Network meta-analysis of the effects of different exercise types on inhibition, cognitive flexibility, and working memory in adolescents

doi:10.3969/j.issn.1004-583X.2026.09.001

Abstract

Abstract:

Objective To compare the effects of different exercise types on inhibition, cognitive flexibility, and working memory in adolescents through traditional meta-analysis and network meta-analysis. Methods CNKI, Wanfang, VIP, Baidu Scholar, Web of Science, PubMed, and ScienceDirect were systematically searched from database inception to December 1, 2025. Traditional meta-analysis, network meta-analysis, and graphical plotting were performed using Review Manager 5.4 and Stata 18. Results A total of 15 randomized controlled trials (RCTs) involving 17 289 adolescents were included, covering five exercise types: aerobic exercise, resistance exercise, cognitively engaging physical games, high-intensity interval training, and multicomponent exercise. Subgroup analysis showed that 20 min/session of low-dose exercise significantly improved inhibition function in adolescents compared with the control group (SMD=0.29, 95%CI: [0.01, 0.58]); 45 min/session of moderate-dose exercise significantly improved cognitive flexibility (SMD=1.15, 95%CI: [0.14, 2.15]); and an intervention frequency of 4 times/week (SMD=1.52, 95%CI:[0.56, 2.48]) and a duration of 10-12 weeks (SMD=0.66, 95%CI: [0.04, 1.29]) significantly improved working memory in adolescents compared with the control group. Network meta-analysis showed that: ① the ranking of exercise types for improving adolescent inhibition function was cognitively engaging physical games (SUCRA=98.7%) > resistance exercise (SUCRA=77.8%) > aerobic exercise (SUCRA=51.9%) > multicomponent exercise (SUCRA=34.0%) > no intervention (SUCRA=30.1%) > high-intensity interval training (SUCRA=7.5%), and cognitively engaging physical games showed significant differences compared with aerobic exercise (SMD=2.96, 95%CI: [0.74, 5.19]), multicomponent exercise (SMD=3.47, 95%CI: [1.63, 5.32]), no intervention (SMD=3.56, 95%CI: [1.70, 5.41]), and high-intensity interval training (SMD=4.38, 95%CI: [2.06, 6.71]); ② the ranking of exercise types for improving cognitive flexibility was aerobic exercise (SUCRA=83.5%) > cognitively engaging physical games (SUCRA=59.3%) > multicomponent exercise (SUCRA=44.9%) > high-intensity interval training (SUCRA=21.1%); ③ the ranking of exercise types for improving working memory was aerobic exercise (SUCRA=71.1%) > high-intensity interval training (SUCRA=61.1%) > multicomponent exercise (SUCRA=57.3%) > resistance exercise (SUCRA=21.5%). Conclusion Cognitively engaging physical games show an advantage in improving inhibition function, whereas aerobic exercise ranks first in enhancing cognitive flexibility and working memory in adolescents. In terms of intervention dose, low-dose exercise of 20 min/session shows a positive trend in improving inhibition function, moderate-dose exercise of 45 min/session has a significant effect on cognitive flexibility, and medium-to long-term intervention of 4 times/week for 10-12 weeks can significantly improve working memory in adolescents.

Key words: cognition disorders, exercise, inhibition, cognitive flexibility, working memory, adolescents, network meta-analysis

CLC Number:

R741

Li Yongjing, Su Huaiyi, Wang Xinyuan, Zhang Jinlong, Song Shuhua. Network meta-analysis of the effects of different exercise types on inhibition, cognitive flexibility, and working memory in adolescents[J]. Clinical Focus, 2026, 41(9): 773-786.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.09.001

