Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

Xie, Yongtao; Gao, Xu; Song, Yiling; Zhu, Xia; Chen, Mengge; Yang, Li; Ren, Yuanchun

doi:10.3389/fpsyt.2021.706625

Cited by 32 publications

(31 citation statements)

References 79 publications

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“…In conjunction with findings of previous research [ 24 , 25 , 48 ], the results of our study suggest that meeting all three of the 24-HMB guidelines is associated with reduced cognitive and social difficulties in children and adolescents with ADHD. Accordingly, our findings support the promotion of the 24-HMB guidelines for children and adolescents with ADHD and their caregivers.…”

Section: Discussionsupporting

confidence: 88%

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Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

Taylor

Kong

Zhang

et al. 2023

Child Adolesc Psychiatry Ment Health

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Background Evidence-based 24-h movement behavior (24-HMB) guidelines have been developed to integrate recommendations for the time spent on physical activity, sedentary behavior, and sleep. For children and adolescents, these 24-HMB guidelines recommend a maximum of two hours of recreational screen time (as part of sedentary behavior), a minimum of 60 min per day of moderate to vigorous physical activity (MVPA), and an age-appropriate sleep duration (9–11 h for 5 to 13-year-olds; 8–10 h for 14 to 17-year-olds). Although adherence to the guidelines has been associated with positive health outcomes, the effects of adhering to the 24-HMB recommendations have not been fully examined in children and adolescents with attention eficit/hyperactive disorder (ADHD). Therefore, this study examined potential associations between meeting the 24-HMB guidelines and indicators of cognitive and social difficulties in children and adolescents with ADHD. Methods Cross-sectional data on 3470 children and adolescents with ADHD aged between 6 and 17 years was extracted from the National Survey for Children’s Health (NSCH 2020). Adherence to 24-HMB guidelines comprised screen time, physical activity, and sleep. ADHD-related outcomes included four indicators; one relating to cognitive difficulties (i.e., serious difficulties in concentrating, remembering, or making decisions) and three indicators of social difficulties (i.e., difficulties in making or keeping friends, bullying others, being bullied). Logistic regression was performed to determine the associations between adherence to 24-HMB guidelines and the cognitive and social outcomes described above, while adjusting for confounders. Results In total, 44.8% of participants met at least one movement behavior guideline, while only 5.7% met all three. Adjusted logistic regressions further showed that meeting all three guidelines was associated with lower odds of cognitive difficulties in relation to none of the guidelines, but the strongest model included only screen time and physical activity as predictors (OR = 0.26, 95% CI 0.12–0.53, p < .001). For social relationships, meeting all three guidelines was associated with lower odds of difficulty keeping friends (OR = 0.46, 95% CI 0.21–0.97, p = .04) in relation to none of the guidelines. Meeting the guideline for screen time was associated with lower odds of being bullied (OR = 0.61, 95% CI 0.39–0.97, p = .04) in relation to none of the guidelines. While screen time only, sleep only and the combination of both were associated with lower odds of bullying others, sleep alone was the strongest predictor (OR = 0.44, 95% CI 0.26–0.76, p = .003) in relation to none of the guidelines. Conclusion Meeting 24-HMB guidelines was associated with reduced likelihood of cognitive and social difficulties in children and adolescents with ADHD. These findings highlight the importance of adhering to healthy lifestyle behaviors as outlined in the 24-HMB recommendations with regard to cognitive and social difficulties in children and adolescents with ADHD. These results need to be confirmed by longitudinal and interventional studies with a large sample size.

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Section: Discussionsupporting

confidence: 88%

“…There is mounting evidence that physical activity is beneficial for behavior and cognitive performance of children and adolescents with ADHD [ 24 , 25 , 48 ]. In addition to physical activity, other lifestyle factors such as sleep and sedentary behavior may also be related to the symptomatology associated with ADHD [ 26 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

Taylor

Kong

Zhang

et al. 2023

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

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“…One may postulate that decrements in CBF and brain activation at high-intensity exercise may promote increased central fatigue, and decrease exercise performance, in ADHD athletes compared to non-ADHD athletes. Overall, numerous studies (Xie et al, 2021) have shown that exercise is a beneficial supplement to medication or could be considered an alternative treatment plan to manage ADHD symptoms and improve cognitive performance and brain activation during and after exercise (Volkow and Swanson, 2013;Chabreck, 2015;Choi et al, 2015;Gapin et al, 2015;Connell et al, 2016;Reardon and Factor, 2016;Rassovsky and Alfassi, 2018;Huertas et al, 2019;Mehren et al, 2019).…”

Section: Neurobehavioral Cognitive and Neurophysiological Effects Of ...mentioning

confidence: 99%

The therapeutic potential of exercise and caffeine on attention-deficit/hyperactivity disorder in athletes

Sogard

Mickleborough

2022

Front. Neurosci.

