The effect of exergaming on executive functions in children with ADHD: A randomized clinical trial

Abstract

Background Children with ADHD frequently suffer from deficits in cognitive (ie, executive functions) and motor abilities. Although medication usually has a positive effect, a lack of commitment and possible side effects result in a need for adjunct or alternative treatments. Thus, the aim of the current study was to investigate the effects of cognitively and physically demanding exergaming on executive functions, ADHD symptoms, and motor abilities. Methods In a parallel group randomized trial, 51 children between 8‐12 years (M = 10.63; SD = 1.32) diagnosed with ADHD were assigned either to an 8‐week exergame intervention group (three training sessions per week for 30 minutes) or a waiting‐list control group. The core executive functions (inhibition, switching, updating), parent ratings of symptoms, and motor abilities were assessed/gathered before and after the intervention. Results Analyses of covariance (using pre‐test values as covariates) revealed that children in the exergame intervention group improved in specific executive functions (reaction times in inhibition and switching), general psychopathology as well as motor abilities compared to control group. Conclusions Findings indicate that exergaming might benefit two domains in which frequent deficits can be observed in children with ADHD, executive functions and motor abilities. Given that these beneficial effects in turn might positively affect psychopathology, exergaming could serve as an individualized home‐based intervention in the future. However, in order to maximize benefits and make exergaming a valuable adjunct to treatment for children with ADHD, customized exergames are needed.

Effects of Cognitive Training and Exergaming in Pediatric Cancer Survivors—A Randomized Clinical Trial

“…Furthermore, Riggs et al ( 26 ) did not use an exergame but an exercise training program, which was provided either in a group setting or a combined setting (group and home) and therefore included social interactions. Although a previous exergaming intervention using a similar protocol as the present study promoted physical and cognitive benefits in children with attention-deficit/hyperactivity disorder ( 31 ), one could speculate that the conducted exergaming intervention was not stimulating enough with regard to quantitative (duration) and qualitative characteristics (cognitive demand, social interaction) to provide benefits in pediatric cancer survivors.…”

“…With larger sample sizes, one could investigate how differences in participant characteristics (e.g., time passed since diagnosis) affect training gains from a differential point of view. Fourth, although the exergaming intervention was previously shown to be physically challenging (moderate-to-vigorous intensities) ( 22 , 30 , 31 ), in the current study, heart rate was not assessed throughout the interventional period. It therefore might be possible that some children did not reach moderate-to-vigorous intensities at all times during exergaming.…”

“…The performance during each session is recorded by the computer and participants can compete to beat their own high scores (records of old performances) in order to ensure a continuous adaptation to their level of performance. In previous studies, Shape UP has been shown to be physically (moderate-to-vigorous intensities) and cognitively challenging ( 22 ), and positive effects on EFs and motor abilities have been reported in children with attention-deficit/hyperactivity disorder ( 30 , 31 ).…”

Strength Abilities: Assessment of Training Effects of Strength Loads in Boys Aged 8 Years

“…The need for balanced efforts in both physical education and sports training is indicated in papers by Washabaugh, Augenstein, and Krishnan (2020), Benzing, and Schmidt (2019), Haghighi, Mohammadtaghipoor, Hamedinia, and Harati (2019). Thus, Bogdanis, Donti, Papia, Donti, Apostolidis, and Sands (2019), Wertheimer, Antekolovic, and Matkovic (2018) note a positive effect of plyometric loads on the level of motor fitness of both children and adults.…”

Updates in technology-based interventions for attention deficit hyperactivity disorder

“…Cognitively engaging physical exercise can increase cognitive performance in ADHD possibly through training the brain regions involved in higher order cognition [ 84 , 85 ]. Benzing and Schmidt [ 86 ] developed a home-based ‘exergaming’ intervention and tested the 8-week programme in 51 children aged 8–12 in their randomized waitlist-control study. Utilizing X-box Kinect to control movement, these adaptive games train strength, coordination and endurance, as well as cognitive functions of inhibition, attention and set shifting.…”