Cognitive Behavioral Therapy And Motor Learning Technique Among Attention Deficit Hyperactivity Disorder Adults

Study Overview
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Brief Summary
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The aim of our study to compare the effect of cognitive behavioral therapy and motor learning techniques in adults with Attention Deficit Hyperactivity Disorder. and help the adults to address and revise cognitive distortions and habits affecting your productivity and emotional mindset.participant allocated to control group will be asked to perform cognitive behavioural therapy and participants allocated to experimental group will be asked to perform motor learning activities and cognitive behavioral therapy.

Detailed Description
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Attention deficit disorder/hyperactivity (ADHD) among adults is a frequent but under-diagnosed clinical situation. Attention deficit hyperactivity disorder prevails from childhood to adulthood and most of the adults suffering from this disorder were the same who went through this syndrome in their childhood. Basically, ADHD has 3 main types in adults: In attentive ADHD with lack of attention to task, Impulsive ADHD with lack of decision-making skills and Combination of type 1 and 2. Risk factors that lead to this disorder include: genetics ,environmental factors and developmental factors. Meyer and Sag olden also found motor impairments in all three subtypes but they reported the strongest motor control problems and difficulty with gross motor skills in the combined type of ADHD. ADHD significantly impairs multiple aspects of life, leading to educational underachievement, unemployment, unsuccessful marriage and criminality, etc. Moreover, ADHD shows significant correlations with a wide range of co-morbid psychiatric disorders, including effective disorders, antisocial personality disorder, self-harm, substance misuse, placing a considerable burden on society and family . This syndrome include difficulty in performing activities of daily living, difficulty in making decisions and loss of attention while performing a task. They feel trouble in following and remembering plans, important events and daily tasks. Men and women suffering from ADHD also encounter some motor control problems in their lives like lack of dexterity, gripping and fine motor skills. A random affect meta-analysis of these studies showed that the global prevalence of ADHD in children and adolescents was 8.0 %. Attention deficit hyperactivity disorder (ADHD) is recognised as the most common neurodevelopmental disorder of childhood. A frequently cited study by Polanszky of 2007 reported a worldwide ADHD prevalence estimate of 5.3%. The overall Canadian ADHD prevalence estimate is similar to worldwide estimates for adults that is 5.3%. Estimates for children include 7.5% in Australia and 10.2% in the United States. Two studies on adolescents in Africa provided estimates of 7.5%. A 2021 survey conducted in the United States, for example, found an ADHD prevalence rate for adults of 4.25% One German study on children and adolescents combined provides an estimate of 6.1. In china there is 7.5% of rural students are at risk of ADHD. A study at India showed that 24.3% of the total study population had the presence of adult ADHD. In Pakistan, a study conducted on 1889 patients showed almost 11% patients had diagnosis of ADHD after a screening questionnaire from their consultant. After analyzing the properties of the ASRS (sensitivity: 83.3% specificity: 66.1%), we administered the Adult ADHD Self-Report Scale (ASRS) to detect the participants with attention deficit hyperactive disorder. To assess the cognitive part of ADHD we use MOCA test also known as Montreal cognitive assessment which involves a picture-based marking system. Perceptual-motor training is the best physical activity intervention for children with ADHD regarding motor ability and working memory. This type of training combines physical activities such as coordination, balance, and strength with perceptual tasks. Longer exercise intervention (motor learning techniques) duration was consistently associated with larger effect sizes (g .627). Results suggest that exercise has a modest positive impact on ADHD functional outcomes, such as executive functions and motor skills, with longer interventions yielding better results. Cognitive behavioral therapy can be given individually as well as in groups to treat main behavioral and cognitive impairments in patients of different age groups and more importantly with attention deficit hyperactivity disorder. A systematic review showed that CBT was superior to control and superior to active control groups with a small to moderate effect size (SMD 0.43, 95% CI [0.14, 0.71], p .004). CBT reduced ADHD symptoms (self and independently rated) compared with the control treatment(s). Cognitive-motor training is an intervention that integrates cognitive and motor tasks to promote an individual's physical and mental health. It has been shown that performing two or more cognitive-motor tasks simultaneously, such as computation in postural training and movement under computer games, will contribute more to improvements in cognitive domains compared to single-task training. Attention-deficit hyperactivity disorder also known as ADHD, is a neurobiological disorder that affects children and adults. It is associated with increased activity level and lack of attention regarding daily activities of living. Cognitive behavioural therapy is method to encounter the negative thoughts and converting them into positive ones by using the method of reinforcement. Also, it can help people change the way they think about their problems. Motor learning strategies can be applied in such people. Motor learning techniques are used to enhance someone's ability to perform a task more effectively and efficiently. They progress from a stage of dependency to automacity. These techniques are used for the acquisition and modification of a task to make it more effective.

