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Media o s o he associa ion be ween physical ac i i y and execu i e unc ions in
p ima y school child en
© 2024 The Au ho (s). Published by In o ma UK Limi ed, ading as Taylo & F ancis G oup
Published e sion
Bao, Ran; Leahy, Angus A.; Lubans, Da id R.; Diallo, Thie no M.O.; Beauchamp,
Ma k R.; Smi h, Jo dan J.; Hillman, Cha les H.; Wade, Le i
Bao, R., Leahy, A. A., Lubans, D. R., Diallo, T. M., Beauchamp, M. R., Smi h, J. J., Hillman, C. H., &
Wade, L. (2024). Media o s o he associa ion be ween physical ac i i y and execu i e unc ions
in p ima y school child en. Jou nal o Spo s Sciences, Ea ly online.
h ps://doi.o g/10.1080/02640414.2024.2422203
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Jou nal o Spo s Sciences
ISSN: (P in ) (Online) Jou nal homepage: www. and online.com/jou nals/ jsp20
Media o s o he associa ion be ween physical
ac i i y and execu i e unc ions in p ima y school
child en
Ran Bao, Angus A. Leahy, Da id R. Lubans, Thie no M.O. Diallo, Ma k R.
Beauchamp, Jo dan J. Smi h, Cha les H. Hillman & Le i Wade
To ci e his a icle: Ran Bao, Angus A. Leahy, Da id R. Lubans, Thie no M.O. Diallo, Ma k R.
Beauchamp, Jo dan J. Smi h, Cha les H. Hillman & Le i Wade (28 Oc 2024): Media o s o he
associa ion be ween physical ac i i y and execu i e unc ions in p ima y school child en,
Jou nal o Spo s Sciences, DOI: 10.1080/02640414.2024.2422203
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PHYSICAL ACTIVITY, HEALTH AND EXERCISE
Media o s o he associa ion be ween physical ac i i y and execu i e unc ions in
p ima y school child en
Ran Bao
a,b
, Angus A. Leahy
a,b
, Da id R. Lubans
a,b,c
, Thie no M.O. Diallo
d
, Ma k R. Beauchamp
e
,
Jo dan J. Smi h
a,b
, Cha les H. Hillman
and Le i Wade
a,b
a
Cen e o Ac i e Li ing and Lea ning, Uni e si y o Newcas le, Callaghan, New Sou h Wales, Aus alia;
b
Ac i e Li ing Resea ch P og am, Hun e
Medical Resea ch Ins i u e, New Lamb on Heigh s, New Sou h Wales, Aus alia;
c
Facul y o Spo and Heal h Sciences, Uni e si y o Jy äskylä,
Jy äskylä, Finland;
d
School o Social Sciences, Wes e n Sydney Uni e si y, Pen i h, New Sou h Wales, Aus alia;
e
School o Kinesiology, Uni e si y o
B i ish Columbia, Vancou e , BC, Canada;
Cen e o Cogni i e & B ain Heal h, Depa men o Psychology, Depa men o Physical The apy,
Mo emen & Rehabili a ion Sciences, Cen e o Cogni i e and B ain Heal h, No heas e n Uni e si y, Bos on, MA, USA
ABSTRACT
The e is g owing in e es in iden i ying he mechanisms unde pinning he e ec s o physical ac i i y on
execu i e unc ions (e.g. inhibi o y con ol, cogni i e lexibili y) in child en. Ou s udy examined ca dio -
espi a o y i ness, muscula i ness, and mo o compe ence as po en ial media o s o his ela ionship.
The s udy used baseline da a om he Lea ning o Lead (L2L) clus e andomised con olled ial. In o al,
675 child en (7–11 yea s, 49.5% gi ls) comple ed measu es o mode a e- o- igo ous physical ac i i y
(MVPA), ca dio espi a o y i ness, muscula i ness, mo o compe ence, and execu i e unc ions.
S uc u al equa ion modelling was used o examine he po en ial media ing oles o ca dio espi a o y
i ness, muscula i ness, and mo o compe ence in he c oss-sec ional associa ion be ween MVPA and
execu i e unc ions. Ca dio espi a o y i ness (β = 0.06, SE = 0.021, p = 0.004) pa ially media ed he
associa ion be ween MVPA and cogni i e lexibili y. Muscula i ness was a signi ican media o o he
associa ion be ween MVPA and bo h inhibi o y con ol (β = 0.03, SE = 0.014, p = 0.027) and cogni i e
lexibili y (β = 0.06, SE = 0.021, p = 0.005). No signi ican media ed e ec s we e ound o mo o compe-
ence. Ou indings sugges ca dio espi a o y and muscula i ness (bu no mo o compe ence) media e
he associa ion be ween physical ac i i y and execu i e unc ions in child en.
ARTICLE HISTORY
Recei ed 18 May 2024
Accep ed 20 Oc obe 2024
KEYWORDS
Mode a e- o- igo ous
physical ac i i y;
ca dio espi a o y i ness;
muscula i ness; mo o
compe ence; execu i e
unc ions; child en
In oduc ion
The heal h bene i s o physical ac i i y o young people a e well
documen ed and include a ange o physical (e.g., enhanced
physical i ness) and psychological (e.g., dec eased dep essi e
symp oms) bene i s (Biddle e al., 2019; Chapu e al., 2020).
