Review Article| Volume 23, ISSUE 10, P949-954, October 2020

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The effects of chronic physical activity interventions on executive functions in children aged 3–7 years: A meta-analysis



      To use a quantitative approach to examine the effects of chronic physical activity (PA) interventions on executive functions (EFs) in children aged 3–7 years.


      Systematic review and meta-analysis.


      PubMed, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, and the China National Knowledge Infrastructure were searched from their inception to December 2019. Intervention studies with a control group that examined the effects of chronic PA interventions on EFs among children aged 3–7 years were included in this meta-analysis. Lastly, subgroup analyses were conducted to examine the potential modifying effects of chronic PA intervention’s characteristics and study quality.


      A total of 10 studies were included in this meta-analysis with a total of 716 participants. The fixed-effects model was used to estimate the pooled effect sizes since heterogeneity across included studies was not significant. The summary effects revealed that chronic PA interventions have a small but positive effects on participants’ overall EFs [standardized mean difference (SMD) = 0.35, 95% CI: 0.20–0.50] as well as inhibition (SMD = 0.37, 95% CI: 0.12–0.62) and working memory (SMD = 0.24, 95% CI: 0.02–0.46) domains and a moderate effect on the cognitive flexibility domain (SMD = 0.66, 95% CI: 0.28–1.05). Lastly, the pooled effect was not significantly modified by intervention duration, session length, or frequency.


      Chronic PA interventions, especially PA plus cognitive challenges interventions, may be a promising way to promote the development of multiple aspects of EFs in children aged 3–7 years.


