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Physical Activity and Academic Achievement: An Umbrella Review

Ana barbosa, stephen whiting, philippa simmonds, rodrigo scotini moreno, romeu mendes.

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Correspondence: [email protected]

Received 2020 Jul 15; Accepted 2020 Aug 12; Issue date 2020 Aug.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/ ).

Background: This umbrella review aimed to summarise the evidence presented in systematic reviews and meta-analyses regarding the effect of physical activity on academic achievement of school-age children and adolescents. Methods: A comprehensive electronic search for relevant systematic reviews and meta-analyses were performed in Pubmed, Cochrane Library, Web of Science, Scopus, and Latin American and Caribbean of Health Sciences Information System, and reference lists of the included studies, from inception to May 2020. Studies were included if they were systematic reviews or meta-analyses, included school-age children or adolescents, the intervention included physical activity, and the outcome was the academic achievement. Two independent authors screened the text of potentially eligible studies and assessed the methodological quality of the studies using the AMSTAR 2 tool. Results: Forty-one systematic reviews and meta-analyses that examined the effects of physical activity on children and adolescents’ academic achievement were identified. Overall, the systematic reviews reported small positive or mixed associations between physical activity and academic achievement. From meta-analyses, it was observed that physical activity had null or small-to-medium positive effects on academic achievement. Chronic physical activity showed a medium positive effect on academic achievement, and acute physical activity did not demonstrate benefits. Conclusions: Physical activity seems not to be detrimental to school-age children and adolescents’ academic achievement, and may, in fact, be beneficial.

Keywords: physical activity, exercise, academic achievement, children, adolescents, school-age

1. Introduction

It is well documented that physical activity (PA) has beneficial effects for both physical and mental health [ 1 ]. If sustainable development goals are to be met, it is essential that PA levels increase among all age groups but particularly among children and adolescents. However, physical inactivity is growing significantly for young people, in part due to the rise in school-related sedentary behaviours [ 2 ].

The World Health Organisation (WHO) recommends children and adolescents aged 5–17 years to achieve a minimum of 60 min of moderate-to-vigorous PA (MVPA) per day [ 3 ]. The accomplishment of recommended levels of PA is crucial for the development of cognitive, motor, and social skills, as well as good musculoskeletal health [ 4 ]. However, in 2016, it was estimated that only 34% of young Europeans met these recommendations [ 4 ]. At school, a study found that European pre-adolescent children (aged 10–12 years) spent an average of 65% of their school time in sedentary activities, while they spent only 16 min per school day (5%) engaged in MVPA [ 5 ]. Investing in school policies that encourage PA would align with the WHO’s Global Action Plan for Physical Activity 2018–2030 [ 6 ], and the Physical Activity Strategy for the WHO European Region 2016–2025 [ 4 ], both of which call for countries to take action to increase the PA of children and adolescents.

For this population group, schools are an ideal setting to promote population health by providing more opportunities to be physically active at school [ 7 ]. However, the school environment can promote a sedentary lifestyle by compelling students to sit still for long periods in the classroom (around 3.5 h, corresponding to approximately 70% of class time being sedentary) during lessons and other study activities [ 8 ]. Moreover, physical education (PE) has not yet been prioritised in many countries due to the prominence of other subjects, such as mathematics, languages, and sciences in which achievement is assessed by standardised testing methods [ 9 ]. The time dedicated to PE and active play is increasingly eroded in favour of sedentary studies, a practice that may not, in fact, be associated with higher test scores [ 10 ]. Aside from academic achievement (AA), PA has a potential range of health benefits, including reduced risk of cardiovascular and metabolic disease and improved bone health [ 3 ]. Taking a holistic view, promoting PA in schools may also contribute to the achievement of the Sustainable Development Goals [ 11 ], in particular, Goals 3 (good health and wellbeing), 4 (quality education), 5 (gender equity), 10 (reduced inequalities), 11 (sustainable cities and communities), and 13 (climate action).

