Mixed comparison of interventions for different exercise types on students with Internet addiction: a network meta-analysis

BACKGROUND: Internet addiction (IA) has a significant negative impact on students. The condition of students with IA can be improved by exercise, which has been identified as an effective intervention strategy. However, the relative effectiveness of different exercise types and the most effective ones remains unknown. This study presents a network meta-analysis to compare six exercise types (team sport, double sport, single sport, team + double sport, team + single sport, and team + double + single sport) based on their effectiveness in reducing Internet addiction and maintaining mental health. METHODS: Systematic searches were conducted in PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang, CQVIP, Web of Science, CBM, EBSCO, APA PsycNet, and Scopus, and all relevant studies from the beginning to 15 July 2022 were included on. According to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria, the listed studies' bias risk was assessed, while the network meta-analysis was performed using STATA 16.0. RESULTS: A total of 39 randomized controlled trials that met all inclusion criteria including 2,408 students with IA were examined. The meta-analysis results showed that compared with the control group, exercising significantly improved loneliness, anxiety, depression, and interpersonal sensitivity (p < 0.05). Specifically, the network meta-analysis discovered that the single sport, team sport, double sport, team + double sport, and team + double + single sport had significant effects on improving Internet addiction as compared to the respective control group (p < 0.05); the single sport, team sport, and double sport tend to be effective compared with controls in improving mental health (p < 0.05). Compared with the other five types of sports, the double sport was ranked first and showed the greatest potential to be the best choice (cluster ranking value = 3699.73) in improving Internet addiction (SUCRA = 85.5) and mental health (SUCRA = 93.1). CONCLUSION: Exercise could be suggested as the best alternative when treating IA in students, based on the extensive positive effects of exercise on IA, anxiety, depression, interpersonal sensitivity, loneliness, and mental health in IA students. Double sport may be the best type of exercise for Internet-addicted students. However, to further examine the benefits of exercise for IA students, more research is required. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=377035, identifier: CRD42022377035.