Abstract / Summary
Abstract Background Acute cognitively engaging physical activity (CEPA) has been proposed as an intervention for improving executive function, but its effects in children remain uncertain. This systematic review and meta-analysis evaluated the immediate effects of acute CEPA on executive function in children and explored whether these effects varied according to exercise modality, intensity, session duration, and participant age. Methods PubMed, Web of Science, the Cochrane Library, Embase, EBSCOhost, and the China National Knowledge Infrastructure were searched from inception through June 28, 2026. Randomized trials comparing a single bout of CEPA with either a non-exercise control or physical activity involving lower cognitive engagement at a comparable intensity were included. Small-sample-corrected standardized mean differences (SMDs) and 95% confidence intervals (CIs) were pooled using random-effects models in RevMan 5.4 and Stata 15.0. Exploratory subgroup analyses were conducted by exercise modality, intensity, session duration, and age. Risk of bias and the certainty of evidence were assessed using RoB 2 and GRADE, respectively. Results Thirteen studies involving 1,117 children were included. Compared with control conditions, acute CEPA produced small improvements in overall executive function (SMD = 0.22, 95% CI 0.14–0.33; I² = 25%), inhibitory control (SMD = 0.22, 95% CI 0.11–0.33; I² = 0%), and working memory (SMD = 0.35, 95% CI 0.17–0.54; I² = 0%). The pooled effect on cognitive flexibility was not statistically significant (SMD = 0.22, 95% CI − 0.08–0.51; I² = 69%). Within-subgroup effects on inhibitory control were significant for both physical activity–based and exergaming interventions, for low- and moderate-intensity activity, and for sessions lasting more than 15 min. Effects on working memory were significant for physical activity–based interventions, moderate-intensity activity, and children aged < 8 years, whereas effects on cognitive flexibility were significant for exergaming and children aged ≥ 8 years. No formal between-subgroup tests were conducted; these findings are therefore exploratory. Conclusions Acute CEPA may produce small immediate improvements in executive function in children, with more consistent evidence for inhibitory control and working memory than for cognitive flexibility. Apparent variation according to exercise characteristics and age remains exploratory and requires confirmation through direct comparisons. Trial registration: The study protocol was prospectively registered with PROSPERO (registration number: CRD420261458285).