ADHD and Exercise

There is a myriad of known benefits of exercise. It has been cited as an essential part of the solution in combating obesity, major illnesses and various psychological disorders, and it’s no surprise to discover that physical activity is now considered a key component of ADHD treatment in both adults and children. This is excellent news considering that ADHD is now the most common behavioural disorder in the UK, with estimates suggesting that it affects about 2-5% of school-aged children and young people. Its full impact is believed to be underestimated by public health officials and there is no single identifiable cause as of yet.

For those not acquainted with the symptoms of this condition, ADHD or attention deficit/hyperactivity disorder (sometimes referred to as hyperkinetic disorder in extreme cases) is a behavioural disorder that comes with a mix of symptoms that can make everyday life far more challenging for the individuals in question. The symptoms listed by the National Institute for Health and Care Excellence (NICE) are split into three main areas: ‘inattentive – unable to concentrate for very long or finish a task, disorganised, often losing things, easily distracted and forgetful, unable to listen when people are talking’, ‘hyperactive – fidgety and unable to sit still, restless (children may be running or climbing much of the time), talking constantly, noisy, having difficulty doing quiet activities’, and ‘impulsive – speaking without thinking about the consequences, interrupting other people, unable to wait or take their turn’ (2008). These symptoms can seriously affect an individual’s ability to perform in the classroom or workplace, causing issues with sleeping, clumsiness, mood swings and socialising amongst other things.

There have been various medications made available over the years, including methylphenidate, dexamfetamine, lisdexamfetamine and atomoxetine. Although medication can work for many, some individuals report side effects that can cancel out the benefits and simply leave the patient with a new list of symptoms. Different diets, supplements, or therapy have also been tried with varying success, alongside other coping mechanisms. However, recent studies have found that regular exercise can bring positive results across the board, including noticeable improvements in concentration, less impulsivity and greater feelings of calm.

One such study investigated the effects of an 8-week aquatic exercise program on inhibitory control in children with ADHD. Participants were monitored for small and large muscle control, static and dynamic balance, and hand-eye coordination and showed significant improvements in accuracy and coordination of motor skills, suggesting that ‘an exercise program that involves both gross and fine exercise characteristics facilitates the restraint inhibition [success in withholding motor actions during a response] component of behavioural inhibition in children with ADHD’ (Chang, Hung, Huang, Hatfield & Hung, 2014, p.217).

Physical Activity, Physical Education and ADHD Symptoms

Another study in 2012 suggested a similar link between physical activity and the lessening of ADHD symptoms, concluding that ‘physical exercise reduces stress, negative effect, anxiety, and depression, as well as self-destructive behaviour (e.g. bad conduct), poor impulse control and inattentiveness’ (Archer & Kostrzewa, 2012, p.203). Another study in 2019 also found that moderate to high intensity exercise during PE lessons can improve cognitive function and behaviour in children including those with attention-deficit/hyperactivity disorder (ADHD).

It is thought that exercise combats ADHD symptoms by increasing the neurotransmitters dopamine and norepinephrine – both of which play a large role in regulating an individual’s attention span and prevent an overreaction to any situation. And when it comes to choosing an exercise, the more complex the activity, the better the effect on combating some of the more obvious symptoms such as fidgeting. Activities involving high levels of technical movement such as ballet, rock climbing, gymnastics and martial arts activate parts of the brain that control balance, timing, fine motor adjustments, concentration and error correction, boosting cognitive abilities as a result. Although even walking just three days a week can make a difference in working memory ability to focus. Including a variety of activities is also important, as one factor in ADHD can be the desire for novelty. Participating in a variety of sports and activities helps to alleviate the potential for boredom, as does listening to different music whilst exercising.

Not everyone with ADHD will experience a dramatic and immediate improvement of all symptoms after beginning a regular exercise routine, and it is not suggested as a replacement for medication. ADHD symptoms vary in different individuals, and it will help to experiment with different types of activity and exercise routines (some report better results after working out first thing in the morning, for example). However, the growing body of evidence suggests a clear benefit to the inclusion of exercise as a part of the solution. Instead of demanding that children sit still and listen, we should be encouraging them to move about, jump around and run.

References

• Archer, T., Kostrzewa, R. Physical Exercise Alleviates ADHD Symptoms: Regional Deficits and Development Trajectory. Neurotoxicity Research [serial online]. February 2012:21(2):195-209. Available from: Academic Search Complete, Ipswich, MA. Accessed September 8, 2014.
• Chang, Y., Huang, C., Hatfield, B., Hung, T. Effects of an Aquatic Exercise Program on Inhibitory Control in Children with ADHD: A Preliminary Study. Archives Of Clinical Neuropsychology [serial online]. n.d.; 29(3):217-223. Available from: Science Citation Index, Ipswich, MA. Accessed September 8, 2014.
• National Institute for Health and Care Excellence (2008) Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults. https://www.nice.org.uk/guidance/cg72 [online]. Accessed September 8 2014.

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