Comparative effects of ball sports on executive function subdomains in children and adolescents: a network meta-analysis

Objectives Ball sports interventions have been shown to yield positive effects on executive functions (EF). The aim of this study is to use network meta-analysis (NMA) to evaluate the differences in the impact of different ball sports on the subdomains of EF among children and adolescents. Methods Five databases, including PubMed, Cochrane, Embase, Web of Science, and Scopus, were searched up to November 2025 to identify randomized controlled trials measuring the effect of different ball sports on the subdomains of EF among children and adolescents. Paired analyses and network meta-analyses were conducted using the random-effects model. Results This study included 12 studies with five ball sports interventions. Ball sports showed domain-specific effects on EF in children and adolescents. The surface under the cumulative ranking curve (SUCRA) reveals that football may be a potentially effective intervention for improving the accuracy rate of inhibitory control (SUCRA = 76.69%). For working memory, ball sports did not consistently enhance accuracy, with the control condition showing the highest ranking (SUCRA = 80.93%). In contrast, tennis exhibited the greatest likelihood of improving reaction time (SUCRA = 99.99%). Table tennis may be a potentially effective intervention for improving reaction time of cognitive flexibility (SUCRA = 99.97%). Sensitivity analyses restricted to typically developing samples revealed notable changes in network structures and SUCRA rankings for inhibitory control accuracy, inhibitory control reaction time, and cognitive flexibility accuracy. Conclusion Different ball sports demonstrated varying effects across executive function subdomains. However, the findings for inhibitory control and cognitive flexibility were highly dependent on sample composition and lacked robustness, whereas those for working memory were relatively stable. Due to limited evidence and high heterogeneity, the results should be interpreted with caution. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251038836 .