Effects of exercise interventions on executive function in adolescents: a systematic review and three-level meta-analysis of randomized controlled trials
- 1School of Physical Education, Yunnan Minzu University
- 2School of Education, Yunnan Minzu University
- 3School of Physical Education, Yunnan University
Abstract
Objective: To estimate the effects of exercise interventions lasting at least 4 weeks on overall executive function and its three domains in adolescents, and to explore differences across population subgroups.
Methods: Nine databases were systematically searched. Individually randomized parallel-group trials of adolescents aged 10–19 years comparing exercise with no additional structured exercise were included. Dependent Hedges’ g estimates were synthesized using three-level models with approximate within-trial covariance and trial-clustered CR2 inference. Risk of bias and evidence certainty were assessed using RoB 2 and GRADE.
Results: Twenty-two independent trials (1,599 unique participants) contributed 27 comparisons and 86 effect sizes. The pooled overall EF effect favored exercise (g = 0.55, 95% CI 0.33 to 0.77; p < 0.001), with substantial total heterogeneity (I² = 84.92%). Domain-specific estimates also favored exercise: inhibitory control (17 trials; g = 0.56, 95% CI 0.28 to 0.84), working memory (10 trials; g = 0.51, 95% CI 0.18 to 0.84), and cognitive flexibility (nine trials; g = 0.43, 95% CI 0.30 to 0.57). The overall estimate was more heavily informed by inhibitory-control scores (47/86) than by working-memory (25/86) or cognitive-flexibility scores (14/86). Correlation, trial-exclusion, risk-of-bias, and task-classification sensitivity analyses retained effects in the same direction. Certainty was low for overall EF, inhibitory control, and working memory, and moderate for cognitive flexibility.
Conclusion: Sustained exercise may improve performance on EF tasks in adolescents, but heterogeneous interventions and controls, overlapping task constructs, and mostly low-certainty evidence limit the generality and real-world interpretation of the pooled effects.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261475826 , identifier CRD420261475826
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BibTeX
@article{li2026effects,
title = {{Effects of exercise interventions on executive function in adolescents: a systematic review and three-level meta-analysis of randomized controlled trials}},
author = {Dongying Li and Shixian Li and Min Yao and Sihong Ye and Kun Geng and Liyong Zhou and Lulu Niu},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1968917},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1968917/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of exercise interventions on executive function in adolescents: a systematic review and three-level meta-analysis of randomized controlled trials
AU - Dongying Li
AU - Shixian Li
AU - Min Yao
AU - Sihong Ye
AU - Kun Geng
AU - Liyong Zhou
AU - Lulu Niu
PY - 2026
DA - 2026/10/27
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1968917
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1968917/full
AB - Objective: To estimate the effects of exercise interventions lasting at least 4 weeks on overall executive function and its three domains in adolescents, and to explore differences across population subgroups. Methods: Nine databases were systematically searched. Individually randomized parallel-group trials of adolescents aged 10–19 years comparing exercise with no additional structured exercise were included. Dependent Hedges’ g estimates were synthesized using three-level models with approximate within-trial covariance and trial-clustered CR2 inference. Risk of bias and evidence certainty were assessed using RoB 2 and GRADE. Results: Twenty-two independent trials (1,599 unique participants) contributed 27 comparisons and 86 effect sizes. The pooled overall EF effect favored exercise (g = 0.55, 95% CI 0.33 to 0.77; p < 0.001), with substantial total heterogeneity (I² = 84.92%). Domain-specific estimates also favored exercise: inhibitory control (17 trials; g = 0.56, 95% CI 0.28 to 0.84), working memory (10 trials; g = 0.51, 95% CI 0.18 to 0.84), and cognitive flexibility (nine trials; g = 0.43, 95% CI 0.30 to 0.57). The overall estimate was more heavily informed by inhibitory-control scores (47/86) than by working-memory (25/86) or cognitive-flexibility scores (14/86). Correlation, trial-exclusion, risk-of-bias, and task-classification sensitivity analyses retained effects in the same direction. Certainty was low for overall EF, inhibitory control, and working memory, and moderate for cognitive flexibility. Conclusion: Sustained exercise may improve performance on EF tasks in adolescents, but heterogeneous interventions and controls, overlapping task constructs, and mostly low-certainty evidence limit the generality and real-world interpretation of the pooled effects. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261475826 , identifier CRD420261475826
SN - 1664-0640
ER -