Effects of a structured fundamental motor skills intervention on executive function in second grade students: a randomized controlled trial

Abstract

Given the relative scarcity of randomized controlled trial evidence regarding systematic fundamental motor skills interventions for lower primary school students, this study aimed to examine the effectiveness of a 10-week structured fundamental motor skills intervention on the executive function and its subcomponents in second-grade students. Between September and November 2023, a randomized controlled trial was conducted. Eighty-nine second grade students were assigned to either an experimental group (n = 44) or a control group (n = 45). The experimental group received a 10-week fundamental motor skills intervention, consisting of three sessions per week, while the control group maintained their regular physical activities. The Chinese version of the Executive Function Scale was used for assessment before and after the intervention. After the intervention, students in the experimental group demonstrated significantly better performance than those in the control group in Sustained Attention, Working Memory, Planning and Initiation, Self-Regulation, Inhibitory Control, Emotion Regulation, and the total executive function score (F-values = 12.852, 8.633, 8.027, 12.786, 5.925, 4.681, 4.529, respectively; all P < 0.05). Within the experimental group, post-intervention scores were significantly higher than pre-intervention scores for Sustained Attention, Working Memory, Theory of Mind, Planning and Initiation, Self-Regulation, Inhibitory Control, Emotion Regulation, and the total executive function score (F-values = 6.122, 6.507, 14.248, 10.787, 9.974, 6.029, 6.242, 4.601, respectively; all P < 0.05). This study confirms that a structured fundamental motor skills intervention can effectively promote the development of multiple core executive functions in second-grade students. These findings provide empirical support for the theory of embodied cognition and suggest that integrating a systematic fundamental motor skills curriculum into school physical education represents a viable pathway for enhancing children’s cognitive health.

Introduction

Executive function refers to a series of higher-order cognitive control processes essential for individual goal-directed behavior, primarily comprising core components such as inhibitory control, working memory, and cognitive flexibility¹. During school age, executive function is crucial for children to manage their learning environment, regulate emotional behaviors, and develop social adaptability. Extensive research has demonstrated that executive function is a key predictor of early academic achievement and social competence development in children². However, the development of executive function does not occur overnight; it exhibits significant plasticity during childhood³. Consequently, exploring effective programs to promote the development of executive function in primary school students has become an important topic in developmental psychology and school health education.

In recent years, the positive benefits of physical activity on cognitive function have gained widespread attention^4,5. Beyond its role in promoting physical health, accumulating evidence indicates that regular moderate-to-vigorous physical exercise can effectively improve children’s executive function⁶. However, compared to general physical activities, fundamental motor skills (FMS), which serve as the foundation for complex physical activities, may have a more intimate relationship with executive function. FMS primarily include locomotor skills, stability skills, and object control skills. Their development is considered a critical period for children’s participation in lifelong physical activity and sports⁷.

From a theoretical perspective, the association between FMS and executive function is supported by the theory of embodied cognition. This theory posits that cognitive processes are grounded in the sensorimotor system, and the accumulation of motor experience provides a foundation for cognitive development⁸. According to this view, motor development offers new opportunities for young children to actively explore their physical and social environments through perception-action cycles, thereby promoting cognitive development⁹. Neuroscience research further provides a mechanistic explanation for this link, indicating tight interactions between the cerebellum and the prefrontal cortex in coordinating complex movements and higher-order cognitive functions¹⁰. Performing FMS often requires planning, monitoring, and coordinating actions, a process that inherently recruits and exercises the neural networks associated with executive function.

Cross-sectional studies provide preliminary evidence for this connection. For instance, a study by Han et al.¹¹ involving Chinese preschoolers found a significant positive correlation between the total FMS score and the total executive function score, with locomotor skills significantly predicting inhibitory control, working memory, and cognitive flexibility. However, cross-sectional research cannot establish causality. In recent years, experimental intervention studies have begun to emerge. A randomized controlled trial by Hudson et al.¹² demonstrated that an intervention program integrating gross and fine motor movements with cognitive challenges effectively enhanced both motor competence and executive function, particularly inhibitory control and early numeracy skills, in preschool children. Similarly, an intervention study by Kashfi et al.¹³ targeting children with learning disabilities showed that Attention, Balance, and Coordination based training simultaneously improved their motor skills and multiple aspects of executive function, with sustained effects.