While there is no clear evidence that increased PA during childhood is associated with increased PA as an adult [ 12 ], it has been shown that higher AA is associated with higher socioeconomic status (SES) as an adult, independently of SES at birth [ 13 ]. SES is a key determinant of health throughout the life course, and therefore, interventions that promote AA may have far-reaching economic and health-promoting effects for students. Thus, in addition to directly enhancing physical health, PA may also have an indirect effect on health if it promotes academic achievement.

It is beyond the scope of this review to discuss the concept of “academic achievement”, but it is important to note that the concept encompasses a broad range of outcomes that are influenced by cognitive, social, and environmental factors [ 14 ]. While the academic literature mainly employs grades and test results to quantify AA, more qualitative social and interpersonal outcomes of education are also vital for health and wellbeing. For the purposes of this review, “academic achievement” can be broadly defined as to what extent a student, teacher, or school has met their academic goals. In the research context, this is measured in different ways, most commonly using test scores and teacher-assigned grades [ 13 ]. AA is affected by several factors, including individual characteristics (motivation, perception of wellbeing, quality of life and parents’ support, involvement in activities, and motivation), school characteristics (human and material resources, class size, teaching, rewards, extra-curricular activities, technology, evaluation system, facilities), family support (home environment, provision of resources, the attitude of family members, education, SES, family size) [ 15 ], and community facilities (youth clubs, gyms, outdoor pursuits) [ 4 ].

Higher levels of PA are not only fully compatible with schools’ mandate to promote the health of their students, but, according to the literature, they are also unlikely to have adverse effects on learning [ 16 ]. Part of the effect of PA on AA is likely mediated via the brain’s executive functions [ 17 ], with PA inducing, neural growth and modification in synaptic transmission, resulting in changes in thinking, decision-making, and, particularly in the prefrontal cortex [ 18 ]. Acute PA increases physiological arousal, and thus attention and triggers the release of neurotransmitters that are thought to enhance cognitive processes. Aerobic PA that increases cardiovascular fitness is considered to improve brain function through neurogenesis and angiogenesis in areas responsible for memory and learning, as well as to promote cognition via changes such as increased oxygen saturation and glucose delivery [ 19 ]. Furthermore, there is evidence that regular PA promotes positive self-perception, emotional regulation, and cognitive functioning, all of which may be factors that contribute to enhancing AA [ 19 , 20 ]. In this review, PA is defined as any movement produced by the human body that involves skeletal muscle and increases energy expenditure [ 21 ].

Due to the significant implications for educational practices at the population level, a substantial body of research has been dedicated to understanding the effect that PA can have on students’ cognition, classroom behaviour, and AA [ 22 ]. However, results from previous reviews have been inconsistent, which may be due to the variety of study designs employed in this area. For example, some reviews have used moderators, such as SES, family support, age, sex, psychological variables, nutritional status, while others have not. There have also been discrepancies in the measurement of AA with both standardised and non-standardised tests being used, as well as ambiguity in the definition of AA. Finally, a range of PA interventions has been included in previous reviews, such as extra-curricular PA, PE, active classrooms, active commuting to and from school, specific modalities, and acute or chronic PA. For these reasons, definitive conclusions cannot yet be drawn [ 17 , 23 , 24 ].

Therefore, this review aimed to summarise the available evidence presented in systematic reviews and meta-analyses regarding the effect of PA on AA of school-age children and adolescents, and explore the effect of PA programmes or modalities on AA in specific subjects.

The relevance of this umbrella review is to address the need for evidence to inform the development of future recommendations, strategies, and policies at different levels, particularly within the education sector.

2. Materials and Methods

2.1. search strategy.

A comprehensive search for relevant systematic reviews was conducted in the following electronic databases: Pubmed, Cochrane Library, Web of Science, Scopus, and Latin American and Caribbean of Health Sciences Information System (LILACS), until May 2020. The full search strategy is described in Appendix A . For each selected database, we used the following search terms: (“physical activity” OR exercise OR “physical education” OR “active transport” OR “active mobility” OR walking OR cycling OR running OR training OR sport) AND ((academic OR school OR cognitive OR cognition) AND (achievement OR performance OR attainment OR function OR result)) AND (child* OR school-age OR schoolchildren OR adolescents OR youth), AND (“systematic review” OR meta-analysis). Specific search terms were modified according to the database requirements. There were no limits applied to the search and the reference lists of the included reviews were searched. The search was conducted by two authors, from inception until May 2020.

