SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. ADHD
This article is part of the Research TopicAssessment and Intervention for Children and Adolescents Affected by Neurodevelopmental DisordersView all 12 articles
A Multilevel Meta-Analysis of the Effects of Exercise Interventions on Inhibitory Control in Children with ADHD
Provisionally accepted
- 1Beijing Normal University College of Physical Education and Sports, Beijing, China
- 2Northwest Minzu University, Lanzhou, China
- 3Northwest Normal University, Lanzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
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 (I² = 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.
Keywords: Attention-Deficit/Hyperactivity Disorder, Children, Exercise Intervention, Inhibitory Control, Meta-analysis, Three-level model
Received: 10 Nov 2025; Accepted: 29 Jan 2026.
Copyright: © 2026 Haozhi, shanshan and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cheng Gong
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.