Although the aforementioned studies have yielded a series of positive results, empirical research examining the impact of systematic, standard-based FMS interventions on executive function in lower primary school grades remains relatively scarce. The lower primary school years represent a critical stage for the development of FMS¹⁴ and a period of rapid development for executive function³. Conducting intervention research during this phase is therefore highly significant. In light of this, the present study aims to investigate the effects of a 10-week fundamental motor skills intervention on the executive function of second-grade primary school students through a randomized controlled trial. This research will not only enrich the empirical evidence regarding the relationship between FMS and cognitive development but also provide a feasible reference pathway for promoting children’s cognitive health through physical education curricula within school educational practice.

Participants and methods

Partisans

Sample size estimation

An a priori sample size estimation was performed using G*Power software, version 3.1 (University of Düsseldorf, Germany). Based on meta-analysis results from studies on exercise interventions improving children’s executive function, a medium effect size (f = 0.25) was set¹⁵, with a significance level (α) of 0.05 and a statistical power (1-β) of 0.90¹⁶. The design for a repeated measures analysis of variance (ANOVA), evaluating the interaction between groups and within-subjects factors, indicated that a total sample size of 46 participants was required. Considering an approximate 20% attrition rate and the feasibility of school administration, 100 subjects were ultimately recruited and randomly assigned to either the experimental group or the control group, with 50 participants in each group.

Sampling and grouping

A multistage cluster random sampling method was employed in this study. Firstly, two public primary schools were randomly selected from all such schools in Panyu District and Zengcheng District of Guangzhou City, Guangdong Province, considering administrative affiliation and homogeneity in teaching management. Subsequently, from all second-grade classes within these two schools, two classes (Class 4, Grade 2 from a school in Panyu District; Class 1, Grade 2 from a school in Zengcheng District) were randomly selected as the research clusters. Second-grade students were chosen primarily because the “Compulsory Education Physical Education and Health Curriculum Standards (2022 Edition)” specifies curriculum content dedicated to fundamental motor skills. Furthermore, pre-surveys indicated that 80% of students in this grade level could comprehend the contents of the executive function scales and complete them, which facilitates a scientific and objective evaluation of the intervention effects.

All second grade students in the selected classes were invited to participate in the study. The inclusion criteria were: (1) a guardian provided written informed consent, and the child themselves was informed and agreed to participate; (2) good physical health, without conditions such as heart disease or severe asthma that are unsuitable for vigorous exercise; (3) no clinically diagnosed motor dysfunction or neurological disorders. The exclusion criterion was students with long-term absenteeism (anticipated absence rate exceeding 30% during the intervention period).

Using a computer generated random number table, the 100 eligible students were allocated in a 1:1 ratio to either the experimental group (n = 50) or the control group (n = 50). The random allocation sequence was generated and kept sealed by an independent researcher not involved in participant recruitment or assessment, ensuring allocation concealment. Ultimately, 6 participants dropped out from the experimental group (44 analyzed), and 5 dropped out from the control group (45 analyzed).

Ethical review and informed consent

This study strictly adhered to the ethical principles outlined in the Declaration of Helsinki. The study protocol, which included the research procedures, intervention content, informed consent forms, measurement tools, and data confidentiality measures, was submitted to and approved by the Ethics Committee of Guangzhou Sport University (Approval No.: 2023LCLL-12). Prior to implementation, the research team submitted all the aforementioned ethically approved materials to the administration departments of each participating primary school (including the two project schools in Panyu District and Zengcheng District of Guangzhou City), obtaining official permission and support from the schools. All participating schools acknowledged and respected the review decision of the Guangzhou Sport University Ethics Committee. Before the study commenced, parent meetings were held to explain the study’s purpose, procedures, potential benefits and risks, data confidentiality, and the right to voluntary participation and withdrawal at any time to all potential participants’ guardians. Written informed consent was obtained from the guardians of all children participating in the study. Simultaneously, the research content was explained to the children themselves in an age-appropriate manner, and their verbal assent was obtained. Additionally, all collected data were coded after removing personally direct identifiers (such as names and student IDs) to ensure the full protection of all participants’ privacy.

Research methods

Research design

This study employed a pretest-posttest randomized controlled trial design. To control for the potential “Hawthorne effect,” the outcome assessors were blinded; specifically, the teachers responsible for pre- and post-test data collection were unaware of the students’ group assignments. Due to the nature of the intervention content, blinding of the participants and intervention implementers was not possible.