The e is also e idence ha physical ac i i y is bene icial o
child and adolescen execu i e unc ioning (Biddle e al., 2019).
Execu i e unc ions encompass he abili y o selec , schedule,
coo dina e, and moni o complex, goal-di ec ed cogni i e ac i -
i ies (Diamond, 2013). They include inhibi o y con ol, which is
he abili y o main ain ocus and supp ess p epo en o au oma-
ised esponses (such as a oiding dis ac ions in he class oom),
wo king memo y, which is he abili y o e ain and upda e
in o ma ion when pe o ming asks ( o ins ance, emembe ing
mul iple s eps in sol ing a ma hs p oblem), and cogni i e lex-
ibili y, which is he abili y o shi men al esou ces be ween asks
(like when we need o adjus s a egies in esponse o new ules
in a game). Execu i e unc ions suppo highe -o de p ocesses
such as p oblem sol ing, easoning, and planning (Diamond,
2013; Willoughby & Hudson, 2023). In child en, be e execu i e
unc ions a e ela ed o posi i e physical, psychological, and
social-emo ional heal h (Diamond, 2013; Riggs e al., 2006;
Yang e al., 2022), whe eas impai ed execu i e unc ions may
ha e de imen al e ec s on physical (e.g., a isk o obesi y
(Mam o & Hanć, 2019)) and men al (e.g., dep ession (Ga dine
& Ia occi, 2018; Hollocks e al., 2014)) heal h. De iciencies in
execu i e unc ions a e also associa ed wi h subop imal aca-
demic pe o mance (Co és Pascual e al., 2019; Jacob &
Pa kinson, 2015) and inc eased social-emo ional challenges
(e.g., poo social adap a ion (Ga dine & Ia occi, 2018; Riggs
e al., 2006)).
P e ious s udies ha e shown ha , al hough he e ec s a e
ypically small, physical ac i i y in e en ions a e gene ally
bene icial o child en and adolescen s’ execu i e unc ions
(Ci ia e al., 2023; Ga cía-He moso e al., 2021; Singh e al.,
2019; Xue e al., 2019). Gi en ha child en spend a subs an ial
amoun o ime a school, i is impo an o explo e how
physical ac i i y du ing school hou s con ibu es o hese cog-
ni i e bene i s. The e is also g owing acknowledgemen o he
impo ance o iden i ying he mechanisms esponsible o he
e ec o physical ac i i y on execu i e unc ions. A deepe
unde s anding o hese mechanisms may help o in o m he
design and implemen a ion o u u e physical ac i i y p o-
g ammes. The exis ing e idence sugges s ha his ela ionship
is likely in luenced by bo h he quali a i e (e.g., ype, le el o
CONTACT Le i Wade [email p o ec ed] Cen e o Ac i e Li ing and Lea ning, Uni e si y o Newcas le, Uni e si y D i e, Callaghan, New Sou h Wale
2308, Aus alia
JOURNAL OF SPORTS SCIENCES
h ps://doi.o g/10.1080/02640414.2024.2422203
© 2024 The Au ho (s). Published by In o ma UK Limi ed, ading as Taylo & F ancis G oup.
This is an Open Access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion-NonComme cial-NoDe i a i es License (h p://c ea i ecommons.o g/licenses/by-nc-nd/4.0/),
which pe mi s non-comme cial e-use, dis ibu ion, and ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed, and is no al e ed, ans o med, o buil upon in any way. The
e ms on which his a icle has been published allow he pos ing o he Accep ed Manusc ip in a eposi o y by he au ho (s) o wi h hei consen .
cogni i e demand) and quan i a i e (e.g., in ensi y) cha ac e -
is ics o he physical ac i i y (Bes , 2010; Hill e al., 2023;
D. R. Lubans e al., 2021; Willoughby & Hudson, 2023).
Howe e , he e is no consensus on he ela i e con ibu ions
o hese cha ac e is ics (Diamond & Ling, 2019; Hillman e al.,
2019). Wo k in his a ea has esul ed in he p oposi ion o wo
ela ed hypo heses: he “ i ness” and he “skill acquisi ion”
hypo heses (Pe uzzello e al., 1997; Tompo owski & Pesce,
2019). The “ i ness” hypo hesis sugges s ha pa icipa ion in
physical ac i i y o su icien du a ion and in ensi y o imp o e
i ness (e.g., ca dio espi a o y i ness, muscula i ness) may
enhance cogni ion ia changes in he s uc u e and unc ion
o he b ain (Pe uzzello e al., 1997; Tompo owski & Pesce,
2019). The “skill acquisi ion” hypo hesis sugges s ha physical
ac i i y p o ides oppo uni ies o skill acquisi ion, and subse-
quen imp o emen s in cogni ion a e d i en by he in luence o
skill acquisi ion on changes o ela ed neu al pa hways
(Tompo owski & Pesce, 2019). Mo e speci ically, i is engage-
men in cogni i e complex and/o no el mo emen s ha likely
lead o imp o emen s in execu i e unc ions.
