Abstract
BACKGROUND: Inhibitory control is a key component of executive function, influencing academic achievement, behavior, and long-term outcomes in children and adolescents. Physical activity (PA) has been identified as a potential intervention to improve inhibitory control, but the optimal type and dosage remain uncertain. This study aimed to assess the effects of different PA modalities on inhibitory control and determine the optimal dosage for improving inhibition accuracy in youth. METHODS: A systematic review and network meta-analysis (NMA) were performed on studies published until July 31, 2025. A comprehensive search was conducted across PubMed, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Thirty-four randomized controlled trials (RCTs) involving 23,209 participants were included. The primary outcomes were inhibition accuracy and inhibition reaction time, with effect sizes calculated as standardized mean differences (SMD) for each outcome. Dose-response analysis was conducted using a Bayesian framework to assess how PA dosage influenced inhibition accuracy and reaction time. RESULTS: Mixed exercise (ME) significantly improved inhibition accuracy compared to the control group (SMD = 0.52, 95% CrI: 0.21-0.82), with the highest effectiveness according to the surface under the cumulative ranking curve (SUCRA = 0.81). A significant dose-response relationship was observed between PA dosage and inhibition accuracy, with the optimal dosage identified as 1,500 METs-min/week (SMD = 1.08, 95% CrI: 0.29-1.84). No significant dose-effect relationship was found for inhibition reaction time. Snack exercise (SE) exhibited the greatest reduction in inhibition reaction time but had no significant impact on inhibition accuracy. CONCLUSION: ME is the most effective PA modality for improving inhibition accuracy, particularly at 1,500 METs-min/week. These findings highlight the importance of PA dosage in optimizing cognitive outcomes in children and adolescents. SYSTEMATIC REVIEW REGISTRATION: CRD420251181222.