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Effects of physical activity interventions on physical fitness in preschool children: a meta-analysis of randomized

Yixin Liang¹, Yong Yang², Yuan Yuan³

¹School of Exercise and Health, Shanghai University of Sport, 399 Changhai Rd, Yangpu District, Shanghai City, 200438, China.

BMC Public Health

|September 2, 2025

Insights

Physical activity interventions significantly boost preschool children's physical fitness, including strength, flexibility, and coordination. Optimal weekly activity doses vary by fitness component, ranging from 180 to 380 minutes.

Area of Science:

Pediatric Exercise Science
Developmental Health
Public Health Interventions

Background:

Preschool children's physical fitness (PF) is crucial for long-term health.
Understanding the impact of physical activity (PA) interventions is key for early childhood development.
Dose-response relationships between PA and PF in this age group require clarification.

Purpose of the Study:

To evaluate the effects of chronic physical activity (PA) interventions on physical fitness (PF) in preschool children.
To determine the optimal weekly PA dose for improving specific fitness components.
To conduct a meta-analysis and dose-response analysis.

Main Methods:

Searched PubMed, Embase, Web of Science, and Cochrane Register up to January 2025.
Included 14 randomized controlled trials (RCTs) of healthy children aged 3-7 years with PA interventions ≥4 weeks.
Used random-effects meta-analysis and Bayesian dose-response models.

Main Results:

PA interventions significantly improved overall PF (SMD=0.30) and specific components like strength, flexibility, cardiorespiratory fitness (CRF), coordination, and balance.
Optimal weekly PA doses ranged from 180 min (static balance) to 380 min (CRF).
Intervention effectiveness was moderated by session frequency, duration, and total program length.

Conclusions:

Physical activity interventions are effective in enhancing preschool children's physical fitness.
Tailored PA strategies are needed, with optimal weekly doses varying by fitness component (180-380 min).
Intervention design elements like session frequency and duration significantly influence outcomes.

Read full analysis

Abstract

Backgroud:

To evaluate the effects of chronic physical activity (PA) interventions on physical fitness (PF) in preschool children and to determine the optimal weekly PA dose for improving specific fitness components through meta-analysis and dose-response analysis.

Methods:

Literature searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials from database inception to January 4, 2025. Eligible randomized controlled trials (RCTs) involved healthy children aged 3-7 years, applied PA interventions lasting ≥ 4 weeks, and assessed at least one PF component, including muscular strength, cardiorespiratory fitness (CRF), flexibility, coordination, or balance. Meta-analyses used random-effects models to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Bayesian dose-response models with restricted cubic splines were used to explore non-linear associations.

Results:

Fourteen RCTs (n = 3376) were included. PA interventions significantly improved overall PF (SMD = 0.30; 95% CI: 0.22-0.38), as well as upper muscle strength (SMD = 0.30), lower muscle strength (SMD = 0.29), flexibility (SMD = 0.27), CRF (SMD = 0.29), coordination (SMD = 0.54), and static balance (SMD = 0.38). Dose-response analysis revealed optimal weekly doses of 270 min for overall PF, 260 min for lower muscle strength, 190 min for upper muscle strength and flexibility, 300 min for coordination, and 180 min for static balance. CRF improved linearly up to 380 min/week. Subgroup analyses indicated that session frequency, length, and total duration moderated intervention effects.

Conclusions:

PA interventions effectively improve physical fitness in preschool children. Optimal weekly doses range from 180 to 380 min, depending on the fitness component. Intervention effectiveness is further moderated by session frequency, duration, and total program length, highlighting the need for tailored PA strategies targeting specific physical fitness outcomes in early childhood.

Prospero Registration:

CRD42025639632.

Keywords:

Dose–response Exercise Meta-analysis Physical activity Physical fitness Preschool children

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