School Physical Activity Interventions for Children and Adolescents With Disability: Systematic Review and Meta-Analysis of Effects on Academic, Cognitive, and Mental Health Outcomes.

Background: Schools are ideal settings for physical activity promotion; however, children and adolescents with disability have largely been neglected in school-based health promotion efforts. This review examines the effects of school-based physical activity interventions on academic, cognitive, and mental health outcomes of children and adolescents living with any type of disability (eg, intellectual, physical, behavioral).

Methods: Six databases (PubMed, PsycINFO, Scopus, MEDLINE, SPORTDiscus, and Embase) were searched from inception to September 2024. Studies were included if they: (1) examined children or adolescents (5-18 y) living with disability, (2) included an experimental or quasi-experimental study design, (3) delivered a school-based physical activity intervention, and (4) examined at least one academic, cognitive, or mental health outcome. Multilevel meta-analyses were conducted to examine intervention effects. Prespecified moderators were also examined.

Results: Thirty-three studies involving 1454 children and adolescents living with disability were included. Significant effects were found for cognitive (g = 0.42; 95% CI, 0.22 to 0.62) and mental health (g = 0.57; 95% CI, 0.21 to 0.94) outcomes, but not for academic outcomes. Disability classification, intervention length, and physical activity type significantly moderated intervention effects.

Conclusions: School-based physical activity programs for children and adolescents with disability can improve measures of cognition and mental health, but not academic performance. Most studies examined children with attention-deficit/hyperactivity disorder, and few were conducted with adolescents which may limit generalizability of study findings. More high-quality research with robust study designs and larger more diverse samples are needed.