Association of Physical Activity and Physical Fitness with Executive Function in Disabled Children and Adolescents.

Purpose

To examine the associations of physical activity (PA) and physical fitness with executive function among disabled children and adolescents, and explore potential differences across disability types and gender.

Methods

Two hundred and forty-one participants (64.3% boys; mean age: 12.96 ± 3.29 years) with physical disabilities (PD, n = 112), intellectual disabilities (ID, n = 119), and hearing impairment (n = 10) were recruited from 19 special schools. PA was measured with wrist-worn accelerometers. Physical fitness, including body composition, muscular strength, muscular endurance, and flexibility, was assessed using the Brockport Physical Fitness Test. Executive function was evaluated through computer-based tasks that measured mean accuracy and reaction time.

Results

Linear mixed models revealed that higher PA and better muscular fitness were positively associated with the accuracy of executive function tests. Both light PA (LPA, B = 0.03; 95% confidence intervals [CI]: 0.00, 0.06; d = 0.295) and moderate-to-vigorous PA (MVPA; B = 0.25; 95%CI: 0.14, 0.36; d = 0.611) showed significant associations with accuracy. Muscular fitness, including curl-ups (B = 0.58; 95% CI: 0.16, 1.00; d = 0.285) and handgrip strength (B = 0.74; 95% CI: 0.42, 1.07; d = 0.587), demonstrated positive associations with accuracy. Disability-specific analyses indicated that MVPA and handgrip strength were consistently associated with accuracy in both PD and ID groups, while PA was associated with reaction time only in the PD group. Gender-stratified analyses revealed that muscular fitness showed stronger associations with executive function in PD boys, whereas MVPA demonstrated stronger associations with accuracy in PD girls.

Conclusions

Promoting PA and improving muscular fitness may enhance executive function in disabled children and adolescents, with patterns varying by disability type and gender. However, the cross-sectional design precludes causal inferences, and future longitudinal studies are needed to establish causality and explore potential mediating mechanisms.