Play Smart, Be Smart? Effect of Cognitively Engaging Physical Activity Interventions on Executive Function among Children 4~12 Years Old: A Systematic Review and Meta-Analysis

Effects of open-skill exercise on executive functions in children and adolescents: a systematic review and meta-analysis

Background

The research on the intervention of open-skill exercise on the executive functions of children and adolescents still requires quantitative synthesis, and there is inconsistency in the effects of intervention by strategic and interceptive skills, which are sub-divided from open-skill exercise. Therefore, this study systematically explores the aforementioned issues and examines the potential moderating factors in the effects of open-skill exercise intervention on executive functions.

Methods

Computer searches of the CNKI, WOS, PubMed, ScienceDirect and SPORTDiscus databases were conducted. Two researchers independently screened the articles and extracted data, and used the bias risk assessment tool recommended by the Cochrane Collaboration Network and the Methodological Index for Non- Randomized Studies (MINORS) scale to assess included randomized controlled trials (RCTs) and quasi-experimental designs (QEDs). Statistical analyses were performed using Stata 16.0 software.

Results

A total of 16 articles and 17 studies were included, comprising 11 RCTs and 6 QEDs. The participants were 1,298 children and adolescents aged 5 to 16. Open skill exercises have significant intervention effects (p < 0.01) on inhibitory control (SMD = -0.627, 95%CI = -0.890 to -0.363), working memory (SMD = -0.517, 95%CI = -0.768 to -0.266), and cognitive flexibility (SMD = -0.652, 95%CI = -1.085 to -0.219). The effects of strategic skill exercises are higher than those of interceptive skills, particularly in the dimension of inhibitory control (SMD = -0.707, 95%CI = -0.819 to -0.594, p < 0.05). In addition, moderate-intensity and higher-frequency exercises overall have a more positive effect on promoting executive functions (p < 0.05); interventions of 6 to 10 weeks are more effective for working memory (p < 0.05), while 30-min sessions are the most effective for working memory (p < 0.05), and sessions lasting 75 to 120 min are the most effective for cognitive flexibility (p < 0.05). Open-skill exercise has a more positive impact on inhibitory control in the 5-9 age group and on working memory in the 10-16 age group (p < 0.05); open-skill exercise, especially, has a more positive intervention effect on inhibitory control in the Eastern group (p < 0.05). Both Egger linear regression analyses and literature sensitivity analyses suggested that the Meta-analysis results were stable and reliable.

Conclusion

Open-skill exercise has a positive intervention effect on executive functioning in children and adolescents, and strategic skill exercise interventions are more effective. In addition, the quantitative elements of exercise (intensity, frequency, and duration per session) and demographic factors (age and ethnicity) play a potential moderating role in this context. Based on this, it is recommended that children and adolescents choose more strategic open-skill exercises according to their actual situation and select appropriate quantitative exercise factors to maximize the enhancement of their executive functions.

Systematic review registration

https://www.crd.york.ac.uk/prospero/#myprospero, CRD42025636714.

Effects of movement behaviors on preschoolers' cognition: a systematic review of randomized controlled trials

BACKGROUND

Movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep, are fundamental to early childhood development. These behaviors interact dynamically within a 24-hour period, creating a complex balance that influences not only physical health but also cognitive and emotional well-being in young children. While the physical health benefits of movement behaviors are well-documented, systematic evaluations of how interventions targeting these behaviors affect cognitive development in preschool-aged children remain limited.

METHODS

This review was guided through PRISMA 2020 guidelines. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the impact of interventions targeting PA, SB, and sleep on cognitive outcomes in preschool-aged children. A comprehensive search was performed across five databases: PubMed, PsycInfo, Web of Science, Embase, and CINAHL, covering studies published between January 2000 and December 2023. Eligible studies were those that focused on at least one movement behavior, had a minimum intervention duration of four weeks, and assessed cognitive development as a primary outcome. The cognitive outcomes evaluated included executive function, attention, memory, and other key domains critical to early childhood development, such as language, processing speed, and social cognition.