Intervention protocol

In addition to maintaining their regular school physical activities, the experimental group received a 10-week, structured fundamental motor skills intervention. This intervention consisted of three 40-minute sessions per week. The intervention protocol was developed by the research team based on the “Compulsory Education Physical Education and Health Curriculum Standards (2022 Edition)” and by referencing established protocols from domestic and international sources^12,13. It was designed to systematically enhance children’s locomotor, stability, and object control skills. The specific content was as follows:

(1) Week 1 (Introduction): Concepts, importance, and safety precautions related to fundamental motor skills were explained.

(2) Weeks 2–4 (Locomotor Skills): Focus was placed on learning and practicing skills such as the “bear crawl,” “dwarf walk,” sliding, side stepping, high-knee running, two-footed jumping, relay running, and shuttle running. These skills were reinforced through game-based activities like “Little Frog Catches Pests” and “One After Another.” The movement distance was set at 15 m. Each exercise was performed for 2–3 sets, with 30–45 s of rest between sets.

(3) Weeks 5–7 (Stability Skills): Focus was placed on learning and practicing skills such as standing toe touch, heel raises, horizontal bar hanging, plank, single-leg standing, and balance beam walking. These were consolidated through games like “Bag-on-Head Race” and “Crossing the Single Log Bridge.” Each exercise was performed for 2–3 sets, lasting 30–60 s per set, with 30–45 s of rest between sets.

(4) Weeks 8–10 (Object Control Skills): Focus was placed on learning and practicing skills such as stationary overhand throwing, basketball/soccer passing and receiving, and softball throwing and catching. These were reinforced through games like “Dodgeball Madness” and “Ground Ball Shooting.” Each exercise was performed for 2–3 sets, lasting 20–30 s per set, with 30–45 s of rest between sets.

To monitor the exercise load, six randomly selected students (half male, half female) per session wore Lifesense smart bracelets (mambo2, China) to monitor their heart rates. This ensured that the average exercise intensity during the session remained between 140 and 160 beats per minute, and the group’s activity density was no less than 75%, meeting the requirements of the new curriculum standards. The control group maintained their original regular physical activities during this period. The content, frequency, and intensity of these activities for the control group were identical to the regular activities maintained by the experimental group, but did not include any of the structured fundamental motor skill training designed for this study. The intervention was implemented by four research staff (two experienced physical education teachers and two uniformly trained graduate students in physical education) to ensure standardization and consistency.

Intervention protocol safeguards

To ensure the structured fundamental motor skills intervention was implemented accurately and consistently according to the design, this study established multi-level, standardized safeguards for the intervention protocol.

(1) Implementer Training. All four intervention implementers received standardized training over two days, totaling four instructional hours. The training content covered: (a) Detailed explanation of the research theory and protocol, including the research purpose, theoretical foundation, overall structure of the intervention protocol, and objectives for each phase; (b) Standardization of skill instruction, involving the step-by-step breakdown and unified practice of the key movement points, teaching progressions, common errors, and correction methods for the three main categories of fundamental motor skills; (c) Session flow and classroom management, clarifying the 40-minute structure of each session, safety protocols, and motivational strategies.

(2) Intervention Process Monitoring. The research team developed a “Classroom Teaching Content Checklist.” Graduate students not involved in teaching conducted random observations of at least one session per week using this checklist. They verified the consistency between the actual teaching content and the lesson plan, the allocation of activity time, and the control of exercise intensity to ensure the intervention protocol was implemented accurately and consistently.

(3) Intervention Protocol Adherence Maintenance. The research team held weekly meetings to discuss and resolve any technical or administrative issues arising during the implementation of the intervention protocol, based on feedback from the “Classroom Teaching Content Checklist.” Minor adjustments were made to the lesson plans to ensure feasibility, while the core intervention components remained unchanged. Additionally, attendance was strictly recorded for each student, with attendance rate serving as an indicator of adherence at the individual participant level. Through these measures, we aimed to maximize the standardization of intervention delivery, thereby attributing the observed effects to the intervention protocol itself.

Executive function assessment tool

The Chinese version of the Executive Function Scale, developed by Geurten et al.¹⁷ and revised by Gao et al.¹⁸, was employed to measure the executive function levels of the second-grade primary school students. This scale comprises 36 items rated on a 4-point scale, ranging from “Never” to “Always,” scored 1 to 4 respectively. Higher scores indicate poorer executive function. In this study, the Cronbach’s α coefficients for the total scale and its subscales were 0.704, 0.575, 0.695, 0.743, 0.733, 0.678, 0.729, 0.704, and 0.702, respectively.

