

Primary outcomes

  1. Handgrip Strength

    Time frame: Baseline and 16 weeks

    Handgrip strength was measured using a calibrated handgrip dynamometer. Participants performed maximal voluntary contractions, and the highest valid value (kilograms) was recorded.

  2. Autism-Related Behaviors

    Time frame: Baseline and 16 weeks

    Autism-related behaviors were assessed using the Autism Behavior Checklist (ABC), a 57-item questionnaire completed by classroom teachers familiar with the participants' daily behavior patterns. Higher total scores indicate greater severity of autism-related behaviors.

  3. Flexibility

    Time frame: Baseline and 16 weeks

    Flexibility will be assessed using the sit-and-reach test with a standardized sit-and-reach box. Participants perform three trials, and the best score (in centimeters) is recorded for analysis. The score represents the maximum forward reach distance. The scale is continuous, with higher values indicating greater flexibility. Typical values range from negative values (unable to reach the toes) to approximately 30-40 cm, depending on performance.

Sponsors and collaborators

Lead sponsor

Princess Nourah Bint Abdulrahman University

Other

Collaborators

  • Aksaray University

Registry information

Official study title

Effects of Adapted Aquatic Exercise on Behavioral Outcomes, Flexibility, and Handgrip Strength in Male Children With Autism Spectrum Disorder: A Randomized Clinical Trial

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Feb 13, 2026
Registry last updated
Mar 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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