The e is e idence om c oss-sec ional and expe imen al
s udies in suppo o he “ i ness” hypo hesis. Re iews o he
li e a u e sugges ha ca dio espi a o y i ness is posi i ely
associa ed wi h execu i e unc ions in child en and adolescen s
(Bes , 2010; De G ee e al., 2018; Hillman e al., 2008). Changes
in execu i e unc ions may be a ibu able, a leas in pa , o
exe cise-induced inc eases in neu o ophins (including b ain-
de i ed neu o ophic ac o and insulin-like g ow h ac o ) ha
subsequen ly in luence b ain s uc u e and unc ion (Khan &
Hillman, 2014; S illman e al., 2016). The e is also e idence ha
changes in muscula i ness (i.e., muscle s eng h, endu ance,
and powe ) may p o ide some explana ion o he ela ionship
be ween physical ac i i y and execu i e unc ions (Robinson
e al., 2023; Soga e al., 2018). A ecen me a-analysis ound ha
muscula i ness was posi i ely associa ed wi h cogni i e lex-
ibili y (Cohen’s d = 0.18) and wo king memo y (Cohen’s
d = 0.14) in child en and adolescen s (Robinson e al., 2023).
Simila o ca dio espi a o y i ness, he associa ion be ween
muscula i ness and execu i e unc ions may be explained by
changes in b ain s uc u e and unc ion (e.g., whi e ma e
olume, b ain-de i ed neu o ophic ac o ) (Es eban-Co nejo
e al., 2019; Isaac e al., 2021). Muscula i ness is associa ed
wi h no able heal h imp o emen s in child en and adolescen s,
including educ ions in me abolic isk ac o s and imp o e-
men s in psychological ou comes (J. Smi h e al., 2014), each
o which may imp o e execu i e unc ions (Kamijo e al., 2012;
D. Lubans e al., 2016). While p omising, limi ed s udies ha e
examined he media ing e ec s o i ness (pa icula ly muscula
i ness) in he ela ionship wi h execu i e unc ions in child en.
The “skill acquisi ion” hypo hesis sugges s ha he p ocess
o lea ning new skills migh explain he bene i s o physical
ac i i y o cogni ion. In suppo o his idea, e iews om he
pas ew yea s no e a posi i e associa ion be ween mo o skill
compe ency and execu i e unc ions in child en and adoles-
cen s (Gando a e al., 2022; Hill e al., 2023; Willoughby &
Hudson, 2023), wi h a ecen me a-analysis indica ing a small
consis en associa ion ( = 0.18) (Bao e al., 2024). The heo y is
ha cogni i ely complex ac i i y (including he acquisi ion o
new skills) elies on sha ed unc ional egions wi hin he b ain,
no ably he p e on al co ex, he ce ebellum, and he basal
ganglia, which a e belie ed o unde pin he associa ion
be ween physical ac i i y and execu i e unc ions (Diamond,
2000; Leisman e al., 2016; Pangelinan e al., 2011). Despi e ew
expe imen al s udies, he exis ing e idence sugges s ha phy-
sical ac i i y p og ammes may bene i he de elopmen o
execu i e unc ions in child en by imp o ing hei mo o com-
pe ence (MC) (Mul ey e al., 2018; Vazou e al., 2020).
As ou lined, eme ging e idence sugges s ca dio espi a o y
i ness, muscula i ness and mo o compe ence may media e
he ela ionship be ween physical ac i i y and execu i e unc-
ions in child en. Howe e , only a ew s udies ha e o mally
es ed he i ness and skill acquisi ion hypo heses ia media ion
analyses (Mun ane -Mas e al., 2022; Spanou e al., 2022). While
hese s udies ha e p o ided aluable indings, hey did no es
he ela i e con ibu ions o ca dio espi a o y i ness, muscula
i ness, and mo o compe ence o execu i e unc ions. To
Figu e 1. Hypo hesized associa ions be ween mode a e- o- igo ous physical ac i i y, ca dio espi a o y i ness, muscula i ness, mo o compe ence and execu i e
unc ions.
2R. BAO ET AL.
add ess hese esea ch gaps, ou s udy aimed o explo e he
media ing oles o hese h ee componen s in he associa ion
be ween school-hou mode a e- o- igo ous physical ac i i y
(MVPA) and execu i e unc ions in child en (Figu e 1). Ou
esea ch ques ions we e as ollows:
(1) Is physical ac i i y posi i ely associa ed wi h ca dio e-
spi a o y i ness, muscula i ness, and mo o compe-
ence (a pa hway)?
(2) Is ca dio espi a o y i ness, muscula i ness, and mo o
compe ence posi i ely associa ed wi h execu i e unc-
ions (b pa hway)?
(3) Is physical ac i i y posi i ely associa ed wi h execu i e
unc ions (c`pa hway)?
(4) Will ca dio espi a o y i ness, muscula i ness, and
mo o compe ence media e he c oss-sec ional associa-
ions be ween physical ac i i y and execu i e unc ions?
We hypo hesized ha ca dio espi a o y i ness, muscula i -
ness, and mo o compe ence would be posi i ely associa ed
wi h physical ac i i y and media e he c oss-sec ional ela ion-
ship wi h execu i e unc ions.
