Research: Physical Exercise Is the Most Effective Natural Treatment for ADHD — and Severely Underutilized

January 22, 2020

Physical exercise is the most effective natural therapy for improving ADHD cognitive symptomology, according to a new meta-analysis published in The Journal of Psychiatric Research that supports the use of non-pharmacological interventions alongside medication for treating ADHD¹. Despite this strong evidence for the power of exercise, children with ADHD are significantly less likely than their non-diagnosed peers to engage in daily physical activity, according to a study published recently in The Journal of Attention Disorders².

The meta-analysis published in The Journal of Psychiatric Research included 18 studies published between 1980 and 2017 on four categories of non-pharmacological interventions: neurofeedback, cognitive behavioral therapy (CBT), cognitive training, and physical exercises. The neuropsychological effects of each intervention were measured using objective cognitive measures including computerized and non-computerized tests completed by and about participants ranging in age from 4 to 50 with both medicated and unmedicated ADHD. They measured improvements in five categories of cognitive functions: mental flexibility, inhibition, attention, working memory, and higher executive functions (planning and reasoning)¹.

This meta-analysis determined that physical activity has the highest impact on targeting and reducing ADHD cognitive symptomology. Furthermore, specific aerobic exercises — such as complex ball sports and martial arts — that target executive functions were deemed the most effective form of physical exercise for treating ADHD cognitive symptomology¹.

Researchers concluded their study with the recommendation to integrate complex sports into the ADHD treatment regimen for children¹.

Though physical exercise was determined the most effective, all four interventions studied led to moderate to large improvements in ADHD cognitive symptomology. Inhibition and flexibility were the most amenable to change, and attention and working memory were moderately improved by interventions. Moreover, there was only a marginal increase in improvement among participants who combined non-pharmacological intervention with medication, as compared to improvements documented in non-medicated participants¹.

Despite clear evidence regarding the power of exercise to moderate ADHD symptoms, new research from Brown University reveals that children with ADHD aged 6 to 17 are less likely to engage in physical activity than are their neurotypical peers². This retrospective, population-based, cross-sectional study assessed data from the 2016 National Survey of Children’s Health (NSCH), which noted a physician’s diagnosis of ADHD. That said, ADHD symptom severity was completely determined by parental self-report and not by objective cognitive measures to determine symptomology.

Though the American Academy of Pediatrics’ (AAP) recommends that children engage in 60 minutes of physical activity every day, researchers found that children with ADHD are significantly less likely than their peers to meet this benchmark². Specifically, the research revealed that:

• 14.3% of children with ADHD reported zero days of physical activity per week, compared to 8.2% of children without a diagnosis
• 22.2% of children with ADHD reported daily physical activity, compared to 24.4% of those without a diagnosis
• Children with ADHD had 21% lower adjusted odds ratio of engaging in daily physical activity than their non-ADHD peers
• A significant inverse relationship between ADHD diagnosis and days of physical activity per week seems to exist; the gaps widens between undiagnosed and diagnosed children who engage in physical exercise 7 days a week

Given the distinct health benefits generated by physical exercise for children with ADHD, these findings are disconcerting.

Both studies individually support integrating physical exercise into an ADHD treatment plan. Together, they underscore the need for schools to preserve and bolster the time, space, and funding needed for physical exercise and education for all children.

Sources

¹ Lambez, Harwood-Gross, A., Golumbic, E. Z., & Rassovsky, Y. (2020). Non-Pharmacological Interventions for Cognitive Difficulties in ADHD: A Systematic Review and Meta-Analysis. Journal of Psychiatric Research, 120, 40-55. doi:10.1016/j.jpsychires.2019.10.007

² Mercurio Y., Amanullah, S., Gill, N., & Gjelsvik, A. (2019). Children with ADHD Engage in Less Physical Activity. Journal of Attention Disorders. https://doi.org/:10.1177/1087054719887789