Table 2 Summary table for the characteristics and methodological quality of experimental studies included in the review

Chen, et al., CHN, Randomized controlled trials [110]

The control group was given routine health education support the experiment group was given both routine health education support and the integration model for intervention (mindfulness meditation training, aerobics exercise course). 30 min (mindfulness meditation training); 45 min, medium intensity (aerobics exercise course); 5 times a week (mindfulness meditation training); 3 times a week (aerobics exercise course); 8 weeks (mindfulness meditation training); 10 weeks (aerobics exercise course)

Positive Affect, General well-being, Life satisfaction, Anxiety, Negative Affect; Self-rating Anxiety Scale, Positive and Negative Affect Scale, Psychological Well-Being Scale

After intervention, a significant difference between groups was obtained in anxiety scores, negative affect scores, positive affect scores (all p < 0.01), and overall well-being index (p = 0.04)

Medium

De Candia, et al., Italy, Randomized controlled trials [111]

Do nothing. Receive 12 weeks of aerobic exercises characterized by fun elements associated with theoretical lessons 90 min (physical activities, such as joint mobility exercises, low-to-moderate intensity aerobic exercise, team-building activities, exercise stations, cardio workout) 2 times a week; 12 weeks

Exercise Dependence, Stress; Exercise Dependence Scale, PSS-10

The post-hoc analysis revealed a significant improvement in the score for exercise dependence (p < 0.001, d = 2.05, large effect size) and stress (p < 0.001, d = 2.17, large effect size) in the intervention group

Medium

Hamed, et al., Saudi Arabia, Randomized controlled trials [112]

Group B (GB) students received an online CBT (1.5 h each session) for 8 weeks (once per week). Group A (GA) were encouraged to increase their aerobic training of moderate to vigorous exercises such as jumping, running, swimming, or dancing, 5 days/week for one h daily.80 min, 70–90% of their maximum heart rate; 5 times a week; 8 weeks (tread mill running, high pace stationary cycling or weight bearing aerobic exercises)

Anxiety, Depression, Stress; DASS-21

A significant improvement of DASS scores after treatment in both groups (p ≤ 0.001). IPAQ scores showed a significant improvement in GA and GB with non-significance in vigorous activities; category. GA showed a significant reduction of anxiety more than GB with a non-significant difference in stress and depression (p ≥ 0.05)

High

Zheng, et al., CHN, Randomized controlled trials [113]

(1) An outline was provided on the recommended 20-20-20 rule during study and viewing of on-screen content; (2) During recess (15 min for each recess; 4 times per day), participants in the control group received SMS text message prompts (≤ 50 characters) to participate in broadcast exercise programs at home, eye relaxation, or to stretch for 10 min. Students had access to at-home workout videos developed by exercise physiologists. Students in the intervention group received the identical health information session, online curriculum, workout videos, and breaks as described above. Additionally, at the beginning of the study, students in the intervention group were asked to log on and download a peer-to-peer live-streaming app (the Recess and Exercise Advocacy Program [REAP]). REAP is a live-streaming platform that allows users to capture short videos and photographs with their smartphones related to their physical exercise or eye relaxation activities (eg., looking outdoors through the window).15 mins for each recess, 4 times per day; 2 weeks

Anxiety, Insomnia; The 45-item Chinese version of the Spence Children’s Anxiety Scale, The 4-item Patient-Reported Outcomes Measurement Information System

Anxiety score fell by − 0.23 in the intervention group and rose (worsened) by 0.12 in the controls by the end of the study. The change in anxiety score was significantly greater in the intervention group compared to the controls (− 0.36, p = 0.02)

High