Effects of different physical activity modalities on executive function in children with attention deficit...

This study systematically evaluated and compared the effects of different physical activity modalities on executive function, including inhibitory control, cognitive flexibility, and working memory, in children with attention-deficit/hyperactivity disorder (ADHD).

Six databases (CNKI, Wanfang, Web of Science, PubMed, Cochrane Library, and Embase) were searched for randomized controlled trials examining physical activity interventions for executive function in children with ADHD. Studies were screened using EndNote 21, methodological quality was assessed with the Cochrane Risk of Bias 2.0 tool, and meta-analyses were conducted in RevMan 5.4. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated, and publication bias was tested using Stata 19.0.

Twenty-one RCTs involving 915 participants were included. Physical activity significantly improved executive function in children with ADHD, with interventions lasting at least six weeks and delivered at moderate-to-vigorous intensity showing greater overall benefits. Open physical activities produced stronger improvements in inhibitory control (SMD = -0.81, 95% CI [-0.97, -0.52], P < 0.00001), whereas closed physical activities were more effective for cognitive flexibility (SMD = -0.61, 95% CI [-0.84, -0.38], P < 0.00001) and working memory (SMD = -0.45, 95% CI [-0.68, -0.23], P < 0.0001). Single aerobic activities showed better effects on inhibitory control and cognitive flexibility, while multi-component activities were more beneficial for working memory. By activity type, leisure-fitness activities had the strongest effect on inhibitory control, traditional aerobic activities such as running and cycling were most effective for cognitive flexibility, and ball sports showed superior effects on working memory.

Structured physical activity is an effective non-pharmacological intervention for improving executive function in children with ADHD. Interventions lasting at least six weeks at moderate-to-vigorous intensity appear most beneficial. Different modalities may target distinct executive domains: open and leisure-fitness activities for inhibitory control, closed and aerobic activities for cognitive flexibility, and closed, multi-component, and ball-sport activities for working memory.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251080013.