2.2. Study Selection

Two authors independently reviewed the search results and screened publications retrieved from databases and reference lists, according to predefined steps. First, articles were screened by the information from the title and abstract. Second, articles with potential relevance were retrieved for full-text review, and their eligibility for inclusion in the review was determined. Disagreements were resolved through discussion until consensus.

All studies that fulfilled the following eligibility criteria were included: type of studies—systematic reviews or meta-analysis; type of participants—school-age children or adolescents, i.e., six to 18 years old (studies that include data on younger or older students were not excluded if data could be interpreted for the eligible age range); type of interventions—any form of acute or chronic physical activity practice and; type of outcome—academic achievement.

Studies were excluded according to study type (editorials, comments, case reports, guidelines, conference abstracts, other reviews); studies which focused exclusively on participants with cognitive disabilities (e.g., autism, attention deficit hyperactivity disorder); studies without any form of PA; studies without measurement and quantification of the outcomes of interest; and studies without available full-text.

For this review, AA refers specifically to grades and standardised test results, and only reviews that reported this outcome were included. “Academic performance” (AP) is sometimes used as a synonym for AA. At the same time, it describes these outcomes plus other measures, such as attendance, classroom behaviour, time on task, or executive function. Cognitive outcomes are often included in reviews in this field, considering they play a role in academic success. We did not exclude studies that used “academic performance” or “cognitive function”, where authors defined the term clearly and reported the specific outcomes included in our definition of AA. The setting for most of the included reviews was educational institutions or the community.

2.3. Data Extraction

Each selected review was independently evaluated by two authors to extract information regarding the study design, objectives, participants (type and age), number and type of included studies, PA intervention and outcome measures, the setting of intervention, subject-specific effects, the overall effect of PA on AA, and the effect sizes from the meta-analyses. If there were discrepancies in data extraction, the authors discussed until there was consensus.

2.4. Methodological Quality

Two independent investigators evaluated the methodological quality of each eligible systematic review, using the AMSTAR 2 tool [ 25 ]. This instrument has 16 items and enables appraisal of systematic reviews of randomised and non-randomised studies of healthcare interventions. Each study is rated according to critical domains that can affect the validity and the conclusion of the review. The critical domains considered for this review were protocol registration before the commencement of the review (item 2); adequacy of the literature search (item 4); justification for excluding individual studies (item 7); risk of bias from individual studies being included in the review (item 9); appropriateness of meta-analytical methods (item 11); consideration of the risk of bias when interpreting the results of the review (item 13); and assessment of the presence and likely impact of publication bias (item 15).

The studies were rated as ’high-quality’ if no or only one non-critical weakness was present; ´moderate-quality´ if there was more than one non-critical weakness; ´low-quality´ if there was only one critical flaw with or without non-critical weaknesses; and ´critically low-quality’ if there was more than one critical flaw with or without non-critical weaknesses. Any disagreements in the classification were resolved by discussion.

3.1. Study Selection

A total of 2314 references were identified in the initial search in electronic databases, and an additional ten references were identified through reference lists. After the duplicated studies were removed ( n = 751), 1573 studies remained. After screening for the title and abstract, 1442 papers were excluded, and 131 studies were eligible for full-text reading, from which 90 were removed. Thus, we included 41 studies for qualitative synthesis ( Figure 1 ).

Flow diagram. LILACS, Latin American and Caribbean of Health Sciences Information System; PA, Physical Activity.

3.2. Study Characteristics

The characteristics of the studies included in this review are shown in Table 1 . Briefly, studies ranged from 2003 to 2020; all studies were published in English, except the one that was published in the Spanish language [ 26 ]. All studies were systematic reviews, and 15 provided meta-analyses [ 23 , 24 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. The study design of the original reviews included only randomised controlled trials (RCT) or cluster RCT [ 29 , 35 , 40 , 41 ], and mixed designs (RCT, cluster RCT, cross-over designs, quasi-experimental studies, cross-sectional, and cohort studies) [ 9 , 17 , 23 , 24 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ].

