The effects of high-intensity interval training on executive function in children and adolescents: a systematic...

To systematically evaluate the effects of high-intensity interval training (HIIT) on executive function in children and adolescents, and to quantify its effects on inhibitory control, working memory, and cognitive flexibility using a three-level meta-analysis.

PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and VIP databases were searched from inception to May 2026. Randomized controlled trials and non-randomized controlled intervention studies examining the effects of HIIT on executive function in children and adolescents were included. Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment. The risk of bias in randomized controlled trials was assessed using the Cochrane RoB 2 tool, while non-randomized intervention studies were assessed using the ROBINS-I tool. Hedges' g was used as the effect size index. A three-level meta-analytic model was applied to account for the dependency of multiple effect sizes within the same study. Three-level Egger regression was used to assess publication bias and small-study effects, and sensitivity analyses were performed to examine the robustness of the findings.

A total of 11 studies were included, comprising 9 randomized controlled trials and 2 non-randomized controlled intervention studies, with 776 children and adolescents. The meta-analysis showed that HIIT significantly improved inhibitory control (Hedges' g = 0.227, 95% CI: 0.066 to 0.388, p = 0.007), working memory (Hedges' g = 0.368, 95% CI: 0.200 to 0.535, p < 0.001), and cognitive flexibility (Hedges' g = 0.389, 95% CI: 0.184 to 0.593, p = 0.002). Sensitivity analyses showed that the positive effects of HIIT on inhibitory control and working memory remained statistically significant after excluding non-randomized studies. Subgroup analyses indicated positive effects across different work-to-rest ratios, intervention durations, and session durations; however, no significant between-subgroup differences were observed. Three-level Egger regression did not indicate significant funnel plot asymmetry or small-study effects. According to the GRADE assessment, the certainty of evidence was moderate for inhibitory control and working memory, but very low for cognitive flexibility.

HIIT has positive effects on executive function in children and adolescents, particularly on inhibitory control and working memory, for which the certainty of evidence is moderate. Although HIIT also showed a positive effect on cognitive flexibility, this finding should be interpreted cautiously because of the limited number of studies and very low certainty of evidence. Further high-quality, large-sample studies with standardized intervention protocols and outcome measures are needed to confirm the effects of HIIT on executive function and to identify optimal training parameters for children and adolescents.