Physical Activity,
SPECIAL COMMUNICATIONS
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EXECUTIVE SUMMARY
T
his systematic review (1) examined the evidence
linking physical activity (PA) to cognition and aca-
demic 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?
METHODS
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 in-
clusion criteria for cognitive function and brain structure and
function, and 73 studies met the inclusion criteria for PA,
fitness, physical education, and academic achievement.
0195-9131/16/4806-1223/0
MEDICINE & SCIENCE IN SPORTS & EXERCISEÒ
Copyright Ó 2016 by the American College of Sports Medicine
DOI: 10.1249/MSS.0000000000000966
1223
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
Fitness, Cognitive
Function, and
Academic
Achievement in
Children: A
Systematic Review
This summary was written for the American College of Sports
Medicine by; Joseph E. Donnelly, Ed.D., FACSM (Co-Chair); Charles
H. Hillman, Ph.D. (Co-Chair); Darla Castelli, Ph.D.; Jennifer L. Etnier,
Ph.D., FACSM; Sarah Lee, Ph.D.; Phillip Tomporowski, Ph.D.,
FACSM; Kate Lambourne, Ph.D.; and Amanda N. Szabo-Reed, Ph.D.
RESULTS
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. Im-
provements 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 in-
consistencies were found when comparing girls and boys.
Attention-to-task is thought to contribute to learning; how-
ever, 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 labo-
ratory studies of PA and academic achievement and class-
room studies that delivered physically active lessons appear
to have the most consistent positive associations for in-
creased academic achievement.
 Recommendations for Research on PA and
SPECIAL COMMUNICATIONS
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 ad-
vance 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 function-
ing, 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 com-
plete 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 aca-
demic achievement, new and innovative strategies are
needed to provide adequate PA for elementary school chil-
dren. 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
REFERENCE
1. American College of Sports Medicine. Physical activity,
fitness, cognitive function, and academic achievement in
1224 Official Journal of the American College of Sports Medicine
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
plausible biological models linking PA and fitness to im-
proved 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. In-
creasing 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 regard-
less of impact on cognition and academic achievement.
CONCLUSION
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 im-
provements in academic achievement; however, definitive
trials are not present in the current literature. Attempts to in-
crease 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 ac-
ademic 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 omis-
sions or for any consequences from application of the information in
this publication and make no warranty, expressed or implied, with re-
spect to the currency, completeness, or accuracy of the contents of the
publication. Application of this information in a particular situation re-
mains the professional responsibility of the practitioner; the clinical
treatments described and recommended may not be considered ab-
solute 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.
children: a systematic review. Med Sci Sports Exerc. 2016:48(6):
1197–1222.
http://www.acsm-msse.org