Quality control

All physical education teachers involved in data collection received a half-day of standardized training. The training covered the explanation of the research purpose, unified interpretation of scale items, standardization of administration instructions, and essentials for maintaining organizational discipline. This ensured consistent assessment procedures across different classes and time points by all assessors. Both pre- and post-test assessments were conducted in the students’ own classrooms, with the homeroom teacher assisting in maintaining order. Assessors used unified instructions and informed students that there were no right or wrong answers, requiring them to fill out the questionnaires independently based on their actual situation. Questionnaires were distributed and collected on-site. Researchers immediately checked the completeness of the responses and requested completion of any missing items promptly.

In addition to strictly recording student attendance, the research team developed a “Classroom Teaching Content Checklist.” Graduate students not involved in teaching conducted random observations of at least one session per week. They verified the consistency between the actual teaching content and the lesson plan, the allocation of activity time, and the control of exercise intensity to ensure the intervention protocol was implemented accurately and consistently. Collected questionnaires were numbered and then independently entered into an electronic database by two individuals, followed by cross-checking to eliminate data entry errors.

Statistical analysis

Statistical analyses were performed using SPSS software, version 27.0. The significance level (α) was set at 0.05, and all statistical tests were two-tailed. The Shapiro-Wilk normality test was conducted on all continuous variables, confirming that the data followed a normal distribution. Measurement data are described as mean ± standard deviation (x̅ ± s). Independent samples t-tests were used to compare baseline differences between the two groups in terms of age, physical fitness level, and pretest scores of executive function. The chi-square test was used to compare the gender composition between the two groups. This was done to confirm the comparability of baseline characteristics between the groups after randomization.

A 2 (Group: Experimental/Control) × 2 (Time: Pretest/Posttest) two-way repeated measures analysis of variance (ANOVA) was employed to examine the main effects of group and time, and the group × time interaction effect on the scores of each executive function indicator. If a significant interaction effect was found, simple effect analysis would be further conducted. For the ANOVA results, partial η² was reported as the effect size, with the following criteria for interpretation: 0.01 (small), 0.06 (medium), and 0.14 (large)¹⁹. The threshold values of Cohen’s d were ≤ 0.20 (trivial),>0.20–0.50 (small), >0.50–0.80 (moderate), and >0.80 (large)²⁰.

Effects of FMS intervention on executive function in second grade students

The analysis results (Table 1) indicated that for the main effect of time, no statistically significant differences were found for sustained attention, working memory, cognitive flexibility, inhibitory control, emotion regulation, and the total executive function score (P > 0.05). However, statistically significant differences in the main effect of time were observed for theory of mind, planning and initiation, and self-regulation (P < 0.05). For the main effect of group, no statistically significant differences were found for working memory, theory of mind, cognitive flexibility, inhibitory control, emotion regulation, and the total executive function score (P > 0.05), whereas statistically significant differences in the main effect of group were observed for sustained attention, planning and initiation, and self-regulation (P < 0.05). Regarding the time × group interaction effect, no statistically significant differences were found for theory of mind, cognitive flexibility, inhibitory control, and emotion regulation (P > 0.05). Conversely, statistically significant differences in the time × group interaction effect were observed for the scores of sustained attention, working memory, planning and initiation, self-regulation, and the total executive function score (P < 0.05).

Table 1.

Comparison of executive function scores among second-grade students before and after intervention(±s).

	Group	SA	WM	ToM	CF	PaI	SR	IC	ER	EF
Pre	EG	14.07±2.03	11.61±2.01	7.75±2.38	8.52±1.99	13.36±1.84	11.73±3.21	15.48±2.34	18.61±3.13	101.14±8.98
	CG	13.98±2.16	11.29±2.26	7.56±2.42	8.44±2.12	13.53±1.78	11.24±2.57	15.18±3.11	18.38±2.73	99.60±9.59
Post	EG	13.16±2.68	11.02±2.77	10.32±2.51	8.50±1.85	11.80±2.99	13.64±2.74	13.82±3.04	16.91±3.58	99.16±12.88
	CG	15.29±2.91	12.60±2.28	9.71±2.87	8.87±2.23	13.38±2.24	11.44±3.03	15.40±3.09	18.44±3.10	105.13±13.58
F time		0.285	0.971	33.828**	0.375	6.590*	6.155*	2.286	2.914	0.939
η²p		0.003	0.011	0.280	0.004	0.070	0.066	0.026	0.032	0.011
F group		7.812**	3.448	1.254	0.250	6.561*	9.099**	2.639	1.958	1.956
η²p		0.082	0.038	0.014	0.003	0.070	0.095	0.029	0.022	0.022
F time×group		8.679**	6.770*	0.258	0.465	4.426*	4.042*	3.920	3.408	4.191*
η²p		0.091	0.072	0.003	0.005	0.048	0.044	0.043	0.038	0.046

