Influence of Physical Activity on Perceived Stress and Mental Health in University Students: A Systematic Review

Alexandra Martin-Rodriguez^1,2*Natalia González Prieto^1,3

• ¹Faculty of Medicine, Health and Sports, Universidad Europea de Madrid,28670 Madrid, Spain, Madrid, Spain
• ²Faculty of Health Sciences, UNIE University, 28015 Madrid, Spain, Madrid, Spain
• ³Faculty of Medicine, University of Málaga, 29071 Málaga, Spain, Málaga, Spain

University students are a population particularly vulnerable to stress, anxiety, and reduced well-being. Physical activity has been proposed as a protective factor, but existing findings are heterogeneous. This systematic review examines the relationship between physical activity and mental health in university students, focusing on perceived stress, anxiety, depression, and psychological well-being. It was conducted in accordance with PRISMA guidelines and protocol is registered in PROSPERO (CRD420251179614). A total of 38 studies published between 2020 and 2025 were analyzed, involving over 20,000 participants from various countries. Most of them are cross-sectional studies, although some longitudinal and quasi-experimental studies are also included. The results show a consistent association between higher levels of physical activity and lower levels of stress, depression, and anxiety, as well as an increase in subjective well-being. Additionally, mediators such as sleep quality and resilience, and moderators such as gender or internet use, were identified. The effect is more significant when physical activity is combined with other healthy habits, such as good sleep and low sedentary behavior. Although most of the studies are not experimental, the evidence suggests a possible beneficial causal effect of exercise. The need for comprehensive interventions in universities is highlighted, promoting physical activity as a preventive and therapeutic strategy to improve students' mental health.