Design and Health Impact of Structured Physical Exercises on Children and Adolescents with ADHD: A Systematic Review and Meta-analysis
Fenghua Sun1, Yuan Fang11Education University of Hong Kong, Tai Po, N.T., Hong Kong
Abstract
Previous empirical studies have examined the efficacy of structured physical exercises (SPE) to treat and manage ADHD symptomatology. To systematically summarize and compare the health impact of SPE on children and adolescents with ADHD, an extensive literature search in the databases of PubMed, Web of Science, and EBSCOhost was conducted, and eligible studies were screened according to the inclusion/exclusion criteria. Among the included studies, thematic analyses provided a systematic summary, and further evidence-based meta-analyses was conducted using RevMan 5.4.1 software. Due to the continuous nature of the extracted data, the standard mean difference (SMD) with 95% confidential intervals (CI) were calculated with random effects models. A total of 30 eligible studies published from 2004-2021 were included in the thematic analyses, of which 18 studies were included in meta-analyses. The majority of the included studies examined the chronic effects of SPE through well-planned structured content and/or physiological monitoring under the supervision of research/sports professionals. The meta-analyses (pooled n=1,037) revealed that SPE had a positive impact on physiological variables (overall fitness level: SMD=1.39, 95%CI 0.98−1.80, p<0.001), ADHD symptomology (psychological problems: SMD=-0.89, 95%CI -1.57−-0.21, p=0.01; behavioral problems: SMD=-0.65, 95%CI -1.02−-0.28, p<0.001), executive function (SMD=2.19, 95%CI 1.41−2.98, p<0.001). Program design, study quality, ethnicity of participants, and methylphenidate use were detected as moderators by subgroup analyses. In conclusion, there is promising emerging evidence that SPE is a promising treatment option to enhance health, well-being, and symptom management in ADHD children and adolescents, whereas a larger sample size is warranted for future studies. This study was substantially supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. EdUHK 18603120).
Biography
Dr. Bob Fenghua SUN is currently an Associate Professor in the Department of Health and Physical Education (HPE), The Education University of Hong Kong (EdUHK). He got his doctoral degree from the Chinese University of Hong Kong (CUHK). During the past several years, Dr. SUN has published numbers of refereed journal articles in physical activity, exercise physiology, and sports nutrition research areas.