1
|
Ward JH, McBride A, Price A, Delgado TN. Psychosocial interventions for improving the physical health of young people and adults with attention deficit hyperactivity disorder: a scoping review. BMC Psychiatry 2024; 24:569. [PMID: 39164688 PMCID: PMC11337789 DOI: 10.1186/s12888-024-06009-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 08/08/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Young people and adults with ADHD are at risk of a range of physical health problems. There is limited guidance on how to approach health problems in ADHD, and especially around 16-25 year olds who will be transitioning from paediatric to adult care. The aim of this scoping review was to identify psychosocial interventions that target physical health in young people and adults with ADHD. METHODS We constructed searches in MEDLINE, PsycInfo, EMBASE of adolescents, young people and adults. Inclusion criteria were; studies of psychosocial interventions examining a component of physical health, applicable to people aged 16-25, with clinical or research diagnoses of ADHD. Data were extracted using a data extraction tool and tabulated, including study intervention framing/aims, population, intervention, and relevant outcomes (including specific statistics where relevant). RESULTS Our search identified 22 unique papers covering, psychosocial interventions targeting at least one of sleep (n=7), smoking (n=3), substance/alcohol use (n=4), physical health/exercise (n=6) and general health (n=3). Studies examined psychotherapy/behaviour interventions (n=12), psychoeducation (n=4), digital (n=2) and social interventions (n=4). There was significant heterogeneity in intervention framing, outcome measures and population. CONCLUSION Further work on the impact of targeted physical health interventions, with explicit reference to a conceptual framework of poor health in ADHD is required. Furthermore, future work standardising reporting of physical health outcomes in ADHD is crucial for the development of an evidence base in this field.
Collapse
Affiliation(s)
- John Headley Ward
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK.
- Royal Devon University NHS Foundation Trust, Exeter, UK.
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Audrey McBride
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
| | - Anna Price
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
| | - Tamsin Newlove Delgado
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
| |
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
|
Qiu C, Zhai Q, Chen S. Effects of Practicing Closed- vs. Open-Skill Exercises on Executive Functions in Individuals with Attention Deficit Hyperactivity Disorder (ADHD)-A Meta-Analysis and Systematic Review. Behav Sci (Basel) 2024; 14:499. [PMID: 38920831 PMCID: PMC11200859 DOI: 10.3390/bs14060499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: Previous studies have identified discrepancies in improvements in executive functioning in typically developing children when comparing closed- and open-skill exercise interventions. However, there is limited research on executive functioning in attention deficit hyperactivity disorder (ADHD). This study aims to conduct a systematic review and meta-analysis to explore the impact of closed- and open-skill exercises on ADHD populations. (2) Methods: The PRISMA guidelines for systematic reviews were followed to search seven databases to evaluate and analyze studies published from 2013 to 2023. Prospero: CRD42023460452. (3) Results: A meta-analysis of 578 subjects with ADHD in 11 RCTs (Randomized control trial) and 3 NRS (Non-randomized studies) revealed that closed-skill exercise significantly improved executive function subdomains, including inhibitory control (standardized mean differences (SMD) = -1.00), cognitive flexibility (SMD = -1.33), and working memory (SMD = -0.85). Furthermore, open-skill exercise was found to have a positive effect on inhibitory control (SMD = -1.98) and cognitive flexibility (SMD = -0.97) in ADHD patients. Both types of exercise interventions demonstrated an improvement in executive function compared to controls, with open-skill exercises exhibiting superior effects (Qb = 6.26). (4) Conclusions: The review recommends a 12-week intervention cycle with exercise at least twice a week of moderate or higher intensity as suitable for ADHD individuals. This review also encourages individuals with ADHD to engage in exercises involving multiple motor skill types.
Collapse
Affiliation(s)
| | - Qun Zhai
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China; (C.Q.); (S.C.)
| | | |
Collapse
|
4
|
Liu C, Liang X, Yang Y, Liu R, Arbour-Nicitopoulos K, Sit CHP. Mechanisms Linking Physical Activity With Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review. Am J Prev Med 2024:S0749-3797(24)00179-X. [PMID: 38844148 DOI: 10.1016/j.amepre.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION Physical activity (PA) is a promising way to improve mental health in children and adolescents with neurodevelopmental disorders (NDDs). However, the underlying mechanisms remain unclear. The current review aimed to explore the potential neurobiological, psychosocial, and behavioral mechanisms between PA interventions and mental health in children and adolescents with NDDs. METHODS Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC were searched from inception to June 2023. Randomized controlled trials/quasi-experimental designs applying PA interventions and reporting at least one mental health outcome and at least one potential mechanism in children and adolescents with NDDs were included. The best evidence synthesis rating system was adopted to determine the strength and consistency of potential mechanisms and was performed in 2024. RESULTS In total, 45 studies were included, 29 of which were randomized controlled trials and 16 were quasi-experimental, with a total of 1,751 participants. According to the best evidence synthesis rating system, neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms were the frequently examined and consistent mechanisms through which PA affected mental health in children and adolescents with NDDs. However, evidence regarding P3 latency, beta activity, and physical self-concept was insufficient. DISCUSSION Future PA interventions could consider neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms. Alternatively, PA can be developed as an adjunctive approach with interventions that specifically focus on these mechanisms to enhance mental health in children and adolescents with NDDs.
Collapse
Affiliation(s)
- Chang Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yijian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ran Liu
- The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China
| | | | - Cindy Hui-Ping Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| |
Collapse
|
5
|
Yu Y, Xia L, Yan H, Lu Y. Effects of 8 weeks parent-accompanied swimming on physical capacity and intelligence in preschool children. Front Public Health 2024; 12:1410707. [PMID: 38883199 PMCID: PMC11176541 DOI: 10.3389/fpubh.2024.1410707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
This study aimed to explore the potential effects of 8-week parents-accompanied swimming on the physical capacity and intelligence of preschool children in China. Thirty-six boys (mean age 3.56 ± 0.27 years) were divided into three groups: the traditional physical exercise group (TP, n = 12), the accompanied swimming group (AS, n = 12) and the independent swimming group (IS, n = 12). Participants' physical capacity was assessed before and after the intervention using the following indicators: height, weight, distance of tennis ball throw, standing long jump distance, time for the 10-meter shuttle run, time for a two-legged continuous jump, sit-and-reach distance, and time on the walking balance beam. Intelligence was assessed at three points: pre-test, mid-test after 4 weeks, and post-test. Data were analyzed using a two-way repeated measures ANOVA, Bonferroni test (p < 0.05) and effect size. The time of the AS and IS groups to walk the balance beam was significantly lower than the TP group, with a difference of 1.81 s (p < 0.01, [95% CI -3.22 to -0.40], ES = 1.53) and 1.25 s (p < 0.05, [95% CI -2.66 to 0.16], ES = 0.81). At the mid-test, the IQ scores of the TP group were lower than the AS group (p < 0.05, [95% CI -12.45 to -0.96], ES = 0.89). Additionally, at post-test, the IQ scores of the TP group were significantly lower than those of both AS (p < 0.01, [95% CI -14.12 to -2.74], ES = 1.15) and IS groups (p < 0.01, [95% CI -12.53 to -3.31], ES = 1.21). Swimming enhances children's balance and IQ scores more than traditional physical exercises. Involving parents in swimming leads to a more significant increase in IQ scores within 4 weeks of initial swimming exercise.