Note: EG: Experimental Group, CG: Control Group; Experimental group participants: 44, Control group participants: 45; SA: Sustained Attention, WM: Working Memory, ToM: Theory of Mind, CF: Cognitive Flexibility, PaI: Planning and Initiation, SR: Self-Regulation, IC: Inhibitory Control, ER: Emotion Regulation, EF: Executive Function; * p < .05, ** p < .01.

Simple effect analysis was conducted to examine the time × group interaction on the executive function of the second-grade students. The results revealed that before the intervention, there were no statistically significant differences between the experimental group and the control group in sustained attention, working memory, theory of mind, cognitive flexibility, planning and initiation, self-regulation, inhibitory control, emotion regulation, or the total executive function score (all P > 0.05).

After the intervention, statistically significant differences between the experimental group and the control group were found for sustained attention (P < 0.01, d = −0.760, 95%CI: −1.189 to −0.327), working memory (P = 0.004, d = −0.623, 95%CI: −1.047 to −0.196), planning and initiation (P = 0.006, d = −0.601, 95%CI: −1.024 to −0.174), self-regulation (P < 0.01, d = 0.758, 95%CI: 0.326 to 1.187), inhibitory control (P = 0.017, d = −0.516, 95%CI: −0.937 to −0.092), emotion regulation (P = 0.033, d = −0.459, 95%CI: −0.878 to −0.036), and the total executive function score (P = 0.036, d = −0.451, 95%CI: −0.871 to −0.029). Furthermore, no statistically significant differences were observed between the experimental group and the control group for theory of mind and cognitive flexibility (P > 0.05).

Within the experimental group, statistically significant differences between pre-intervention and post-intervention were found for sustained attention (P < 0.01, d = 0.382, 95%CI: 0.073 to 0.686), working memory (P < 0.01, d = 0.244, 95%CI: −0.057 to 0.542), theory of mind (P < 0.01, d = −1.049, 95%CI: −1.414 to −0.676), planning and initiation (P = 0.008, d = 0.637, 95%CI:0.309 to 0.958), self-regulation (P = 0.008, d = −0.641, 95%CI:−0.962 to −0.313), inhibitory control (P = 0.011, d = 0.614, 95%CI: 0.288 to 0.933), emotion regulation (P = 0.009, d = 0.506, 95%CI: 0.189 to 0.817), and the total executive function score (P < 0.05, d = 0.179, 95%CI: −0.120 to 0.475). However, no statistically significant difference was found within the experimental group for cognitive flexibility (P > 0.05).

Within the control group, a statistically significant difference between pre-intervention and post-intervention was found for theory of mind (P < 0.01, d =−0.814, 95%CI: −1.148 to −0.472). In contrast, no statistically significant differences were observed between pre-intervention and post-intervention for sustained attention, working memory, cognitive flexibility, planning and initiation, self-regulation, inhibitory control, emotion regulation, or the total executive function score (all P > 0.05).

Discussion

This study found that after the 10 weeks structured fundamental motor skills intervention, children in the experimental group demonstrated significantly improved sustained attention compared to the control group. This result aligns with previous research findings²¹, suggesting that motor activities requiring continuous focus and target tracking positively impact attentional development. From a theoretical perspective, repeatedly practicing goal-directed object control skills requires continuous optimization of attentional resource allocation through perception-action cycles. This behavioral improvement is thought to be associated with enhanced functional connectivity within the prefrontal-striatal-cerebellar circuit, which may underpin cognitive control stability and resistance to interference²². Therefore, the goal-directed fundamental motor skills intervention in this study may have effectively enhanced children’s sustained attention by engaging neural and psychological processes related to attentional regulation.