RESULTS

Twenty-two RCTs (14 individual, 8 cluster) met the inclusion criteria. Of these, 21 studies focused on PA, while only one targeted SB, and none specifically addressed sleep or combined movement behaviors. PA interventions, particularly those involving cognitively engaging activities, significantly improved cognitive domains such as executive function, inhibition, and attention, with effect sizes ranging from moderate to large (Cohen's d > 0.5). The SB-focused study did not report significant cognitive improvements. A clear gap exists in understanding the effects of sleep and multi-behavior interventions on cognitive outcomes.

CONCLUSIONS

Cognitively engaging PA interventions demonstrated the largest effects, while motor skill-focused and general PA programs produced moderate to smaller gains. Evidence on SB and sleep interventions remains limited, with no studies exploring the combined effects of these three movement behaviors. Future research should focus on integrated interventions that address PA, SB, and sleep to achieve a more comprehensive understanding of their collective impact on cognitive development in early childhood.

TRIAL REGISTRATION

This study was registered with PROSPERO under the registration number CRD42023479156.

The Impact of the Interactive Floor Device and Aerobic Training on Executive Functions in Children

BACKGROUND/OBJECTIVES

Considering the importance of physical activity on the development of cognitive functions in children, the aim of this study was to assess the effects of a ten-week training program using the Interactive Floor device (© Funtronic), i.e., a kinesthetic educational game, and aerobic activity training on executive functions in 9-year-old children. Given current knowledge of the advantages of gamification and on-task switching, stronger improvement was expected for the Interactive Floor device than aerobic exercise activities.

METHODS

Sixty-four children (29 boys/35 girls) were randomly assigned to the Interactive Floor (n = 22), Aerobic Training (n = 22), or Control groups (n = 20). The participants had their cognitive abilities assessed twice (pre- and post-intervention) using computer tests from the Vienna Test System (VTS) and subtests from the Wechsler Intelligence Scale for Children® Fifth Edition (WISC®-V). From VTS, the Stroop Test was used to measure inhibition and attentional control, while the Corsi Block test assessed visuospatial short-term working memory. To assess auditory working memory, the Digit Span subtest from the WISC®-V was applied. Additionally, fluid intelligence was estimated using Raven's Progressive Matrices.

RESULTS

Repeated-measures mixed ANOVA and post hoc tests with Bonferroni correction for multiple comparisons showed that all intervention program groups improved in terms of intelligence and non-verbal abstract reasoning. The second significant finding in this study was that especially children from the Interactive Floor group developed their executive functions, i.e., inhibition and attentional control as well as their spatial short-term memory capacity.

CONCLUSIONS

The results suggest that a combination of both physical exercise and cognitive games in the Interactive Floor group resulted in greater improvement in cognitive abilities in children than aerobic exercise or physical education lessons. It seems that a multidisciplinary approach combining physical and cognitive stimulation effectively promotes child development. Future programs aiming to improve cognitive skills in children should consider incorporating interactive and engaging activities that stimulate both the body and the mind.

Effects of aerobic exercise on executive function among overweight and obese children: a systematic review and meta-analysis

Objective

Overweight and obesity are serious public health issues worldwide and significantly impair children's executive function (EF). However, there is no consensus regarding the benefits of aerobic exercise, on the EF of overweight and obese children. This study systematically evaluated the intervention effects of aerobic exercise on EF and its subcomponents (inhibitory control, working memory, and cognitive flexibility) in overweight and obese children.

Methods

We searched six databases-PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, and China National Knowledge Infrastructure-until March 17, 2024 for randomized controlled trials examining the effects of aerobic exercise on the EF of overweight and obese children the Cochrane Risk of Bias Assessment Tool. Following heterogeneity testing, RevMan 5.4 and Stata 17.0 were used for meta-analysis and subgroup analysis of the three indicators. The standardized mean difference (SMD) and 95% confidence intervals (CI) were used as statistical measures for effect analysis with the SMD value as the effect size and a p-value of ≤0.05 indicating statistical significance.

