The impact of physical activity on children's attention and math performance: A meta-analysis

Although physical activity has been associated with cognitive and academic benefits in children and adolescents, the intervention characteristics most relevant to attention and mathematics performance remain unclear. This study systematically compares intervention types and parameters to inform targeted cognitive enhancement strategies. RCTs published up to October 2025 were identified through systematic searches of four databases. Two reviewers independently performed screening, data extraction, and quality assessment (TESTEX; RoB 2.0). Network meta-analysis and related analyses were conducted in Stata 15.1 in accordance with PRISMA guidelines. Forty RCTs (28 attention; 18 mathematics) were included. Physical activity interventions showed small positive pooled effects on attention (SMD = 0.19) and mathematics achievement (SMD = 0.21) in the primary random-effects analyses. However, trim-and-fill analyses imputed potentially missing studies for both outcomes, and the 95% CIs of the adjusted estimates included the null value, suggesting that the pooled estimates may be sensitive to small-study effects. For attention, larger descriptive effects were observed for 30-45-min sessions (SMD = 0.30), ≤ 3 sessions/week (SMD = 0.17), and programs lasting < 6 weeks (SMD = 0.42); resistance training ranked highest in SUCRA. For mathematics, larger descriptive effects were observed for sessions < 30 min (SMD = 0.30), 3-4 sessions/week (SMD = 0.08), and programs lasting 6-9 weeks (SMD = 0.49); physically active academic lessons showed favorable trends.

This review suggests that physical activity interventions are associated with small positive improvements in attention and mathematics performance among children and adolescents. Descriptive subgroup patterns indicate that attention outcomes showed more favorable patterns in shorter programs with 30-45-min sessions, whereas mathematics performance showed more favorable descriptive patterns for brief, classroom-based physically active lessons integrating mathematics content. However, these findings should be interpreted cautiously because subgroup comparisons were descriptive, formal tests of differences between subgroups were not conducted, and some network estimates were imprecise.

Registration and protocol CRD420251118483.

• Physical activity may support cognitive and academic outcomes in children and adolescents. • Previous reviews have not fully compared intervention types and exercise parameters for attention and mathematics outcomes..

• This meta-analysis suggests small positive effects of physical activity on attention and mathematics performance. • Intervention rankings and subgroup patterns should be interpreted cautiously because of heterogeneity and uncertainty in some estimates.