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Peer-reviewedCC BY 4.0Frontiers in Public Health

Intervention effects of physical exercise on negative emotional symptoms in college students: a three-level meta-analysis

  • Zhenyao Wang1
  • Lingling Dong2
  • Yan Rao3
  • Haiyan Wen4
  • Cong Liu5
  • Min Huang6
6 affiliations
  1. 1School of Sport, Loughborough University
  2. 2Department of Psychiatry, Shanghai Baoshan District Mental Health Center
  3. 3Shanghai Normal University Tianhua College
  4. 4School of Physical Education & Health, Shanghai University of International Business and Economics
  5. 5School of Physical Education, Shanghai University of Sport
  6. 6School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance
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Abstract

Objective: To systematically evaluate the effects of physical exercise on negative emotional symptoms in college students and examine potential moderators and dose–response relationships.

Methods: Five English-language databases were searched from inception to March 22, 2026. Risk of bias was assessed using the Risk of Bias 2.0 (RoB 2.0) tool, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Hedges’ g values with 95% confidence intervals (CIs) and prediction intervals (PIs) were pooled using three-level random-effects models. Influence diagnostics, sensitivity analyses, subgroup analyses, publication bias tests, and dose–response analyses were conducted.

Results: Forty-three studies were included. The full-dataset three-level model, retained as the primary analysis, showed a non-significant overall effect (Hedges’ g = −1.48, 95% CI −3.21 to 0.26, p = 0.094; 95% PI −12.95 to 9.99). Two highly influential effect sizes from one study were identified. Excluding these effects, the influence-adjusted analysis showed a significant effect (Hedges’ g = −0.56, 95% CI −0.73 to −0.39, p < 0.001; 95% PI −1.45 to 0.33). In influence-adjusted exploratory analyses, baseline population characteristics, geographic region, and outcome measurement instrument were significant moderators, whereas symptom category, exercise modality, frequency, session duration, intervention duration, and publication year were not. No significant linear or nonlinear dose–response relationships were found for weekly or total exercise duration. Overall certainty of evidence was very low.

Conclusion: The full-dataset analysis did not provide statistically significant evidence of an overall effect. Although the influence-adjusted analysis suggested a potential benefit, the result was sensitive to influential observations and certainty of evidence was very low. Accordingly, no definitive conclusion regarding efficacy can be drawn. Potential moderator findings require confirmation in future high-quality randomized controlled trials.

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Cite

BibTeXRIS
BibTeX
@article{wang2026intervention,
  title = {{Intervention effects of physical exercise on negative emotional symptoms in college students: a three-level meta-analysis}},
  author = {Zhenyao Wang and Lingling Dong and Yan Rao and Haiyan Wen and Cong Liu and Min Huang},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1911631},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1911631/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Intervention effects of physical exercise on negative emotional symptoms in college students: a three-level meta-analysis
AU  - Zhenyao Wang
AU  - Lingling Dong
AU  - Yan Rao
AU  - Haiyan Wen
AU  - Cong Liu
AU  - Min Huang
PY  - 2026
DA  - 2026/10/22
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1911631
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1911631/full
AB  - Objective: To systematically evaluate the effects of physical exercise on negative emotional symptoms in college students and examine potential moderators and dose–response relationships.  Methods: Five English-language databases were searched from inception to March 22, 2026. Risk of bias was assessed using the Risk of Bias 2.0 (RoB 2.0) tool, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Hedges’ g values with 95% confidence intervals (CIs) and prediction intervals (PIs) were pooled using three-level random-effects models. Influence diagnostics, sensitivity analyses, subgroup analyses, publication bias tests, and dose–response analyses were conducted.  Results: Forty-three studies were included. The full-dataset three-level model, retained as the primary analysis, showed a non-significant overall effect (Hedges’ g = −1.48, 95% CI −3.21 to 0.26, p = 0.094; 95% PI −12.95 to 9.99). Two highly influential effect sizes from one study were identified. Excluding these effects, the influence-adjusted analysis showed a significant effect (Hedges’ g = −0.56, 95% CI −0.73 to −0.39, p < 0.001; 95% PI −1.45 to 0.33). In influence-adjusted exploratory analyses, baseline population characteristics, geographic region, and outcome measurement instrument were significant moderators, whereas symptom category, exercise modality, frequency, session duration, intervention duration, and publication year were not. No significant linear or nonlinear dose–response relationships were found for weekly or total exercise duration. Overall certainty of evidence was very low.  Conclusion: The full-dataset analysis did not provide statistically significant evidence of an overall effect. Although the influence-adjusted analysis suggested a potential benefit, the result was sensitive to influential observations and certainty of evidence was very low. Accordingly, no definitive conclusion regarding efficacy can be drawn. Potential moderator findings require confirmation in future high-quality randomized controlled trials.
SN  - 2296-2565
ER  -