Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis

Executive functions are often impaired in individuals with schizophrenia spectrum disorders. Understanding the impact of physical exercise on these cognitive domains is essential for developing effective interventions. The aim of this review is to assess the effect of physical exercise on executive...

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Main Authors: Nuria Pérez-Romero, Christian Campos-Jara, Caterina Pesce, Sergio Araya Sierralta, Enrique Cerda-Vega, Rodrigo Ramirez-Campillo, Rodrigo Campos-Jara, Cristian Martínez-Salazar, Cristián Arellano-Roco, Victoria Hernández-Cifuentes, Falonn Contreras-Osorio
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Language:English
Published: MDPI AG 2025-04-01
Series:Sports
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Online Access:https://www.mdpi.com/2075-4663/13/4/123
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author Nuria Pérez-Romero
Christian Campos-Jara
Caterina Pesce
Sergio Araya Sierralta
Enrique Cerda-Vega
Rodrigo Ramirez-Campillo
Rodrigo Campos-Jara
Cristian Martínez-Salazar
Cristián Arellano-Roco
Victoria Hernández-Cifuentes
Falonn Contreras-Osorio
author_facet Nuria Pérez-Romero
Christian Campos-Jara
Caterina Pesce
Sergio Araya Sierralta
Enrique Cerda-Vega
Rodrigo Ramirez-Campillo
Rodrigo Campos-Jara
Cristian Martínez-Salazar
Cristián Arellano-Roco
Victoria Hernández-Cifuentes
Falonn Contreras-Osorio
author_sort Nuria Pérez-Romero
collection DOAJ
description Executive functions are often impaired in individuals with schizophrenia spectrum disorders. Understanding the impact of physical exercise on these cognitive domains is essential for developing effective interventions. The aim of this review is to assess the effect of physical exercise on executive functions in adults diagnosed with schizophrenia spectrum disorders. A systematic search was conducted in Web of Science, PubMed, Scopus, and EBSCO, initially from inception through January 2024, followed by an update through January 2025. Studies involved adults diagnosed with schizophrenia spectrum disorders, employed physical exercise as an intervention, and measured executive functions as outcomes. The selection followed PRISMA guidelines, with inclusion determined by consensus among multiple reviewers. Data extraction and risk of bias assessment were conducted independently by two reviewers using the Cochrane RoB 2 tool and GRADE approach for certainty of evidence. Meta-analyses were performed using random-effects models, with effect sizes (ES) and 95% confidence intervals (CI) calculated for each outcome. From 1517 records, 9 studies were included in the meta-analysis. The analysis revealed a small but significant effect of physical exercise on working memory (ES = 0.300, 95% CI = 0.060–0.539, <i>p</i> = 0.014; <i>I</i><sup>2</sup> = 0.0%, <i>Q</i> = 2.2, <i>p</i> = 0.951) and a non-significant effect on emotion recognition (ES = 0.51, 95% CI = −0.291–1.303, <i>p</i> = 0.213; <i>I</i><sup>2</sup> = 83%), inhibition (ES = 0.156, 95% CI = −0.173 to 0.484, <i>p</i> = 0.353; <i>I</i><sup>2</sup> = 0.0%, <i>Q</i> = 1.1, <i>p</i> = 0.781), and cognitive flexibility (ES = 0.240, 95% CI = −0.270 to 0.749, 95% PI = −1.706 to 2.185; <i>p</i> = 0.356; <i>I</i><sup>2</sup> = 53.2%, <i>Q</i> = 3.0, <i>p</i> = 0.094). Physical exercise, particularly aerobic exercise, appears to have a small beneficial effect on working memory in individuals with schizophrenia spectrum disorders. However, the evidence for its effect on emotion recognition is less clear and may be influenced by the type of exercise, such as yoga. Further research is needed to provide more robust conclusions. PROSPERO registration number: CRD42023392295.