Official Title
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Comparing The Effects Of Cognitive Behavioral Therapy And Motor Learning Technique in Adults With Attention Deficit Hyperactivity Disorder.

Conditions
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Attention Deficit Hyperactivity Disorder

Intervention / Treatment
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* Behavioral: cognitive behavioral therapy
* Behavioral: Motor Learning Techniques


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medical & Allied health students, both male and females, aged between (18-29). Students who will score less than 26 out of 30 in MOCA test Exclusion Criteria: •Students with any history of systemic disease.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 29 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The subjects in the experimental group will be given a 10 minute session of Progressive Muscle Relaxation (PMR), 2 minutes deep breathing exercises,3 minutes training for life style modification which includes the use of planners, setting alarms, breaking a difficult task into parts, positive reinforcement and communication combined with a 3 minute session of drawing a specific pattern with installing pegs on pegboard, 2 minutes session of balance board training, 3 min session of solving jigsaw puzzles, 1 minute session of squeezing a ball with maximum repetition and 1 minute session of finding beads in puttey. . After the completion of therapy, the participants will be assessed by the proforma used to diagnose the ADHD and their respective scores will be noted and compared with the previous ones.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: cognitive behvioral therapy<br>The subjects in the control group will be given a 10 minute session of Progressive Muscle Relaxation (PMR) 2 minutes deep breathing exercises and 3 minutes training for life style modification which includes the use of planners, setting alarms, breaking a difficult task into parts, positive reinforcement and communication. This would be taught for 15 days at one day interval. | Behavioral: cognitive behavioral therapy<br>* In control group there is 10 min session of PMR, 2 min deep breathing exercises,3 min training for life style modification which include use of planner, setting alarms breaking a task into parts positive reinforcement and communication.<br>|
| Experimental: motor learning techniques<br>The subjects in the experimental group will be given a 10 minute session of Progressive Muscle Relaxation (PMR), 2 minutes deep breathing exercises,3 minutes training for life style modification which includes the use of planners, setting alarms, breaking a difficult task into parts, positive reinforcement and communication combined with a 3 minute session of drawing a specific pattern with installing pegs on pegboard, 2 minutes session of balance board training, 3 min session of solving jigsaw puzzles, 1 minute session of squeezing a ball with maximum repetition and 1 minute session of finding beads in puttey. This would be taught for 15 days at one day interval. | Behavioral: cognitive behavioral therapy<br>* In control group there is 10 min session of PMR, 2 min deep breathing exercises,3 min training for life style modification which include use of planner, setting alarms breaking a task into parts positive reinforcement and communication.<br>Behavioral: Motor Learning Techniques<br>* In experimental group, participants will be given a 10 min PMR ,2 min deep breathing exercises, 3 min training for life style modification which include the use of planners setting alarms, breaking a difficult task into parts, positive reinforcement and communication combined with 3 min session of drawing a specific pattern with installing pegs on pegboard, 2 min session of balance board training, 3 min session of jigsaw puzzle training, 1 min session of squeezing a ball with maximum repetition and 1 min session of finding beads in puttey.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparing the Effect of Cognitive Behavioral Therapy and Motor Learning Techniques in Adults with Attention Deficit Hyperactivity Disorder. | After analyzing the properties of the Adult self report scale( sensitivity: 83.3%, specificity:66.1 %) we administered adult self report scale to detect the participants with attention deficit hyperactivity disorder. In this 0 will be considered as the normal score( 14 or 14 above will be considered positive for attention deficit hyperactivity disorder) and 72 shows the severity of attention deficit hyperactivity disorder participants. | 1-Month |