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        • Funahashi S.
        Neuronal mechanisms of executive control by the prefrontal cortex.
        Neurosci Res. 2001; 39: 147-165
        • Diamond A.
        Executive functions.
        Annu Rev Psychol. 2013; 64: 135-168
        • Espy K.A.
        • Mcdiarmid M.M.
        • Cwik M.F.
        • et al.
        The contribution of executive functions to emergent mathematic skills in preschool children.
        Dev Neuropsychol. 2004; 26: 465-486
        • Blair C.
        School readiness: integrating cognition and emotion in a neurobiological conceptualization of children’s functioning at school entry.
        Am Psychol. 2002; 57: 111-127
        • Espy K.A.
        • Sheffield T.D.
        • Wiebe S.A.
        • et al.
        Executive control and dimensions of problem behaviors in preschool children.
        J Child Psychol Psychiatry. 2011; 52: 33-46
        • Moffitt T.E.
        • Arseneault L.
        • Belsky D.W.
        • et al.
        A gradient of childhood self-control predicts health, wealth, and public safety.
        Proc Natl Acad Sci U S A. 2011; 108: 2693-2698
        • Vergunst F.
        • Tremblay R.E.
        • Nagin D.S.
        • et al.
        Association between childhood behaviors and adult employment earnings in Canada.
        JAMA Psychiatry. 2019; 76: 1044-1051
        • Elliott R.
        Executive functions and their disorders.
        Br Med Bull. 2003; 65: 49-59
        • Schoemaker K.
        • Bunte T.L.
        • Wiebe S.A.
        • et al.
        Executive function deficits in preschool children with ADHD and DBD.
        J Child Psychol Psychiatry. 2012; 53: 111-119
        • Anderson P.J.
        • Reidy N.
        Assessing executive function in preschoolers.
        Neuropsychol Rev. 2012; 22: 345-360
        • Diamond A.
        • Ling D.S.
        Conclusions about interventions, programs, and approaches for improving executive functions that appear justified and those that, despite much hype, do not.
        Dev Cogn Neurosci. 2016; 18: 34-48
        • Caspersen C.J.
        • Powell K.E.
        • Christenson G.M.
        Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.
        Public Health Rep. 1985; 100: 126-131
        • Xue Y.
        • Yang Y.
        • Huang T.
        Effects of chronic exercise interventions on executive function among children and adolescents: a systematic review with meta-analysis.
        Br J Sports Med. 2019; 53: 1397-1404
        • Petruzzello S.J.
        • Landers D.M.
        • Hatfield B.D.
        • et al.
        A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Outcomes and mechanisms.
        Sports Med. 1991; 11: 143-182
        • Martín-García M.
        • Alegre L.M.
        • García-Cuartero B.
        • et al.
        Effects of a 3-month vigorous physical activity intervention on eating behaviors and body composition in overweight and obese boys and girls.
        J Sport Health Sci. 2019; 8: 170-176
        • Annesi J.J.
        Correlations of depression and total mood disturbance with physical activity and self-concept in preadolescents enrolled in an after-school exercise program.
        Psychol Rep. 2005; 96: 891-898
        • Mackelvie K.J.
        • Khan K.M.
        • Petit M.A.
        • et al.
        A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls.
        Pediatrics. 2003; 112: e447-e452
        • Alvarezbueno C.
        • Pesce C.
        • Caveroredondo I.
        • et al.
        The effect of physical activity interventions on children’s cognition and metacognition: a systematic review and meta-analysis.
        J Am Acad Child Adolesc Psychiatry. 2017; 56: 729-738
        • De Greeff J.W.
        • Bosker R.
        • Oosterlaan J.
        • et al.
        Effects of physical activity on executive functions, attention and academic performance in preadolescent children: a meta-analysis.
        J Sci Med Sport. 2017; 21: 501-507
        • Fisher A.
        • Boyle J.M.E.
        • Paton J.Y.
        • et al.
        Effects of a physical education intervention on cognitive function in young children: randomized controlled pilot study.
        BMC Pediatr. 2011; 11
        • Chang Y.K.
        • Tsai Y.J.
        • Chen T.T.
        • et al.
        The impacts of coordinative exercise on executive function in kindergarten children: an ERP study.
        Exp Brain Res. 2013; 225: 187-196
        • Mavilidi M.
        Effects of integrated physical exercises and gestures on preschool’s foreign language vocabulary learning.
        Educ Psychol Rev. 2015; 27: 413-426
        • Liu J.
        The effect of sports games on observation and memory in preschool children: a experimental study.
        CHN J Sch Health. 2015; : 1888-1890
        • Robinson L.E.
        • Palmer K.K.
        • Bub K.L.
        Effect of the children’s health activity motor program on motor skills and self-regulation in head start preschoolers: an efficacy trial.
        Front Public Health. 2016; 4: 173
        • Xiong S.
        • Li X.
        • Tao K.
        Effects of structured physical activity program on Chinese young children’s executive functions and perceived physical competence in a day care center.
        Biomed Res Int. 2017; 20175635070
        • Mulvey K.L.
        • Taunton S.
        • Pennell A.
        • et al.
        Head, toes, knees, skip! Improving preschool children’s executive function through a motor competence intervention.
        J Sport Exerc Psychol. 2018; 40: 233-239
        • Gao Z.
        • Lee J.E.
        • Zeng N.
        • et al.
        Home-based exergaming on preschoolers’ energy expenditure, cardiovascular fitness, body mass index and cognitive flexibility: a randomized controlled trial.
        J Clin Med. 2019; 8: 1745
        • Jiang D.
        • Ceng C.
        The effect of 8-week soccer exercise with medium intensity on executive function in preschool children.
        CHN Sport Sci and Tech. 2015; : 43-50
        • Wen X.
        • Zhang Y.
        • Gao Z.
        • et al.
        Effect of mini-trampoline physical activity on executive functions in preschool children.
        Biomed Res Int. 2018; 20182712803
        • Carson V.
        • Hunter S.
        • Kuzik N.
        • et al.
        Systematic review of physical activity and cognitive development in early childhood.
        J Sci Med Sport. 2016; 19: 573-578
        • Tandon P.S.
        • Tovar A.
        • Jayasuriya A.T.
        • et al.
        The relationship between physical activity and diet and young children’s cognitive development: a systematic review.
        Pre Med Rep. 2016; 3: 379-390
        • Zeng N.
        • Ayyub M.
        • Sun H.
        • et al.
        Effects of physical activity on motor skills and cognitive development in early childhood: a systematic review.
        Biomed Res Int. 2017; 20172760716
        • Best J.R.
        Effects of physical activity on children’s executive function: contributions of experimental research on aerobic exercise.
        Dev Rev. 2010; 30: 331-351
        • Moher D.
        • Shamseer L.
        • Clarke M.
        • et al.
        Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.
        Sys Rev. 2015; 4: 1-9
        • Higgins J.P.
        • Green S.
        Cochrane handbook for systematic reviews of interventions version 5.1.0.
        Naunyn Schmiedebergs Arch Exp Pathol Pharmakol. 2011; : S38
        • Costigan S.A.
        • Eather N.
        • Plotnikoff R.C.
        • et al.
        High-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis.
        Br J Sports Med. 2015; 49: 1253-1261
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        2nd ed. Lawrence erlbaum, Hillsdale, NJ1988
        • Higgins J.P.T.
        • Thompson S.G.
        Quantifying heterogeneity in a meta‐analysis.
        Stat Med. 2002; 21: 1539-1558
        • Egger M.
        • Smith G.D.
        • Schneider M.
        • et al.
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Weinhandl E.D.
        • Duval S.
        Generalization of trim and fill for application in meta-regression.
        Res Synth Methods. 2012; 3: 51-67
      1. Quan M, Xun P, Wang R et al. Walking pace and the risk of stroke: A meta-analysis of prospective cohort studies. J Sport Health Sci. In press.

