Effects of Exercise on Cognitive Function in People with Intellectual Disabilities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

TL;DR

Exercise improves cognitive function in people with intellectual disabilities, especially when sessions are long and sustained over time.

Contribution

This study provides the first meta-analysis on optimal exercise prescriptions for cognitive improvement in individuals with intellectual disabilities.

Findings

Exercise significantly improves cognitive function in individuals with intellectual disabilities (Hedges’ g = 0.85).

Longer exercise sessions (≥60 min) and total weekly durations (>180 min) yield the greatest cognitive benefits.

Adolescents with intellectual disabilities show greater cognitive gains from exercise compared to other age groups.

Abstract

Objectives: This study aimed to evaluate the effects of exercise on cognitive function in individuals with intellectual disabilities (ID) and to identify the optimal exercise prescription. Methods: A comprehensive search of PubMed, Web of Science, EBSCO, Cochrane, and Scopus was conducted through 13 May 2025. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included studies. Results: Twenty studies fulfilled the inclusion criteria, of which six were rated as high quality and eleven as moderate quality. A meta-analytic synthesis of 14 eligible studies demonstrated that exercise elicited a significant improvement of cognitive function in ID patients (Hedges’ g = 0.85, p < 0.001), with the greatest effect observed for cognitive speed (Hedges’ g = 0.93, p < 0.01). Subgroup analyses indicated that interventions lasting ≥12 weeks (Hedges’ g = 0.92, p < 0.001), performed <3 times per week (Hedges’ g = 1.22, p < 0.01), with sessions ≥60 min (Hedges’ g = 1.91, p < 0.01), and >180 min per week in total (Hedges’ g = 3.10, p < 0.01) yielded the most pronounced benefits. Adolescents with ID exhibited greater cognitive gains (Hedges’ g = 1.01, p < 0.001). Conclusions: Exercise significantly improved cognitive function in ID patients. Our findings suggested that ID patients may benefit from exercise sessions lasting at least 60 min, performed fewer than three times per week, and sustained for at least 12 weeks. Achieving an exercise target of more than 180 min per week may further enhance cognitive function. Moreover, younger ID patients may experience greater improvements in cognitive function. Future studies should focus on standardizing exercise protocols and cognitive assessment tools to ensure consistency and comparability of findings in this population.

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