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Comparative effectiveness of physical activity interventions on cognitive functions in children and adolescents with
Ruiyuan Tao1, Yijian Yang1, Mark Wilson2
1Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
Insights
Mind-body exercise, exergaming, and multi-component physical activity significantly improve cognitive functions in children with neurodevelopmental disorders. Mind-body exercise is particularly beneficial for attention, while multi-component physical activity shows consistent gains across memory and executive functions.
Area of Science:
- Neuroscience
- Developmental Psychology
- Sports Medicine
Background:
- Physical activity interventions positively impact cognitive functions.
- Effectiveness of different physical activity types for children with Neurodevelopmental Disorders (NDDs) remains unclear.
- This study compares physical activity interventions for cognitive function in NDD populations, including ADHD and ASD.
Purpose of the Study:
- To compare the effectiveness of various physical activity interventions on cognitive functions in children and adolescents with NDDs.
- To examine intervention effects across specific NDD types like ADHD and ASD.
- To assess intervention acceptability through dropout rates.
Main Methods:
- Systematic review and frequentist network meta-analysis of 31 randomized controlled trials (n=1,403).
- Searched seven databases from inception to September 2023 for trials involving children aged 5-17 with NDDs.
- Analyzed cognitive functions (attention, memory, executive functions) using standardized mean differences (SMD) and random effects models.
Main Results:
- Mind-body exercise (MBE), exergaming, and multi-component physical activity (MPA) showed moderate to substantial cognitive improvements versus usual care.
- Exergaming and MPA were more effective than aerobic exercise (AE) for executive functions.
- MPA demonstrated consistent benefits across attention, memory, and executive functions in ADHD and ASD populations, unlike exergaming.
Conclusions:
- MBE, exergaming, and MPA are effective for improving cognitive functions in children with NDDs; AE was not effective.
- MBE shows promise for attention enhancement, while MPA offers broad benefits for memory and executive functions across NDD types.
- Further high-quality direct comparison trials are needed to validate these network meta-analysis findings.
Background:
Physical activity (PA) interventions have been shown to yield positive effects on cognitive functions. However, it is unclear which type of PA intervention is the most effective in children and adolescents with Neurodevelopmental Disorders (NDDs). This study aimed to compare the effectiveness of different types of PA interventions on cognitive functions in children and adolescents with NDDs, with additional analyses examining intervention effects across specific NDD types including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
Methods:
In this systematic review and network meta-analysis, seven databases (Web of Science, PubMed, Medline, APA PsycINFO, Embase, CINAHL, and SPORTDiscus) for randomized controlled trials from database inception to September 2023 were searched. Randomized controlled trials comparing the effectiveness of PA intervention with any non-pharmacological treatment or control group on cognitive functions in children and adolescents diagnosed with NDDs aged 5-17 years were included. Frequentist network meta-analyses were performed based on standardized mean differences (SMD) using random effects models to examine post-intervention differences in cognitive functions, including attention, memory, and executive functions. Intervention dropout was assessed as a measure of treatment acceptability.
Results:
Thirty-one randomized controlled trials (n = 1,403, mean age 10.0 ± 1.9 years) with 66 arms were included in the network. Mind-body exercise (MBE; SMD = 1.91 for attention; 0.92 for executive functions), exergaming (SMD = 1.58 for attention; 0.97 for memory; 0.94 for executive functions), and multi-component physical activity (MPA; SMD = 0.79 for executive functions) were associated with moderate to substantial cognitive improvements compared with usual care, whereas the effectiveness of aerobic exercise (AE) was non-significant. Exergaming (SMD = 0.78, 95%CI 0.12 to 1.45) and MPA (SMD = 0.64, 95%CI 0.11 to 1.18) were more effective than AE for executive functions. When analyzing specific NDD types, exergaming lost its superiority over usual care for attention and memory in ADHD, nor for executive functions in ASD. Instead, MPA demonstrated significant benefits across these domains and populations. The certainty of evidence for these comparisons was very low to low. No significant differences in acceptability were observed among MBE, exergaming, and MPA.
Conclusions:
The findings in this study suggest that MBE, exergaming, and MPA were effective interventions for improving domain-specific cognitive functions in children and adolescents with NDDs. AE demonstrated non-significant effectiveness for all outcomes. MBE emerges as particularly advantageous for attention. MPA yielded consistent improvements in memory and executive functions across NDD types. Further high-quality randomized controlled trials of direct comparisons are needed to confirm and expand on the findings from this NMA.
Trial Registration:
PROSPERO CRD42023409606.
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