Me hods
S udy design and pa icipan s
We used baseline da a om he Lea ning o Lead (L2L) clus e
andomised con olled ial. De ailed in o ma ion abou his
p og amme is a ailable in ou published p o ocol pape
(Wade e al., 2023). Da a we e collec ed by ained esea che s
be ween 2022 (coho 1) and 2023 (coho 2) ac oss 20 p ima y
schools in he s a e o New Sou h Wales (NSW), Aus alia. In
o al, 675 child en (7–11 yea s, 49.5% gi ls) who we e in G ades
3 and 4 we e eligible and included in he cu en c oss-sec ional
s udy. We ob ained w i en in o med assen om s uden s and
w i en consen om hei pa en s o legal gua dians. The s udy
was app o ed by he human esea ch e hics commi ee o he
Uni e si y o Newcas le (app o al numbe : H-2020–0109) and
he NSW Depa men o Educa ion ( e e ence numbe :
2020143). The L2L ial was p ospec i ely egis e ed wi h he
Aus alian New Zealand Clinical T ials Regis y ( e e ence num-
be : ACTRN12621000376842).
Measu emen
Baseline da a ega ding pa icipan s’ demog aphic in o ma ion
(e.g., age, socioeconomic s a us) we e collec ed ia an online
su ey using elec onic able s.
Physical ac i i y
Child en’s physical ac i i y le els we e assessed by w is -
wo n accele ome e s (Ac iG aph GT9X). Pa icipan s wo e
he de ice on hei non-dominan w is and we e asked o
wea hem du ing he school day o i e school days
(app oxima ely be ween he hou s o 9:00 am and 3:00 pm).
Physical ac i i y in ensi y was ca ego ised as ligh , mode a e,
and igo ous using alida ed cu poin s (Chandle e al.,
2016).
Physical i ness
Ca dio espi a o y i ness was e alua ed using he 20 m
Mul is age Fi ness Tes . This es has shown mode a e- o-high
alidi y o es ima e maximum oxygen up ake in child en
(Mayo ga-Vega e al., 2015). The child en we e equi ed o un
be ween wo lines se up 20 m apa . The o al sco e was he
numbe o comple ed laps.
Muscula i ness was assessed by he s anding long jump,
which has shown good alidi y and eliabili y o assess muscu-
la i ness in child en and adolescen s (Cas o-Piñe o e al.,
2010; Ruiz e al., 2011). Pa icipan s pe o med wo jumps,
wi h he u hes jump eco ded in cen ime es as hei inal
sco e.
Mo o compe ence
Mo o compe ence was assessed using a subse o objec
con ol skills ( h owing, ca ching, and kicking) om he Tes
o G oss Mo o De elopmen 3 (TGMD-3) (Webs e & Ul ich,
2017). Child en we e ilmed pe o ming h ee ials o each
o he h ee skills (including an ini ial p ac ice ial ha was
no assessed). These skills we e selec ed based on hei
ans e abili y in o a a ie y o di e en spo s ha a e pop-
ula among Aus alian child en. Each skill in he eco ding
was assessed acco ding o skill-speci ic pe o mance c i e ia
by ained esea ch assis an s. Each skill componen was
sco ed a “1” i pe o med co ec ly, o “0” i pe o med
inco ec ly. This p ocedu e was comple ed o each o he
wo p ima y ials, and ial sco es we e summed o calcula e
a o al sco e o each skill. An o e all objec con ol mo e-
men skills sco e was calcula ed by summing he sco es om
all h ee skills.
Execu i e unc ions
Inhibi o y con ol and cogni i e lexibili y we e measu ed using
wo assessmen s om he Na ional Ins i u e o Heal h Toolbox
o he Assessmen o Neu ological and Beha iou al Func ion.
Pa icipan s comple ed bo h es s on an iPad app in a quie
oom alongside a maximum o 20 o he s uden s comple ing
he es s a he same ime. Ins uc ions o bo h es s we e
explained by a membe o he esea ch eam and we e also
shown on he sc een. All pa icipan s wo e headphones o he
du a ion o he es ba e y, which ook app oxima ely 10 min
o comple e. Inhibi o y con ol was assessed using he “Flanke
Inhibi o y Con ol and A en ion Tes ” ( e sion o child en
be ween 8 and 11 yea s). In his popula ion, sco es de i ed
om his es ha e shown con e gen alidi y and good es –
e es eliabili y (ICC = 0.95, 95% CI = 0.92–0.97) (Wein aub
e al., 2013). Inhibi ion pe o mance was calcula ed as
a combina ion o speed and accu acy and p oduced a sco e
be ween 0 and 10, wi h a highe sco e indica ing g ea e pe -
o mance. Cogni i e lexibili y was assessed by he Dimensional
Change Ca d So Tes ( e sion o child en be ween 8 and 11
yea s). Sco es de i ed om his es ha e also shown good es –
e es eliabili y (ICC = 0.94, 95% CI = 0.92–0.96), and alidi y
when used wi h child en and adolescen s (Wein aub e al.,
2013). Based on a combina ion o es accu acy and speed,
JOURNAL OF SPORTS SCIENCES 3

he es p o ides a sco e be ween 0 and 10, wi h highe sco es
indica ing supe io pe o mance.