Collapse
Affiliation(s)
- Yichao Yu
- The School of Sports Coaching, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
| | - Lei Xia
- Shenzhen School Affiliated to Sun Yat-sen University, Shenzhen, China
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
| | - Huiping Yan
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
| | - Yifan Lu
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sport University, Beijing, China
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing, China
| |
Collapse
|
6
|
Liu C, Liang X, Sit CHP. Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024; 178:247-257. [PMID: 38285440 PMCID: PMC10825789 DOI: 10.1001/jamapediatrics.2023.6251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/24/2023] [Indexed: 01/30/2024]
Abstract
Importance Children and adolescents with neurodevelopmental disorders experience mental health issues and are encouraged to be brought together in real-life treatment. However, physical activity, which is a promising method for boosting mental health, has only been examined in children and adolescents with certain types of neurodevelopmental disorders. Objective To examine the association of physical activity interventions with mental health (ie, cognitive function, psychological well-being, internalizing, and externalizing problems) in children and adolescents with neurodevelopmental disorders and to identify possible moderators. Data Sources Studies were searched from inception to May 2023 through Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC. Study Selection Randomized clinical trials or nonrandomized designs applying physical activity interventions and reporting at least 1 mental health outcome in children and adolescents aged 5 to 17 years with neurodevelopmental disorders were included. Two independent reviewers selected and assessed the studies. Data Extraction and Synthesis Random multilevel meta-analysis using Hedges g was performed. Data extraction and risk-of-bias assessment were conducted by multiple reviewers. Heterogeneity, publication bias, sensitivity analysis, and moderator analysis were examined to substantiate the results. Main Outcomes and Measures The main outcomes were mental health related to cognitive function, psychological well-being, internalizing, or externalizing problems measured by neurocognitive tasks or subjective questionnaires. Results A total of 76 studies involving 3007 participants were included in systematic review, 59 of which were used for meta-analysis. The findings indicated that physical activity interventions were associated with significant benefits for overall mental health (g, 0.67; 95% CI, 0.50-0.85), cognitive function (g, 0.74; 95% CI, 0.53-0.95), psychological well-being (g, 0.56; 95% CI, 0.16-0.96), internalizing (g, 0.72; 95% CI, 0.34-1.10), and externalizing problems (g, 0.58; 95% CI, 0.28-0.89). Moderators were also identified: frequency, total sessions, and total duration for overall mental health; total sessions, and total duration for cognitive function; session duration and frequency for psychological well-being; physical activity type for internalizing problems; and session duration for externalizing problems. Moderator analyses showed that type of neurodevelopmental disorder did not modify the associations between physical activity and overall mental health or its subgroups. Conclusions and Relevance The findings in this study suggest that children and adolescents with different types of neurodevelopmental disorders may be grouped together when performing physical activity interventions, which were confirmed to be beneficial to overall mental health and its subgroups in this new diagnostic population, but that physical activity interventions should be tailored when targeting different mental health domains.
Collapse
Affiliation(s)
- Chang Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Cindy H. P. Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| |
Collapse
|
7
|
Wilens TE, Stone M, Lanni S, Berger A, Wilson RLH, Lydston M, Surman CB. Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions. J Atten Disord 2024; 28:751-790. [PMID: 38178649 DOI: 10.1177/10870547231218925] [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: 01/06/2024]
Abstract
INTRODUCTION Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear. METHODS We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD. RESULTS Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions. CONCLUSION A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.
Collapse
Affiliation(s)
- Timothy E Wilens
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Stone
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Amy Berger
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Craig B Surman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
8
|
Doyenart R, Boeira D, Milhomens YP, Oliveira Silva da Silva V, Zilli Réus G, Silveira PCL, da Silva LA. Effects of aquatic high intensity interval training on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly subjects with type 2 diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:826-838. [PMID: 36780534 DOI: 10.1080/09603123.2023.2175797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
The present study investigated the effects of aquatic exercise on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly patients with DM2. A total of 130 elderly were included in the longitudinal clinical study and were attributed to the non-diabetic group (n = 27) and diabetes the group (n = 22). Both groups participated in 24 sessions of Hydro-HIIT, 48 h before and after Hydro-HIIT, the GDLAM index, depression, and anxiety scores and markers of oxidative dysfunction were quantified. After intervention, GI decreased in both groups (non-diabetes group = -24%; diabetes group = -22%) (p < 0.05), markers of depression (-46%), anxiety (-60%), DCFH-DA (-55%), SOD (+59%), TNF-α (-37%) and IL-1 (-48%) in diabetes group (p < 0.05). The intervention with Hydro-HIIT improves aspects related to functional autonomy, mental health, and exerts consequently, a modulating effect on oxidative stress and inflammatory response in elderly people diagnosed with DM2.
Collapse
Affiliation(s)
- Ramiro Doyenart
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Daniel Boeira
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Yuri Pinheiro Milhomens
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Vitória Oliveira Silva da Silva
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gislaine Zilli Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Exercise Biochemistry and Physiology, Graduate Programme in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | | |
Collapse
|
9
|
Sun F, Fang Y, Chan CKM, Poon ETC, Chung LMY, Or PPL, Chen Y, Cooper SB. Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis. Child Care Health Dev 2024; 50:e13150. [PMID: 37433667 DOI: 10.1111/cch.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND The efficacy of structured physical exercise (SPE) has been examined in empirical studies to treat attention deficit hyperactivity disorder (ADHD). This review aimed (i) to systematically review and quantify the effects of SPE on ADHD symptomology and executive function (primary outcomes) and on physical health, physical fitness and mental health issues (secondary outcomes) in children/adolescents with ADHD; (ii) to evaluate the study quality and explore moderation of the effects of SPE; and (iii) to summarize the design of SPE interventions. METHODS An extensive literature search in the databases of PubMed, Web of Science and EBSCOhost was conducted to identify eligible intervention studies for meta-analysis. A descriptive account of the features of the studies is provided, including assessment of risk/quality (ROB-2/ROBINS-I). Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated with random effects models to compare post-intervention effects. RESULTS A total of 18 studies were included in the review. The majority of the studies examined the effects of SPE lasting for 3-12 weeks. Assessment of bias/quality indicated half of the included studies as high quality. The meta-analysis (pooled n = 627) revealed that SPE had a positive effect on primary and secondary outcomes, that is, inattention (SMD = -1.79), executive function (SMD = 2.19), physical fitness (SMD = 1.39) and mental health issues (SMD = -0.89). Subgroup analysis showed that long-term practice of SPE, featured/tailored SPE, non-Chinese participants, taking methylphenidate and study with low quality had larger effects. CONCLUSIONS There is emerging evidence that SPE is a promising option to enhance symptom management and physical/mental health in children/adolescents with ADHD.