Summary table of included reviews.

AA, Academic Achievement; AP, Academic Performance; MVPA, Moderate-to-Vigorous Physical Activity; NR, Not Reported; PA, Physical Activity; PE, Physical Education; RCT, Randomised Controlled Trial; SR, Systematic Review.

Regarding the participants, the studies included children [ 17 , 32 , 33 , 38 , 57 , 62 ], adolescents [ 26 , 30 , 47 , 48 , 52 , 56 ], or both populations [ 9 , 23 , 24 , 27 , 28 , 29 , 31 , 34 , 35 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 49 , 50 , 51 , 53 , 55 , 58 , 59 , 60 , 61 ], with the age ranging from one month to 21 years old.

Concerning the type of PA intervention, two studies focused on active commuting to and from school [ 23 , 24 ]; one studied a yoga intervention [ 29 ] and another in school gardening participation [ 57 ]. The remaining reviews focused on active breaks and physically active lessons [ 31 , 32 , 35 , 38 , 46 , 50 , 58 , 62 ], and on increasing PA through a variety of forms, including PE lessons, aerobic PA or extra-curricular PA) [ 9 , 17 , 26 , 27 , 28 , 30 , 31 , 33 , 34 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 59 , 60 , 61 ]. Almost all the interventions were delivered in the school setting, including classrooms or playgrounds, and one study also reported interventions in the community context [ 9 , 51 ].

Studies reported distinct definitions and instruments to assess AA, such as school grades, grade point average, standardised test scores, and subject-specific test scores (e.g., mathematics, reading, spelling).

3.3. Study Outcomes

3.3.1. overall academic achievement reported in systematic reviews.

The effects of PA on AA are described in detail in Table 2 . In general, there were small positive effects of different types of PA on AA [ 27 , 30 , 31 , 32 , 37 , 39 , 42 , 44 , 46 , 49 , 50 , 55 , 57 , 61 ] or mixed (small positive and null) effects [ 9 , 17 , 26 , 29 , 33 , 35 , 41 , 43 , 47 , 48 , 51 , 52 , 53 , 56 , 58 , 59 ].

Summary of the results included systematic reviews.

AA, Academic Achievement; AP, Academic Performance; ES: Effect Size; N/A, Not Applicable; PA, Physical Activity; PE, Physical Education; RCT, Randomised Controlled Trial.

Regarding the effects of PA on specific subjects, the included reviews evaluated reading, language, science, spelling, geography and mathematics. Mathematics was the subject where positive associations were found with more consistency [ 27 , 31 , 33 , 36 , 39 , 52 , 61 ].

3.3.2. Overall Academic Achievement Reported in the Meta-Analyses

Thirteen studies performed meta-analyses and provided effect sizes for AA, which are summarised in Table 3 . In brief, the overall effect of different modes of PA had null [ 28 , 32 , 33 ] or small to medium [ 27 , 30 , 33 , 35 , 37 ] effects on AA.

Summary of effect sizes retrieved from the meta-analyses.

CI, Confidence Interval; d, Cohen’s d; g, Hedges’ g; ES, Effect Size; N/R, Not Reported; OR, Odds Ratio; PA, Physical Activity; SMD, Standardised Mean Differences. Effects: ● beneficial; ⊘ null; ● Small effect size; ●● medium effect size; ●●● large effect size.

Considering the type of PA on overall AA, increasing the allocation of PE at school had a small [ 37 ] or medium [ 27 , 39 ] effects; active classrooms, compared with traditional sedentary classrooms, had null [ 32 ] or medium [ 35 ] effects. Chronic PA had a medium effect on AA; however, acute PA had a null effect on AA [ 33 ].

