Can exercise help with ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects approximately 3-10% of children and 3-7% of adults [1, 2, 3, 4]. There are several treatment options for individuals with ADHD including medication, behavioural therapy, counseling, and parent training. Many people also report benefits of exercise to manage their symptoms, such as improving focus or limiting excessive movements, but what does the research say? We decided to explore this further by diving into the current literature in order to better understand the potential benefits of exercise on symptoms of ADHD.

What is Attention-Deficit/Hyperactivity Disorder (ADHD)?

The diagnostic criteria for ADHD includes a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with a person’s functioning or development [5]. Inattention symptoms include getting off task, lacking persistence, and difficulty focussing, among others. Hyperactivity symptoms include (but are not limited to) excessive movement, fidgeting, tapping, or talking [5]. Impulsivity refers to acting without thinking with a potential for harm to the person [5]. Symptoms of ADHD typically vary depending on circumstances and context [5]. People can have only symptoms of inattention (predominantly inattentive presentation) or hyperactivity/impulsivity (predominantly hyperactive/impulsive presentation). You can also have enough symptoms from both the inattentive and hyperactive/impulsive sets (combined presentation).

Is there a relationship between exercise and symptoms of ADHD?

Short-term and long-term studies support the benefits of physical activity for those diagnosed with ADHD [6]. Many cognitive, behavioural, and physical symptoms of ADHD can be alleviated, with the largest effects reported for children who vary their exercise types [6]. In a meta-analysis exploring the relationship between exercise and ADHD functional outcomes, longer periods of exercise were found to be associated with positive impacts on a range of executive functions (e.g., inhibition and switching) and motor skills [7].Compared to children with ADHD who participated in a sedentary control program, children with ADHD who participated in a 10-week after school exercise program saw decreases in hyperactive symptoms and they performed better on verbal working memory tasks [8]. Tasks requiring sustained attention have also been found to be improved following exercise in children with ADHD [9]. Intense exercise can improve the attention of children with ADHD and it may even help their performance in school [9].

When children with ADHD are compared to children without ADHD, exercise still shows to be beneficial. Children who participated in moderate intensity exercise showed improvements in speed of processing and inhibitory control [10]. Notably, planning and set-shifting were executive functions that did not improve with exercise [10]. These findings suggest that children without ADHD also significantly benefit from exercise; however, children with ADHD may actually perform better than their non-ADHD peers following exercise. Results of this study confirm past findings that exercise benefits both children with and without ADHD [10]. In addition, another study found that during a physical activity (walking), ADHD participants showed a faster response time, made fewer omission errors, and experienced larger performance gains when compared to when they were sedentary (sitting) [11]. There was also a larger change in the ADHD group when compared to the control group [11].

Each of the studies reviewed supported using exercise to help improve symptoms of ADHD, but exercise alone may not be sufficient to alleviate all symptoms. No adverse effects were found to arise from exercising in any of the studies included in this review, which supports the idea that exercise is a beneficial intervention for those with ADHD [6]. The studies emphasized the importance of routines, making activities engaging, behavioural management strategies, and positive reinforcement from adults. Longer periods of exercise were associated with better management of symptoms [7]. Studies also highlight the potential for involvement in after-school programs to benefit children with ADHD and disruptive behaviour disorders [8].

To conclude…

Overall, the current research does suggest that exercise can help to improve and alleviate some symptoms that are often associated with ADHD, such as hyperactivity, attention, and processing speed. With the various alternative treatment options available, it is important to talk to your healthcare professional about the best options for you.

If you’re concerned that you or your child might have ADHD, let’s chat about an assessment. Contact us at info@highpointpsychology.com.

Blog post written by Kassandra Burk and Dr. Andrea Stelnicki.

Literature review prepared by Kassandra Burk.

*The information contained in this blog post is based on a narrative review of available literature. Some studies may have been unintentionally omitted. You are advised to speak with a healthcare professional to determine if the information is appropriate to your specific circumstances.*

References:

[1] Bélanger, S. A., Andrews, D., Gray, C., & Korczak, D. (2018). ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity. Canadian Paediatric Society.

[2] Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudna, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of Global Health.

[3] Faraone, S.V., Sergeant, J., Gillberg, C., Biederman, J. The worldwide prevalence of ADHD:

is it an American condition. World Psychiatry. 2003; 2 (June (2)):104–113.

[4] Centre for ADHD Awareness Canada. What ADHD is. Retrieved from https://caddac.ca/understanding-adhd/in-general/

[5] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

[6] Ng, Q. X., Ho, C. Y. X., Chan, H. W., Yong, B. Z. J., & Yeo, W. (2017). Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: A systematic review. Science Direct.

[7] Vysniauske, R., Verburgh, L., Oosterlaan, J., & Molendijk, M. L. (2016). The Effects of Physical Exercise on Functional Outcomes in the Treatment of ADHD: A Meta-Analysis. Journal of Attention Disorders.

[8] Bustamante, E. E., Davis, C. L., Frazier, S. L., Rusch, D., Fogg, L. F., Atkins, M. S., & Marquez, D. X. (2016). Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders. US National Library of Medicine.

[9] Silva, A. P., Prado, S. O. S., Scardovelli, T. A., Boschi, S. R. M. S., Campos, L. C., & Frère, A. F. (2015). Measurement of the Effect of Physical Exercise on the Concentration of Individuals with ADHD. PLoS ONE 10(3): e0122119. https://doi.org/10.1371/journal.pone.0122119

[10] Piepmeier, A. T., Shih, C., Whedon, M., Williams, L. M., Davis, M. E., Henning, D. A., Park, S., Calkins, S. D., & Etnier, J. L. (2015). The effect of acute exercise on cognitive performance in children with and without ADHD. Journal of Sport and Health Science.

[11] Rassovsky, Y., & Alfassi, T. (2019). Attention Improves During Physical Exercise in Individuals With ADHD. Movement Science and Sport Psychology.