Effects of physical activity on cognition, behavior, and hyperactivity symptoms in elementary school children with adhd

The aim of this study was to systematically analyze the effects of physical activity on cognition, behavior, and hyperactivity symptoms in primary school children diagnosed with ADHD. A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines and the Cochrane Handbook, and the protocol was registered in PROSPERO. The literature search was conducted in the PubMed, Scopus, CINAHL, and Web of Science databases between March and April 2025. Specific combinations of terms related to physical activity, ADHD, children, and school settings were used. Twenty randomized clinical trial (RCT) studies involving exercise interventions in children aged 6 to 12 years diagnosed with ADHD were selected. Methodological quality was assessed using the PEDro scale, and risk of bias was assessed using the RoB 2 tool. The main findings indicated that physical activity generated significant improvements in externalizing and internalizing behaviors and general ADHD symptoms, although the effects on executive cognition and attention/inattention were not always statistically significant. Secondary benefits were also observed in sleep quality. The conclusions highlight that physical activity is a complementary, effective, and safe therapeutic strategy, with a positive impact on the cognitive, emotional, and social domains of children with ADHD. Evidence supports its inclusion in school and family programs as an alternative or complement to traditional treatments.