Meta-analysis of the effect of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder

SONG Yiling; FAN Biyao; BAI Xiaotian; YU Hongjun

doi:10.11852/zgetbjzz2022-1568

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Chinese Journal of Child Health Care ›› 2023, Vol. 31 ›› Issue (9) : 1010-1016. DOI: 10.11852/zgetbjzz2022-1568

Meta-analysis of the effect of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder

SONG Yiling¹, FAN Biyao², BAI Xiaotian¹, YU Hongjun¹

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Abstract

Objective To systematically evaluate the effects of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder (ADHD), in order to provide a basis for developing non-pharmacological treatments for children with ADHD. Methods Literature related to the effects of exercise interventions on executive function in children and adolescents with ADHD published to November 8th, 2022 was captured through searching PubMed, Web of Science, Cochrane Library, Embase, CNKI and Wanfang databases. Reviewer Manager 5.4 was used for Meta-analysis, combined effect sizes were calculated. Heterogeneity test, sensitivity analysis and subgroup analysis were performed. Egger's test in Stata 15.0 was used to test for publication bias in the literature. Results Fifteen studies with a total number of 592 participants with ADHD were included. Meta-analysis showed that exercise interventions improved inhibitory control (SMD=0.54, 95%CI: 0.23 - 0.86,P<0.001), working memory (SMD=0.61, 95%CI: 0.29 - 0.93,P<0.001), and cognitive flexibility (SMD=0.66, 95%CI: 0.23 - 1.09,P＝0.003) of ADHD children and adolescents. Subgroup analysis showed the following results: 1) Moderate-intensity exercise had a moderate effect on inhibitory control and working memory, and moderate-to-vigorous-intensity exercise had a moderate effect on cognitive flexibility(P＜0.05). 2) Open-skilled sports had a moderate effect on inhibitory control, working memory and cognitive flexibility(P＜0.05),while closed-skilled sports did not significantly improve executive functions (P＞0.05). 3) Exercising regularly two times/week produced a large effect on inhibitory control (P＜0.05), and a more frequent (≥3 times/week) had a moderate-to-large effect on cognitive flexibility. 4) Interventions ranging from 6 to 8 weeks had a positive effect on inhibitory control and cognitive flexibility, and interventions with 12 weeks had a moderate-to-large effect on working memory (P＜0.05). Conclusions Exercise interventions are effective in improving executive function in children and adolescents with ADHD. Moderate-intensity exercise is most effective in improving inhibitory control and working memory, and moderate- to high-intensity exercise interventions are required in order to improve cognitive flexibility. Open-motor skills improve executive function of ADHD children. Exercise 2 times/week for 6-8 weeks can improve inhibitory control, while improving working memory requires more frequent and longer periods of exercise intervention.

Key words

attention deficit hyperactivity disorder / executive function / inhibitory control / working memory / cognitive flexibility / exercise

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SONG Yiling, FAN Biyao, BAI Xiaotian, YU Hongjun. Meta-analysis of the effect of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2023, 31(9): 1010-1016 https://doi.org/10.11852/zgetbjzz2022-1568

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