Clinical trial NCT05150223: The Effects of Functional Power Training in Children With Attention Deficit Hyperactivity Disorder
Official title: The Effects of Functional Power Training on Attention, Gross and Fine Motor Skills, Participation and Quality of Life in Children With Attention Deficit Hyperactivity Disorder
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Attention Deficit Hyperactivity Disorder
Child Mental Disorder
Keywords: attention deficit
hyperactivity disorder
power
strength
training
Lead sponsor: Akdeniz University
Sponsor class: OTHER
Collaborators: name: Antalya Training and Research Hospital
First posted: 2021-12-09
Enrollment: 61
Sex: ALL
Minimum age (years): 6
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study is aimed to investigate the effectiveness of functional power training on attention, gross and fine motor skill, participation and quality of life in children with attention deficit hyperactivity disorder (ADHD) by comparing traditional strength training and their healthy peers. In the literature, there are limited studies that investigate the effect of power exercise in children with ADHD. But there is no randomized controlled trial include power exercises which is designed to the National Strength and Conditioning Association (NSCA) criteria and investigate the effects on attention, gross and fine motor skill, participation and quality of life in children with ADHD. This study hypothesizes that power exercises could improve attention, gross and fine motor skill, participation, and quality of life better than traditional strength training in children with ADHD.

Detailed description: Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity. These core symptoms cause poor gross and fine motor skills. Recent critical review results suggest that motor performance not only consists of motor response activation. It also includes mental representation of activity, attention, memory, makes decisions, and control over preponderant responses. These findings support that ADHD symptoms could affect motor performance negatively. DSM-V (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) also specifies the relationship between ADHD symptoms and poor motor performance. DSM-V pointed out motor difficulties that occur in ADHD are caused by inattention and impulsivity rather than neurological origin. In the literature, Tseng et al. investigated ADHD symptom's negative effect on motor performance in 42 school-aged children with ADHD. Tseng et al.'s study was shown that inattention and impulsivity were determinative symptoms for motor difficulties. Because of the ADHD's symptoms' effect on the motor skill, children with ADHD have poor fine manual control, manual coordination, body coordination, strength, and agility when they are compared with health peers.

These motor difficulties affect the academic, social, and daily life of children with ADHD. They have many restrictions on participation of daily living activities, school, social and sport activities and have decreased quality of life scores. It is considered that these symptoms of ADHD related to catecholamine systems. Jeyanthi et al. suggest that exercises both directly and indirectly affects catecholamine systems. In the literature, there are many studies that was included different exercise interventions involving children with ADHD. Many of the studies were shown that exercise had positive effects on ADHD symptoms. However, there is not enough information about the type, duration, intensity, and frequency of appropriate exercises. Power exercises can be an appropriate approach given the previously reported problems in children with ADHD. This type of exercise shown positive effects on the other populations (CP). The aim of the study is to investigate the effect of power exercises on children with ADHD by comparing these effects with traditional strength training and their healthy peers.

Eligibility criteria: Inclusion Criteria:

* • age between 6 years and 12 years;

  * Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) by a child and adolescent health psychiatrist, regardless of subtype, according to DSM-V criteria
  * Have cognitive ability to follow instructions for assessment measures and exercise intervention

Exclusion Criteria:

* • Children have any other psychiatric diagnosis like autism spectrum disorder, psychotic symptoms, depression, etc.

  * Children have any neurological or orthopedic disorders like head injury, cerebral palsy, epileptic seizure, visual and speech disorder.

Inclusion Criteria for Healthy Children:

* Healthy children aged 6-12 years old
* Children without a psychiatric and neurological diagnosis

Exclusion Criteria for Healthy Children:

* Children got medical treatment for a neuropsychiatric disorder
* Children whose parents or themselves refused to participate

Primary outcomes:
measure: Conners' Teacher Rating Scale (CTRS)
timeFrame: change from baseline to end of the 8 weeks
measure: Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) to measure motor proficiency.
timeFrame: change from baseline to end of the 8 weeks
measure: Evaluation of muscle power of lower extremity
timeFrame: change from baseline to end of the 8 weeks
measure: Evaluation of muscle power of upper extremity
timeFrame: change from baseline to end of the 8 weeks
Secondary outcomes:
measure: The 30 seconds Repetition Maximum test
timeFrame: change from baseline to end of the 8 weeks
measure: walking speed
timeFrame: change from baseline to end of the 8 weeks
measure: Evaluation of participation
timeFrame: change from baseline to end of the 8 weeks
measure: Evaluation of quality of life
timeFrame: change from baseline to end of the 8 weeks
Other outcomes:
Locations:
city: Antalya
country: Turkey
facility: Akdeniz University
Study officials:
References:
citation: Tseng MH, Henderson A, Chow SM, Yao G. Relationship between motor proficiency, attention, impulse, and activity in children with ADHD. Dev Med Child Neurol. 2004 Jun;46(6):381-8. doi: 10.1017/s0012162204000623.
citation: S J, Arumugam N, Parasher RK. Effect of physical exercises on attention, motor skill and physical fitness in children with attention deficit hyperactivity disorder: a systematic review. Atten Defic Hyperact Disord. 2019 Jun;11(2):125-137. doi: 10.1007/s12402-018-0270-0. Epub 2018 Sep 27.
citation: Cho H, Ji S, Chung S, Kim M, Joung YS. Motor function in school-aged children with attention-deficit/hyperactivity disorder in Korea. Psychiatry Investig. 2014 Jul;11(3):223-7. doi: 10.4306/pi.2014.11.3.223. Epub 2014 Jul 21.
citation: Kaya Kara O, Livanelioglu A, Yardimci BN, Soylu AR. The Effects of Functional Progressive Strength and Power Training in Children With Unilateral Cerebral Palsy. Pediatr Phys Ther. 2019 Jul;31(3):286-295. doi: 10.1097/PEP.0000000000000628.
citation: Moreau NG, Holthaus K, Marlow N. Differential adaptations of muscle architecture to high-velocity versus traditional strength training in cerebral palsy. Neurorehabil Neural Repair. 2013 May;27(4):325-34. doi: 10.1177/1545968312469834. Epub 2013 Jan 4.
citation: Messler CF, Holmberg HC, Sperlich B. Multimodal Therapy Involving High-Intensity Interval Training Improves the Physical Fitness, Motor Skills, Social Behavior, and Quality of Life of Boys With ADHD: A Randomized Controlled Study. J Atten Disord. 2018 Jun;22(8):806-812. doi: 10.1177/1087054716636936. Epub 2016 Mar 24.
citation: Goulardins JB, Marques JC, De Oliveira JA. Attention Deficit Hyperactivity Disorder and Motor Impairment. Percept Mot Skills. 2017 Apr;124(2):425-440. doi: 10.1177/0031512517690607. Epub 2017 Jan 31.