Health Promotion in Educational Settings: Influence of Physical Activity and Physiotherapy on Functional Capacity, Concentration, and Academic Performance

Abstract

Background: Promoting health in educational settings has become a priority for public health systems worldwide. Physical activity (PA) and physiotherapy interventions offer promising avenues for enhancing students' functional capacity, concentration, and academic performance. However, the mechanisms through which these interventions exert their effects remain insufficiently integrated in the literature.
Objective: This narrative review synthesizes current evidence on the influence of PA and physiotherapy on functional capacity, concentration, and academic performance in school-age populations, examining the neurobiological and cognitive mechanisms underlying these relationships.
Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and specialized databases (Elicit, Consensus, Scite) from 2010 to 2026. Studies examining PA interventions, school-based physiotherapy programs, executive functions, neuroplasticity markers (BDNF), and academic outcomes in children and adolescents (ages 5–18) were included.
Results: Evidence from meta-analyses indicates that PA interventions produce small-to-moderate positive effects on academic performance (d = 0.21–0.46), with stronger effects on mathematics than reading. Executive functions—particularly inhibitory control and working memory—serve as key mediators (d = 0.31–0.52). Exercise-induced increases in brain-derived neurotrophic factor (BDNF) facilitate neuroplasticity, hippocampal neurogenesis, and prefrontal cortex activation. Physiotherapy interventions, including postural education and ergonomic programs, improve functional capacity and reduce musculoskeletal complaints (30–50% reduction), indirectly supporting sustained attention and classroom engagement.
Conclusions: Integrating PA and physiotherapy into school health promotion programs offers a multifaceted approach to improving both physical and cognitive outcomes. Future research should employ longitudinal designs and examine dose–response relationships to optimize implementation strategies.