Acute effects of physical activity on cognitive function in children and adolescents with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis

Abstract

Attention-deficit/hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders in children and adolescents, is typically managed with medications which are associated with negative side effects. Therefore, non-pharmacological treatments, such as physical activity, are an attractive option. The aim of this meta-analysis was to explore the effects of acute physical activity on cognition in children and adolescents with ADHD. A comprehensive search of three literature databases yielded 14 studies for inclusion. An overall meta-analysis was conducted alongside sub-group analyses for cognitive domain, physical activity characteristics, and timing of cognitive measurements. Results revealed a small beneficial effect of physical activity on cognitive function (SMD = 0.18, [0.12,0.25], p < 0.01). Sub-group analyses revealed beneficial effects of physical activity on the domains of cognitive flexibility (SMD = 0.21, [0.09,0.32], p < 0.01), attention (SMD = 0.20, [0.09,0.32], p = 0.001), and inhibitory control (SMD = 0.18, [0.03,0.33], p = 0.02), but not memory (p = 0.87). Cognitive benefits also differed depending on physical activity duration (<10 min, p = 0.27; 11–20 min, SMD = 0.23, [0.14,0.31], p < 0.01; >20 min, SMD = 0.13, [-0.00,0.26], p = 0.05), and modality (running, SMD = 0.21, [0.12,0.29], p < 0.01; ‘other’, SMD = 0.39, [0.18,0.61], p < 0.01; cycling, p = 0.35), and the timing of cognitive measurement following physical activity (immediately, SMD = 0.17, [-0.01,0.35], p = 0.06; 2–10 min, SMD = 0.21, [0.12,0.30], p < 0.01; >10 min, SMD = 0.19, [-0.09,0.47], p = 0.19). Overall, physical activity has a positive acute effect on subsequent cognition in children and adolescents with ADHD, though effects may be domain specific and influenced by the duration and modality of physical activity. These findings have practical implications for those interested in using physical activity to enhance cognition in children and adolescents with ADHD.