Overweight or obese children and adolescents have been shown to exhibit executive function deficits when compared to healthy populations with normal body mass. These deficits may serve to exacerbate existing overweight or obesity and, in some cases, may serve to predispose the individual to the development of other diseases. A growing body of research has demonstrated that exercise can positively impact executive function; however, the specific benefits and drawbacks of different exercise modalities require further investigation.

To explore the most effective exercise methods for improving executive function in overweight or obese children and adolescents.

A comprehensive search of the CNKI, Wanfang Data, Cochrane Library, PubMed, Embase, and Web of Science databases was conducted to identify randomized controlled trials of exercise interventions for executive function in adolescents and young adults with overweight or obesity. This search was conducted from database construction to October 2024. The literature was screened and the data was extracted by two independent researchers. A network meta-analysis was performed using RevMan 5.4 and Stata 18.0 software to compare the differences between exercise modalities as well as to calculate and rank cumulative probability ranked area under the curve (SUCRA) values. The standardized mean difference (SMD) and its 95% confidence interval (CI) were used as an effect indicator. The Cochrane risk of bias assessment tool was used for risk of bias assessment, and Egger's test was used for publication bias analysis.

A total of 10 papers in English and Chinese were included, encompassing 675 overweight or obese children and adolescents, aged 8 to 15 years old, with outcome indicators of inhibitory control, working memory, and cognitive flexibility. A total of four movement style groups (sports games, ball games, martial arts practice, and physical training) were included with the no-exercise group. With respect to the enhancement of inhibitory control, sports games (SMD=-1.75, 95%CI=-2.83 to -0.68, P<0.05), ball games (SMD=-1.93, 95%CI=-3.87 to -0.10, P<0.05), and physical training (SMD=-1.20, 95%CI=-2.40 to -0.05, P<0.05) all significantly increased the level of inhibitory control in overweight or obese children and adolescents, with ball sports having the largest SUCRA value (82.8) and being ranked first. In terms of enhancing working memory, ball sports demonstrated superiority over physical training (SMD=-1.02, 95%CI=-1.68 to -0.36, P<0.05). Similarly, in the context of promoting cognitive flexibility, ball sports exhibited greater efficacy in comparison to physical training (SMD=-1.22, 95%CI=-1.90 to -0.54, P<0.05) .

A comparison of ball games with other exercise modalities has demonstrated that the former is superior in improving executive function in overweight or obese children and adolescents. A comprehensive consideration of the synergistic integration of ball games with intensity, periodization, frequency, and volume is imperative during practice interventions. Further evidence is necessary to develop more accurate and efficient exercise prescriptions for overweight or obese children and adolescents.

与健康体质量人群相比，超重或肥胖儿童青少年多存在执行功能缺陷，可能加剧超重或肥胖和诱发其他疾病。运动能促进执行功能已被证实，但不同运动方式效果的优劣仍需进一步探讨。

探索改善超重或肥胖儿童青少年执行功能效果最佳的运动方式。

检索中国知网、万方数据知识服务平台、Cochrane Library、PubMed、Embase和Web of Science数据库，汇总运动干预超重或肥胖儿童青少年执行功能的随机对照试验，检索时间为数据库建库至2024年10月。由2名研究人员独立进行文献筛选和资料提取，使用RevMan 5.4和Stata 18.0软件进行网状Meta分析，以标准化均数差（SMD）及其95%CI为效应指标，比较各运动方式间的差异以及计算累计概率排名曲线下面积（SUCRA）值并进行排序。采用Cochrane风险偏倚评估工具进行风险偏倚评估和Egger's检验进行发表偏倚分析。

本研究共纳入10篇中英文文献，其中超重或肥胖儿童青少年675名，年龄8~15岁，结局指标为抑制控制、工作记忆和认知灵活性。共纳入4种运动方式组（体育游戏、球类运动、武术练习、体能训练）与无运动组。在改善抑制控制方面，与无运动组相比，体育游戏（SMD=-1.75，95%CI=-2.83~-0.68，P<0.05）、球类运动（SMD=-1.93，95%CI=-3.87~-0.10，P<0.05）、体能训练（SMD=-1.20，95%CI=-2.40~-0.05，P<0.05）均能提高超重或肥胖儿童青少年的抑制控制水平，其中球类运动SUCRA值最大（82.8），排序第一。在提高超重或肥胖儿童青少年的工作记忆方面，球类运动优于体能训练（SMD=-1.02，95%CI=-1.68~-0.36，P<0.05）；在提高超重或肥胖儿童青少年的认知灵活性方面，球类运动优于体能训练（SMD=-1.22，95%CI=-1.90~-0.54，P<0.05）。

与其他运动方式相比，球类运动在改善超重或肥胖儿童青少年的执行功能方面展现出了较优良的改善效果。在实践干预过程中应综合考虑球类运动与强度、周期、频率以及量的协同搭配。后续需进一步充实与超重或肥胖儿童青少年执行功能改善相关的证据，从而制订出更为精确、高效的运动处方。