Physical Activity and Its Effects on Executive Functions and Brain Outcomes in Children: A Narrative Review

Background/Objectives: Executive functions-including inhibitory control, working memory, and cognitive flexibility-are fundamental for children's learning and development. Physical activity is recognized as a key factor that enhances these functions through neurobiological and structural brain adaptations. This narrative review aims to synthesize current evidence on the relationship between physical activity, executive functions, and brain outcomes in children. Methods: A narrative review was conducted using systematic evidence search across PubMed, Scopus, and Web of Science until August 2025. Search terms encompassed physical activity, executive functions, and brain mechanisms. Eligible studies included randomized controlled trials, longitudinal and cross-sectional studies, systematic reviews, and meta-analyses that examined executive function domains and brain-related outcomes in children, with or without neurodevelopmental disorders. Results: The evidence reviewed highlights that acute physical activity improves inhibitory control, working memory, and cognitive flexibility, primarily through enhanced neurotransmission and cerebral oxygenation. Chronic interventions promote structural and functional brain adaptations, including improved white matter integrity and increased network efficiency. Benefits are observed in both neurotypical children and those with ADHD, with inhibitory control emerging as the most responsive domain. However, findings are moderated by intervention type, intensity, and duration, with heterogeneity across protocols. Conclusions: Physical activity is a promising strategy to support the development of executive and brain functions in childhood, with implications for education and clinical practice. Despite consistent short- and long-term benefits, further research is required to establish optimal prescriptions and evaluate sustained real-world impacts, particularly in children with neurodevelopmental disorders.