Eur J Pediatr. 2026 Sep 2;185(9):710. doi: 10.1007/s00431-026-07371-x.
ABSTRACT
This systematic review and meta-analysis evaluated the immediate effects of acute exercise on state anxiety in children and adolescents. It also examined whether exercise modality, developmental stage, and setting influenced the effects. Five databases were searched up to March 2026 for studies on acute exercise and state anxiety in individuals aged 6-18 years. Meta-analysis was conducted using Stata 17.0, with effect sizes pooled as standardized mean differences (SMDs). Sensitivity analysis and GRADE were used to assess heterogeneity and evidence certainty. Twelve studies involving 739 participants were included. Acute exercise significantly reduced state anxiety (SMD = – 0.77, 95% CI [- 1.37, – 0.16], P = 0.01), although heterogeneity was substantial (I2 = 94.90%). In sensitivity-adjusted subgroup analyses, significant effects were observed in adolescents aged 13-18 years (SMD = – 2.97, 95% CI [- 3.39, – 2.55], P < 0.01), passive-control comparisons (SMD = – 0.28, 95% CI [- 0.53, – 0.04], P = 0.02), group-based interventions (SMD = – 0.30, 95% CI [- 0.51, – 0.09], P = 0.01), non-stress-induced conditions (SMD = – 0.28, 95% CI [- 0.47, – 0.10], P < 0.01), high-autonomy settings (SMD = – 0.62, 95% CI [- 1.00, – 0.24], P < 0.01), aerobic exercise (SMD = – 0.19, 95% CI [- 0.36, – 0.02], P = 0.03), and multimodal exercise (SMD = – 0.25, 95% CI [- 0.43, – 0.06], P = 0.01). The certainty of evidence was moderate.
CONCLUSIONS: Acute exercise may reduce anxiety in children and adolescents, although the substantial heterogeneity warrants cautious interpretation. Sensitivity-adjusted subgroup analyses suggest that effects may vary according to developmental stage, exercise characteristics, and situational autonomy. These subgroup findings should be considered exploratory and require confirmation in larger, well-designed trials.
WHAT IS KNOWN: • Regular physical activity is associated with better mental health and lower anxiety in young people, but evidence on the immediate effects of a single bout of exercise remains limited. • Previous research has mainly focused on exercise intensity, with less attention to developmental stage, exercise format, and contextual factors.
WHAT IS NEW: • This meta-analysis found that acute exercise was associated with an immediate reduction in anxiety in children and adolescents, although substantial between-study heterogeneity was present. • Exploratory subgroup analyses suggest that developmental stage, situational autonomy, and exercise characteristics may contribute to variation in the short-term anxiety response to acute exercise.
PMID:42684440 | DOI:10.1007/s00431-026-07371-x
