Effects of Physical Activity and Exercise Interventions on Physical Fitness Outcomes in Children and Adolescents with Developmental Coordination Disorder: A Systematic Review

BACKGROUND: Developmental Coordination Disorder (DCD) affects 5-6% of school-aged children and is associated with reduced physical activity (PA) and poorer physical fitness (PF). However, it remains unclear which PA and exercise interventions effectively improve specific PF components in this population. OBJECTIVE: To synthesize randomized controlled trial (RCT) evidence on PA and exercise interventions for PF outcomes and PA behavior in individuals with DCD. METHODS: We searched six databases for RCTs of PA or exercise interventions involving participants with DCD aged 3-25 years. Primary PF outcomes were standardized measures of cardiorespiratory fitness (CRF), muscular strength/power, muscular endurance, and speed/agility; PA behavior was extracted separately when reported. Findings were synthesized narratively by component and timing and certainty were assessed using GRADE. RESULTS: Ten RCTs with sample sizes ranging from 21 to 161 participants were included. Nine trials enrolled children, one adolescent, and none enrolled young adults. Heterogeneity in interventions, outcome measures, assessment times and reporting precluded meta-analysis. Several trials reported immediate improvements in selected muscular strength/power outcomes, but certainty was low. Evidence for CRF and speed/agility was very low certainty; muscular endurance improved in one low certainty trial. Evidence for PA behavior was very low certainty and did not establish sustained change specific to DCD. CONCLUSIONS: PA and exercise interventions may improve selected immediate muscular strength/power outcomes in children and adolescents with DCD, but the evidence is low certainty and outcome specific. Evidence for CRF, speed/agility, PA behavior, and persistence of effects remain very uncertain. Future trials should include adolescents and young adults, prespecify core PF outcomes, report compatible between-group estimates, and assess persistence of effects post-cessation.