It's not just what you do, but the way you do it: network meta-analysis of the effects of different exercise modalities on the executive function of children and adolescents

It is recommended that regular exercise be used to improve the executive function of children and adolescents, but the most effective type of exercise remains unclear. This study aimed to compare the effects of different exercise types on the executive function of children and adolescents and rank them. Randomized controlled trials (RCTs) on "exercise interventions on the executive function of children and adolescents" were searched in multiple databases up to December 31, 2024. Two researchers independently screened the literature, extracted data, evaluated methodological quality, and performed statistical analysis using Stata 17.0. Forty-three trials with 6944 participants were included. Net Meta-analysis showed that single aerobic exercise, cognitive + exercise, and ball games significantly improved inhibitory control compared to controls. Ball games were superior to combined exercises. Cognitive + exercise improved working memory, while ball games enhanced cognitive flexibility. SUCRA probability ranking indicated that ball games had the most significant effects on inhibitory control (SUCRA = 97.4), working memory (SUCRA = 77.0), and cognitive flexibility (SUCRA = 93.6). Ball games, single aerobic exercise, and cognitive + exercise significantly improved children's executive function. Ball games were the most effective intervention for inhibitory control, working memory, and cognitive flexibility.