Peer-reviewed article
Effects of school-based physical activity interventions on physical fitness and psychosocial adaptation in children: a systematic review and meta-analysis
Manyin Zhang, Bing Zhang ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This systematic review and meta-analysis pooled 40 controlled trials of school-based physical activity programmes. The trials involved 21,793 children aged 6 to 12. The programmes were linked to small-to-moderate gains in cardiorespiratory and muscular fitness, and to small gains in self-esteem, psychological well-being and social functioning. The small drop in body mass index was not statistically significant. The authors report very high variation between studies and call for more rigorous studies with standardised measurement.
Key points
- Cardiorespiratory fitness improved (g = 0.36, 95% CI 0.25 to 0.46).
- Muscular fitness improved (g = 0.24, 95% CI 0.17 to 0.31).
- The change in body mass index was not statistically significant (g = -0.11, p = 0.154).
- Small significant effects were found for self-esteem (g = 0.18), psychological well-being (g = 0.15) and social functioning (g = 0.21).
- Exploratory subgroup analyses suggested larger effects with multicomponent interventions, durations of 24 weeks or more, and 3 or more sessions per week.
Limitations
Heterogeneity between studies was very high (I2 up to 98%), and the subgroup analyses were exploratory. The abstract does not name the countries studied, the risk-of-bias results or long-term follow-up, so it cannot show how well the effects hold in specific settings or over time.
Abstract
Background School-based physical activity (PA) interventions are a population-level strategy for improving children’s health, yet evidence on their combined effects on physical fitness and psychosocial adaptation remains fragmented. This systematic review and meta-analysis synthesized evidence from controlled intervention trials (randomized and non-randomized) examining school-based PA interventions on physical fitness (cardiorespiratory fitness, muscular fitness, body composition) and psychosocial adaptation (self-esteem, psychological well-being, social functioning) in children aged 6–12 years. Methods Following PRISMA 2020 guidelines, we searched PubMed, Web of Science, Embase, SPORTDiscus, Cochrane Library, and PsycINFO from inception to 15 January 2026. Randomized controlled trials (RCTs) and non-randomized controlled trials with a minimum 8-week school-based PA intervention and at least one physical fitness or psychosocial outcome were eligible. Random-effects meta-analyses were performed using Hedges’ g. Heterogeneity was assessed with I2 and Cochran’s Q. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool for RCTs and ROBINS-I for non-randomized trials. Results Forty studies (39 randomized, 1 non-randomized) involving 21,793 participants met inclusion criteria. School-based PA interventions were associated with significant improvements in cardiorespiratory fitness (g = 0.36, 95% CI [0.25, 0.46], p < 0.001, I2 = 98%) and muscular fitness (g = 0.24, 95% CI [0.17, 0.31], p < 0.001, I2 = 93%); the small reduction in body mass index did not reach statistical significance (g = −0.11, 95% CI [−0.27, 0.04], p = 0.154, I2 = 98%). For psychosocial outcomes, significant small effects were found for self-esteem (g = 0.18, 95% CI [0.10, 0.27], p < 0.001), psychological well-being (g = 0.15, 95% CI [0.09, 0.21], p < 0.001), and social functioning (g = 0.21, 95% CI [0.04, 0.38], p = 0.018). Exploratory subgroup analyses suggested that larger effects were associated with multicomponent interventions, durations of ≥24 weeks, and ≥3 sessions per week. Conclusion School-based PA interventions were associated with small-to-moderate improvements in physical fitness and small improvements in psychosocial adaptation in children. The findings support integrating comprehensive PA programs into school curricula. However, the small effect sizes for psychosocial outcomes and substantial heterogeneity underscore the need for rigorous studies with standardized measurement protocols.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- School-based physical activity programmes lasting at least 8 weeks
- Population
- Children aged 6 to 12 years in 40 studies, 21,793 participants in total
Key finding
Cardiorespiratory fitness: g = 0.36 (95% CI 0.25 to 0.46), I2 = 98%
Zhang et al. · OpenAlex · 2 Oct 2026