S a is ical analysis
To maximise he numbe o s uden s in he cu en s udy whils
p ese ing he alidi y o he measu emen , we conduc ed ICC
analyses compa ing wo o mo e and h ee o mo e days o
alid accele ome y. The alues we e as ollows: wo o mo e,
ICC = 0.75, and h ee o mo e, ICC = 0.83. Acco ding o p e ious
s udies, an ICC o 0.75, calcula ed om wo o mo e days, is
conside ed accep able o accele ome y (An czak e al., 2021;
Ba boza e al., 2021; Ridley e al., 2009), acco dingly, we used
da a wi h wo o mo e days o alid wea ime. Desc ip i e
analyses ( he Chi-squa e and independen - es ) and bi a ia e
co ela ions be ween physical ac i i y, mo o compe ence, ca -
dio espi a o y i ness, muscula i ness, and execu i e unc ions
(alpha le els se a p < 0.05) we e conduc ed in IBM SPSS
S a is ics o Windows, V.28.0 (IBM, A monk, New Yo k, USA)
and a e p esen ed in Table 1.
We used mul i-le el s uc u al equa ion modelling in Mplus
e sion 8.10 o in es iga e whe he ca dio espi a o y i ness,
muscula i ness, o mo o compe ence media e he c oss-
sec ional associa ions be ween MVPA and execu i e unc ions
(indi ec e ec ). These ques ions we e in es iga ed using he
models shown in Figu es 2 and 3. To add ess missing da a and
Table 1. Cha ac e is ics o he s udy sample.
O e all (n = 675
a
) Boys (n = 336, 50.5%) Gi ls (n = 329, 49.5%)
S a is ic (χ
2
/ ) P aluen (%) Mean (SD) n (%) Mean (SD) n (%) Mean (SD)
Cul u al backg ound, n (%)
Aus alian 606 (90.2%) 300 (89.3%) 302 (91.8%) 1.22 0.270
O he 66 (9.8%) 36 (10.7%) 27 (8.2%)
Socioeconomic s a us, n (%)
Low 66 (9.9%) 32 (9.6%) 33 (10.1%) 0.83 0.659
Medium 512 (76.4%) 253 (75.5%) 254 (77.4%)
High 92 (13.7%) 50 (14.9%) 41 (12.5%)
Age 672 8.7 (0.7) 336 8.7 (0.7) 329 8.6 (0.7) 1.87 0.062
MVPA (minu es) 675 34.3 (14.1) 336 39.6 (14.8) 329 29.0 (10.8) 10.52 <0.001
MC (sco es) 643 14.4 (3.5) 316 15.9 (3.2) 320 12.9 (3.2) 11.74 <0.001
Ca dio espi a o y i ness (laps) 653 26.2 (15.4) 327 29.6 (17.6) 318 22.7 (12.0) 5.80 <0.001
Muscula i ness (cm) 662 119.7 (22. 6) 329 125.6 (23.5) 325 114.0 (19.9) 6.78 <0.001
Inhibi o y con ol (sco es) 666 7.4 (1.1) 331 7.5 (1.1) 327 7.4 (1.0) 1.28 0.202
Cogni i e lexibili y (sco es) 666 6.9 (1.1) 331 6.9 (1.1) 327 6.8 (1.1) 0.63 0.532
a
= he e was missing da a o he sex o 10 pa icipan s.
Figu e 2. The media ing associa ion be ween MVPA and inhibi o y con ol in o e all sample (n = 664). (No e: adjus ed o socioeconomic s a us and sex, he numbe s in
he b acke s e e o SE, solid lines ep esen signi ican β coe icien s and dashed lines indica e non-signi ican β coe icien s)
4R. BAO ET AL.
he non-independence o s uden s clus e ing wi hin schools,
we applied obus maximum likelihood es ima ion by adjus ing
s anda d e o s using a sandwich es ima o . Each ou come was
s anda dised by con e ing hem in o z-sco es be o e analysis.
Two mul iple media o models we e used o es ima e he
indi ec e ec s o physical ac i i y on inhibi o y con ol and
cogni i e lexibili y. The goodness o model i s we e e alua ed
using χ
2
(Chi-squa e s a is ics), he Compa a i e Fi Index (CFI)
(Ben le , 1990), he Tucke -Lewis Index (TLI) (Tucke & Lewis,
1973), he Roo Mean Squa e E o o App oxima ion (RMSEA)
(B owne & Cudeck, 1992) and hei 90% con idence in e al
(90% CI). A alue o TLI and CFI g ea e han 0.95 and an
RMSEA less han 0.05 indica e an adequa e model i o he
obse ed da a (Hu & Ben le , 1999). Each model adjus ed o
socioeconomic s a us and sex. Each model es ed he ela ion-
ship be ween he independen a iable and he hypo hesised
media o s (a pa h); he media o s and he dependen a iables
(b pa h). Then, a se ies o p oduc o coe icien s (a pa h × b
pa h) we e es ed o calcula e he media ed es ima es o each
hypo hesised media o (ca dio espi a o y i ness, muscula i -
ness, and mo o compe ence). The indi ec es ima es we e
conside ed signi ican whe e p < 0.05. The magni ude o he
associa ions can be desc ibed as small (0.10–0.29), mode a e
(0.30–0.49), and s ong (≥0.50) (Cohen, 2013).
