Effectiveness of physical education interventions on physical and mental health in pre- and school-aged children: a systematic review and meta-analysis

Introduction This systematic review and meta-analysis aimed to evaluate the efficacy of school-based physical education interventions for improving pre- and school-aged children’s physical and mental health outcomes (3–12 years) and to examine whether effects vary across intervention and outcome types. Method Following PRISMA 2020 guidelines, an extensive search was conducted in Ovid MEDLINE, Embase, the Cochrane Controlled Trials Registry, and Scopus up to October 2023. Randomized controlled trials evaluating PE- or school-day activity–based interventions targeting physical and/or mental health outcomes in preschool (3–6 years) and school-aged children (6–12 years) were included. Random-effects meta-analysis (REML) was performed using standardized mean differences (SMDs), and heterogeneity was assessed using Q and I 2 statistics. Subgroup analyses and influence diagnostics were conducted to explore between-study variability”. Results Nineteen studies were included in the analysis. The results of the meta-analysis revealed no significant evidence of the effectiveness of these interventions on physical or mental health (1.61, 95CI; −1.37, 4.60; p = 0.29). The subgroup analysis results showed no significant difference between physical activity (0.05, 95%CI: −0.20, 0.29) and psychological exercise (0.06, 95%CI: −0.36, 0.24) ( p = 0.58). Notably, substantial heterogeneity across studies indicates variability in the interventions’ effects. Conclusion The evidence remains inconclusive due to substantial heterogeneity, variability in intervention content, and differences in outcome measurement. Future trials should adopt standardized outcome measures, improve reporting of intervention implementation, and strengthen methodological rigor to enable more definitive synthesis of physical education intervention effects in children.