Effects of structured dance-based exercise on cardiorespiratory fitness and cardiovascular function in children and adolescents: a systematic review and meta-analysis of randomized controlled trials

Objective To examine randomized between-group effects of structured dance-based exercise on cardiorespiratory fitness (CRF), resting blood pressure and heart rate, endothelial function, and arterial stiffness in children and adolescents. Methods PubMed, Scopus, and Web of Science Core Collection were searched through 12 September 2026 for parallel-group and cluster-randomized trials involving participants aged 5–18 years. Risk of bias was assessed using RoB 2 and certainty using GRADE. Comparator strata were analyzed separately. Random-effects meta-analysis required at least three clinically comparable trials with usable variances; restricted maximum likelihood and modified Knapp–Hartung inference were used. Results Seven studies randomized 345 participants. Three active-exercise comparisons (114 analyzed participants) yielded Hedges' g = −0.46 (95% CI −1.86 to 0.95; p = 0.298; I 2 = 67.0%; τ 2 = 0.214). Two inactive/usual-practice comparisons in children with overweight or obesity (70 analyzed participants) yielded separate, unpooled endpoint mean differences in directly measured VO 2 peak of 4.77 (95% CI 1.64 to 7.90) and 5.20 (95% CI 1.92 to 8.48) mL·kg −1 ·min −1 . Cardiovascular outcomes could not be pooled, and no eligible trial reported arterial stiffness. Ten outcome assessments had some concerns and four were at high risk of bias. Certainty was very low for all assessed outcome bodies. Conclusions Two small trials reported higher VO 2 peak after dance than after inactive/usual-practice conditions, but the intervention effect remains very uncertain. The active-exercise comparison is inconclusive and does not establish superiority, equivalence, or non-inferiority. Evidence for resting hemodynamic and endothelial outcomes is insufficient. Systematic Review Registration https://osf.io/e8v67/ . OSF e8v67.