Collapse
Affiliation(s)
- Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Carmen Ka Man Chan
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Eric Tsz Chun Poon
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Louisa Ming Yan Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Peggy Pui Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Simon B Cooper
- Department of Sport Sciences, Sport, Health and Performance Enhancement (SHAPE) Research Centre, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
10
|
Shi P, Zhang Z, Feng X, Li C, Tang Y. Effect of physical exercise in real-world settings on executive function of atypical children: A systematic review and meta-analysis. Child Care Health Dev 2024; 50:e13182. [PMID: 37873578 DOI: 10.1111/cch.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 09/07/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Impaired executive function is a core symptom of cognitive impairment in atypical children. The purpose of this systematic review and meta-analysis is to explore the effectiveness of interventions for exercise in real-life settings on executive function in atypical children. METHODS This study searched the CNKI, Wan-Fang, VIP, WOS, PubMed, Scopus and EBSCO databases. Two researchers independently selected articles, extracted data and assessed the risk of bias for the included studies. Exercise activities were categorized into open and closed skills based on the unpredictability of the environmental context and into sequential and continuous skills based on the complexity of the movement structure. Based on these two classifications, motor skills were categorized into open-sequential (e.g. basketball), open-continuous (e.g. obstacle running), closed-sequential (e.g. martial arts) and closed-continuous (e.g. swimming) skills. The SPSS 25.0 and Stata 16.0 software were used for statistical analysis. RESULTS A total of 19 articles (23 studies) were included in the systematic review and meta-analysis. The participants were 990 atypical children with neurodevelopmental disorders. Physical exercise in real-world settings had significant intervention effects on inhibitory control (SMD = -0.592, P = 0.033), working memory (SMD = -0.473, P = 0.034) and cognitive flexibility (SMD = -0.793, P = 0.014) in atypical children. Quantitative intervention characteristics and motor skill types moderated the effect of exercise on promoting executive function in atypical children. Overall, exercise for 30-50 min, three to seven times a week for less than 10 weeks is effective in improving executive function in atypical children. Open skills and sequential skills have a positive intervention effect on more dimensions of executive function in atypical children. CONCLUSIONS Physical exercise in real-world settings has a positive intervention effect on executive function in atypical children. We should design interventions based on the personality traits of the subject and the type of exercise they are interested in to better promote improved executive function in atypical children.
Collapse
Affiliation(s)
- Peng Shi
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Ziyun Zhang
- School of Life and Health, Huzhou College, Huzhou, China
| | - Xiaosu Feng
- School of Physical Educaiton, Liaoning Normal University, Dalian, China
| | - Chenyang Li
- Department of Physical Education, Huaiyin Institute of Technology, Huaian, China
| | - Yan Tang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
11
|
Donath C, Atzmüller L, Florack J, Engel C, Luttenberger K. [The Effect of Exercise Therapy on Adolescent Mental Health: A Systematic Review with Practical Example]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2023; 52:94-108. [PMID: 38063057 DOI: 10.1024/1422-4917/a000960] [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: 03/05/2024]
Abstract
The Effect of Exercise Therapy on Adolescent Mental Health: A Systematic Review with Practical Example Abstract: The mental health of children and adolescents in Germany is currently highly burdened. Because of the psychotherapeutic care situation, easily accessible, less stigmatizing, and efficient offers are urgently needed. Exercise therapy would be one possibility. However, the effectiveness of such offers must first be proven. We conducted a systematic review concerning the effectiveness of exercise therapy on the mental health of children and adolescents which included studies since 2020 (subsequent to Hale et al., 2021). We analyzed a total of 17 intervention studies based on the PRISMA statement. The results show that exercise therapy interventions significantly affect certain populations: Attention and cognitive skills significantly improved in children and adolescents with ADHD; for depression, we found positive effects for affection. Some studies revealed significant effects across populations on the quality of life and sleep. In children and adolescents with autism or learning disabilities, we found positive effects on social behavior. Thus, according to the literature, exercise therapy is a recommendable therapy option for children and adolescents with mental health problems. As an illustration, we present a boulder intervention as a combined exercise intervention and psychotherapy along with its feasibility as a possible practical example.
Collapse
Affiliation(s)
- Carolin Donath
- Universitätsklinikum Erlangen, Klinik für Psychiatrie und Psychotherapie, Zentrum für Medizinische Versorgungsforschung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Lukas Atzmüller
- Universitätsklinikum Erlangen, Klinik für Psychiatrie und Psychotherapie, Zentrum für Medizinische Versorgungsforschung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Jakob Florack
- St. Joseph Krankenhaus, Klinik für seelische Gesundheit im Kindes- und Jugendalter, Berlin, Deutschland
- Vivantes Klinikum im Friedrichshain, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Berlin, Deutschland
| | - Caroline Engel
- Vivantes Klinikum im Friedrichshain, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Berlin, Deutschland
| | - Katharina Luttenberger
- Universitätsklinikum Erlangen, Klinik für Psychiatrie und Psychotherapie, Zentrum für Medizinische Versorgungsforschung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| |
Collapse
|
12
|
Hadar-Frumer M, Ten-Napel H, Yuste-Sánchez MJ, Rodríguez-Costa I. Feasibility of Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Framework for Aquatic Activities: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1856. [PMID: 38136058 PMCID: PMC10741913 DOI: 10.3390/children10121856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: In recent years, reviewing studies of aquatic activities for children with developmental delays has been a complex task due to the multitude of indices and professional languages. (2) Aim: To determine if the ICF-CY framework can be used as the unifying language in AA studies of children with DD. (3) Methods: Part One-A systematic review of selected studies focusing on goals that were found to be positive. These goals were linked to the ICF-CY categories. Part Two-Review of all studies using the ICF-CY's functioning components. (4) Results: Most of the positive goals were properly linked to ICF-CY and made it possible to review the 71 articles in a uniform language. (5) Conclusions: It is feasible to use the ICF framework as a universal structure and language.
Collapse
Affiliation(s)
- Merav Hadar-Frumer
- Israel Sport Centre for the Disabled (ISCD) Ilan Spivak, Ramat Gan 52535, Israel;
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain;
| | - Huib Ten-Napel
- WHO-FIC Collaborating Centre RIVM, 3720 Bilthoven, The Netherlands;
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 Nijmegen, The Netherlands
| | | | - Isabel Rodríguez-Costa
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain;
| |
Collapse
|
13
|
Li XW, Xin YF, Chang AH, Zhang XG, Weng Y, Yang JH, Fu QZ. Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke. World J Psychiatry 2023; 13:912-918. [DOI: 10.5498/wjp.v13.i11.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/09/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.
