A meta-analysis of the dose–response relationship between aerobic exercise and executive function in children

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Objective: While existing meta-analyses of executive function focus on older adults and clinical pediatric populations, a substantial gap remains regarding typically developing children during this critical period. Our meta-analysis elucidates the dose-response relationship between aerobic exercise and executive function in this group, providing an evidence-based framework for exercise prescription and translational research. Methods: A comprehensive literature search was conducted to retrieve 4,135 relevant articles examining the impact of aerobic exercise on children's executive function from multiple databases, including PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Database (CBM), CNKI, Wanfang, and VIP. The search period spanned from the inception of each database to December 2024. The quality of the included literature was assessed using the ROB 2 tool, and data analysis was conducted using RevMan 5.4 and Stata 16 software. Furthermore, the GRADE evidence quality evaluation tool was employed to assess the outcome indicators of the included studies. Results: A total of 19 articles were ultimately included, consisting of 17 English-language articles and 2 Chinese-language articles. All studies were randomized controlled trials (RCTs) involving a total of 18,650 children. The results indicated that the standardized mean differences (SMD) for the effects of aerobic exercise interventions on children's inhibitory control, working memory, and cognitive flexibility were as follows: SMD = 0.06, 95% CI (-0.09, -0.03) for inhibitory control; SMD = -0.01, 95% CI (-0.04, -0.02) for working memory; and SMD = -0.02, 95% CI (-0.01, -0.05) for cognitive flexibility. According to the GRADE evidence quality assessment, the three outcome indicators (inhibitory control, working memory, and cognitive flexibility) were rated as moderate quality. Conclusion: Single acute aerobic exercise sessions lasting less than 30 min demonstrate the most significant improvement in executive function among children aged 6 to 8 years. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025631031, identifier (CRD42025631031).

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