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Attention-deficit/hyperactivity disorder (ADHD) is characterized by evident and persistent inattention, hyperactivity, impulsivity, and social difficulties and is the most common childhood neuropsychiatric disorder, and which may persist into adulthood. Seventy to 80% of children and adults with ADHD are treated with stimulant medication, with positive response rates occurring for both populations. Medicated ADHD individuals generally show sustained and improved attention, inhibition control, cognitive flexibility, on-task behavior, and cognitive performance. The ethics of ADHD medication use in athletics has been a debated topic in sport performance for a long time. Stimulants are banned from competition in accordance with World Anti-Doping Association and National Collegiate Athletic Association regulations, due to their ability to not only enhance cognitive performance but also exercise performance. Limited research has been conducted looking at the differences in exercise performance variables in unmedicated ADHD verses medicated ADHD. Not all ADHD athletes choose stimulant medication in their treatment plan due to personal, financial, or other reasons. Non-stimulant treatment options include non-stimulant medication and behavioral therapy. However, the use of caffeinated compounds and exercise has both independently been shown to be effective in the management of ADHD symptoms in human studies and animal models. This mini review will discuss the effect of exercise and caffeine on neurobehavioral, cognitive, and neurophysiological factors, and exercise performance in ADHD athletes, and whether exercise and caffeine should be considered in the treatment plan for an individual with ADHD.

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“…Currently, medications and behavioral and psychological therapy are the mainstays of ADHD treatment (13,14). Researchers have found that more than one-third of children do not respond, respond only partially, or encounter adverse drug reactions to these medications (15), and it may be challenging to adhere to these drug regimens owing to their time-consuming nature and high financial cost (16). In recent years, physical exercise interventions for children and adolescents with ADHD have gained increased attention from researchers.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of various physical exercise interventions on executive functions and related symptoms in children and adolescents with attention deficit hyperactivity disorder: A systematic review and network meta-analysis

Zhu

et al. 2023

Front. Public Health

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BackgroundPhysical exercise has been recommended as an important nonpharmacological therapeutic strategy for managing attention deficit hyperactivity disorder (ADHD). We conducted a network meta-analysis (NMA) to assess the comparative impact of different physical exercise modalities on enhancing executive functions (EFs) and alleviating symptoms in children and adolescents with ADHD.MethodsWe searched Web of Science, PubMed, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycINFO, CNKI, and clinical trials databases from inception to October 20, 2022. Randomized controlled trials (RCTs) and quasi-experimental studies investigating physical exercise for ADHD-related symptoms of hyperactivity/impulsivity and inattention, and executive functions were included. The frequentist random-effect NMA method was applied to pool the results.ResultsA total of 59 studies (including 39 RCTs, 5 quasi-RCTs, and 15 self-controlled trials) published between 1983 and 2022 were incorporated into the systematic review, of which 44 studies with 1757 participants were eligible for meta-analysis. All types of physical exercise were effective in improving EFs (SMD = 1.15, 95% CI: 0.83 to 1.46), and open-skill activities which require participants to react in a dynamically changing and externally paced environment induced the most incredible benefits for executive functions (SUCRA = 98.0%, SMD = 1.96, and 95% CI: 1.15 to 2.77). Subgroup analyses for EFs revealed varied findings that open-skill activities were the most promising physical exercise type for improving inhibitory control (SUCRA = 99.1%, SMD = 1.94, and 95% CI: 1.24 to 2.64), and closed-skill activities dominated by aerobic exercises had a slightly higher probability of being the most promising physical exercise intervention for working memory (SUCRA = 75.9%, SMD = 1.21, and 95% CI: −0.22 to 2.65), and multicomponent physical exercise tended to be the most effective in cognitive flexibility (SUCRA = 70.3%, SMD = 1.44, and 95% CI: −0.19 to 3.07). Regarding ADHD-related symptoms, closed-skill activities dominated by aerobic exercises might be more advantageous for hyperactivity/impulsivity (SUCRA = 72.5%, SMD = -1.60, and 95% CI: −3.02 to −0.19) and inattention (SUCRA = 96.3%, SMD = -1.51, and 95% CI: −2.33 to −0.69) improvement.ConclusionPhysical exercise can significantly help to alleviate the symptoms of ADHD and improve executive functions in children and adolescents with ADHD. Most of all, to promote adherence to treatment, they should be encouraged to perform the physical exercises that they enjoy most.

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Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

Cited by 32 publications

References 79 publications

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder

The therapeutic potential of exercise and caffeine on attention-deficit/hyperactivity disorder in athletes

Comparative effectiveness of various physical exercise interventions on executive functions and related symptoms in children and adolescents with attention deficit hyperactivity disorder: A systematic review and network meta-analysis

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