ObjectiveTo evaluate the effect of physical activity on children and adolescents with disabilities using the International Classification of Functioning, Disability and Health (ICF), and systematically review the systematic reviews. MethodsThe systematic reviews of participation of children and adolescents with disabilities in physical activity and their health benefits were searched from databases of Web of Science, PubMed, EBSCO, CNKI, Wanfang Data and VIP, from the establishment of the database to October, 2022, and a systematic review was conducted. ResultsNine systematic reviews were included, from six countries, with 138 randomized controlled trials and 4 878 participants (three to 18 years). The main sources were journals in rehabilitation psychology, medicine, and sports psychology, etc., published between 2015 and 2022. The main health-related conditions were Down syndrome, cerebral palsy, motor coordination disorder, tetraplegia, attention deficit hyperactivity disorder, anxiety disorder and depression, mood disorders, vestibular impairment, and sensorineural hearing loss. Beneficial physical activity modalities included aerobic exercise, core strengthening, progressive resistance training, high intensity interval training, attentional motor training, gait and balance training, vestibular specific neuromuscular training, perceptual motor training, swimming, soccer, tennis, gymnastics, and dance, etc.; recommended as five to 120 minutes a time, one to 80 times a week, moderate to high intensity, for one to 139 weeks. The scenarios were mainly exercise training, and the settings were in special education schools and the community. Health benefits included improving health condition, such as reducing symptoms of disabilities (physical disability, intellectual disability, hearing impairment and psychiatric disability); increasing levels of physical activity such as walking, mobility, balance, dexterity, postural control; promote mental health, such as relieving depression, anxiety and stress; improving quality of life and well-being, such as socialization, self-worth, self-efficacy, exercise habits and happiness. ConclusionA conceptual framework of the health effects of physical activity on the children and adolescents with disabilities had been constructed using ICF. The health-related conditions of children and adolescents with disabilities are mainly divided into four categories: intellectual and developmental disabilities, physical disabilities, psychiatric disabilities, and hearing impairments. The types of physical activities in which children and adolescents with disabilities participate include physical fitness, skills and sports programs. The health and functional benefits of participation in physical activity are reflected in three main areas: physical and mental health, activity and participation, and quality of life and well-being.