Effects of active breaks on attention and executive function in children and adolescents: A meta-analysis.

UNLABELLED: Executive function and attention are essential cognitive abilities that support learning, behavioral regulation, and long-term developmental outcomes in children and adolescents. In modern school environments, prolonged sedentary classroom time may negatively affect cognitive performance. Active breaks, defined as short bouts of physical activity embedded within classroom instruction, have been proposed as a practical strategy to increase physical activity and improve cognitive functioning. However, previous studies and reviews have reported inconsistent findings regarding their effectiveness, particularly across different subcomponents of executive function. This meta-analysis aimed to quantify the effects of classroom-based active breaks on attention, inhibitory control, working memory, and cognitive flexibility in children and adolescents. Four databases, namely PubMed, Cochrane Library, Embase, and Web of Science, were searched for randomized controlled trials assessing the effects of active breaks on attention and executive function in children and adolescents. The search covered the period from the inception of the databases until March 2026. Two researchers independently conducted literature screening, data extraction, and quality assessment. Meta-analysis was performed using Stata 15.1. Twenty-five randomized controlled trials were included. Pooled estimates favored active breaks for attention (SMD =  - 0.53) and inhibitory control (SMD =  - 0.49), and also favored active breaks for working memory and cognitive flexibility. Exploratory subgroup analyses suggested that 5-15-min, acute, and single-session formats may be associated with larger pooled cognitive effects, although these patterns should be interpreted cautiously. CONCLUSION: The available RCT evidence suggests that classroom-based active breaks may be associated with improvements in attention and executive function in children and adolescents. Short activity breaks integrated into lessons may represent a practical strategy for supporting cognitive functioning; however, substantial heterogeneity and uncertainty in the subgroup findings warrant cautious interpretation. WHAT IS KNOWN: • Prolonged sedentary classroom time may negatively affect attention and executive function in children and adolescents. • Active breaks are feasible school-based physical activity strategies, but previous evidence on cognitive benefits remains inconsistent. WHAT IS NEW: • This meta-analysis of 25 randomized controlled trials found pooled effects favoring active breaks across attention and executive function domains, although confidence in the exact magnitude of benefit is limited by considerable heterogeneity. • Exploratory subgroup patterns suggest that 5-15-min sessions and acute or single-session formats may be promising in several domains; these patterns do not establish an optimal active-break prescription.