AIM To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.
METHODS Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study. Based on Hospital Anxiety and Depression Scale (HADS) scores measured before rehabilitation, patients with HADS scores ≥ 8 were divided into the psychological group; otherwise, the patients were included in the normal group. Motor function and daily living abilities were compared between the normal and psychological groups. Correlations between the motor function and psychological status of patients, and between daily living ability and psychological status of patients were analyzed.
RESULTS After 1, 2, and 3 wk of rehabilitation, both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores (P < 0.05). A greater degree of improvement was observed in the normal group compared to the psychological group (P < 0.05). There was a negative correlation between negative emotions and limb rehabilitation (-0.592 ≤ r ≤ -0.233, P < 0.05), and between negative emotions and daily living ability (-0.395 ≤ r ≤ -0.199, P < 0.05).
CONCLUSION There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders. The higher the negative emotions, the worse the rehabilitation effect.
Collapse
Affiliation(s)
- Xiao-Wan Li
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yu-Fu Xin
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Ai-Hui Chang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Xiao-Ge Zhang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yan Weng
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Jia-Hao Yang
- Department of Logistics, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Qi-Zhi Fu
- Department of Medical Intensive Care Unit, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| |
Collapse
|
14
|
Li J, Zhou X, Huang Z, Shao T. Effect of exercise intervention on depression in children and adolescents: A systematic review and network meta-analysis. J Affect Disord 2023:S0165-0327(23)01209-0. [PMID: 37832731 DOI: 10.1016/j.jad.2023.10.044] [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] [Received: 05/15/2023] [Revised: 09/08/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVES To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents. METHODS Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA). RESULTS A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2 %), followed by group training (62.5 %), resistance exercise (59.0 %), and aerobic combined with resistance exercise (57.9 %). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD = -0.41, 95 % CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD = -0.25, 95 % CI (-0.41, -0.08), P < 0.01); SMD = -0.15, 95 % CI (-0.31, -0.00), P < 0.01; SMD = -0.75, 95 % CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD = -0.14, 95 % CI (-0,81, -0.01), P < 0.01), and 40-50 min of exercise had the best effect (SMD = -0.17, 95 % CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD = -0.42, 95 % CI (-0,66, -0.18), P < 0.01). CONCLUSION Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-min exercise intervention was found to be more effective in younger children and adolescents.
Collapse
Affiliation(s)
- Jiayu Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, Zhejiang 321004, China.
| | - Xianxian Zhou
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, Zhejiang 321004, China.
| | - Zan Huang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, Zhejiang 321004, China.
| | - Tianyi Shao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, Zhejiang 321004, China.
| |
Collapse
|
15
|
Li J, Zhou X, Huang Z, Shao T. Effect of exercise intervention on depression in children and adolescents: a systematic review and network meta-analysis. BMC Public Health 2023; 23:1918. [PMID: 37794338 PMCID: PMC10552327 DOI: 10.1186/s12889-023-16824-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents. METHODS Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA). RESULTS A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2%), followed by group training (62.5%), resistance exercise (59.0%), and aerobic combined with resistance exercise (57.9%). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD=-0.41, 95% CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD=-0.25, 95% CI (-0.41, -0.08), P < 0.01); SMD=-0.15, 95% CI (-0.31, -0.00), P < 0.01; SMD=-0.75, 95% CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD=-0.14, 95% CI (-0,81, -0.01), P < 0.01), and 40-50 min of exercise had the best effect (SMD=-0.17, 95% CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD=-0.42, 95% CI (-0,66, -0.18), P < 0.01). CONCLUSION Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-minute exercise intervention was found to be more effective in younger children and adolescents.
Collapse
Affiliation(s)
- Jiayu Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Xianxian Zhou
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Zan Huang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Tianyi Shao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China.
| |
Collapse
|
16
|
Qiu H, Liang X, Wang P, Zhang H, Shum DHK. Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: A systematic review and meta-analysis. Asian J Psychiatr 2023; 87:103692. [PMID: 37450981 DOI: 10.1016/j.ajp.2023.103692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Although front-line doctors recommend medications, this kind of treatment has limited efficacy in improving executive functions (EFs) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This study explored the effects of non-pharmacological intervention on EFs in children and adolescents with ADHD. METHODS In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, we searched seven electronic databases: APA PsycINFO, CINAHL Complete, EMBASE, ERIC, Medline, Pubmed, and Web of Science, from inception to March 2022. Two authors independently screened studies for eligibility, extracted data, and assessed bias risk using the Physiotherapy Evidence Database scale. Our analyses included randomized controlled trials and non-randomized comparison studies of non-pharmacological interventions and assessed EFs through neurocognitive tasks in children and adolescents between 5 and 18 years. RESULTS Sixty-seven studies with 3147 participants met the inclusion criteria. The final meta-analysis included 74 independent interventions categorized into six categories: cognitive training, EF-specific curriculum, game-based training, mindfulness practice, neurofeedback training, and physical exercise. Overall, non-pharmacological interventions (combined) produced significant moderate to large effects on overall EFs in children and adolescents with ADHD (g=0.673). Physical exercise had a large positive effect on domain-specific EFs, including inhibitory control (g=0.900) and cognitive flexibility (g=1.377). Cognitive training had a large training effect on working memory (g=0.907), and an EF-specific curriculum had a small to moderate beneficial effect on planning performance (g=0.532). CONCLUSION Non-pharmacological interventions, particularly physical exercise, cognitive training, and an EF-specific curriculum, appear to have beneficial effects on EFs in children and adolescents with ADHD.
Collapse
Affiliation(s)
- Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
| | - Peng Wang
- Center for Lifestyle Medicine, Fuwai Hospital, Chinese Academy of Medical, Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China; Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| |
Collapse
|
17
|
Sinclair L, Roscoe CMP. The Impact of Swimming on Fundamental Movement Skill Development in Children (3-11 Years): A Systematic Literature Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1411. [PMID: 37628410 PMCID: PMC10453388 DOI: 10.3390/children10081411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
Swimming is the only sport providing lifesaving skills, reducing the risk of death by drowning, a top cause of deaths in children aged 1-14 years. Research shows swimming amongst other sports can aid fundamental movement skill (FMS) development. Therefore, this review investigated the following: (1) how swimming impacts FMS development in children aged 3-11 years, (2) successful tools assessing swimming and FMS, and (3) recommendations appropriate to the UK curriculum based on findings of this study. A systematic literature review using Google Scholar, PubMed, and SPORTDiscuss was conducted to investigate the effects of swimming on FMS development. Methods included database searching, finalising articles appropriate to the inclusion and exclusion criteria, and identifying relevant articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Mixed Methods Appraisal Tool assessed data quality and bias risk, whilst thematic analysis synthesised data alongside descriptive results. Ten papers were synthesised, identifying significant positive impacts of swimming on FMS, including significant pre-post testing (p < 0.01), significant improvements compared to other sports (p < 0.001), and significant improvements in specific motor skills (Balance; p = 0.0004). Future research specifically addressing swimming and FMS is essential to improving the curriculum.