        • Klenberg L.
        • Korkman M.
        • Lahtinuuttila P.
        Differential development of attention and executive functions in 3- to 12-year-old Finnish children.
        Dev Neuropsychol. 2001; 20: 407-428
        • Schmidt M.
        • Jager K.
        • Egger F.
        • et al.
        Cognitively engaging chronic physical activity, but not aerobic exercise, affects executive functions in primary school children: a group-randomized controlled trial.
        J Sport Exerc Psychol. 2015; 37: 575-591
        • Crova C.
        • Struzzolino I.
        • Marchetti R.
        • et al.
        Cognitively challenging physical activity benefits executive function in overweight children.
        J Sports Sci. 2014; 32: 201-211
      2. WHO. Global recommendations on physical activity for health. Available at: Accessed 2 January 2020.

        • Ahn S.
        • Fedewa A.L.
        A meta-analysis of the relationship between children’s physical activity and mental health.
        J Pediatr Psychol. 2011; 36: 385-397
        • Erickson K.I.
        • Hillman C.H.
        • Stillman C.M.
        • et al.
        Physical activity, cognition, and brain outcomes: a review of the 2018 physical activity guidelines.
        Med Sci Sports Exerc. 2019; 51: 1242-1251
        • Quan M.
        • Zhang H.
        • Zhang J.
        • et al.
        Are preschool children active enough in Shanghai: an accelerometer-based cross-sectional study.
        BMJ Open. 2019; 9e024090
        • Quan M.
        • Zhang H.
        • Zhang J.
        • et al.
        Preschoolers’ technology-assessed physical activity and cognitive function: a cross-sectional study.
        J Clin Med. 2018; 7: 108
        • Erickson K.I.
        • Prakash R.S.
        • Voss M.W.
        • et al.
        Aerobic fitness is associated with hippocampal volume in elderly humans.
        Hippocampus. 2009; 19: 1030-1039
        • Carey J.R.
        • Bhatt E.
        • Nagpal A.
        Neuroplasticity promoted by task complexity.
        Exerc Sport Sci Rev. 2005; 33: 24-31
        • Clark P.J.
        • Brzezinska W.J.
        • Puchalski E.K.
        • et al.
        Functional analysis of neurovascular adaptations to exercise in the dentate gyrus of young adult mice associated with cognitive gain.
        Hippocampus. 2009; 19: 937-950
        • Lambrick D.
        • Stoner L.
        • Grigg R.
        • et al.
        Effects of continuous and intermittent exercise on executive function in children aged 8-10 years.
        Psychophysiology. 2016; 53: 1335-1342
        • Lucas S.J.E.
        • Ainslie P.N.
        • Murrell C.
        • et al.
        Effect of age on exercise-induced alterations in cognitive executive function: relationship to cerebral perfusion.
        Exp Gerontol. 2012; 47: 541-551
        • Berchtold N.C.
        • Chinn G.
        • Chou M.
        • et al.
        Exercise primes a molecular memory for brain-derived neurotrophic factor protein induction in the rat hippocampus.
        Neuroscience. 2005; 133: 853-861
        • Ding Q.
        • Vaynman S.
        • Akhavan M.M.
        • et al.
        Insulin-like growth factor I interfaces with brain-derived neurotrophic factor-mediated synaptic plasticity to modulate aspects of exercise-induced cognitive function.
        Neuroscience. 2006; 140: 823-833
        • Hattori S.
        • Naoi M.
        • Nishino H.
        Striatal dopamine turnover during treadmill running in the rat: Relation to the speed of running.
        Brain Res Bull. 1994; 35: 41-49
        • Robbins T.W.
        • Arnsten A.F.T.
        The neuropsychopharmacology of fronto-executive function: Monoaminergic modulation.
        Ann Rev Neurosci. 2009; 32: 267-287
        • Cotman C.W.
        • Berchtold N.C.
        • Christie L.
        Exercise builds brain health: key roles of growth factor cascades and inflammation.
        Trends Neurosci. 2007; 30: 464-472