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spelling doaj-art-3eabea850ed8429c93e00be67f2d4e202025-08-20T03:13:59ZengMDPI AGSports2075-46632025-04-0113412310.3390/sports13040123Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-AnalysisNuria Pérez-Romero0Christian Campos-Jara1Caterina Pesce2Sergio Araya Sierralta3Enrique Cerda-Vega4Rodrigo Ramirez-Campillo5Rodrigo Campos-Jara6Cristian Martínez-Salazar7Cristián Arellano-Roco8Victoria Hernández-Cifuentes9Falonn Contreras-Osorio10Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileExercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileDepartment of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, ItalyDepartamento de Educación Física, Universidad de Atacama, Copiapó 1531772, ChileExercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileExercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileServicio de Psiquiatría, Hospital Mauricio Heyermann, Angol 4650207, ChileDepartment of Physical Education, Sports and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco 4811230, ChileDepartamento de Kinesiología, Universidad Católica del Maule, Talca 3480112, ChileExercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileExercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, ChileExecutive functions are often impaired in individuals with schizophrenia spectrum disorders. Understanding the impact of physical exercise on these cognitive domains is essential for developing effective interventions. The aim of this review is to assess the effect of physical exercise on executive functions in adults diagnosed with schizophrenia spectrum disorders. A systematic search was conducted in Web of Science, PubMed, Scopus, and EBSCO, initially from inception through January 2024, followed by an update through January 2025. Studies involved adults diagnosed with schizophrenia spectrum disorders, employed physical exercise as an intervention, and measured executive functions as outcomes. The selection followed PRISMA guidelines, with inclusion determined by consensus among multiple reviewers. Data extraction and risk of bias assessment were conducted independently by two reviewers using the Cochrane RoB 2 tool and GRADE approach for certainty of evidence. Meta-analyses were performed using random-effects models, with effect sizes (ES) and 95% confidence intervals (CI) calculated for each outcome. From 1517 records, 9 studies were included in the meta-analysis. The analysis revealed a small but significant effect of physical exercise on working memory (ES = 0.300, 95% CI = 0.060–0.539, <i>p</i> = 0.014; <i>I</i><sup>2</sup> = 0.0%, <i>Q</i> = 2.2, <i>p</i> = 0.951) and a non-significant effect on emotion recognition (ES = 0.51, 95% CI = −0.291–1.303, <i>p</i> = 0.213; <i>I</i><sup>2</sup> = 83%), inhibition (ES = 0.156, 95% CI = −0.173 to 0.484, <i>p</i> = 0.353; <i>I</i><sup>2</sup> = 0.0%, <i>Q</i> = 1.1, <i>p</i> = 0.781), and cognitive flexibility (ES = 0.240, 95% CI = −0.270 to 0.749, 95% PI = −1.706 to 2.185; <i>p</i> = 0.356; <i>I</i><sup>2</sup> = 53.2%, <i>Q</i> = 3.0, <i>p</i> = 0.094). Physical exercise, particularly aerobic exercise, appears to have a small beneficial effect on working memory in individuals with schizophrenia spectrum disorders. However, the evidence for its effect on emotion recognition is less clear and may be influenced by the type of exercise, such as yoga. Further research is needed to provide more robust conclusions. PROSPERO registration number: CRD42023392295.https://www.mdpi.com/2075-4663/13/4/123inhibitionworking memorycognitive flexibilitycold and hot executive functionsmental healthphysical activity
spellingShingle Nuria Pérez-Romero
Christian Campos-Jara
Caterina Pesce
Sergio Araya Sierralta
Enrique Cerda-Vega
Rodrigo Ramirez-Campillo
Rodrigo Campos-Jara
Cristian Martínez-Salazar
Cristián Arellano-Roco
Victoria Hernández-Cifuentes
Falonn Contreras-Osorio
Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
Sports
inhibition
working memory
cognitive flexibility
cold and hot executive functions
mental health
physical activity
title Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
title_full Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
title_fullStr Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
title_full_unstemmed Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
title_short Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis
title_sort effects of physical exercise on executive function in schizophrenia systematic review and meta analysis
topic inhibition
working memory
cognitive flexibility
cold and hot executive functions
mental health
physical activity
url https://www.mdpi.com/2075-4663/13/4/123
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