1
|
Garrett J, Chak C, Bullock T, Giesbrecht B. A systematic review and Bayesian meta-analysis provide evidence for an effect of acute physical activity on cognition in young adults. COMMUNICATIONS PSYCHOLOGY 2024; 2:82. [PMID: 39242965 PMCID: PMC11358546 DOI: 10.1038/s44271-024-00124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/31/2024] [Indexed: 09/09/2024]
Abstract
Physical exercise is a potential intervention for enhancing cognitive function across the lifespan. However, while studies employing long-term exercise interventions consistently show positive effects on cognition, studies using single acute bouts have produced mixed results. Here, a systematic review and meta-analysis was conducted to determine the impact of acute exercise on cognitive task performance in healthy young adults. A Bayesian hierarchical model quantified probabilistic evidence for a modulatory relationship by synthesizing 651 effect sizes from 113 studies from PsychInfo and Google Scholar representing 4,390 participants. Publication bias was mitigated using the trim-and-fill method. Acute exercise was found to have a small beneficial effect on cognition (g = 0.13 ± 0.04; BF = 3.67) and decrease reaction time. A meta-analysis restricted to executive function tasks revealed improvements in working memory and inhibition. Meta-analytic estimates were consistent across multiple priors and likelihood functions. Physical activities were categorized based on exercise type (e.g., cycling) because many activities have aerobic and anaerobic components, but this approach may limit comparison to studies that categorize activities based on metabolic demands. The current study provides an updated synthesis of the existing literature and insights into the robustness of acute exercise-induced effects on cognition. Funding provided by the United States Army Research Office.
Collapse
Affiliation(s)
- Jordan Garrett
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, CA, USA.
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, CA, USA.
| | - Carly Chak
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, CA, USA
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, CA, USA
| | - Tom Bullock
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, CA, USA
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, CA, USA
| | - Barry Giesbrecht
- Department of Psychological & Brain Sciences, University of California, Santa Barbara, CA, USA.
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, CA, USA.
| |
Collapse
|
2
|
Chen JW, Du WQ, Zhu K. Optimal exercise intensity for improving executive function in patients with attention deficit hyperactivity disorder: systematic review and network meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02507-6. [PMID: 38922348 DOI: 10.1007/s00787-024-02507-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024]
Abstract
This study aimed to compare and rank the effectiveness of optimal exercise intensity in improving executive function in patients with ADHD (Attention deficit hyperactivity disorder, ADHD) through a comprehensive comparison of direct and indirect evidence. A systematic search was performed in five electronic databases to explore the optimal exercise intensity for improving executive function in patients with ADHD by directly and indirectly comparing a variety of exercise intervention intensities. In addition, the isolated effects of exercise on improving executive function in patients with ADHD were explored through classical meta-analysis of paired direct comparisons. Twenty-nine studies were retrieved and included in this study. Classical paired meta-analysis showed that for the patients with ADHD in the age group of 7-17 years, statistical difference was observed for all the parameters of exercise interventions (intensity, frequency, period, and training method), the three dimensions of executive function, the use of medication or not, the high and low quality of the methodological approach. Network meta-analysis showed that high-intensity exercise training was optimal for improving working memory (97.4%) and inhibitory function (85.7%) in patients with ADHD. Meanwhile, moderate-intensity exercise training was optimal for improving cognitive flexibility (77.3%) in patients with ADHD. Moderate to high intensity exercise training shows potential for improving executive function in these patients. Therefore, we recommend applying high-intensity exercise intervention to improve executive function in patients with ADHD to achieve substantial improvement.
