Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis

Fenghua SUN, Yuan FANG, Ka Man CHAN, Tsz Chun Eric POON, Ming Yan CHUNG, Pui Lai OR, Yajun CHEN, Simon B. COOPER

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Abstract

Background: The efficacy of structured physical exercise (SPE) has been examined in empirical studies to treat attention deficit hyperactivity disorder (ADHD). This review aimed (i) to systematically review and quantify the effects of SPE on ADHD symptomology and executive function (primary outcomes) and on physical health, physical fitness and mental health issues (secondary outcomes) in children/adolescents with ADHD; (ii) to evaluate the study quality and explore moderation of the effects of SPE; and (iii) to summarize the design of SPE interventions. 

Methods: An extensive literature search in the databases of PubMed, Web of Science and EBSCOhost was conducted to identify eligible intervention studies for meta-analysis. A descriptive account of the features of the studies is provided, including assessment of risk/quality (ROB-2/ROBINS-I). Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated with random effects models to compare post-intervention effects. 

Results: A total of 18 studies were included in the review. The majority of the studies examined the effects of SPE lasting for 3–12 weeks. Assessment of bias/quality indicated half of the included studies as high quality. The meta-analysis (pooled n = 627) revealed that SPE had a positive effect on primary and secondary outcomes, that is, inattention (SMD = −1.79), executive function (SMD = 2.19), physical fitness (SMD = 1.39) and mental health issues (SMD = −0.89). Subgroup analysis showed that long-term practice of SPE, featured/tailored SPE, non-Chinese participants, taking methylphenidate and study with low quality had larger effects. 

Conclusions: There is emerging evidence that SPE is a promising option to enhance symptom management and physical/mental health in children/adolescents with ADHD. Copyright © 2023 John Wiley & Sons Ltd.

Original languageEnglish
Article numbere13150
JournalChild: Care, Health and Development
Volume50
Issue number1
Early online dateJul 2023
DOIs
Publication statusPublished - Jan 2024

Citation

Sun, F., Fang, Y., Chan, C. K. M., Poon, E. T. C., Chung, L. M. Y., Or, P. P. L., Chen, Y., & Cooper, S. B. (2024). Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis. Child: Care, Health and Development, 50(1), Article e13150. https://doi.org/10.1111/cch.13150

Keywords

  • ADHD symptoms
  • Executive function
  • Mental health issues
  • Physical fitness
  • Physical health
  • Structured physical exercise

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