Working memory, a core component of executive function, involves the capacity for temporary storage and online manipulation of information¹. The present study found an improvement in Working Memory among students in the experimental group following the intervention, consistent with results reported by Phung et al.²³, who employed mixed martial arts training to improve executive function in children with autism. Locomotor skills included in the intervention, such as short-distance shuttle runs, might exert their beneficial effects partly through aerobic component-induced neuroplastic changes. Chaddock et al.²⁴ confirmed that children’s aerobic fitness levels were significantly correlated with increased hippocampal volume and enhanced relational memory. As the hippocampus is a critical neural substrate for working memory, its structural plasticity may play a role in this process. However, Nakutin and Gutierrez²⁵ did not observe significant improvements in working memory following a 3 weeks jogging intervention, suggesting that the intervention effects might be moderated by factors such as dosage, intensity, and the cognitive demands of the tasks. Therefore, the beneficial effect of fundamental motor skills on Working Memory likely depends on long-term, structured program design that integrates physical activity with cognitive challenges to optimize benefits.

Planning and initiation encompasses advanced cognitive processes such as goal setting, organization of action sequences, and strategy adjustment. This study showed that the fundamental motor skills intervention significantly enhanced primary school students’ planning and initiation, aligning with evidence for the benefits of cognitively engaging physical activity on executive function²⁶. This effect is likely because learning fundamental motor skills is inherently a complex, goal-directed behavior. While performing locomotor, object control, or postural tasks, children must continuously plan, predict outcomes, and adjust their execution strategies in real time. Such cognitively demanding movement may activate the prefrontal-cerebellar neural network more effectively than simple repetitive practice²⁷. Notably, Tse et al.²⁶ found that basketball training incorporating decision-making components improved executive function, whereas single form exercise showed limited effects. The multi-dimensional skill intervention in this study, through its structured and sequential practice design, provided continuous cognitive challenges for children, thereby contributing to the development of planning and initiation.

The fundamental motor skills intervention significantly improved self-regulation in the second grade students, a result consistent with existing evidence on rhythmic physical activities promoting self-regulation²⁸. Specifically, the intervention included rhythmic activities requiring multisensory integration, which demanded children to synchronously process auditory rhythms, visual cues, and motor execution. Such activities are believed to promote neural synchronization within the sensorimotor system, enhancing functional connectivity between the prefrontal cortex and related neural networks^28,29. These networks are also activated by rhythmic movement and serve as the neural foundation for self-regulation, as they underpin behavioral inhibition, emotion regulation, and attentional control¹. Therefore, in light of the aforementioned theories, this intervention, through its systematic and multi-modal fundamental motor skills training, may have effectively engaged the neurocognitive resources associated with self-regulation. This provides a theoretical basis for explaining the observed behavioral improvements.

The improvement in inhibitory control associated with the fundamental motor skills intervention may stem from the synergy between task characteristics and neural mechanisms. Object control skills require individuals to make rapid decisions and inhibit prepotent responses in dynamic environments, consistent with findings by Tse et al.²⁶ where basketball training enhanced inhibitory control in children with autism. That study proposed that motor skill learning necessitates the continuous inhibition of inappropriate movement patterns, which may contribute to strengthening functions related to the prefrontal cortex, a brain region central to inhibitory control³⁰. This mechanism is further supported by neuroplasticity theory, which suggests that coordinated movement can enhance prefrontal-cerebellar circuit function, potentially optimizing response inhibition efficiency¹⁰. Furthermore, the structured program itself incorporated elements such as rule adherence and turn-taking, providing a continuous training context for inhibitory control. It is noteworthy that different exercise modalities may improve inhibitory control through distinct pathways. Guan et al.³¹ found that adaptive roller-skating indirectly promoted behavioral regulation through emotion regulation, whereas Sotoodeh et al.³² demonstrated that yoga enhanced inhibition capacity by improving self-awareness. The present multi-dimensional fundamental motor skills intervention integrated the aforementioned elements, which may explain its effectiveness in improving inhibitory control.

