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Effects of physical education interventions on cognition and academic performance outcomes in children and adolescents: a systematic review and meta-analysis
  1. Antonio García-Hermoso1,2,
  2. Robinson Ramírez-Vélez1,
  3. David Revalds Lubans3,
  4. Mikel Izquierdo1
  1. 1 Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
  2. 2 Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
  3. 3 Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
  1. Correspondence to Dr Antonio García-Hermoso, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain; antonio.garciah{at}


Objective To determine the effects of interventions aimed at optimising the quantity and quality of physical education (PE) on cognition and academic performance in children and adolescents.

Design A systematic review and meta-analysis.

Data sources Studies from electronic databases from inception to 3 January 2021 were identified.

Eligibility criteria for selecting studies Experimental studies that assessed the effect of quantity-based (ie, increasing the amount of curriculum time allocated to PE) or quality-based (ie, increasing students’ participation in physical activity during PE) PE interventions, or both, on changes in cognition and/or academic performance in youth (aged 5–18 years) were included.

Results 19 trials comprising 8676 youth (46.5% girls) were included. Individual quality-based PE interventions increased cognition performance (Hedges’ g=0.38, 95% CI 0.15 to 0.60; I 2=83.70%), mainly in primary education settings (g=0.48, 95% CI 0.07 to 0.89; I 2=90.43%). Academic performance, principally mathematics-related skills, was also increased by quality-based PE interventions (g=0.15, 95% CI 0.06 to 0.24; I 2=41.75%). Among these interventions, teaching strategies favoured similar results, but without heterogeneity in the results (g=0.12, 95% CI 0.05 to 0.18; I 2=0%). In contrast, quantity-based PE interventions had a very small and non-significant effect on academic performance (g=0.09, 95% CI −0.05 to 0.24; Q=11.65; I 2=48.48%). Finally, there were no differences between the three PE interventions (ie, quantity, quality, and combined PE interventions) in regard to academic performance.

Conclusion Improving the quality of PE classes may improve students’ cognition and academic performance in children and adolescents. Importantly, allocating more time for PE does not seem to compromise this performance.

  • school
  • brain
  • meta-analysis
  • education

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  • Twitter @a_garciahermoso, @Robinso77315134, @davidlubans, @mikelizquierdo_

  • Contributors AG-H and MI conceptualised and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. RR-V designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript. DRL conceptualised and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding AG-H is a Miguel Servet Fellow (Instituto de Salud Carlos III – CP18/0150). RR-V is funded in part by a Postdoctoral Fellowship Resolution ID 420/2019 of the Universidad Pública de Navarra.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.