Acute cognitive effects of interruptions to prolonged sitting with brief standing or physical activity breaks: a systematic review and three-level meta-analysis
Abstract
Background: Prolonged sitting is strongly associated with impaired cognitive function. Although traditional exercise interventions have been shown to improve cognitive outcomes, their implementation is often limited by practical constraints. In contrast, introducing interruptions to prolonged sitting with brief bouts of standing or physical activity has emerged as a more feasible alternative. However, previous research has been dominated by qualitative reviews. Moreover, some quantitative studies have not adequately addressed effect-size dependency arising from multiple outcomes and time points within the same study, and quantitative evidence regarding specific cognitive domains and interruption-protocol parameters remains limited.
Methods: Following the PRISMA guidelines, this study systematically searched PubMed, Web of Science, the Cochrane Library, Embase, and Scopus for randomized crossover trials published up to January 2026 that examined the effects of brief standing or physical activity breaks during prolonged sitting on cognitive function. A three-level random-effects meta-analysis was conducted to pool effect sizes, with cluster-robust variance estimation used to account for effect-size dependency resulting from multiple outcomes and time points within the same study. In addition, subgroup and meta-regression analyses were performed to investigate potential moderating factors. Risk of bias was assessed using the Risk of Bias 2 tool, and the certainty of the…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 433 participants or records.
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