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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder

Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder

Marissa Robles
KIN 4520: Psychosocial Aspects of Physical Activity
Louisiana State University

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder

Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder
Attention deficit hyperactivity disorder is a common mental disorder in children that can

continue all the way into adulthood. Symptoms of this disorder included difficulty focusing on
task, behavioral changes, hyperactivity, impulse behavior and even mood changes (Center for
Disease Control and Prevention, 2015). In the profession of athletic training, clinical patients
can include children in grade school all the way to adults in semi-professional and professional
sports. The athletic training curriculum does not focus on ADHD. When informed about mental
health, the curriculum tends to focus on concussion and its effect on the brain and depression.
Students are taught that these mental disorders are common and very serious. Therefore, students
are informed on techniques on how to identify characteristics of the mental disorders, how to
approach them and how to begin treatment. ADHD is not a common metal disorder recognized,
however it is apparent in the clinical setting how big of a role the disorder plays in athletes of all
ages. Athletic Trainers play a role in inter-profession collaboration to help accommodate athletes
with ADHD. The Athletic Trainer puts the athlete in contact with a doctor to help monitor the
mental disorder and administer medication, a psychologist to help cope with the disorder and a
even a nutritionist to help with their diet that could impact the disorder. Other than refer the
athlete, Athletic Trainers do not monitor or help with symptoms of ADHD. Is there an alternate
form of treatment Athletic Trainers could use, within the scope of their practice, to help with
ADHD symptoms? There are multiple studies that are exploring the treatment effects of physical
activity on the symptoms of athletes. It is important for Athletic Trainers to be able to help
athletes with ADHD, especially because referral resources are not regularly an option. At smaller
and low budget clinical sites, the Athletic Trainer may be the only resource. The purpose of this

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder



literature review is to determine if physical activity is a positive and beneficial treatment that
Athletic Trainers could prescribe to athletes of all ages with ADHD to help with their symptoms.
Literature Review
Physical Activity as Treatment for Children with ADHD
Children and adolescents are affected most by ADHD. Their personal, academic and
social lives can take a toll from the symptoms cause by the mental disorder (Center for Disease
Control and Prevention, 2015). Many studies are aimed at children using different forms of
exercise in school and outside of school as a way to minimize, lessen and cope with symptoms.
Studies are mostly comparing moderate to high- intensity activities and their benefit on a variety
of symptoms. Fitness level, motor skills, behaviors and cognitive functions were compared
before and after physical activity in children (Verret and Guay, 2010). Physical activity on a
daily basis is believed to help with brain function thus possibly helping make beneficial
alterations for children with ADHD. Positive findings included addition to strength and motor
skills, it positively influences behaviors and cognitive functions in children (Verret and Guay,
2010). Exercise has also been studied as a non-pharmacological treatment for symptoms in
children. Measures such as attention, brain neurophysiology and scholastic performance were
tested though exercise and its effect on neurocognitive function and inhibitory control (Pontifex
and Saliba, 2013). Changes in neurophysiology, with as little as 20 minutes of moderate to highintensity exercises, suggested an increase of cognitive function and inhibitory control. (Pontifex
and Saliba, 2013) suggest exercise as a stimulus, just as a pharmacological intervention would
act as. The stimulus helps alter symptoms without the adverse effects and implications on the

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder



body that a pharmacological intervention would create. Children, however, generally do not
participate and/ or are not willing to participate in moderate to vigorous activity. Children with
ADHD who performed intense physical activity versus children who did not perform physical
activity, showed improved performance for task that required attention (Silva and Prado, 2014).
Physical activity helped children with focus attention and greater impulse control. Physical
activity can have a positive impact on brain function, which can be positively reciprocated in
helping with personal, social and academic performance. There are many forms of physical
activity children and adolescences can partake in. These activities include physical education in
school, recess, sports, outside playtime at home and group physical activities. In order for the
outcomes of the mentioned studies, that suggest physical activity is a positive form of treatment
for children and adolescence with ADHD, to have significance more research needs to be
conducted. There is little research on physical activity and the development and cognitive
function (Verret and Guay, 2010) of children and adolescences. Most of the studies are based on
academic performance in school and the ability to remain focused on task.
Physical Activity as Treatment for Adults with ADHD
ADHD is persisting into adulthood from individuals who were diagnosed as children
(Berger and Mller, 2014). Since research in children has shown a positive effect of physical
activity as treatment for ADHD symptoms, research of the treatment in adults has surfaced.
Exercise as a substitution for pharmacology intervention in adults was based on the idea that:
Physical exercise provides a plethora of beneficial effects against stress, anxiety, depression,
negative affect and behavior, poor impulse control, and compulsive behavior concomitant with
improved executive functioning, working memory and positive affect(Archer and Kostrzewa,