Resul s
The sample cha ac e is ics a e displayed in Table 1. Among 675
child en (wi h a mean o 8.67 ± 0.67 yea s), 49.5% we e emale,
and 90.2% o hem we e bo n in Aus alia. Table 2 ou lines he
bi a ia e co ela ions among all measu es. Figu e 2 p esen s he
esul s o di ec es ima es o MVPA and media o s on inhibi o y
con ol in child en. The media ion model o inhibi o y con ol
p o ided an adequa e i o he da a wi h χ
2
(18) = 8.126,
CFI = 0.994, TLI = 0.979, RMSEA = 0.031 and 90% CI = 0.000–-
0.067. Figu e 3 shows he esul s o di ec es ima es o MVPA
and media o s on cogni i e lexibili y in child en. The media ion
Figu e 3. The media ing associa ion be ween MVPA and cogni i e lexibili y in o e all sample (n = 664). (No e: adjus ed o socioeconomic s a us and sex, he numbe s
in he b acke s e e o SE, solid lines ep esen signi ican β coe icien s and dashed lines indica e non-signi ican β coe icien s)
Table 2. Pea son’s bi a ia e co ela ions among a iables in child en.
Coe icien s (sample size) 1 2 3 4 5 6
1. MVPA 1
2. CRF 0.462** (653) 1
3. MF 0.387** (662) 0.590** (649) 1
4. MC 0.389** (643) 0.363** (627) 0.413** (636) 1
5. Inhibi o y con ol 0.012 (666) 0.093* (647) 0.122** (656) 0.084* (637) 1
6. Cogni i e lexibili y 0.039 (666) 0.197** (647) 0.218** (656) 0.109** (637) 0.332** (666) 1
MVPA = mode a e- o- igo ous physical ac i i y; CRF = ca dio espi a o y i ness; MF = muscula i ness; MC = mo o compe ence. *. Co ela ion is signi ican a he 0.05
le el (2- ailed); **. Co ela ion is signi ican a he 0.01 le el (2- ailed).
JOURNAL OF SPORTS SCIENCES 5
model o cogni i e lexibili y also p o ided an adequa e i o
he da a, χ
2
(18) = 605.754, CFI = 0.994, TLI = 0.979, RMSEA =
0.032 and 90% CI = 0.000–0.069.
MVPA on hypo hesised media o s (a pa hway – ac ion
heo y es s)
MVPA was associa ed wi h ca dio espi a o y i ness (β = 0.46,
SE = 0.049, p < 0.001), muscula i ness (β = 0.35, SE = 0.055,
p < 0.001) and mo o compe ence (β = 0.27, SE = 0.049,
p < 0.001).
Hypo hesised media o s on execu i e unc ions (b
pa hway – concep ual heo y es s)
Muscula i ness was associa ed wi h inhibi o y con ol (β = 0.09,
SE = 0.043, p = 0.045) and cogni i e lexibili y (β = 0.16,
SE = 0.053, p = 0.002), while ca dio espi a o y i ness was only
associa ed wi h cogni i e lexibili y (β = 0.13, SE = 0.044,
p = 0.003). No signi ican associa ions we e obse ed be ween
mo o compe ence and measu es o execu i e unc ion.
MVPA on execu i e unc ions (c` pa hway – including
media o s)
MVPA was nega i ely associa ed wi h cogni i e lexibili y
(β = −0.10, SE = 0.043, p = 0.016), while no associa ion was
obse ed be ween MVPA and inhibi o y con ol.
Signi icance o he indi ec e ec s (ab pa hway –
media ion es s)
Table 3 displays he indi ec es ima es o MVPA on inhibi o y
con ol and cogni i e lexibili y. Ca dio espi a o y i ness
media ed he associa ion be ween MVPA and cogni i e lexibili y
in he o e all sample (β = 0.06, SE = 0.021, p = 0.004). Muscula
i ness media ed he ela ionship be ween MVPA and inhibi o y
con ol in he o e all sample (β = 0.03, SE = 0.014, p = 0.027).
Muscula i ness was also a signi ican media o o he e ec o
MVPA on cogni i e lexibili y (β = 0.06, SE = 0.021, p = 0.005) in
he o e all sample. We did no obse e indi ec e ec s o mo o
compe ence in he ela ionship be ween MVPA and execu i e
unc ions in child en.
Discussion
The aim o ou s udy was o examine whe he ca dio espi a o y
i ness, muscula i ness, o mo o compe ence media ed he
c oss-sec ional associa ion be ween MVPA and execu i e unc-
ions in child en. The indings indica ed ha ca dio espi a o y
i ness media ed he associa ion be ween MVPA and cogni i e
lexibili y, while muscula i ness media ed he ela ionship
be ween MVPA and bo h inhibi o y con ol and cogni i e lex-
ibili y. Con e sely, we did no ind a media ing ole o mo o
compe ence on ei he ou come.
The “ i ness” hypo hesis pos ula es ha pa icipa ion in
physical ac i i y o su icien du a ion and in ensi y can p o-
duce ca dio espi a o y i ness gains, which may subsequen ly
enhance cogni ion (Pe uzzello e al., 1997; Tompo owski &
Pesce, 2019). In line wi h his hypo hesis, ou indings sug-
ges ed ha ca dio espi a o y i ness was posi i ely associa ed
wi h execu i e unc ions in child en, which is consis en wi h
e iews on he opic (De G ee e al., 2018; Hillman e al.,
2008; Van Wael elde e al., 2020). No ably, ew s udies ha e
o mally examined he media ion o ca dio espi a o y i ness
in child en (Visie -Al onso e al., 2021; Yangüez e al., 2021).