Collapse
Affiliation(s)
| | - Clare M. P. Roscoe
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK;
| |
Collapse
|
18
|
Song Y, Fan B, Wang C, Yu H. Meta-analysis of the effects of physical activity on executive function in children and adolescents with attention deficit hyperactivity disorder. PLoS One 2023; 18:e0289732. [PMID: 37590250 PMCID: PMC10434964 DOI: 10.1371/journal.pone.0289732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Executive function is a core deficit in children with attention deficit hyperactivity disorder (ADHD). This study systematically reviewed the evidence for the effects of physical activity (PA) interventions on executive function in children and adolescents with ADHD and explored the moderating effects of key variables of PA on executive function. METHODS Relevant literature in four electronic databases, Pubmed, Web of Science, Cochrane Library, and Embase, were systematically searched. Revman 5.4 was used for data analysis, and combined effect sizes, heterogeneity tests, subgroup analyses, and sensitivity analyses were calculated. Egger's test in Stata 15.0 was used for publication bias testing. RESULTS A total of 24 articles with 914 participants were included. Meta-analysis showed that PA interventions improved inhibitory control (SMD = -0.50, 95%CI [-0.71, -0.29], P < 0.00001), working memory (SMD = -0.50, 95%CI [-0.83, -0.16], P = 0.004) and cognitive flexibility in children and adolescents with ADHD (SMD = -0.45, 95%CI [-0.81, -0.09], P = 0.01). Subgroup analysis revealed a moderating effect of intervention intensity, motor skill type, sessions of PA, and weekly exercise volume on executive function. CONCLUSION PA interventions had positive effects on improvements in core executive functions in children and adolescents with ADHD and were influenced by intervention intensity, type of motor skill, sessions of PA, and amount of exercise. This has practical implications for the formulation of PA interventions programs.
Collapse
Affiliation(s)
- Yiling Song
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Biyao Fan
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Chunshun Wang
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
| |
Collapse
|
19
|
Li D, Li L, Zang W, Wang D, Miao C, Li C, Zhou L, Yan J. Effect of physical activity on attention in school-age children with ADHD: a systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1189443. [PMID: 37576338 PMCID: PMC10415683 DOI: 10.3389/fphys.2023.1189443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background: Attention problems are one of the core symptoms of Attention-deficit/hyperactivity disorder (ADHD) in children. Previous studies have shown that physical activity intervention has a positive impact on executive function in children and adolescents with ADHD, but there is limited research on attention problems in school-aged children with ADHD. There are still uncertainties about the appropriate physical activity interventions to improve attention problems in this population. This study conducted a Meta-analysis of randomized controlled trials (RCTs) related to physical activity intervention for attention problems in school-aged children with ADHD, providing a certain reference for precise intervention in attention problems for this population. Methods: We systematically searched the following databases up to October 2022: PubMed, Embase, Web of Science, and Cochrane Library, to identify RCTs that investigated the effects of physical activity interventions on children with ADHD. Two investigators independently conducted literature screening, extraction, and quality assessment. We performed a meta-analysis using Stata 15.1. Results: In total, we included 10 studies in this meta-analysis. The results indicated that physical activity intervention had a moderate effect in improving attention problems in school-aged children with ADHD (SMD = -0.48, 95% CI: 0.85, -0.07, p < 0.05). Furthermore, subgroup analysis showed that the effect of physical activity intervention was moderated by intervention type, frequency, and period, rather than the physical activity environment or single intervention time. Conclusion: Our study suggests that cognitively engaging exercise is more effective in improving attention problems in school-aged children with ADHD. Specifically, when cognitive-engaging exercise is used as the type of physical activity and the intervention frequency is less than 3 times per week, with an intervention period of less than weeks, it is most beneficial for improving attention problems in school-aged children with ADHD. However, we should also consider individual differences in children with respect to their ADHD symptoms and accurately evaluate each child's specific symptoms before intervention. Systematic Review Registration: identifier (CRD42022363255).
Collapse
Affiliation(s)
- Dong Li
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
- Department of International Culture Education, Chodang University, Muan, Republic of Korea
| | - Lan Li
- Universuty of Maine at Presque Isle, Presque Isle, ME, United States
| | - Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Deng Wang
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Chuyuan Miao
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Chenmu Li
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
| | - Li Zhou
- School of Sports and Health, Guizhou Medical University, Guiyang, China
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
20
|
Freire K, Pope R, Size I, Andrews K, Fitz-Gerald E, Bowman T. Social exercise interventions for children who have complex developmental needs: A systematic review. J Child Health Care 2023:13674935231190984. [PMID: 37471588 DOI: 10.1177/13674935231190984] [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: 07/22/2023]
Abstract
Exercise interventions are identified as effective treatments for children not meeting developmental milestones. This systematic review synthesizes research regarding exercise interventions that involved social participatory elements, for children with complex developmental needs. Academic Search Complete, CINAHL, Emcare, Proquest Theses and Dissertations, MEDLINE, and Google Scholar were searched systematically for relevant studies. Peer-reviewed studies meeting the review aim and published between 2000 and 2021 in English, were included. Methodological quality of 49 eligible studies (47 controlled trials, two mixed methods, total of 2355 participants) was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis identified two groups of studies: Group 1 incorporated intentional social participatory elements; Group 2 likely involved incidental social participation. Most studies were of moderate to low methodological quality. Few measured impacts of interventions upon total physical activity levels. Short-term improvements in physical outcomes - particularly motor skills - were most frequently reported and were the main benefit of social exercise interventions for children with complex developmental needs, for which evidence exists. Further rigorous, longitudinal research is needed to assess social, psychological, and executive function outcomes of social exercise interventions in this population. Such interventions should incorporate booster sessions to provide children with greater opportunity to meet developmental milestones.