Regarding the effects of PA on subject-specific effects, mixed findings were observed, with studies reporting null effects or small to medium effects. The effects of PA on mathematics were null [ 23 , 24 , 28 , 33 , 34 , 35 ], small [ 39 ], or medium [ 27 , 31 , 36 ]. Concerning other subjects—for reading, null [ 28 , 33 , 34 , 35 ], small [ 31 , 39 ], or medium [ 27 ] effects were found; for language, null [ 23 , 28 , 31 ], medium [ 27 ], or large [ 35 ] effects were found; for science, a null effect was found in two studies [ 27 , 35 ]; for spelling, a null effect was found in one study [ 35 ], and another which assessed acute PA [ 33 ], as well as a null effect from chronic PA [ 33 ]; for geography, a large effect was found in one study [ 35 ].

Looking at the type of PA intervention on subject-specific achievement, active commuting to and from school was not associated with mathematics [ 23 , 24 ] and language [ 23 ]; increasing the allocation of PE at school had a small [ 39 ] or medium [ 27 ] effect on mathematics and reading; active classrooms, compared with traditional sedentary classrooms, had a null [ 35 ] or medium effect in mathematics [ 31 ], a null [ 35 ] or small [ 31 ] effect on reading, a null [ 31 ] or large [ 35 ] effect on language, a null effect on spelling and science [ 35 ], and a large effect on geography [ 35 ].

3.4. Methodological Quality

Table A1 shows the assessment of methodological quality for each study. Two studies were rated as ‘high-quality’, five studies with ‘moderate-quality’, 11 studies with ‘low-quality’, and 23 studies with ‘critically low-quality’. The critical domains where studies did not meet the quality requirements were the registration of the protocol before the commencement of the review (item 2, n = 30), the consideration of the risk of bias when interpreting the results of the review (item 13, n = 22), and the assessment of the risk of bias from individual studies being included in the review (item 9, n = 15). In non-critical domains, the majority of reviews (item 10, n = 39) did not report the sources of funding of individual studies (item 10), did not report the complete Population, Intervention, Control group, and Outcome (PICO) components (item 1, n = 32), and did not explain the selection of study designs for inclusion (item 3, n = 28). There was total agreement between the reviewers on the methodological quality assigned to each study.

4. Discussion

4.1. main results.

This review summarises the evidence of 41 systematic reviews and meta-analyses examining the relationship between physical activity and AA in school-aged children and adolescents. Overall, the findings suggest that PA has a null or small to medium effect on AA in school-age children and adolescents.

Our results are consistent with the latest studies in this field [ 35 ]. However, the findings are mixed when reviews include experimental or longitudinal studies. Mathematics was the subject measured more frequently, compared with other subjects, with null or small to medium effects. It has been hypothesised that PA improves executive function, which, in turn, has an impact on inhibition, working memory, and cognitive flexibility, components associated to this subject [ 36 ]. Furthermore, improving cognitive skills, such as visuospatial skills, rapid automatised naming, and memory can contribute to arithmetic learning [ 63 , 64 ]. Despite these considerations, more studies are needed to assess the effect of long-term PA intervention on mathematics’ performance [ 62 ], and also whether PA interventions that increase student’s enjoyment of classes can promote psychological wellbeing—another factor in academic performance [ 36 ].

The allocation of time for PE at school has a small to medium effects, and active classrooms, compared with traditional sedentary classrooms, had mixed effects. These mixed findings could, in part, be explained by methodological issues, such as the variety of type and length of PA interventions, the heterogeneity of populations included, as well as the specific definition of AA and the method of measurement utilised. In addition, a lack of moderators, including SES, family support, age, sex, psychological variables, nutritional status, may have also contributed to these diverse findings [ 17 ].

The studies which assessed chronic PA also reported small positive effects after the observational period, which is a very promising finding. To investigate this further, it is important to conduct high-quality RCTs over a longer period of time, as well as long-term and large-sample size longitudinal observational studies.

Active commuting to and from school was not associated with improvements in mathematics [ 23 , 24 ] and language [ 23 ]. This may be explained by specific methodological factors, such as the different definitions employed across the primary studies and the various ways of measuring active commuting to and from school, including objective and subjective measures, the low frequency of participants who engage in active commuting to and from school, and the lack of moderators’ assessment in the studies [ 23 ]. Other environmental factors may affect the low frequency of active commuting to and from school, such as air pollution, the existence of safe sidewalks, cycle paths, and routes to school, as well as perceived neighbourhood safety [ 24 ].

