A team of Spanish researchers has published a systematic review of 16 studies with a total of 728 participants exploring the effects of physical exercise on children and adolescents with ADHD. Fourteen studies were judged to be of high quality, and two of medium quality.

Seven studies looked at the acute effects of exercise on eight to twelve-year-old youths with ADHD. Acute means that the effects were measured immediately after periods of exercise lasting up to 30 minutes. Five studies used treadmills and two used stationary bicycles, for periods of five to 30 minutes. Three studies “showed a significant increase in the speed reaction and precision of response after an intervention of 20–30 min, but at moderate intensity (50–75%).” Another study, however, found no improvement in mathematical problem solving after 25 minutes using a stationary bicycle at low (40–50%) or moderate intensity (65–75%). The three others found improvements in executive functioning, planning, and organization in children after 20- to 30-minute exercise sessions.

Nine studies examined longer-term effects, following regular exercise over a period of many weeks. One reported that twenty consecutive weekly yoga sessions improved attention. Another found that moderate to vigorous physical activity (MVPA) led to improved behavior beginning in the third week, and improved motor, emotional and attentional control, by the end of five weeks. A third study reported that eight weeks of starting the school day with 30 minutes of physical activity led to improvement in Connors ADHD scores, oppositional scores, and response inhibition. Another study found that twelve weeks of aerobic activity led to declines in bad mood and inattention. Yet another reported that thrice-weekly 45-minute sessions of MVPA over a ten-week period improved not only muscle strength and motor skills, but also attention, response inhibition, and information processing.

Two seventy-minute table tennis per week over a twelve-week period improved executive functioning and planning in addition to locomotor and object-control skills.

Two studies found a significant increase in brain activity. One involved two hour-long sessions of rowing per week for eight weeks, the other three 90-minute land-based sessions per week for six weeks. Both studies measured higher activation of the right frontal and right temporal lobes in children, and lower theta/alpha ratios in male adolescents.

All 16 studies found positive effects on cognition. Five of the nine longer-term studies found positive effects on behavior. No study found any negative effects. The authors of the review concluded that physical activity “improves executive functions, increases attention, contributes to greater planning capacity and processing speed and working memory, improves the behavior of students with ADHD in the learning context, and consequently improves academic performance.” Although the data are limited by lack of appropriate controls, they suggest that, in addition to the well-known positive effects of physical activity, one may expect to see improvements in ADHD symptoms and associated features, especially for periods of sustained exercise.

REFERENCES

Sara Suarez-Manzano, Alberto Ruiz-Ariza, Manuel De La Torre-Cruz, Emilio J. Martínez-López, “Acute and chronic effect of physical activity on cognition and behaviour in young people with ADHD: A systematic review of intervention studies,” Research in Developmental Disabilities, vol. 77, 12-23 (2018).