A narrative review of the effect of sport and exercise on ADHD symptomatology in children and adolescents with ADHD

PurposeAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition with community prevalence globally of 2%-7% (M = 5%; Sayal, Prasad, Daley, Ford, and Coghill; 2018). Clinicians are routinely encouraged to explain to children and young people the benefits of a healthy lifestyle, including exercise (NICE NG87, 2018). Exercise has been proposed as a safe and low-cost adjunctive approach for ADHD and is reported to be accompanied by positive effects on several aspects of executive functioning (EF). The purpose of this narrative review was to synthesise the contemporary randomised control trial (RCT) studies that examine the effect of sport, physical activity and movement on EF in children and adolescents with ADHD. Design/methodology/approachA narrative review approach with a systematic literature search using PRISMA guidelines for screening and selecting relevant systematic reviews was used. The final review included four peer-review systematic reviews (>2019). FindingsThe results identified three RCT meta-analyses and findings showed that children and adolescents with lower baseline cognitive performance demonstrated greater improvements in functioning after physical activity interventions, particularly for tasks with higher executive function demands, where baseline performance reaches an optimal level. Findings suggest that 10-20 min of acute moderate-high-intensity exercise interventions (cycling/running) appeared to have positive effects on indices of inhibitory control. Preliminary evidence suggests that as little as 5 min of jumping exercises improved inhibitory control. And 60-80 min of moderately intense, repeated (chronic) exercise appeared to demonstrate the greatest beneficial impact on selection attention. Originality/valueTo the best of the authors' knowledge, this review is the first to present the extant literature on the effect of physical activity and sport on symptoms of young people with ADHD. It presents evidence to suggest that exercise with progressively increasing cognitive demands may have positive effects for children with ADHD, specifically in terms of improving cognitive flexibility. Further large-scale clinical trials are needed to confirm the positive effects of physical exercise on cognitive functioning in children with ADHD.