The majority of the included reviews were scored as ‘low-quality’ or ‘critically low-quality’ when assessing the methodological quality. For a study being rated as ‘low’ quality, it must present one critical weakness. Nevertheless, part of these studies failed to contain an explicit statement that the review methods were established before the conduct of the review, which does not necessarily mean the study has low-quality. Furthermore, AMSTAR 2 does not intend to provide a score, so these findings must be interpreted with caution.

4.2. Limitations

There are several limitations that must be considered when interpreting these findings. First, the included reviews were heterogeneous in the type of interventions (single or multiple interventions), the population included (children, adolescents, or both), type of study designs, outcome measures, and lack standardised definitions for outcomes, with the terms “academic achievement” and “academic performance” not clearly defined and sometimes used interchangeably [ 65 ], which may limit clear interpretations of the results.

Second, many reviews did not include risk of bias scoring, and did not report details of participant and assessor blinding, or provided insufficient information regarding concealment of allocation to the intervention or the control group [ 52 ] and, therefore, incorporated low-quality evidence to draw their conclusions, especially the oldest publications.

4.3. Implications for Practice

Innovative strategies are needed to provide adequate PA for children and adolescents. It would be beneficial to ascertain whether some types of PA, such as active breaks, could be recommended. Several European cities report less cycling and walking in the commute to and from school and policy actions to ensure that young people can actively travel to and from school, which could increase both PA and AA. Our findings may be useful to support national and local governments to design intersectoral approaches, involving the health, sports, and education sectors, that aim to improve both academic and physical development through the promotion of PA to students in and out of the school settings [ 4 ].

At the school level, teachers may need to be supported to apply innovative approaches and strategies to increase PA levels; teachers and school administrators could receive training on the well-understood beneficial effects of PA on health, and the likely beneficial effects on AA. This should include practical guidance on how to implement increased PA in schools, including how to involve students and parents in planning activities, with support from suitably qualified PE professionals to maximise its potentially beneficial effect on AA. Schools also need to have appropriate open spaces, materials and resources to provide diverse opportunities for regular PA for children and young people of all ages. Partnering with sports and community organisations can support the development of extra-curricular opportunities for physical activity [ 4 ].

At the community level, safe environments are needed to enable regular PA and active commuting to and from school. The availability of sports and fitness clubs/gyms, community youth clubs, such as scouts, can also increase opportunities while a range of age- and gender-specific forms of PA need to be available, especially for adolescents. Awareness of the availability of opportunities could be raised through information and communication technology, social media approaches, and community and youth organisations [ 4 ].

4.4. Future Research

There are a number of areas for potential future research that can be highlighted, with the most prominent being the need to establish the causality of the relationship between PA and AA. Insights may be gained from conducting high-quality RCTs with a number of different PA intervention arms in addition to a non-active control group [ 60 ].

Greater collaboration between exercise scientists and neuroscientists may also help to improve the quality of future research and attempts to understand more clearly the relationship between PA and AA [ 52 ].

Also, future research should incorporate standardised outcome measures and strive towards increased standardisation of PA interventions with attention to methodological rigour and consideration of relevant moderators.

While some reviews provide policy recommendations, these are often not sufficiently detailed or disseminated to the appropriate audiences [ 65 ]. Researchers may be advised to publish practical articles in association with education specialists so that their findings could actually be translated and implemented by school administrators.

5. Conclusions

PA seems not to be detrimental to school-age children and adolescents’ AA, and may, in fact, be beneficial. Different types of PA appear to have different effects, with the most benefit gained from longitudinal programmes incorporating aerobic exercise. Policymakers at the national, local, and school level should be made aware of the latest evidence and encouraged to make changes accordingly.

Appendix A. Full Search Strategy

Appendix a.1. pubmed.

