Chronic Exercise for Core Symptoms and Executive Functions in ADHD: A Meta-analysis 

Huan Huang, BD; Zhijuan Jin, PhD; Changshuang He, BD; Shaoyu Guo, BD; Yiwen Zhang, MD; Minghui Quan, MS, PhD

Address correspondence to Minghui Quan, MS, PhD, School of Exercise and Health, Shanghai University of Sport, 399 Chang Hai Rd, Shanghai 200438, China. E-mail: quanminghui@163.com

FUNDING: Funded by the National Social Science Fund of China (22BTY099). The funder did not participate in the design or conduct of this study.

CONFLICT OF INTEREST DISCLAIMER: The authors have indicated they have no conflicts of interest relevant to this article to disclose.

Pediatrics e2022057745.

https://doi.org/10.1542/peds.2022-057745

BACKGROUND AND OBJECTIVES:

The effects of chronic exercise interventions (CEIs) on core symptoms and executive functions (EFs) of attention-deficit/hyperactivity disorder (ADHD) and how different characteristics of CEIs could modify the effect remain unclear. We synthesized the current evidence on the effects of CEIs on core symptoms and EFs in children and adolescents with ADHD.

METHODS:

Data sources include PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure from database inception to July 31, 2022. Study selection includes randomized controlled trials that reported on the effects of CEIs on core symptoms and/or EFs in ADHD aged 6 to 18 years.

RESULTS:

Twenty-two randomized controlled trials were included. CEIs had a small beneficial effect on overall core symptoms (standardized mean difference [SMD] = −0.39, 95% confidence interval [CI]: −0.64 to −0.14), as well as inattention (SMD = −0.32, 95% CI: −0.63 to −0.004) among children and adolescents with ADHD. Closed-skill exercise showed a large improvement in core symptoms (SMD = −0.83, 95% CI: −1.30 to −0.35), whereas open-skill exercise did not. Additionally, CEIs had a moderately beneficial effect on overall EFs (SMD = −0.68, 95% CI: −0.91 to −0.45) and a moderate-to-large effect on the specific domains of EFs. The pooled effects on overall core symptoms and EFs were not significantly modified by study population (children or adolescents), exercise session duration (≤50 or >50 minutes per session, median), or total exercise sessions (<24 or ≥24 sessions, median).

CONCLUSIONS:

CEIs have small-to-moderate beneficial effects on overall core symptoms and EFs in children and adolescents with ADHD。