Collapse
Affiliation(s)
- Kate Freire
- Three Rivers Department of Rural Health, Charles Sturt University, Albury, NSW, Australia
| | - Rod Pope
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW, Australia
| | - Isabella Size
- Child and Family Services, Royal Far West, Manly, NSW, Australia
| | - Kristen Andrews
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW, Australia
| | - Emma Fitz-Gerald
- Child and Family Services, Royal Far West, Manly, NSW, Australia
| | - Tricia Bowman
- Division of Library Services, Charles Sturt University, Albury, NSW, Australia
| |
Collapse
|
21
|
Skalidou S, Anestis A, Bakolas N, Tsoulfa G, Papadimitriou K. Swimming Activity Alleviates the Symptoms of Attention: Deficit Hyperactivity Disorder (ADHD) a Case Report. Healthcare (Basel) 2023; 11:1999. [PMID: 37510440 PMCID: PMC10379488 DOI: 10.3390/healthcare11141999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, hyperactivity, and impulsivity. Sport and physical activity have been shown to play a major role in the development of cognition, memory, selective attention, and motor reaction time, especially among adolescents with ADHD. In this context, the objective of this study was to investigate the effects of a swimming exercise program on the symptoms of ADHD in an adult with a diagnosis since childhood. The training intervention was performed for eight weeks, and the results demonstrated that the swimming-learning program significantly alleviated the symptoms of inattention and hyperactivity, as measured by the psychometric indices used in the study. Further studies are needed to establish and understand the association between physical activities and improved mental performance in adults with ADHD.
Collapse
Affiliation(s)
- Smaragda Skalidou
- Laboratory of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Andreas Anestis
- Laboratory of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Division of Technology and Sciences, The American College of Thessaloniki, 55535 Thessaloniki, Greece
| | | | - Georgia Tsoulfa
- Division of Technology and Sciences, The American College of Thessaloniki, 55535 Thessaloniki, Greece
| | - Konstantinos Papadimitriou
- Faculty of Health and Rehabilitation Sciences, University of East London, Metropolitan College of Thessaloniki, 54624 Thessaloniki, Greece
| |
Collapse
|
22
|
Liu HLV, Sun F, Anderson DI, Tse CYA. The Effect of Physical Activity Intervention on Motor Proficiency in Children and Adolescents with ADHD: A Systematic Review and Meta-analysis. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01546-5. [PMID: 37245166 DOI: 10.1007/s10578-023-01546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 05/29/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed neurodevelopmental disorder in children and adolescents. The objective of this review was to synthesize empirical studies that investigated the effects of physical activity (PA) on motor proficiency in this population. A systematic review and meta-analysis were conducted following the cochrane guidelines for systematic reviews. In May 2022, a systematic search of eight electronic databases retrieved 476 results, which were screened independently by two reviewers. Based on the inclusion and exclusion criteria, 12 studies were selected for systematic review, and 10 were included in the meta-analysis. A beneficial effect of PA on overall motor proficiency (SMD = 1.12; 95% CI [0.63 to 1.61]; p < 0.05) was observed. Similar positive effects were found for motor proficiency composites, including object control, fine manual control, and body coordination. These results indicate that PA improves the motor proficiency of children and adolescents with ADHD.
Collapse
Affiliation(s)
- Hok Ling Venus Liu
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China.
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - David I Anderson
- Marian Wright Edelman Institute, San Francisco State University, San Francisco, USA
| | - Choi Yeung Andy Tse
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| |
Collapse
|
23
|
Ogrodnik M, Karsan S, Heisz JJ. Mental Health in Adults With ADHD: Examining the Relationship With Cardiorespiratory Fitness. J Atten Disord 2023; 27:698-708. [PMID: 36915221 PMCID: PMC10173354 DOI: 10.1177/10870547231158383] [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: 03/16/2023]
Abstract
OBJECTIVE The mental health of adults with ADHD was compared to neurotypical controls, and associations between cardiorespiratory fitness (CRF) and mental health were examined. METHOD Seventy-two participants (n = 36 with ADHD) completed demographic questions assessing ADHD and mental health symptoms. CRF was estimated using the 6-Minute Walk Test and a self-perception question. RESULTS Those with ADHD had significantly poorer mental health outcomes than controls (p < .001), with 50% of adults with ADHD reporting moderate to extremely severe symptoms of depression, anxiety, and stress. Critically, lower CRF was associated with worse depression, anxiety, and stress (all p ≤ .03) across both groups. Within the ADHD group, those with higher estimated CRF had significantly lower stress. Among participants with less severe ADHD symptoms, those with higher perceived CRF had significantly lower depressive symptoms. CONCLUSION In our cross-sectional study, participants with ADHD had poorer mental health than neurotypical controls, and higher fitness was associated with better mental health.
Collapse
|
24
|
Recchia F, Bernal JDK, Fong DY, Wong SHS, Chung PK, Chan DKC, Capio CM, Yu CCW, Wong SWS, Sit CHP, Chen YJ, Thompson WR, Siu PM. Physical Activity Interventions to Alleviate Depressive Symptoms in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:132-140. [PMID: 36595284 PMCID: PMC9857695 DOI: 10.1001/jamapediatrics.2022.5090] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/21/2022] [Indexed: 01/04/2023]
Abstract
Importance Depression is the second most prevalent mental disorder among children and adolescents, yet only a small proportion seek or receive disorder-specific treatment. Physical activity interventions hold promise as an alternative or adjunctive approach to clinical treatment for depression. Objective To determine the association of physical activity interventions with depressive symptoms in children and adolescents. Data Sources PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian. Study Selection Two independent researchers selected studies that assessed the effects of physical activity interventions on depressive symptoms in children and adolescents compared with a control condition. Data Extraction and Synthesis A random-effects meta-analysis using Hedges g was performed. Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline. Main Outcomes and Measures The main outcome was depressive symptoms as measured by validated depression scales at postintervention and follow-up. Results Twenty-one studies involving 2441 participants (1148 [47.0%] boys; 1293 [53.0%] girls; mean [SD] age, 14 [3] years) were included. Meta-analysis of the postintervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition (g = -0.29; 95% CI, -0.47 to -0.10; P = .004). Analysis of the follow-up outcomes in 4 studies revealed no differences between the physical activity and control groups (g = -0.39; 95% CI, -1.01 to 0.24; P = .14). Moderate study heterogeneity was detected (Q = 53.92; df = 20; P < .001; I2 = 62.9% [95% CI, 40.7%-76.8%]). The primary moderator analysis accounting for total physical activity volume, study design, participant health status, and allocation and/or assessment concealment did not moderate the main treatment effect. Secondary analyses demonstrated that intervention (ie, <12 weeks in duration, 3 times per week, unsupervised) and participant characteristics (ie, aged ≥13 years, with a mental illness and/or depression diagnosis) may influence the overall treatment effect. Conclusions and Relevance Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis. The association with physical activity parameters such as frequency, duration, and supervision of the sessions remains unclear and needs further investigation.
