The association between physical activity and mental health in children with special educational needs: A systematic review

The association between physical activity (PA) and mental health in typically developing children has been amply documented, but little is known about the corresponding association in children with special educational needs (SEN). This systematic review aimed to synthesize the evidence for the association between PA and mental health in children with SEN. A systematic literature search of five databases (PsycINFO, SPORTDiscus, PubMed, Web of Science, and CINAHL) was conducted, and the publication year was between October 2010 and February 2021. Two researchers performed abstract and full text screening and extracted the data independently. Inclusion and exclusion criteria followed the PICOS framework, and the quality of eligible studies was assessed using the McMaster critical review form. Eighteen studies that met the inclusion criteria and had quality ratings ≥ 60% were included in this review. PA was positively associated with overall psychological well-being and its subtypes (including enjoyment, self-worth, self-competence, mental wellness, and quality of life), and negatively associated with anxiety and fatigue. Body composition, age, and sex were moderators of the association. The findings of this review indicated that PA was consistently associated with mental health in children with SEN. These associations were the most powerful when PA was conducted in unstructured types such as free play and recess activities. Structured types including physical education classes were more strongly related to mental health than overall PA (combined structured and unstructured types). Future PA interventions are needed to promote mental health in children with SEN.