Results

Eighteen studies involving 1,260 participants were included. Aerobic exercise significantly improved overall EF (SMD = -0.50, 95% CI [-0.68, -0.32], p < 0.01) with a moderate to high positive effect on inhibitory control (SMD = -0.52, 95% CI [-0.72, -0.31], p < 0.01) and working memory (SMD = -0.63, 95% CI [-1.06, -0.20], p < 0.01) but not on cognitive flexibility (SMD = -0.32, 95% CI [-0.71, 0.07], p = 0.11). These results suggest that EF in overweight and obese children is influenced by factors such as exercise characteristics and body mass index (BMI). Subgroup analysis revealed a significant moderating effect of exercise type, exercise intensity, session time, and individual BMI on EF.

Conclusion

Aerobic exercise selectively improved EF in overweight and obese children. Subgroup analysis indicated that cognitive engagement in ball game interventions of at least moderate intensity and a single session of 25-40 min are more beneficial for improving EF in overweight and obese children. Extremely obese children (BMI > 25 kg/m2) do not benefit from the intervention, highlighting the need for a specific focus on intervention outcomes in future studies.

Effects of cognitively engaging physical activity interventions on executive function in children and adolescents: a systematic review and meta-analysis

Background

This systematic review and meta-analysis aim to evaluate the effects of cognitively engaging Physical Activity (PA) interventions on Executive Function (EF) in children and adolescents. It examines how different intervention modalities, durations, frequencies, and session lengths influence these effects.

Methods

We followed the PRISMA guidelines and searched PubMed, SPORTDiscus, Embase, and Web of Science for relevant studies. Studies were included if they were Randomized Controlled Trials (RCTs) focusing on PA with cognitive elements targeting EF in healthy children and adolescents. Data were extracted and effect sizes computed using Standardized Mean Differences (SMDs).

Results

From an initial 1,635 articles, 23 studies with 2,857 participants were included. The overall effect of cognitively engaging PA on EF was significant (SMD = 0.32, 95% CI 0.14-0.51), with notable improvements in inhibitory control (SMD = 0.35) and working memory (SMD = 0.34). High heterogeneity was observed (I 2 = 91.1%). Moderator analyses revealed that interventions lasting more than 6 weeks, with sessions over 20 min and conducted more than twice a week, were particularly effective.

Conclusion

Cognitively engaging PA interventions positively impact EF in children and adolescents, particularly in inhibitory control. Effective interventions are characterized by longer duration, higher frequency, and extended session lengths. These findings underscore the importance of integrating cognitive challenges within PA programs to enhance EF, warranting future research and practical applications in educational and developmental settings.

Advances in Social Cognitive and Affective Neuroscience: Ten Highly Cited Articles Published in Brain Sciences in 2022-2023

In the realm of Social Cognitive and Affective Neuroscience, researchers employ a variety of methods to address theoretical and practical questions that focus on the intricate interplay between social perception, cognition, and emotion across diverse populations and contexts [...].

Comparative efficacy of physical activity types on executive functions in children and adolescents: A network meta-analysis of randomized controlled trials

OBJECTIVES

This study investigates the impact of various physical activity (PA) types on executive functions (EFs) in children and adolescents.

DESIGN

A systematic review and network meta-analysis of randomized clinical trials.

METHODS

We searched databases such as PubMed, Embase, Cochrane, and Web of Science up to April 2023, including randomized controlled trials involving 6 distinct PA types for healthy children and adolescents. The Cochrane risk of bias tool was used to assess the risk of bias, and a random-effects model in STATA 17.0 was used to calculate standardized mean differences (SMDs) and 95 % confidence intervals (CI).