Collapse
Affiliation(s)
- Ji-Wei Chen
- Shanghai University of Sport, Shanghai, China
| | - Wen-Qian Du
- Shanghai University of Sport, Shanghai, China
| | - Kun Zhu
- Shanghai University of Sport, Shanghai, China.
| |
Collapse
|
3
|
Wang YH, Gau SF, Yang LK, Chang JC, Cheong PL, Kuo HI. Acute aerobic exercise at different intensities modulates inhibitory control and cortical excitability in adults with attention-deficit hyperactivity disorder (ADHD). Asian J Psychiatr 2024; 95:103993. [PMID: 38485649 DOI: 10.1016/j.ajp.2024.103993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/30/2023] [Accepted: 03/02/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND This study aimed to investigate the effects of different aerobic exercise intensities on inhibitory control and cortical excitability in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS The study was conducted in a within-subject design. Twenty-four adults with ADHD completed a stop signal task and received cortical excitability assessment by transcranial magnetic stimulation (TMS) before and after a single session of low-, moderate-, high-intensity aerobic exercise or a control intervention. RESULTS Acute moderate-, and high-intensity aerobic exercise improved inhibitory control in adults with ADHD. Moreover, the improving effect was similar between moderate-, and high-intensity aerobic exercise conditions. As shown by the brain physiology results, short interval intracortical inhibition was significantly increased following both, moderate- and high-intensity aerobic exercise intervention conditions. Additionally, the alteration of short interval intracortical inhibition and inhibitory control improvement were positively correlated. CONCLUSIONS The moderate-, and high-intensity aerobic exercise-dependent alterations of cortical excitability in adults with ADHD might partially explain the inhibitory control-improving effects of aerobic exercise in this population.
Collapse
Affiliation(s)
- Yu-Han Wang
- School and Graduate Institute of Physical Therapy, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan
| | - Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Pou-Leng Cheong
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Hospital, No. 25, Lane 442, Section 1, Hsinchu, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao Tung University, 75 Po-Ai Street, Hsinchu 300, Taiwan
| | - Hsiao-I Kuo
- School and Graduate Institute of Physical Therapy, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan.
| |
Collapse
|
4
|
Donnelly S, Penny K, Kynn M. The effectiveness of physical activity interventions in improving higher education students' mental health: A systematic review. Health Promot Int 2024; 39:daae027. [PMID: 38563387 PMCID: PMC10985680 DOI: 10.1093/heapro/daae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Traditional interventions aiming to improve students' mental health and quality of life include meditation or canine therapy. The development of physical activity-related interventions has increased over the past decade. We aimed to review all studies using physical activity for improving the mental health and quality of life in higher education students whilst describing the interventions, measurements and effectiveness. A systematic search of six electronic databases including: ProQuest, MEDLINE, Embase, CINAHL, SPORTDiscus and CENTRAL, was conducted following PRISMA guidelines. Randomized or non-randomized controlled trial physical activity-related interventions involving higher education students aiming to improve their mental health and quality of life were included. Searches yielded 58 articles with interventions involving martial arts, sport, mind-body exercises and anaerobic exercises. Psychological measures varied across studies including the State Trait Anxiety Inventory, Beck Depression Inventory and the Perceived Stress Scale. Over half of the studies included in this review (n = 36) were effective in improving students' mental health or quality of life. Findings from our review suggest that interventions aiming to be effective in improving students' mental health quality of life should aim to deliver moderate-vigorous intensity exercises such as dance or Pilates. This systematic review was based on a published protocol in PROSPERO (registration number: CRD42022325975).
Collapse
Affiliation(s)
- Samantha Donnelly
- The University of the West of Scotland, Division of Sport, Exercise and Health, Stephenson Place, Hamilton International Technology Park, South Lanarkshire G72 0LH, UK
| | - Kay Penny
- University of Aberdeen, School of Medicine, Medical Sciences and Nutrition, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Mary Kynn
- Curtin University, Faculty of Science and Engineering, Wark Avenue, Bentley, WA 6102, Australia
| |
Collapse
|
5
|
Mehren A, Philipsen A. [Is Physical Activity a Treatment Option for ADHD?]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024; 52:124-133. [PMID: 38335974 DOI: 10.1024/1422-4917/a000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Is Physical Activity a Treatment Option for ADHD? Abstract: Physical activity as an option for the prevention and treatment of psychiatric disorders is increasingly becoming the focus of research. In particular, because of improvements in cognitive functioning, attentional performance, impulsivity, and hyperactivity, physical exercise could be a promising treatment option for attention deficit hyperactivity disorder (ADHD). In this narrative review, we present and evaluate the current state of research on exercise effects in children and adolescents as well as in adults with ADHD. While studies of the short-term effects of a single bout of physical activity indicate robust effects on attention and inhibitory control, results on the impact on further symptoms of ADHD as well as in adults are mixed. Randomized controlled trials of longer-term physical activity are scarce and show high heterogeneity. Nevertheless, they are encouraging for further research in this area.