Speci ically, we ound ha ca dio espi a o y i ness media ed
he ela ionship be ween MVPA and cogni i e lexibili y bu
no o inhibi o y con ol. Resea ch on he media ing e ec s
o ca dio espi a o y i ness, as assessed by he 20-m shu le
un es , has yielded mixed esul s. Some s udies ha e
epo ed simila indings o he cu en s udy (Yangüez
e al., 2021), while o he s ha e ound ha ca dio espi a o y
i ness media es inhibi o y con ol bu no cogni i e lexibili y
(Visie -Al onso e al., 2021). These disc epancies may be pa ly
due o me hodological di e ences in how ca dio espi a o y
i ness is measu ed. Fo ins ance, while some s udies ha e
used di ec measu es o maximal oxygen consump ion, in he
cu en s udy, ca dio espi a o y i ness was assessed based on
he numbe o comple ed laps in he shu le un. The inding
ha ca dio espi a o y i ness media ed he ela ionship
be ween MVPA and cogni i e lexibili y may be explained
by se e al hypo heses.
Ca dio espi a o y i ness can con ibu e o g ea e ce eb al
ci cula ion, and an up egula ion o neu o ophins (e.g., b ain-
de i ed neu o ophic ac o ) ha con ibu e o execu i e unc-
ion pe o mance (S impson e al., 2018). Al e na i ely, he e is
a beha iou al explana ion o ca dio espi a o y i ness as
a media o o execu i e unc ions. Ae obic exe cises demand
a ying le els o cogni i e engagemen , which may pose chal-
lenges o child en’s execu i e unc ions (Bes , 2010;
Tompo owski & Pesce, 2019). In pa icula , con ex ual in e e -
ence a ises du ing pa icipa ion in ae obic exe cises, compel-
ling child en’s need o c ea e, moni o and modi y hei ac ions
o accomplish di e se and complex exe cise asks (Bes , 2010;
Tompo owski & Pesce, 2019). This p ocess necessi a es he
in ol emen o execu i e p ocesses, and he cogni i e skills
essen ial o engaging in ae obic exe cises may ans e o
pe o mance on execu i e unc ion asks (Bes , 2010).
We ound ha muscula i ness was a media o be ween
MVPA and bo h o ou execu i e unc ioning ou comes. The
Table 3. The indi ec es ima es o MVPA on execu i e unc ions h ough
media o s.
Pa hways
O e all (n = 675)
βSE p
MVPA o inhibi o y con ol ia CRF 0.02 0.027 0.404
MVPA o inhibi o y con ol ia MF 0.03 0.014 0.027
MVPA o inhibi o y con ol ia MC 0.02 0.012 0.185
MVPA o cogni i e lexibili y ia CRF 0.06 0.021 0.004
MVPA o cogni i e lexibili y ia MF 0.06 0.021 0.005
MVPA o cogni i e lexibili y ia MC 0.01 0.010 0.435
MVPA, mode a e- o- igo ous physical ac i i y; CRF, ca dio espi a o y i ness; MF,
muscula i ness; MC, mo o compe ence; β, s anda dised coe icien s; SE,
s anda d e o .
6R. BAO ET AL.
ela ionship be ween muscula i ness and execu i e unc ions
in child en is s ill an eme ging ield o esea ch, bu ou indings
a e consis en wi h he exis ing li e a u e (Robinson e al., 2023;
J. J. Smi h e al., 2014). A ecen e iew ound ha muscula
i ness is posi i ely associa ed wi h cogni i e lexibili y (Cohen’s
d = 0.18) and wo king memo y (Cohen’s d = 0.14) in child en
and adolescen s (Robinson e al., 2023). Fu he , he e is e i-
dence ha highe le els o muscula i ness a e associa ed wi h
g ea e inhibi o y con ol and cogni i e lexibili y (Solis‐U a
e al., 2021; Zeng e al., 2023). The e is also e idence o
a posi i e associa ion be ween muscula i ness and whi e
ma e olume in child en (Es eban-Co nejo e al., 2019).
Howe e , i is impo an o acknowledge he di e ences in
how muscula i ness was assessed ac oss s udies. Fo example,
se e al s udies ha e used composi e measu es, such as he
combina ion o handg ip s eng h and he s anding long
jump (Es eban-Co nejo e al., 2019; Solis‐U a e al., 2021), o
a b oade ba e y o es s, including he assessmen o g ip
s eng h, pull ups (boys), si -ups (gi ls) and s anding long
jump (Zeng e al., 2023). In con as , ou s udy assessed mus-
cula i ness solely using he s anding long jump es . These
me hodological di e ences in how muscula i ness is assessed
mus be conside ed when compa ing ou esul s wi h hose o
o he s udies.
In e es ingly, ou s udy has shown ha muscula i ness was
a p edic o o execu i e unc ioning, independen ly o ca dio -
espi a o y i ness. This ela ionship may be explained, a leas in
pa , by he ela ionship o muscula i ness o b ain s uc u e
and unc ions. The ac i a ion o skele al muscle may s imula e
he elease o neu o ophins (such as i isin and b ain-de i ed
neu o ophic ac o ), which may acili a e execu i e unc ions
(Isaac e al., 2021). The e o e, i may be he case ha ac i i ies
ha a e pa icula ly axing on skele al muscle (e.g., esis ance
exe cise), and hus con ibu e o muscula i ness, may be
especially e ec i e on execu i e unc ions. Clea ly, he e is
a need o u he esea ch on he ela ionship be ween mus-
cula i ness and execu i e unc ions.