RESULTS

Ball Games emerged as the most effective modality for improving updating accuracy, securing a SUCRA score of 94.4 %, and for reducing inhibition reaction time, with a SUCRA score of 94.8 %. Cognitively Engaging Physical Activity led in improving inhibition accuracy with a SUCRA score of 71.7 %. Dance excelled in improving update accuracy and reducing shifting reaction time, with SUCRA scores of 86.6 % and 99.5 %, respectively.

CONCLUSIONS

PA has a significant benefit in EFs in children and adolescents, however the size of the effect varies by type of PA. Ball Games emerged as the most efficacious modality for enhancing updating accuracy and for expediting inhibition reaction time. Cognitively Engaging Physical Activity proved to be the preeminent strategy for improving inhibition accuracy. Dance was distinguished as the optimal approach for improving updating accuracy and reducing shifting reaction time.

Effects of open and closed skill exercise interventions on executive function in typical children: a meta-analysis

BACKGROUND

The effects of open and closed skill exercise interventions for executive function in children and adolescents have received widespread attention. Open skill refers to the skill of performing motor tasks in an unpredictable environment; closed skill refers to the skill of performing motor tasks in a stable environment. However, the results of related studies are currently controversial and Meta-analysis is urgently needed.

METHODS

After computer searches of CNKI, Wan-Fang, VIP, WOS, PubMed, and EBSCO databases, two researchers independently screened articles, extracted information, and evaluated the quality of the articles. This study was statistical analyzed using Stata 16.0 software.

RESULTS

A total of 31 articles were included, including 2988 typical children. Open, closed, continuous and sequential skills all improved executive function in typical children to varying degrees, but open and sequential skills were more effective in improving executive function, particularly in the former in the working memory (SMD=-0.833, P < 0.001) and in the latter in the inhibitory control (SMD=-0.834, P < 0.001) and cognitive flexibility (SMD=-0.903, P < 0.001). Long-term, moderate- intensity interventions were better than acute, vigorous-intensity interventions for executive function, with long-term interventions reflected in working memory (SMD=-0.579, P < 0.001) and moderate-intensity interventions reflected in all three dimensions of executive function (P < 0.01). Intervention periods, intervention intensity and continuous and sequential skills classified by action structure play a significant moderating role. Better results for long-term, sequential structural action interventions based on open skills (P < 0.001); better results for acute, moderate intensity, sequential structural action interventions based on closed (P < 0.05). Whereas intervention intensity had a non-significant moderating effect in the open skills intervention, both moderate and vigorous intensity had a significant effect on executive function (P < 0.001).

CONCLUSION

Open and closed skills have different levels of facilitation effects on executive function in typical children, but open skills are more effective. The facilitation effects of open and closed skills were moderated by the qualitative characteristics and action structure of the intervention.

The Effect of a Single Bout of Chinese Archery on Core Executive Functions in Preadolescent Children in Shanghai

BACKGROUND

Recent literature has demonstrated that acute physical activity benefits the transfer of executive functions. However, further studies indicated the type of variability in the effect of physical activity on executive functions. Therefore, this study initially explored the effect of a single bout of Chinese archery on subdomains of core EFs in preadolescent children; Method: Eligible participants were allocated either an intervention group (n = 36) or a control group (n = 36). The subjects in the intervention group received a 45-min Chinese archery session. The primary outcomes were the performance of core EFs (inhibition control, working memory, and cognitive flexibility) in preadolescent children, assessed with psychological paradigms (Fish Flanker Task, N-Back Task, and DCCS (Border version), respectively). Paired t-test and ANCOVA were used to analyze the mean difference in the performance of core EFs within and between subjects, respectively; Results: Considering reaction time and accuracy, we explored the impressive performance in three cognitive tasks with acute Chinese archery; Conclusion: The finding suggests that a single bout of Chinese archery benefited three subdomains of core EFs in healthy preadolescent children.