Collapse
Affiliation(s)
- Francesco Recchia
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Joshua D. K. Bernal
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Y. Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Stephen H. S. Wong
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Pak-Kwong Chung
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China
| | - Derwin K. C. Chan
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China
| | - Catherine M. Capio
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China
| | - Clare C. W. Yu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sam W. S. Wong
- Physical Fitness Association of Hong Kong, Hong Kong, China
| | - Cindy H. P. Sit
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat Sen University, Guangzhou, China
| | - Walter R. Thompson
- College of Education and Human Development, Georgia State University, Atlanta
| | - Parco M. Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
25
|
Kleeren L, Hallemans A, Hoskens J, Klingels K, Smits-Engelsman B, Verbecque E. A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis. J Atten Disord 2023; 27:354-367. [PMID: 36635879 DOI: 10.1177/10870547221146244] [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: 01/14/2023]
Abstract
OBJECTIVE To map the effect of motor-based interventions on motor skills in children with ADHD. METHOD A systematic literature search was performed in Pubmed, Web of Science, and the SCOPUS database (last search: October 30th 2022). Methodological quality was assessed using the PEDro-scale and the quality of evidence was determined with the GRADE-method. Meta-analysis was performed when at least five studies were available. RESULTS Thirteen studies (7 RCTs) satisfied the inclusion criteria, five of which were eligible for meta-analysis. Only one of the included studies reached the low risk of bias threshold. Comparing different motor-based interventions to any non-motor control intervention showed large motor skill improvements (SMD = 1.46; 95% CI = [1.00;1.93]; I² = 47.07%). The most effective type of motor-based intervention and the optimal treatment parameters could not be determined yet. CONCLUSION Motor-based interventions in general seem to improve motor skills in children with ADHD. Additional RCTs are needed to increase current low GRADE confidence.
Collapse
|
26
|
Huang H, Jin Z, He C, Guo S, Zhang Y, Quan M. Chronic Exercise for Core Symptoms and Executive Functions in ADHD: A Meta-analysis. Pediatrics 2023; 151:190271. [PMID: 36510746 DOI: 10.1542/peds.2022-057745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The effects of chronic exercise interventions (CEIs) on core symptoms and executive functions (EFs) of attention-deficit/hyperactivity disorder (ADHD) and how different characteristics of CEIs could modify the effect remain unclear. We synthesized the current evidence on the effects of CEIs on core symptoms and EFs in children and adolescents with ADHD. METHODS Data sources include PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure from database inception to July 31, 2022. Study selection includes randomized controlled trials that reported on the effects of CEIs on core symptoms and/or EFs in ADHD aged 6 to 18 years. RESULTS Twenty-two randomized controlled trials were included. CEIs had a small beneficial effect on overall core symptoms (standardized mean difference [SMD] = -0.39, 95% confidence interval [CI]: -0.64 to -0.14), as well as inattention (SMD = -0.32, 95% CI: -0.63 to -0.004) among children and adolescents with ADHD. Closed-skill exercise showed a large improvement in core symptoms (SMD = -0.83, 95% CI: -1.30 to -0.35), whereas open-skill exercise did not. Additionally, CEIs had a moderately beneficial effect on overall EFs (SMD = -0.68, 95% CI: -0.91 to -0.45) and a moderate-to-large effect on the specific domains of EFs. The pooled effects on overall core symptoms and EFs were not significantly modified by study population (children or adolescents), exercise session duration (≤50 or >50 minutes per session, median), or total exercise sessions (<24 or ≥24 sessions, median). CONCLUSIONS CEIs have small-to-moderate beneficial effects on overall core symptoms and EFs in children and adolescents with ADHD.
Collapse
Affiliation(s)
| | - Zhijuan Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | | | | | - Yiwen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Minghui Quan
- School of Exercise and Health.,Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
27
|
Li D, Wang D, Cui W, Yan J, Zang W, Li C. Effects of different physical activity interventions on children with attention-deficit/hyperactivity disorder: A network meta-analysis of randomized controlled trials. Front Neurosci 2023; 17:1139263. [PMID: 37021131 PMCID: PMC10067581 DOI: 10.3389/fnins.2023.1139263] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/17/2023] [Indexed: 04/07/2023] Open
Abstract
Background Previous studies have shown that physical activity interventions positively affect core symptoms and executive functioning in children with attention-deficit/hyperactivity disorder (ADHD). However, comparisons between different physical activity interventions still need to be made. This study is the first to analyze the effects of 10 different types of physical activity on children with ADHD through a network meta-analysis. Methods PubMed, Embase, Web of Science, and Cochrane Library databases were searched for randomized controlled trials on the effects of physical activity interventions on children with ADHD. The search time frame was from database creation to October 2022. Two investigators independently performed literature screening, extraction, and quality assessment. Network meta-analysis was performed with Stata 15.1. Results A total of 31 studies were included, and the results indicated that perceptual-motor training was the most effective in terms of motor ability and working memory (SUCRA = 82.7 and 73.3%, respectively). For attention problems and cognitive flexibility, aquatic exercise was the most effective (SUCRA = 80.9 and 86.6%, respectively). For social problems, horsemanship was the most effective (SUCRA = 79.4%). For inhibition switching, cognitive-motor training was the most effective (SUCRA = 83.5%). Conclusion Our study revealed that aquatic exercise and perceptual-motor training had a superior overall performance. However, the effects of various physical activity interventions on different indicators in children with ADHD can vary depending on the individual and the intervention's validity. To ensure an appropriate physical activity intervention is selected, it is important to assess the severity of symptoms exhibited by children with ADHD beforehand.
Collapse
Affiliation(s)
- Dong Li
- School of Physical Education and Sports Science, Guangzhou Sport University, Guangzhou, China
| | - Deng Wang
- LFE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Wenlai Cui
- School of Dance and Martial Arts, Capital University of Physical Education and Sports, Beijing, China
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
| | - Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Chenmu Li
- School of Physical Education and Sports Science, Guangzhou Sport University, Guangzhou, China
- *Correspondence: Chenmu Li,
| |
Collapse
|
28
|
Zhu F, Zhu X, Bi X, Kuang D, Liu B, Zhou J, Yang Y, Ren Y. Comparative effectiveness of various physical exercise interventions on executive functions and related symptoms in children and adolescents with attention deficit hyperactivity disorder: A systematic review and network meta-analysis. Front Public Health 2023; 11:1133727. [PMID: 37033046 PMCID: PMC10080114 DOI: 10.3389/fpubh.2023.1133727] [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: 12/29/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Background Physical exercise has been recommended as an important nonpharmacological therapeutic strategy for managing attention deficit hyperactivity disorder (ADHD). We conducted a network meta-analysis (NMA) to assess the comparative impact of different physical exercise modalities on enhancing executive functions (EFs) and alleviating symptoms in children and adolescents with ADHD. Methods We searched Web of Science, PubMed, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycINFO, CNKI, and clinical trials databases from inception to October 20, 2022. Randomized controlled trials (RCTs) and quasi-experimental studies investigating physical exercise for ADHD-related symptoms of hyperactivity/impulsivity and inattention, and executive functions were included. The frequentist random-effect NMA method was applied to pool the results. Results A total of 59 studies (including 39 RCTs, 5 quasi-RCTs, and 15 self-controlled trials) published between 1983 and 2022 were incorporated into the systematic review, of which 44 studies with 1757 participants were eligible for meta-analysis. All types of physical exercise were effective in improving EFs (SMD = 1.15, 95% CI: 0.83 to 1.46), and open-skill activities which require participants to react in a dynamically changing and externally paced environment induced the most incredible benefits for executive functions (SUCRA = 98.0%, SMD = 1.96, and 95% CI: 1.15 to 2.77). Subgroup analyses for EFs revealed varied findings that open-skill activities were the most promising physical exercise type for improving inhibitory control (SUCRA = 99.1%, SMD = 1.94, and 95% CI: 1.24 to 2.64), and closed-skill activities dominated by aerobic exercises had a slightly higher probability of being the most promising physical exercise intervention for working memory (SUCRA = 75.9%, SMD = 1.21, and 95% CI: -0.22 to 2.65), and multicomponent physical exercise tended to be the most effective in cognitive flexibility (SUCRA = 70.3%, SMD = 1.44, and 95% CI: -0.19 to 3.07). Regarding ADHD-related symptoms, closed-skill activities dominated by aerobic exercises might be more advantageous for hyperactivity/impulsivity (SUCRA = 72.5%, SMD = -1.60, and 95% CI: -3.02 to -0.19) and inattention (SUCRA = 96.3%, SMD = -1.51, and 95% CI: -2.33 to -0.69) improvement. Conclusion Physical exercise can significantly help to alleviate the symptoms of ADHD and improve executive functions in children and adolescents with ADHD. Most of all, to promote adherence to treatment, they should be encouraged to perform the physical exercises that they enjoy most.
