Background This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs). Methods RCTs including children and adolescents with clinically diagnosed ADHD, implementing regular MVPA, and assessing ADHD core-symptoms on a valid rating scale post-intervention (primary outcome) were included. Outcomes were pooled through random-effects meta-analysis. Prospero registration: CRD42019142166. Results MVPA had a small effect on total ADHD core symptoms ( n = 11; g = −0.33; 95% CI [−0.63; −0.02]; p = .037). Conclusions MVPA could serve as an alternative treatment for ADHD. New RCTs are necessary to increase the understanding of the effect regarding frequency, intensity, type of MVPA interventions, and differential effects on age groups.
Attention deficit hyperactivity disorder (ADHD) is a frequent disorder in childhood and adolescence; however, approximately 50% of patients receive treatment that does not conform to the guidelines. For these untreated patients physical exercise, which is only mentioned in passing in the current guidelines, could be an alternative treatment option. Meta-analysis results have shown effects of physical exercise on ADHD symptoms in the moderate intensity range. Executive functions also seem to improve with physical activity. Initial studies particularly reported positive effects on vigilance and behavioral inhibition. The results suggest that cognitively demanding sports that immanently address executive functions, seem to be even more effective in improving executive functions. Thus, it is assumed that due to the increased effect on a central pathophysiological correlate of ADHD, specific cognitively demanding sports programs may be even more efficacious in improving ADHD symptoms than purely endurance-oriented sports programs.