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Figures/Tables 12

References 63

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研究者	国家	样本量 (T/C)	平均年龄 (T/C)	干预措施 (T/C)	干预方案	结局指标
Benzing等^[31],2016	瑞士	42(21/21)	T1:14.52±1.03 T2:14.61±1.22 C:14.38±1.02	②/③/①	15min/次,-,-	D-KEFS
Tavakoil等^[32],2024	伊朗	60(30/30)	12.13±0.28/12.83±0.61	④/①	45 min/次,3次/周,8周	Simon任务
Sjöwall等^[33],2019	瑞典	167(108/59)	-	②/①	20 min/次,-,-	D-KEFS/Stroop色词测验/WISC
Silva等^[34],2020	巴西	20(10/10)	12±2/12±1	②/①	-,2次/周,8周	TMT
Jeon等^[35],2017	美国	40(10/10/10/10)	T1:15.06±0.73 T2:15.47±0.78 T3:15.15±0.33 C:15.05±0.41	②/①	-,4次/周,12周	WISC
Kolovelonis等^[36],2023	希腊	102(36/34/32)	-	③/⑤/①	45 min/次,-,-	DFT
李琳等^[37],2020	中国	58(18/21/19)	T1:18.44±0.51 T2:18.43±0.51 C:18.58±0.51	②/④/①	50 min/次,3次/周,8周	Stroop色词测验/N-back任务
张凯等^[38],2019	中国	32(17/15)	-	⑤/①	45 min/次,2次/周,10周	Flanker任务
张立敏等^[39],2019	中国	66(33/33)	-	⑤/①	45 min/次,-,12周	Flanker任务/shifting task/N-back任务
Rutkauskaite等^[40],2025	立陶宛	63(31/32)	13.7±0.8/13.9±0.8	⑤/①	60 min/次,3次/周,4周	Stroop色词测验/VDST
Hillman等^[41],2014	美国	221(109/112)	-	⑤/①	70 min/次,5次/周,20周	CSST
Ludyga等^[42],2018	瑞士	35(19/16)	12.5±0.7/12.4±0.7	⑤/①	20 min/次,5次/周,8周	Stroop色词测验
Subramanian等^[43],2015	英国	350(172/175)	-	⑤/①	120 min/次,6次/周,24周	RFFT
Williams等^[44],2022	英国	16(8/8)	11.8±0.2/11.6±0.4	⑥/①	60 min/次,3次/周,2周	Stroop色词测验、Sternberg paradigm
Wassenaar等^[45],2021	英国	16 017(7 860/8 157)	12.5±0.30/12.5±0.29	⑥/①	60 min/次,2次/周,40周	Flanker任务/CSST/2-Back任务

研究者	国家	样本量 (T/C)	平均年龄 (T/C)	干预措施 (T/C)	干预方案	结局指标
Benzing等^[31],2016	瑞士	42(21/21)	T1:14.52±1.03 T2:14.61±1.22 C:14.38±1.02	②/③/①	15min/次,-,-	D-KEFS
Tavakoil等^[32],2024	伊朗	60(30/30)	12.13±0.28/12.83±0.61	④/①	45 min/次,3次/周,8周	Simon任务
Sjöwall等^[33],2019	瑞典	167(108/59)	-	②/①	20 min/次,-,-	D-KEFS/Stroop色词测验/WISC
Silva等^[34],2020	巴西	20(10/10)	12±2/12±1	②/①	-,2次/周,8周	TMT
Jeon等^[35],2017	美国	40(10/10/10/10)	T1:15.06±0.73 T2:15.47±0.78 T3:15.15±0.33 C:15.05±0.41	②/①	-,4次/周,12周	WISC
Kolovelonis等^[36],2023	希腊	102(36/34/32)	-	③/⑤/①	45 min/次,-,-	DFT
李琳等^[37],2020	中国	58(18/21/19)	T1:18.44±0.51 T2:18.43±0.51 C:18.58±0.51	②/④/①	50 min/次,3次/周,8周	Stroop色词测验/N-back任务
张凯等^[38],2019	中国	32(17/15)	-	⑤/①	45 min/次,2次/周,10周	Flanker任务
张立敏等^[39],2019	中国	66(33/33)	-	⑤/①	45 min/次,-,12周	Flanker任务/shifting task/N-back任务
Rutkauskaite等^[40],2025	立陶宛	63(31/32)	13.7±0.8/13.9±0.8	⑤/①	60 min/次,3次/周,4周	Stroop色词测验/VDST
Hillman等^[41],2014	美国	221(109/112)	-	⑤/①	70 min/次,5次/周,20周	CSST
Ludyga等^[42],2018	瑞士	35(19/16)	12.5±0.7/12.4±0.7	⑤/①	20 min/次,5次/周,8周	Stroop色词测验
Subramanian等^[43],2015	英国	350(172/175)	-	⑤/①	120 min/次,6次/周,24周	RFFT
Williams等^[44],2022	英国	16(8/8)	11.8±0.2/11.6±0.4	⑥/①	60 min/次,3次/周,2周	Stroop色词测验、Sternberg paradigm
Wassenaar等^[45],2021	英国	16 017(7 860/8 157)	12.5±0.30/12.5±0.29	⑥/①	60 min/次,2次/周,40周	Flanker任务/CSST/2-Back任务

结局指标	纳入研究数(个)	异质性检验结果		效应模型	meta分析结果
结局指标	纳入研究数(个)	I²值(%)	P值	效应模型	SMD(95%CI)	P值
抑制	10	85.55	<0.01	随机	0.36[0.04, 0.65]	<0.05
认知灵活性	8	98.47	<0.01	随机	0.77[0.03, 1.51]	<0.05
工作记忆	9	95.37	<0.01	随机	0.66[0.03, 0.70]	<0.05

结局指标	纳入研究数(个)	异质性检验结果		效应模型	meta分析结果
结局指标	纳入研究数(个)	I²值(%)	P值	效应模型	SMD(95%CI)	P值
抑制	10	85.55	<0.01	随机	0.36[0.04, 0.65]	<0.05
认知灵活性	8	98.47	<0.01	随机	0.77[0.03, 1.51]	<0.05
工作记忆	9	95.37	<0.01	随机	0.66[0.03, 0.70]	<0.05

