Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment.

OBJECTIVE To describe the prospective relationship between physical activity and academic performance. DATA SOURCES Prospective studies were identified from searches in PubMed, PsycINFO, Cochrane Central, and Sportdiscus from 1990 through 2010. STUDY SELECTION We screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. MAIN EXPOSURE Studies had to report at least 1 physical activity or physical fitness measurement during childhood or adolescence. MAIN OUTCOME MEASURES Studies had to report at least 1 academic performance or cognition measure during childhood or adolescence. RESULTS We identified 10 observational and 4 intervention studies. The quality score of the studies ranged from 22% to 75%. Two studies were scored as high quality. Methodological quality scores were particularly low for the reliability and validity of the measurement instruments. Based on the results of the best-evidence synthesis, we found evidence of a significant longitudinal positive relationship between physical activity and academic performance. CONCLUSIONS Participation in physical activity is positively related to academic performance in children. Because we found only 2 high-quality studies, future high-quality studies are needed to confirm our findings. These studies should thoroughly examine the dose-response relationship between physical activity and academic performance as well as explanatory mechanisms for this relationship.