The multiple benefits of aerobic exercise in children with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders diagnosed in childhood, with symptoms continuing into adolescence and adulthood. It is estimated to affect 2-8% of children and 5-6% of adults worldwide³. The impact of ADHD on individuals’ lives underscores the importance of appropriate and scientifically based treatment options. In recent decades, the prescription of stimulant drugs has increased significantly and has become a topic of social debate. Many parents worry about their child being “overmedicated” and the short-term (headache, nausea, and anorexia) and long-term (slowed growth) side effects of stimulants. On the other hand, psychosocial interventions are considered complex and difficult to adhere to on an ongoing basis for many patients and families. ADHD symptoms generally recur upon discontinuation of pharmacological and/or psychotherapeutic treatments. The potential benefits of an alternative or additional treatment option for ADHD, in terms of efficacy and safety, are extremely important. Recent research has introduced exercise as a potential treatment option¹.

Large review studies support the clinical benefits of physical activity for individuals with ADHD. Cognitive, behavioral, and physical symptoms of ADHD were alleviated in most cases, and the largest intervention effect was reported for mixed exercise programs². No adverse side effects resulting from exercise were reported in any of the studies, suggesting that exercise is a well-tolerated intervention.

Are there immediate results? According to research data^1,2, even a single 20-30 minute session of moderate-to-high intensity aerobic exercise (e.g., treadmill) produced significant improvements in response time and normalization of impulsivity and alertness for children with ADHD. Both children with ADHD and healthy children had better response accuracy and improved processing of information and stimuli during the attention control process following exercise. Academic performance in mathematics and reading also improved after the exercise session in both groups. At the behavioral level, reduced involuntary aggression and fewer interruptions and disruptions of the lesson at school were observed.

According to studies of at least 8 weeks exercise-interventions in children with ADHD, long-term physical activity seemed to have a positive effect on the executive functions of children with ADHD, regardless of the specific characteristics of the sports program.

Improved attention (including auditory sustained attention and selective attention/information processing), verbal working memory, and cognitive speed were noted among the long-term effects of exercise.

In conclusion, physical activity, particularly moderate-to-vigorous aerobic exercise, is a beneficial and well-tolerated intervention for children and adolescents with ADHD. Regular exercise, sports and physical recreation should be recommended for a positive effect on neurocognitive function and inhibitory control. Although the current evidence appears modestly optimistic, exercise is a lifestyle recommendation that could be a useful non-pharmacological adjunct to optimize lifelong ADHD care.

1. Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review. J Neural Transm (Vienna). 2017 Feb;124(Suppl 1):3-26. doi: 10.1007/s00702-016-1593-7. Epub 2016 Jul 11. PMID: 27400928; PMCID: PMC5281644.
2. Ng QX, Ho CYX, Chan HW, Yong BZJ, Yeo WS. Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: A systematic review. Complement Ther Med. 2017 Oct;34:123-128. doi: 10.1016/j.ctim.2017.08.018. Epub 2017 Aug 31. PMID: 28917364.
3. Epidemiology ADHD. https://adhd-institute.com/burden-of-adhd/epidemiology/

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