# Exercise as it relates to Disease/ADHD in children and the impact physical activity plays

This is an analysis of the journal article "Effects of physical activity on executive function and motor performance in children with ADHD" by Ziereis & Jansen (2014).

## What is the background to this research?
##### What is ADHD

Attention- deficit/hyperactivity disorder is neurobehavioral disorder characterised by a combination of inattentiveness, distractibility, hyperactivity and impulsive behaviour.
ADHD appear early in life and it is estimated it affects 3-7% of school age children, boys are often diagnosed more than girls. Children with untreated ADHD are more prone to drug abuse and anti social behaviour as they grow older. It is the most prevalent disorder in childhood.
The use of pharmacological treatment, which is current practice, is very distressing for both the child and the parents as there are many side affects. It is highly desirable that a non drug solution is found. Physical activity has the potential of providing, at least in part, a non drug solution.. Physical activity has the means to improve.
- Executive function, - Health of population, - Distractibility, - Hyperactivity, and
- Motor abilities
The article examined clearly demonstrates that there is a positive correlation between physical activity and improvements in executive function of children with clinical ADHD.

## Where is the research from?

The study was conducted at the University of Regensburg, Germany on a small group of children from the region, approved by the Institute of Sports Science of the university.

## What kind of research was this?

The qualitative research was conducted on a small cohort of ADHD certified children from the Regensburg region. The were subdivided into three groups for the purpose of the study. A control group with no extra exercise, a group with exercise focused on ball handling balance and manual dexterity and a final group exercised without specific direction. The tests were conducted over a twelve week period at the institute of sports science between the times of 4:00pm and 6:00pm in the afternoon. The design of the experiment insured that there was no cross over between the three groups. The results of the study were subjected to rigorous statistical analysis.

## What did the research involve?

In order to ensure that the cohort selected had clinical ADHD each child was tested prior to the experiment by the resident child psychiatrist of the Institute of Sports Science, thus ensuring that the selection was professional based. A total of 43 children were selected to participate in the study. The cohort comprised of 32 boys and 11 girls between the ages of 7 and 12 years of age. Measurements of working memory and motor performance were conducted pre and post the exercise regime. The first group of children tasks involved various ball catching and balancing exercises including bouncing, juggling and acrobatics; the second group had generalised exercising considered normal school sports of swimming, games and gymnastics. For comparison purposes, a control group was established which did not have any specific physical activity assigned to it and conduct their normal after school activity for that period of time.
The digital and letter number sequencing tasks were used to assess working memory performance in accordance with well established clinical practice. These primarily involved repeat ability of varying length sequences of numbers/letters. Likewise, a variety of motor performance measures appropriate to each age bracket were conducted using manual dexterity as a measure of performance again in accordance with well established clinical practice.

## What were the basic results?

Other than the ability to catch and aim, the results have no significant effect on executive function over the short term. The long term results for digital span does show very significant results in both exercise groups in both pre and post testing and a slight reducing in the control group. Similar results were found for letter number sequencing and again with a reducing in the control group capacity. Using international statical techniques, the results were combined into a score call (the working index score used as a measure of working memory performance). The combined results in index form confirm greater statistical significance of the influence of physical activity on the executive function.

## What conclusions can we take from this research?

Previous experiments have demonstrated that in healthy populations there is a direct correlation between physical activity and executive function as measured by working memory and manual dexterity. In a small cohort of children with clinical ADHD the present study as showed a similar correlation. As this finding is likely to lead to a reducing or elimination of drug treatment of ADHD further studies are needed to validate this important finding.

## Practical advice

The research demonstrates that the affect of physical activity in improving the performance of children with ADHD is quite pronounced and statistically valid. With the approval and involvement of the individual child's doctor there is scope for using reduced quantities of medicine. An important conclusion of relevance to the parents is that the type of exercise is not of itself important but that exercise of any type of a long period is important. Further research into the long term effects of physical exercise is required to provide further guidance as to efficacy of reducing ADHD medication.

## Further Information/Resources

For further information regarding the benefits of physical activity on ADHD; click on the links below.
* Child and institute: http://childmind.org/article/exercise-and-adhd/
* Focus exercises for ADHD kids: https://www.empoweringparents.com/article/5-focus-exercises-for-adhd-kids/
* Exercise is ADHD medication: http://www.theatlantic.com/health/archive/2014/09/exercise-seems-to-be-beneficial-to-children/380844/
* Great activities for kids with ADHD: http://www.parenting.com/gallery/activities-for-kids-with-adhd

## References

* ↑ Ziereis, S. Jansen, P. (2015). Effects of physical activity on executive function and motor performance in children with ADHD. National Centre for Biotechnology Information. E-journal. doi: 10.1016/j.ridd.2014.12.005. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/25561359
* ↑ Bhandari, S. (2015). Understanding ADHD – the basics. Retrieved from WebMD website: http://www.webmd.com/add-adhd/childhood-adhd/understanding-adhd-basics
* ↑ Centers For Disease Control and Prevention. (2016). Attention deficient/hyperactivity disorder (ADHD) – facts about ADHD. Retrieved from Centers For Disease Control and Prevention website: http://www.cdc.gov/ncbddd/adhd/facts.html
* ↑ Hamblin, J. (2014). Exercise is ADHD medication. Retrieved from The Atlantic website: http://www.theatlantic.com/health/archive/2014/09/exercise-seems-to-be-beneficial-to-children/380844/
* ↑ Chang, Y-K., Lui, S., Yu, H-H., Lee, Y-H. (2012). Effect of acute exercise on executive function in children with attention deficit hyperactivity disorder. Archives of Clinical Neuropsychology, Vol 27(2), 225-237. doi: 10.1093/arclin/acr094. Retrieved from: http://acn.oxfordjournals.org/content/27/2/225.short
* ↑ Tantillo, M., Kesick, C., Hynd, G., Dishman, R. (2002). The effects of exercise on children with attention-deficit hyperactivity disorder. Medicine & Science in Sports & Exercise, Vol 34(2), 203-212. doi: 10.1097/00005768-200202000-00004. Retrieved from: http://psycnet.apa.org/psycinfo/2002-00614-002
* ↑ Verret, C., Guay, M-C., Berthiaume, C., Gardiner, P., Beliveau, L. (2010). A physical activity program improves behaviour and cognitive functions in children with ADHD: an exploratory study. Journal of Attention Disorders. E-journal. doi: 10.1177/1087054710379735. Retrieved from: http://jad.sagepub.com/content/early/2010/08/05/1087054710379735.abstract
* ↑ Wigal, S., Emmerson, N., Gehricke., J-G., Gallassetti, P. (2012). Exercise: applications to childhood ADHD. Journal of Attention Disorders. E-journal. doi: 10.1177/1087054712454192. Retrieved from: http://jad.sagepub.com/content/early/2012/08/02/1087054712454192.abstract
* ↑ Jacobson, R. (2016). ADHD and exercise. Retrieved from Child Mind Institute website: http://childmind.org/article/exercise-and-adhd/