The “skill” hypo hesis p oposed ha physical ac i i y pa i-
cipa ion can acili a e he acquisi ion o mo o skill compe-
ency, which subsequen ly imp o es cogni i e unc ion.
Engagemen in cogni i ely complex and/o no el mo o skill
asks may lead o imp o emen s in execu i e unc ions. The e is
e idence ha mo o compe ence is posi i ely associa ed wi h
execu i e unc ions in child en and adolescen s (Gando a
e al., 2022; Hill e al., 2023; Willoughby & Hudson, 2023).
Recen ly, indings om a me a-analysis sugges ha mo o
compe ence ( = 0.18) is associa ed wi h execu i e unc ions
in child en and adolescen s (Bao e al., 2024). Fu he , eme ging
e idence sugges s ha mo o compe ence may in luence he
ela ionship be ween physical ac i i y and execu i e unc ions
(Hill e al., 2023; Willoughby & Hudson, 2023). The unde lying
mechanisms may be ela ed o he use o unc ional egions
wi hin he b ain, such as p e on al co ex, he ce ebellum, and
he basal ganglia ha a e common o bo h mo o and cogni-
i e ac i i ies (Diamond, 2000; Leisman e al., 2016). Con a y o
ou hypo hesis, we did no ind ha mo o compe ence
media ed he associa ion be ween MVPA and execu i e unc-
ions. No ably, ew s udies ha e o mally in es iga ed he
po en ial media ing ole o mo o compe ence in his
ela ionship. Among hem, Spanou e al. (2022), ound ha
mo o compe ence, assessed using he B uininks – Ose e sky
Tes o Mo o P o iciency-Second Edi ion (BOT-2), media ed he
associa ion be ween physical ac i i y and execu i e unc ions
in child en. Gi en he limi ed esea ch on he po en ially med-
ia ing ole o mo o compe ence, u u e longi udinal and
expe imen al esea ch is needed o be e unde s and he em-
po ali y o his ela ionship and he causal pa hways linking
mo o compe ence, physical ac i i y, and execu i e unc ions.
To da e, much o he exis ing esea ch has ocused on he
ela ionship be ween ca dio espi a o y i ness and execu i e
unc ioning, wi h subs an ially less a en ion gi en o he
po en ial con ibu ions o muscula i ness and mo o compe-
ence (De G ee e al., 2018; Xue e al., 2019). This imbalance
lea es a gap in ou unde s anding o he speci ic aspec s o
physical ac i i y ha may in luence cogni i e de elopmen in
child en. The cu en s udy add esses his gap by es ing he
ela i e con ibu ions o ca dio espi a o y i ness, muscula i -
ness, and mo o compe ence o child en’s execu i e unc ions.
Ou indings lend suppo o he “ i ness hypo hesis”, sugges -
ing ha physical ac i i y-induced imp o emen s in bo h ca di-
o espi a o y and muscula i ness a e signi ican ly associa ed
wi h enhanced execu i e unc ioning pe o mance.
Impo an ly, his is one o he ew s udies o o mally es and
compa e he ela i e impac o hese dis inc aspec s o physi-
cal i ness and compe ence on execu i e unc ions, he eby
p o iding a mo e comp ehensi e unde s anding o he in i-
ca e ela ionships be ween physical ac i i y and cogni i e
de elopmen .
S eng hs and limi a ions
To ou knowledge, his is he i s s udy o o mally es ca dio -
espi a o y i ness, mo o compe ence, and muscula i ness as
media o s in he ela ionship be ween de ice-assessed physical
ac i i y and execu i e unc ions in child en. We used a mul i-
le el modelling app oach, which is conside ed bes p ac ice o
analysing clus e ed da a. Howe e , se e al limi a ions should be
conside ed. Fi s , ou indings a e based on a c oss-sec ional
s udy design, p e en ing he analysis o a causal ela ionship
be ween MVPA and execu i e unc ions in child en. The e a e
po en ial bi-di ec ional associa ions be ween physical ac i i y
and mo o compe ence, as well as ca dio espi a o y and mus-
cula i ness in child en and adolescen s (Ba ne e al., 2022).
Fo example, imp o emen s in mo o compe ence may lead o
inc eased physical ac i i y among you h. Con e sely, inc easing
physical ac i i y could also enhance mo o compe ence. Fu u e
expe imen al esea ch is needed o es ablish he empo al o de
o hese ela ionships. Second, al hough inhibi ion, cogni i e
lexibili y, and wo king memo y a e conside ed he h ee co e
execu i e unc ions (Zelazo, 2020), we did no measu e wo king
memo y due o logis ical cons ain s. We used he NIH oolbox
ha includes a measu e o wo king memo y ha equi es one-
on-one adminis a ion. This was no easible, as we needed o
es se e al s uden s simul aneously. Fu u e esea ch should
include wo king memo y o p o ide a mo e comp ehensi e
accoun o he ela ionship be ween physical ac i i y and
execu i e unc ions. Thi d, ou assessmen o mo o compe-
ence was limi ed o h ee objec con ol skills. I is possible
JOURNAL OF SPORTS SCIENCES 7