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder




2011). Exercise has been used a therapeutic agent and treatment for many other forms of diseases
and co-morbidities such as obesity without negative effects and the outcomes have proven to be
beneficial. Applying intense planned exercise programs to adults with ADHD has shown positive
benefits and can be used instead of pharmacological interventions. Other studies, instead of
applying exercise program or exercise duration to adults with ADHD, compared the amount of
physical activity the individual was partaking in versus the number/ severity of their symptoms.
For people who were diagnosed as children, in their adulthood it was more likely for them to
participate in excessive exercising (Berger and Mller, 2014). Exercising for the individual
proved immediate and long-term improved cognitive function. There is a significant relationship
between abdominal fat and the number of ADHD reported symptoms. Furthermore, if an
exercise program that improves muscular strength and endurance were developed and applied, it
would contribute to a reduction in ADHD tendency in college students(Jeoung, 2014). Exercise
in adults as treatment for ADHD research is limited. The few conducted studies have found a
positive impact with individuals who exercise regularly. There is a minimum of studies
conducted on the fitness level of ADHD individuals and the number/ severity of their symptoms.
A few studies have prescribed exercise/ physical activity as treatment for ADH. A few studies
have researched the option of substituting exercise as a non-pharmacological approach. The
studies that have been conducted show positive data increased positive functions and impulse
control. In order for these outcomes to have significance more research needs to be conducted in
order to defend physical activity as treatment for ADHD in adults.
Physical Activity as Treatment in General for ADHD
In general, 50-65% of children diagnosed with ADHD, have symptoms that persist into

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder



adulthood (Jeoung, 2014). Treatment for ADHD in children, adolescences and adults include
medication and behavior modification. Because there is a long-term span of using these
treatments, the treatments can become costly and the maintenance of the treatments tends to
decrease as the individual ages (Halperin and Healey, 2011). These treatments are beneficial,
showing positive impacts on reducing the number and severity of symptoms due to ADHD. The
current research for all ages shows a positive impact of physical activity as treatment in reducing
the number and severity in for each specific group: children, adolescences and adults. In the
research that looked at exercise effects long-term (Rommel and Lichtenstein, 2015), indicated
physical activity was inversely related with ADHD symptoms. Based on studies of each group,
exercise as treatment has had a positive effect on individuals with ADHD and all studies concur
more research needs to be completed.
Conclusions
Summary of the Literature
(ADHD) is characterized by a pervasive pattern of developmentally inappropriate
inattentive, impulsive and hyperactive behaviors (Halperin and Healey, 2011). Athletic trainers
can use the evidence from these studies to help monitor athletes with ADHD. An athlete with
ADHD is hyperactive when he/she first begins an activity. The Athletic Trainer can monitor the
athlete so that the practice/ event does not expend them too quickly or entirely by the end. If the
Athletic Trainer is trained to monitor and look for symptoms, he/she can identify there is a
problem and attempt to help. Excessive motoric activity associated with clinically significant
ADHD symptoms may reflect compensatory efforts to modulate attention and alertness
(Hartanto and Krafft, 2015). Physical activity/ exercise as treatment for athletes can help in

