Does Cognitively Enhanced Physical Activity Improve Executive Functions in Preschool Children? A Systematic Review and Meta-Analysis

Executive functions (EFs) predict school readiness and academic achievement in young children. Cognitively enhanced physical activity (CEPA), defined as physical activity (PA) combined with concurrent cognitive tasks, may substantially enhance EFs in preschool-aged children. Given that EFs are crucial for children’s intellectual development and later achievements in life, we sought to systematically review the literature on the effects of CEPA on EFs in preschool children following the PRISMA 2020 guidelines. Web of Science, PubMed and APA PsycINFO were systematically searched from inception to June 2024 for the relevant literature using predetermined keywords. Only randomized controlled trials that had performed CEPA in healthy preschool children and evaluated EFs were included. Quality appraisal of the included studies was assessed via Cochrane RoB2 tool. Eight studies comprised of 838 participants met the inclusion criteria and were analysed. The most consistent improvements in EFs were found in exergaming studies, which fostered CEPA through interactive video games adjusted for preschool children. The meta-analysis revealed that CEPA programs led to significantly better EFs outcomes in children than control conditions, with longer program durations yielding the greatest improvements. Future research should compare the effect sizes of CEPA, standard PA, and isolated cognitive training in preschool populations.