Effects of physical activity on executive function components and academic performance in children aged 6–12 years: a systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis aimed to evaluate the effects of physical activity on distinct domains of executive function and academic performance in children aged 6–12 years. A systematic search was conducted in MEDLINE (via PubMed), EMBASE, Web of Science, Cochrane Library, and APA PsycInfo to identify randomized controlled trials published from January 1, 2006, to June 11, 2026. Primary outcomes included components of executive function (inhibitory control, working memory, and cognitive flexibility) and academic performance (language and mathematics-related performance). Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a DerSimonian–Laird random-effects model in Stata 18.0. Statistical significance was set at p < 0.05, and heterogeneity was assessed using I². Hartung–Knapp–adjusted sensitivity analyses, leave-one-out analyses, publication bias assessments, subgroup analyses, and exploratory univariable meta-regression analyses were performed where appropriate. Thirty-one studies were included in the systematic review, of which 18 were eligible for meta-analysis. The methodological quality of the included studies ranged from fair to good. Physical activity interventions significantly improved inhibitory control reaction time (SMD = − 0.55, 95% CI [− 0.89, − 0.22], p = 0.001), working memory span (SMD = 1.66, 95% CI [1.00, 2.46], p = 0.001), and mathematics performance (SMD = 0.94, 95% CI [0.57, 1.30], p = 0.001). No significant effects were found for inhibitory control accuracy, working memory accuracy, working memory reaction time, cognitive flexibility, or language performance. Hartung–Knapp–adjusted sensitivity analyses confirmed the robustness of the mathematics outcome, whereas the effects on inhibitory control reaction time and working memory span were less stable under the more conservative model. Physical activity interventions may have selective beneficial effects on specific dimensions of executive function and academic performance in children, with the most robust evidence observed for mathematics performance. Potential benefits were also observed for inhibitory control reaction time and working memory span, although these findings were less stable in conservative sensitivity analyses. The certainty of evidence was low to very low across the meta-analyzed outcomes, mainly because of risk of bias, substantial heterogeneity, imprecision, and potential publication bias. These findings should therefore be interpreted with caution.