Objective To analyze the influencing factors of exercise deficiency disorder (EDD) in children and adolescents, with the aim of providing a reference for promoting physical activity and improving physical fitness in Chinese children and adolescents.

Methods Seven Chinese and English databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database, were searched to identify relevant Chinese and English studies on EDD in children and adolescents published from database inception to August 2023. A systematic literature review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to analyze the factors influencing EDD.

Results A total of 53 articles with 245777 participants were included. Gender, race/ethnicity, self-efficacy, perceptual ability, motivation to be active, cognitive ability, motor skills, parental support, parental involvement, socio-cultural factors, family support, parental education, parental marital status, peer support, role model, school environment, availability of sports facilities, built environment around the home, urban built environment, geographic region, urban-rural differences, weather conditions are positively correlated with EDD in children and adolescents. Age, weight, sedentary behavior, socioeconomic level, and household income are negatively correlated with EDD in children and adolescents. There is no significant correlation between parenting style, school performance, and EDD in children and adolescents.

Conclusions EDD in children and adolescents is influenced by factors in five dimensions: demographic and biological factors, psychological cognition and emotions, behavioral characteristics and skills, social and cultural factors, and the physical environment. Relevant authorities should use these factors to guide targeted prevention and intervention efforts to improve the physical activity and health levels of Chinese children and adolescents.