A multilevel meta-analysis of the effects of exercise interventions on inhibitory control in children with ADHD
- Forfatter(e)
- Wang, H. Z., Wang, S. S., Cheng, G.
- År
- 2026
- Tidsskrift
- Frontiers in Psychiatry
- Volum
- 17
- Sider
- 19
- Kategori(er)
- ADHDKognisjon (hukommelse, oppmerksomhet og eksekutive funksjoner)
- Tiltakstype(r)
- Fysisk aktivitet
- Abstract
Background
Inhibitory control deficits are core cognitive dysfunctions in children with attention-deficit/hyperactivity disorder (ADHD). Exercise interventions, as a non-pharmacological approach, show promise for improving executive functions, yet quantitative evidence regarding their effectiveness and moderating factors remains limited.
Methods
We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library from inception to October 2025. Randomized controlled trials examining exercise effects on inhibitory control in children with ADHD were included. Risk of bias was assessed using the RoB 2 tool. A three-level random-effects model was employed to pool effect sizes while accounting for within-study dependencies. Meta-regression analyses examined moderating effects of gender ratio, training frequency, session duration, and intervention duration. Evidence quality was evaluated using GRADE.
Results
Eleven trials (512 participants; 268 intervention, 244 control) yielded 15 effect sizes. The three-level meta-analysis revealed a medium-to-large beneficial effect of exercise on inhibitory control (SMD = 0.71, 95% CI [0.52, 0.91], p < 0.001) with negligible heterogeneity (I & sup2; = 0%). Within-group analyses showed significant improvements in intervention groups (SMD = 0.98, 95% CI [0.68, 1.28], p < 0.001), but not in controls (SMD = 0.13, 95% CI [-0.06, 0.31], p = 0.158). Meta-regression found no significant moderators (all p > 0.05). Sensitivity analyses confirmed robust results. Egger's test indicated no publication bias (p = 0.606). GRADE assessment indicated low-quality evidence due to lack of blinding and trial preregistration.
Conclusion
Exercise interventions may produce medium-to-large improvements in inhibitory control among children with ADHD. Although robust across intervention parameters, overall evidence certainty remains low due to methodological limitations. High-quality studies are needed to confirm these findings. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD420251178371.