The effects of physical exercise on executive function, internalizing symptoms and externalizing symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background The aim of this study is to comprehensively assess the potential effects of physical exercise on executive function, internalizing symptoms and externalizing symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD), and to explore the moderating factors influencing these effects. Methods We performed a systematic search of six databases (including Web of Science, PubMed, Embase, PsycNET, the Cochrane Library and SPORTDiscus). Data analysis was performed using R software, and a meta-analysis was conducted using a random-effects model to estimate the pooled effect size. In addition, subgroup analyses and meta-regression were conducted to explore potential moderating factors. Results A total of 25 randomised controlled trials involving 1,116 participants were included. With low certainty of evidence, the pooled effect of inhibitory control was statistically significant ( g = 0.45, p < 0.01). With very low certainty of evidence, the pooled effect of internalizing symptoms was statistically significant ( g = 0.97, p = 0.03). The pooled effects of cognitive flexibility ( g = 0.69, p = 0.054), working memory ( g = 0.28, p = 0.10), and externalizing symptoms ( g = 0.64, p = 0.29) did not reach statistical significance, all rated as very low certainty of evidence. Conclusion Physical exercise may be positively associated with inhibitory control in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). However, the effects of interventions show high heterogeneity, have wide confidence intervals, and exhibit limited stability. Systematic review registration PROSPERO CRD420261380631.
Source: Frontiers in Psychology
Authors: Jinghui Shi, Xianwei Zheng, Wenzeng Wang
Institution: Shenyang Sport University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223881763