Collapse
Affiliation(s)
- Aylin Mehren
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Deutschland
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Alexandra Philipsen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Deutschland
| |
Collapse
|
6
|
Chen JW, Zhu K. Single Exercise for Core Symptoms and Executive Functions in ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:399-414. [PMID: 38156611 DOI: 10.1177/10870547231217321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVES A systematic review and meta-analysis of studies of single exercise on core symptoms and executive function in adolescents with ADHD. METHODS Four databases were searched for studies of the effects of single exercise on core symptoms and executive functioning in adolescents with ADHD. RESULTS Thirteen studies were included, and a single session of exercise had small effect-size improvements in core symptoms and executive function in adolescents with ADHD: 10 to 13 year olds in the early adolescent-elementary school years and 18 to 24 year olds in the late adolescent-college years. Moderate-intensity continuous training, high-intensity interval training, single sessions of less than 30 minutes, and single sessions of 30 minutes and more significantly improved cycling training, attention, inhibition, substance use, and pre-study abstinence. CONCLUSIONS A single session of exercise had an overall ameliorative effect on core symptoms and executive function in adolescents with ADHD.
Collapse
Affiliation(s)
| | - Kun Zhu
- Shanghai University of Sport, China
| |
Collapse
|
7
|
Bodalski EA, Flory K, Meinzer MC. A Scoping Review of Factors Associated With Emotional Dysregulation in Adults With ADHD. J Atten Disord 2023; 27:1540-1558. [PMID: 37470198 DOI: 10.1177/10870547231187148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Emotion dysregulation is frequently seen in adults with ADHD and is associated with many adverse outcomes. We conducted a scoping review of factors associated with emotion dysregulation in adults with ADHD. METHOD PubMed and PsycInfo (EBSCO) were searched. Articles were included if they measured ADHD, emotional dysregulation or some aspect of emotional dysregulation, and at least one other construct. Studies examining physiological underpinnings as well as clinical trials examining the effect of ADHD medications on emotional dysregulation were excluded because recent reviews have already examined these topics. RESULTS Thirty-five studies were included in the review. Factors such as biological sex, comorbidities, attachment style, using certain emotional regulation strategies, and ADHD subtype tend to be related to emotion dysregulation. CONCLUSION Clinicians working with adults with ADHD can collect information on these factors to better understand risk for emotion dysregulation, and emotion regulation skills may be one area for intervention.
Collapse
Affiliation(s)
| | - Kate Flory
- University of South Carolina, Columbia, USA
| | | |
Collapse
|
8
|
Svedell LA, Holmqvist KL, Lindvall MA, Cao Y, Msghina M. Feasibility and tolerability of moderate intensity regular physical exercise as treatment for core symptoms of attention deficit hyperactivity disorder: a randomized pilot study. Front Sports Act Living 2023; 5:1133256. [PMID: 37255729 PMCID: PMC10225649 DOI: 10.3389/fspor.2023.1133256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/21/2023] [Indexed: 06/01/2023] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is associated with sedentary lifestyle, low quality of life and low physical fitness. Studies in children with ADHD have shown that regular physical exercise can help reduce core ADHD symptoms, but evidence for this is lacking in adults. Although guidelines recommend multi-modal treatment, central stimulants (CS) remain the mainstay of treatment. CS are effective in the short-term, but their long-term efficacy remains to be established. There is thus huge unmet need for developing non-pharmacological treatment options, and for well-designed randomized controlled trials (RCTs). Objective The study aimed to test the feasibility and tolerability of structured moderate-intensity 12-week physical exercise program for adults with ADHD, as a prelude to an adequately powered RCT which includes long-term follow-up. Materials and methods Fourteen adults with ADHD were recruited, 9 randomized to an intervention group and 5 to a control group. The intervention group received physiotherapist-led 50-minute mixed exercise program, three times a week for 12 weeks, and the control group treatment as usual. Participants were assessed at baseline and after 6 and 12 weeks using clinical and physical evaluations, self-rating questionnaires, and functional magnetic resonance imaging (fMRI) together with paradigms that tested attention, impulsivity and emotion regulation. Results Three participants (21%) dropped out shortly after inclusion before receiving any intervention, while roughly 80% completed the intervention according to protocol. One participant from the intervention group participated in less than 60% of treatment sessions, and one who had done baseline fMRI was unwilling to do post-intervention imaging. Four participants in the intervention group (67%) reported increased stress in prioritizing the intervention due to time-management difficulties. Overall, consistent trends were observed that indicated the feasibility and potential benefits of the intervention on core ADHD symptoms, quality of life, body awareness, sleep and cognitive functioning. Conclusion Physiotherapist-led twelve-week regular physical exercise is a feasible and potentially beneficial intervention for adults with ADHD. There was a 20% drop-out initially and 67% of those who completed the intervention reported stress with time management difficulties due to participation. A third arm was thus added to the planned RCT where cognitive intervention administered by an occupational therapist will be given together with physical exercise.Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT05049239.