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder




numerous ways. If the athlete is having adverse affects with medication that are interfering with
activities of daily living and even sports activities. Physical activity can be a less invasive
treatment. The treatment would help the athlete focus during team meetings, watching film,
listening to instructions and staying on task during practice/ event. If the athlete is in a
rehabilitation program, being ADHD, they can loose focus. By incorporating a moderate-tovigorous warm-up (if able), the athlete will be more likely to pay attention to the task being
asked for rehabilitation. The more intense the physical activity was, the more correct task the
individual performed (Halperin and Healey, 2011). It is important for the athlete to focus and
perform task in a correct to insure their safety, whether its play or rehabilitation exercise. The use
of physical activity as treatment for athletes of all ages with ADHD would be beneficial to aiding
with decreasing and minimizing the number of symptoms and the symptom severity.
Future Research
Further research is needed to support current studies. Current studies are limited by the given
the size of the effect, the clinical value of this intervention needs to be explored further
(Rommel and Lichtenstein, 2015). Further research can be conducted to narrow down the
concentrated areas that are being compared when assessing if physical activity is an effective
treatment for ADHD symptoms in individuals. Development and cognitive functions/
performance are concentrated areas that could benefit from a more narrow study (Gapin and
Labban, 2011). By narrowing, the data received from studies can be applied more specifically.
From this research, physical activity as treatment for general ADHD symptoms in children,
adolescents and adults can be supported. Therefore physical activity can be prescribed as
treatment.

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder


Practical Implications

The implication of these studies and future studies conducted with the concentration of
using physical activity as treatment for people of all ages with ADHD, would promote a
worldwide change in the treatment of ADHD. Based upon these largely distinct scientific
literatures, we propose an approach that employs directed play and physical exercise to promote
brain growth which, in turn, could lead to the development of potentially more enduring
treatments for the disorder (Halperin and Berwind, 2012). The general population could use a
non-invasive treatment form that would also more economical than pharmacological
interventions.

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Effects of Physical Activity as Treatment for Attention Deficit Hyperactive Disorder

References

Archer, T., & Kostrzewa, R. M. (2012). Physical exercise alleviates ADHD symptoms: regional
deficits and development trajectory. Neurotoxicity research, 21(2), 195-209.
Berger, N. A., Mller, A., Brhler, E., Philipsen, A., & de Zwaan, M. (2014). Association of
symptoms of attention-deficit/hyperactivity disorder with symptoms of excessive
exercising in an adult general population sample. BMC psychiatry, 14(1), 250.
Berwid, O. G., & Halperin, J. M. (2012). Emerging support for a role of exercise in attentiondeficit/hyperactivity disorder intervention planning. Current psychiatry reports, 14(5),
543-551.
Facts About ADHD. (2015, June 26). Retrieved November 16, 2015, from
http://www.cdc.gov/ncbddd/adhd/facts.html
Gapin, J. I., Labban, J. D., & Etnier, J. L. (2011). The effects of physical activity on attention
deficit hyperactivity disorder symptoms: the evidence. Preventive Medicine, 52, S70-S74.
Halperin, J. M., & Healey, D. M. (2011). The influences of environmental enrichment, cognitive
enhancement, and physical exercise on brain development: can we alter the
developmental trajectory of ADHD?. Neuroscience & Biobehavioral Reviews, 35(3),
621-634.
Hartanto, T. A., Krafft, C. E., Iosif, A. M., & Schweitzer, J. B. (2015). A trial-by-trial analysis
reveals more intense physical activity is associated with better cognitive control
performance in attention-deficit/hyperactivity disorder. Child Neuropsychology, (aheadof-print), 1-9.
Jeoung, B. J. (2014). The relationship between attention deficit hyperactivity disorder and healthrelated physical fitness in university students. Journal of exercise rehabilitation, 10(6),
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Pontifex, M. B., Saliba, B. J., Raine, L. B., Picchietti, D. L., & Hillman, C. H. (2013). Exercise
improves behavioral, neurocognitive, and scholastic performance in children with
attention-deficit/hyperactivity disorder. The Journal of pediatrics, 162(3), 543-551.
Rommel, A. S., Lichtenstein, P., Rydell, M., Kuja-Halkola, R., Asherson, P., Kuntsi, J., &
Larsson, H. (2015). Is Physical Activity Causally Associated With Symptoms of
Attention-Deficit/Hyperactivity Disorder?. Journal of the American Academy of Child &
Adolescent Psychiatry.

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Silva, A. P., Prado, S. O., Scardovelli, T. A., Boschi, S. R., Campos, L. C., & Frre, A. F. (2015).
Measurement of the Effect of Physical Exercise on the Concentration of Individuals with
ADHD. PloS one, 10(3), e0122119.
Verret, C., Guay, M. C., Berthiaume, C., Gardiner, P., & Bliveau, L. (2010). A physical activity
program improves behaviour and cognitive functions in children with ADHD: An
exploratory study. Journal of Attention Disorders.