The present study found that the 10 weeks fundamental motor skills intervention did not significantly enhance the students’ theory of mind, with no statistically significant difference observed between the groups. This result may reflect the developmental characteristics of theory of mind during the school-age period. Extensive research indicates that core theory of mind abilities, such as understanding false beliefs, predominantly develop between ages 3–6³³. In school-aged children, the development of theory of mind focuses more on higher-order reasoning in complex situations. Therefore, it may be less responsive to a general motor intervention centered on fundamental motor skills. A longitudinal study by Austin et al.³⁴ noted that while a relationship exists between executive function and theory of mind in children aged 6–11, the strength of this association is moderated by specific executive function subcomponents, and theory of mind tends to stabilize over time. This may lead to diminishing marginal effects of external interventions. Moreover, Di Tella et al.³⁵ found no direct link between theory of mind and executive function in adults, suggesting a greater reliance on fluid intelligence and verbal reasoning. This indicates that with increasing age, theory of mind may gradually decouple from basic executive functions and instead depend on other cognitive systems. Overall, the improvement in theory of mind observed in the control group may primarily reflect the effects of natural maturation or repeated testing, with the intervention program failing to yield additional promotive effects beyond this baseline. Given the relatively stable development of theory of mind during the school-age period and its close association with social-cognitive experiences, future research could attempt to design more targeted intervention programs. For instance, integrating fundamental motor skills training with contextualized tasks involving social interaction and perspective-taking, and employing more refined social cognition tasks for assessment, would allow for a deeper investigation into the potential impact of motor interventions on higher-order social cognitive development.

This study found that the fundamental motor skills intervention did not produce significant improvements in cognitive flexibility among the primary school students. This result is consistent with the intervention study by Westendorp et al.³⁶, where a ball skill intervention also failed to significantly enhance children’s cognitive flexibility. Cognitive flexibility, a core component of executive function, involves higher-order cognitive processes such as task switching and attentional allocation³⁷. Some studies suggest that cognitive flexibility develops rapidly during the preschool years, with growth slowing after age 5, potentially influenced by genetic factors and neural maturation, resulting in relative stability³⁸. This stability might render it less sensitive to short-term interventions. Additionally, although the present intervention incorporated cognitively challenging games, the intervention intensity, frequency, or task complexity might still have been insufficient to effectively elicit the neuroplastic changes required for this specific cognitive dimension³⁹. Consequently, the current intervention design may not have provided sufficiently intense or specific stimulation for cognitive flexibility. It is worth further consideration that the assessment tool used in this study was a child self-report scale, which captures children’s perceptions of their own behavioral regulation in daily life contexts. For a core cognitive ability like cognitive flexibility, which highly depends on immediate performance in specific experimental contexts, a self-report scale may lack the sensitivity to detect subtle changes. Given this limitation, future research needs to optimize intervention protocols; for example, by designing games or activities that explicitly incorporate task switching and cognitive set shifting, thereby imposing more targeted demands on cognitive flexibility. Furthermore, such studies should employ experimental paradigms with greater ecological validity and sensitivity to more precisely examine the potential of these interventions to promote the development of cognitive flexibility.

The results of this study demonstrate an overall improvement in executive function among students in the experimental group following the intervention, which aligns with numerous studies confirming the promotive effect of physical activity on executive function in children and adolescents⁴⁰. Diversified and structured fundamental motor skills interventions, by requiring continuous planning, monitoring, and adjustment of actions in changing environments, place persistent demands on cognitive control, making them more beneficial for executive function development than single-form exercise¹⁰. From a theoretical neuro-mechanistic perspective, the benefits of such complex motor activities are often attributed to enhanced neuroplasticity, potentially through pathways such as the promotion of brain-derived neurotrophic factor release⁴¹. The locomotor, stability, and object control skills practiced in this intervention, such as sliding and ball throwing/catching, not only improved physical coordination but were also linked to improvements in key executive subcomponents including inhibitory control, working memory, and cognitive flexibility. Thus, the intervention contributed to executive function development across multiple dimensions⁴².

Conclusion

This randomized controlled trial systematically investigated the effects of a 10-week structured fundamental motor skills intervention on the executive function of second-grade primary school students. The results indicate that the intervention was associated with improvements in multiple core dimensions, including sustained attention, working memory, planning and initiation, self-regulation, inhibitory control, and overall executive function. These observed improvements provide support for the theoretical framework of embodied cognition, namely that goal-directed, structured physical activity operates by reinforcing perception-action integration. Although the evidence from this study is derived from behavioral measures, these positive changes align with theoretical expectations that such activities may optimize the function of neural circuits, including the prefrontal-cerebellar pathway. Consequently, they offer empirical support at the behavioral level for the development of executive function. However, the promotive effects of the intervention on theory of mind and cognitive flexibility were limited. This may be attributed to the relatively stable developmental trajectories of these components during the school-age period, or to their greater dependence on specific social-cognitive experiences and complex tasks imposing higher cognitive loads. Consequently, implementing a systematic fundamental motor skills curriculum within the school education system represents a feasible and effective approach to promote executive function development in lower primary school students. Future research should further optimize intervention protocols, for example by incorporating tasks with greater cognitive challenges and social interaction, to more specifically foster the synergistic development of various executive function subcomponents.