Collapse
Affiliation(s)
- L. A. Svedell
- Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - K. L. Holmqvist
- Department of Neurology and Rehabilitation Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M. A. Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Y. Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M. Msghina
- Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
9
|
Ogrodnik M, Karsan S, Cirone V, Heisz JJ. Exploring the Relationship between Cardiorespiratory Fitness and Executive Functioning in Adults with ADHD. Brain Sci 2023; 13:673. [PMID: 37190638 PMCID: PMC10136722 DOI: 10.3390/brainsci13040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD. METHOD Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 ADHD; n = 36 Control). Participants completed the Six-Minute Walk Test to estimate CRF. RESULTS Mean performance measures of executive function did not differ by group. However, higher estimated CRF was associated with better Stroop task performance, and the association was strongest for individuals with ADHD. CONCLUSION In adults with ADHD, higher estimated CRF was associated with better inhibitory control, but not with other measures of executive functioning.
Collapse
Affiliation(s)
- Michelle Ogrodnik
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Sameena Karsan
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Victoria Cirone
- Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, The Centre for Aging SMART, The University of British Columbia, Vancouver, BC V1Y 1T3, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| |
Collapse
|
10
|
Zhang Y, Hasibagen, Zhang C. The influence of social support on the physical exercise behavior of college students: The mediating role of self-efficacy. Front Psychol 2022; 13:1037518. [PMID: 36532973 PMCID: PMC9756807 DOI: 10.3389/fpsyg.2022.1037518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/14/2022] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES To study the influencing factors on college students' physical exercise behavior and the mediating relationship of self-efficacy based on the theory of social support and self-efficacy; to provide theoretical support and practical guidance for college students engaging independently in physical exercise. METHODS A total of 1,440 college students from six universities in the Inner Mongolia Autonomous Region of China were selected as the research objects, and three scales (Self-Efficacy Scale, Social Support Scale, and Physical Exercise Rating Scale) were used to construct a structural equation model. RESULTS (1) A comprehensive sports facility environment is conducive to college students' physical activities and the emotional support of friends and family and the campus cultural atmosphere cannot be ignored. (2) Peer support has a direct impact on physical exercise behavior, family support and school support indirectly affect college students' physical exercise behavior, based on the intermediary role of self-efficacy. (3) According to the total effect, social support was ranked as school support (0.444), peer support (0.312), and family support (0.145). CONCLUSION Social support not only directly affects physical exercise behavior but also indirectly affects physical exercise behavior based on the mediating effect of self-efficacy.
Collapse
Affiliation(s)
- Yan Zhang
- School of Resource and Environmental Economy, Inner Mongolia University of Finance and Economics, Hohhot, China
| | - Hasibagen
- School of Resource and Environmental Economy, Inner Mongolia University of Finance and Economics, Hohhot, China
| | - Chang Zhang
- School of Business, Central South University, Changsha, China
| |
Collapse
|