结局指标	亚组		纳入研究数 (个)	异质性检验结果		meta分析结果
结局指标	亚组		纳入研究数 (个)	I²值(%)	P值	SMD(95%CI)	P值
抑制	结局指标	D-KEFS	1	-	-	0.32[0.00, 0.64]	>0.05
		Simon任务	1	-	-	1.62[1.04, 2.20]	<0.01
		DFT	1	-	-	0.90[0.40, 1.39]	<0.01
		Stroop色词测验	4	0.00	>0.05	0.17[-0.15, 0.48]	>0.05
		Flanker任务	3	60.69	>0.05	0.09[-0.27, 0.45]	>0.05
	干预措施	有氧运动	1	-	-	0.32[0.00, 0.64]	>0.05
		认知体能游戏	2	71.27	>0.05	1.24[0.53, 1.95]	<0.01
		多模式运动	4	0.00	>0.05	0.28[0.01, 0.56]	<0.05
		抗阻运动	1	-	-	0.00[-0.63, 0.63]	>0.05
		高强度间歇训练	2	0.00	>0.05	-0.04[-0.07, -0.01]	<0.05
	剂量	20 min/次	2	0.00	0.05	0.29[0.01, 0.58]	0.05
		45~50 min/次	5	83.23	<0.01	0.59[-0.03, 1.21]	>0.05
		60 min/次	3	32.24	>0.05	0.03[-0.23, 0.29]	>0.05
	频率	2次/周	2	0.00	>0.05	-0.04[-0.07, -0.01]	<0.05
		3次/周	4	84.18	<0.01	0.49[-0.30, 1.28]	>0.05
		5次/周	1	-	-	0.16[-0.49, 0.81]	>0.05
	周期	2~4周	2	0.00	>0.05	0.25[-0.19, 0.68]	>0.05
		8周	3	87.71	<0.01	0.60[-0.42, 1.62]	>0.05
		10~12周	2	59.09	>0.05	0.22[-0.43, 0.87]	>0.05
		40周	1	-	-	-0.04[-0.07, -0.01]	<0.05
认知灵活性	干预措施	有氧运动	2	95.99	<0.01	1.96[-1.84, 5.75]	>0.05
		认知体能游戏	2	82.65	<0.05	1.17[0.19, 2.16]	<0.05
		多模式运动	3	0.00	>0.05	0.20[0.04, 0.35]	<0.05
		高强度间歇训练	1	-	-	-0.01[-0.04, 0.03]	>0.05
	剂量	15~20 min/次	2	62.21	>0.05	0.31[-0.23, 0.86]	>0.05
		45 min/次	2	86.58	<0.05	1.15[0.14, 2.15]	<0.05
		60~70 min/次	2	0.00	>0.05	-0.00[-0.03, 0.03]	>0.05
		120 min/次	1	-	-	0.16[-0.05, 0.37]	>0.05
	频率	2次/周	2	96.34	<0.01	1.91[-1.98, 5.8]	>0.05
		5~6次/周	2	0.00	>0.05	0.15[-0.02, 0.31]	>0.05
工作记忆	结局指标	N-back任务	5	96.65	<0.01	0.78[-0.29, 1.84]	>0.05
		WISC	2	87.67	<0.01	0.71[-0.73, 2.14]	>0.05
		VDST	1	-	-	0.26[-0.23, 0.75]	>0.05
		Sternberg paradigm	1	-	-	0.50[-0.44, 1.44]	>0.05
	干预措施	有氧运动	2	87.67	<0.01	0.71[-0.73, 2.14]	>0.05
		多模式运动	3	0.00	>0.05	0.36[0.05, 0.66]	<0.05
		抗阻运动	2	96.81	<0.01	1.62[-1.10, 4.33]	>0.05
		高强度间歇训练	2	11.80	>0.05	0.02[-0.22, 0.26]	>0.05
	剂量	20 min/次	1	-	-	0.05[-0.27, 0.36]	>0.05
		45~50min/次	4	94.26	<0.01	0.99[-0.31, 2.29]	>0.05
		60 min/次	3	26.73	>0.05	0.07[-0.17, 0.30]	>0.05
	频率	2次/周	2	0.00	>0.05	-0.01[-0.04, 0.02]	>0.05
		3次/周	4	93.49	<0.01	1.00[-0.32, 2.31]	>0.05
		4次/周	1	-	-	1.52[0.56, 2.48]	<0.01
	周期	2~4周	2	0.00	>0.05	0.31[-0.12, 0.75]	>0.05
		8周	2	96.81	<0.01	1.62[-1.10, 4.33]	>0.05
		10~12周	3	60.16	>0.05	0.66[0.04, 1.29]	<0.05
		40周	1	-	-	-0.01[-0.04, 0.02]	>0.05