Research limitations and prospects

This study has several limitations. First, the sample size was relatively small (N = 89), and all participants were recruited from two primary schools in Guangzhou City. The limited sample size may have constrained statistical power. Concurrently, the restricted geographical representation may affect the generalizability of the findings to broader and more culturally diverse primary school populations. Furthermore, although the overall attrition rate (11%) in this study was within an acceptable range and the proportion of attrition was similar between the experimental and control groups, a systematic comparative analysis of key characteristics, such as baseline executive function levels, between completers and dropouts was not conducted. Therefore, the possibility of bias introduced by non-random attrition cannot be completely ruled out, which may affect the internal validity of the study results to some extent.

Second, methodologically, blinding of the participating students was not feasible due to the nature of the intervention. Additionally, although efforts were made to standardize the assessment process, assessors were not blinded to group assignment, potentially introducing expectation bias during the behavioral assessment of executive function.

Third, the assessment of executive function relied entirely on child self-reported behavioral scales. Although these scales demonstrate good reliability and validity and are convenient for group administration, they carry the risk of response biases such as social desirability. More importantly, self-report scales assess individuals’ generalized perceptions of their behavioral performance in daily contexts. They cannot dissociate specific executive subcomponents as precisely as experimental tasks. Consequently, the observed improvements in each dimension score in this study should be interpreted as positive intervention-related changes at the level of daily life behaviors, rather than precise measures of discrete neurocognitive processes. Moreover, the lack of supporting neurophysiological evidence means that the discussion of the underlying neural mechanisms remains largely theoretical.

Fourth, this study measured only the immediate post-intervention effects, lacking long-term follow-up assessments. Therefore, it remains undetermined whether the observed promotive effects are transient or can have a lasting positive impact on children’s executive function development. Furthermore, although the average exercise intensity in each session was controlled through random heart rate monitoring, continuous, individualized, and objective physical activity monitoring was not conducted for all participants. Thus, the precise quantification of the actual exercise dose received by each child during the intervention was not possible, limiting in-depth analysis of the relationship between exercise dose and cognitive benefits at the individual level.

Future research could be deepened and expanded in the following three directions. First, by expanding the sample scope and assessment methods. Multi-center randomized controlled trials involving more diverse populations across broader geographical areas are needed to test the generalizability of the intervention protocol. Where feasible, an assessor-blinded design should be employed to control for bias. Crucially, a combined subjective and objective assessment system should be adopted to overcome the limitations of single self-report methods. Specifically, while using behavioral scales to assess changes in daily behaviors, laboratory-based or quasi-laboratory computerized cognitive tasks, such as the Flanker task, N-back task, and task-switching paradigms, should be systematically introduced. This would provide more direct and precise objective measurements of core executive function components like inhibitory control, working memory, and cognitive flexibility, thereby offering a more comprehensive and profound understanding of the intervention effects.

Second, by delving deeper into neurophysiological mechanisms. Utilizing technologies such as functional near-infrared spectroscopy and electroencephalography to directly observe structural and functional changes in key brain regions like the prefrontal cortex before and after the intervention could provide empirical support for the “embodied cognition” theory and reveal the underlying mechanisms at the neural level.

Third, by precisely quantifying the intervention dose and tracking long-term effects. Employing objective devices like accelerometers to monitor key dose metrics during the intervention, such as physical activity intensity and time spent in moderate-to-vigorous physical activity, would help establish precise relationships between exercise dose and cognitive gains. Simultaneously, setting up follow-up points months or even longer after the intervention ends would allow for the evaluation of the long-term benefits of structured fundamental motor skills interventions on children’s executive function development and the pattern of effect decay.

Author contributions

C.C. and W.Z. designed the study and written the original manuscript. X.G. revised the manuscript. X.Y. collected and analyzed the data. All authors contributed to the article and approved the submitted version.

Funding

This study was supported by the 2024 Annual Ministry of Education Humanities and Social Sciences Research General Project (24YJA890006).

Data availability

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

Declarations

Competing interests

The authors declare no competing interests.