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Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children

A Systematic Review

Donnelly, Joseph E. Ed.D., FACSM (Co-Chair); Hillman, Charles H. Ph.D. (Co-Chair); Castelli, Darla Ph.D.; Etnier, Jennifer L. Ph.D., FACSM; Lee, Sarah Ph.D.; Tomporowski, Phillip Ph.D., FACSM; Lambourne, Kate Ph.D.; Szabo-Reed, Amanda N. Ph.D. This summary was written for the American College of Sports Medicine by

Medicine & Science in Sports & Exercise: June 2016 - Volume 48 - Issue 6 - p 1223-1224
doi: 10.1249/MSS.0000000000000966
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This systematic review (1) examined the evidence linking physical activity (PA) to cognition and academic performance in elementary school children. Specifically, in reviewing the literature, we sought to answer the following two questions: 1) Among children age 5–13 yr, do PA and physical fitness influence brain structure, brain function, cognition, and learning? 2) Among children age 5–13 yr, do PA, physical education, and sports programs influence standardized achievement test performance and concentration/attention?


The review was performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (ref. 105 in [1]). The search was applied to PubMed and adapted for Embase, Education Resources Information Center, PsychInfo, SportDiscus, Scopus, Web of Science, and Academic Search Premier (1990 to September 2014). A reference librarian was consulted on the search process. Study quality was assessed using a checklist developed by Downs and Black (ref. 59 in [1]) that was designed to assess the quality of both nonrandomized and randomized intervention trials. Sixty-four studies met the inclusion criteria for cognitive function and brain structure and function, and 73 studies met the inclusion criteria for PA, fitness, physical education, and academic achievement.


Collectively, the literature suggests that PA has a positive influence on cognitive function as well as brain structure and function. Studies that have examined relations between PA, brain, and cognition have generally yielded promising results. Acute exercise studies show a positive relationship between PA and cognitive function, with greater amounts of PA being associated with greater improvements in cognitive function. Cross-sectional and cohort-based studies involving PA have also supported the relationship between PA and cognitive function, with greater amounts of PA being associated with greater improvements in cognitive function. Although only a handful of studies using RCT designs exist in the literature to date, the findings are promising in that they provide a causal link between PA, brain function, and cognition.

Studies that examined PA, fitness, physical education, and academic achievement provided mixed results. Improvements in academic achievement were inconsistent. For example, one study might find improvements in math and reading and another study would find improvements in reading and spelling but not math and reading. Similar inconsistencies were found when comparing girls and boys. Attention-to-task is thought to contribute to learning; however, a strong relationship was not found and may warrant further investigation due to the intuitive link between attention-to-task and learning. Attempts to increase PA in the context of PE were generally unsuccessful. Acute laboratory studies of PA and academic achievement and classroom studies that delivered physically active lessons appear to have the most consistent positive associations for increased academic achievement.

Recommendations for Research on PA and Academic Achievement

  • Many limitations exist in the current literature assessed by the Downs and Black criteria, including failure to report participant characteristics, lack of control for known confounders, failure to report statistical power, absence of estimates of variability, lack of account for participants lost to follow-up, blinding of personnel obtaining outcomes, compliance to exercise, and others. Future research must overcome these limitations to advance our understanding for the role of PA on cognition and academic achievement.
  • The use of recent advances in neuroimaging techniques is encouraged to gain a more complete understanding of the effects of PA on the entire brain rather than isolated brain regions.
  • To further explore PA and academic achievement, the following types of research are needed: 1) theory-based efficacy research, which identifies conditions that best promote improvements in children’s cognitive functioning, and effectiveness research, which evaluates the success of specific types of interventions in authentic school environments. Progress in these areas of research will benefit from the consistent selection of reliable and valid measures of PA and academic achievement and the use of randomized controlled trials.

Policy implications of this research.

A more complete understanding of the effects of PA on cognition and academic achievement will provide guidance for public policy surrounding the benefits and delivery of PA. Because of constraints of budget and the heightened need for academic achievement, new and innovative strategies are needed to provide adequate PA for elementary school children. Fortunately, PA can be provided in many before, during, and after school activities that does not compete for time spent on academic instruction. Furthermore, there are plausible biological models linking PA and fitness to improved cognitive control that in turn are linked to learning. Moreover, programs to increase PA at schools do not show interference in learning and academic achievement. Increasing PA is congruent with the school health policy and can contribute to growth and development, motor ability, higher levels of fitness, and lower levels of fatness regardless of impact on cognition and academic achievement.


The present systematic review found evidence suggesting that there are associations between PA, fitness, cognition, and academic achievement. Improvements in executive function are frequently associated with acute bouts of activity and fitness as well as improvements in academic achievement. Delivery of physically active lessons generally shows improvements in academic achievement; however, definitive trials are not present in the current literature. Attempts to increase activity in PE have not been shown to yield consistent benefits for improvement of academic achievement. Evidence linking PA and fitness to improvements in cognition and academic achievement may be useful to support public policy to increase PA in elementary schools without jeopardizing the primary mission of academic instruction.

Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this publication and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations.

The findings and conclusions in this report are those of the authors and do not necessarily reflect the official position of the Centers for Disease Control and Prevention.


1. American College of Sports Medicine. Physical activity, fitness, cognitive function, and academic achievement in children: a systematic review. Med Sci Sports Exerc. 2016: 48(6): 1197–1222.
© 2016 American College of Sports Medicine