(“physical activity” [Title/Abstract] OR exercise [Title/Abstract] OR “physical education” [Title/Abstract] OR “active transport” [Title/Abstract] OR “active mobility” [Title/Abstract] OR “active commuting” [Title/Abstract] OR “active travel” [Title/Abstract] OR walking [Title/Abstract] OR cycling [Title/Abstract] OR running [Title/Abstract] OR training [Title/Abstract] OR sport [Title/Abstract]) AND (academic [Title/Abstract] OR school [Title/Abstract]) AND (achievement [Title/Abstract] OR performance [Title/Abstract] OR attainment [Title/Abstract] OR function [Title/Abstract] OR result [Title/Abstract] OR cognitive [Title/Abstract] OR cognition [Title/Abstract]) AND (child* [Title/Abstract] OR school-age [Title/Abstract] OR schoolchildren [Title/Abstract] OR adolescents [Title/Abstract] OR youth [Title/Abstract]) AND (“systematic review” [Title/Abstract] OR meta-analysis [Title/Abstract]).

Appendix A.2. Cochrane Database of Systematic Reviews

“physical activity” OR exercise OR “physical education” OR “active transport” OR “active mobility” OR “active commuting” OR “active travel” OR walking OR cycling OR running OR training OR sport (Title Abstract Keyword) AND academic OR school (Title Abstract Keyword) AND achievement OR performance OR attainment OR function OR result OR cognitive OR cognition (Title Abstract Keyword) AND child* OR school-age OR schoolchildren OR adolescents OR youth (Title Abstract Keyword) AND “systematic review” OR meta-analysis (Title Abstract Keyword).

Appendix A.3. Web of Science

“physical activity” OR exercise OR “physical education” OR “active transport” OR “active mobility” OR “active commuting” OR “active travel” OR walking OR cycling OR running OR training OR sport [Title/Abstract/Keywords] AND academic OR school [Title/Abstract/Keywords] AND achievement OR performance OR attainment OR function OR result OR cognitive OR cognition [Title/Abstract/Keywords] AND child* OR school-age OR schoolchildren OR adolescents OR youth [Title/Abstract/Keywords] AND “systematic review” OR meta-analysis [Title/Abstract/Keywords].

Appendix A.4. Scopus

(“physical activity” OR exercise OR “physical education” OR “active transport” OR “active mobility” OR “active commuting” OR “active travel” OR walking OR cycling OR running OR training OR sport) [Title/Abstract/Keywords] AND (academic OR school) [Title/Abstract/Keywords] AND (achievement OR performance OR attainment OR function OR result OR cognitive OR cognition) [Title/Abstract/Keywords] AND (child* OR school-age OR schoolchildren OR adolescents OR youth) [Title/Abstract/Keywords] AND (“systematic review” OR meta-analysis) [Title/Abstract/Keywords].

Appendix A.5. LILACS

(“physical activity” OR exercise OR “physical education” OR “active transport” OR “active mobility” OR “active commuting” OR “active travel” OR walking OR cycling OR running OR training OR sport) [Title/Abstract/Subject] AND (academic OR school) [Title/Abstract/Subject] AND (achievement OR performance OR attainment OR function OR result OR cognitive OR cognition) [Title/Abstract/Subject] AND (child* OR school-age OR schoolchildren OR adolescents OR youth) [Title/Abstract/Subject] AND (“systematic review” OR meta-analysis) [Title/Abstract/Subject].

Appendix B. Assessment of Methodological Quality, Using AMSTAR 2 Tool

Assessment of the methodological quality using AMSTAR 2 tool.

Author Contributions

Conceptualisation, A.B., S.W., P.S., R.S.M. and R.M.; methodology, A.B., S.W; formal analysis, A.B., S.W.; investigation, A.B., S.W., R.M.; writing—original draft preparation, A.B.; writing—review and editing, A.B., S.W., P.S., R.S.M., R.M. and J.B.; supervision, R.M. and J.B.; All authors have read and agreed to the published version of the manuscript.

This work was support by a grant from the Government of the Russian Federation in the context of the WHO European Office for the Prevention and Control of Noncommunicable Diseases.

Conflicts of Interest

The authors declare no conflict of interest.

Disclaimer: J.B. and S.W. are staff members of the WHO. R.M. is a WHO consultant. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.

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