Collapse
Affiliation(s)
- Feilong Zhu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xiaotong Zhu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xiaoyu Bi
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Dongqing Kuang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Boya Liu
- School of Social Ecology, University of California, Irvine, Irvine, CA, United States
| | - Jingyi Zhou
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yiming Yang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yuanchun Ren
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
- *Correspondence: Yuanchun Ren,
| |
Collapse
|
29
|
Hattabi S, Forte P, Kukic F, Bouden A, Have M, Chtourou H, Sortwell A. A Randomized Trial of a Swimming-Based Alternative Treatment for Children with Attention Deficit Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16238. [PMID: 36498313 PMCID: PMC9739874 DOI: 10.3390/ijerph192316238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is considered a highly prevalent neurodevelopmental childhood disorder extending from ages 1−2 to 12−13, associated with impairment across multiple domains, including social, emotional, and cognitive functioning. Little is known about alternative treatments for this disorder. Interest has grown in physical activity as a potential intervention for rehabilitating children with ADHD. This study aimed to investigate the impact of adapted swimming activity on cognitive functions, academic performance, and related behavior of Tunisian children with ADHD. The study was conducted on school children aged 9 to 12 years (n = 40, 5 female and 35 male) diagnosed with ADHD. They were randomly assigned to an experimental group (exercise intervention) or the control group. The Hayling test was used to assess cognitive performance, the Children Behavior Check List (CBCL) was used to assess ADHD-related behavior, and the change in reading and numeracy proficiency was assessed pre- and post-intervention. After 12 weeks of the intervention, the results revealed that there were significant improvements in behavior (p < 0.001), inhibition process (p < 0.001), and academic performance (p < 0.001) in the experimental group compared with the control group. These findings suggest that adapted swimming activity may have positive implications for cognitive function, behavior, and academic performance. This research may provide preliminary support for alternative therapeutic interventions that could be used by practitioners. Moreover, the results support active practice of recreational physical activities as a strategy to support children in overcoming ADHD deficiencies.
Collapse
Affiliation(s)
- Soukaina Hattabi
- High Institute of Sports and Physical Education of Elkef, University of Jendouba, El Kef 7100, Tunisia
- Research Unit UR12SP20, Razi Hospital, Mannouba 2010, Tunisia
| | - Pedro Forte
- Department of Sports, Higher Institute of Educational Sciences of the Douro, 4560-708 Penafiel, Portugal
- Department of Sports Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
| | - Filip Kukic
- Abu Dhabi Police, Abu Dhabi 253, United Arab Emirates
| | - Asma Bouden
- Research Unit UR12SP20, Razi Hospital, Mannouba 2010, Tunisia
- Department of Child Psychiatry, Razi Hospital, Tunisia Faculty of Medicine of Tunis, Manouba 2010, Tunisia
| | - Mona Have
- Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern, Campusvej, 55, 5230 Odense, Denmark
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, Sfax 3000, Tunisia
| | - Andrew Sortwell
- Research Center in Sports, Health and Human Development, 5001-801 Vila Real, Portugal
- School of Nursing, Midwifery, Health Sciences and Physiotherapy, University of Notre Dame Australia, Sydney 2007, Australia
| |
Collapse
|
30
|
Xu D, Meng Y, An S, Meng W, Li H, Zhang W, Xue Y, Lan X, Wang X, Li M, Zhang X, Zhihao Z, Zhao Y, Yang H, Zhang C, Zhang R, Zhen Z. Swimming exercise is a promising early intervention for autism-like behavior in Shank3 deletion rats. CNS Neurosci Ther 2022; 29:78-90. [PMID: 36221783 PMCID: PMC9804047 DOI: 10.1111/cns.13920] [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: 03/15/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION SHANK3 is an important excitatory postsynaptic scaffold protein, and its mutations lead to genetic cause of neurodevelopmental diseases including autism spectrum disorders (ASD), Philan McDermid syndrome (PMS), and intellectual disability (ID). Early prevention and treatment are important for Shank3 gene mutation disease. Swimming has been proven to have a positive effect on neurodegenerative diseases. METHODS Shank3 gene exon 11-21 knockout rats were intervened by a 40 min/day, 5 day/week for 8-week protocol. After the intervention, the rats were tested to behavioral measures such as learning and memory, and the volume and H-spectrum of the brain were measured using MRI; hippocampal dendritic spines were measured using Golgi staining and laser confocal. RESULTS The results showed that Shank3-deficient rats had significant deficits in social memory, object recognition, and water maze learning decreased hippocampal volume and number of neurons, and lower levels of related scaffold proteins and receptor proteins were found in Shank3-deficient rats. CONCLUSION It is suggested that early swimming exercise has a positive effect on Shank3 gene-deficient rats, which provides a new therapeutic strategy for the prevention and recovery of neurodevelopmental disorders.
Collapse
Affiliation(s)
- Dan Xu
- College of P.E and SportsBeijing Normal UniversityBeijingChina,Sports and Health Editorial OfficePeople's education pressBeijingChina
| | - Yunchen Meng
- Department of P.E.China University of Mining and Technology‐BeijingBeijingChina
| | - Shasha An
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Wenshu Meng
- College of Life SciencesBeijing Normal UniversityBeijingChina
| | - Hanran Li
- Centre for Cognitive and Brain Sciences and Department of PsychologyUniversity of MacauTaipaMacau
| | - Weinan Zhang
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Yaqi Xue
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Xinyu Lan
- Department of Neurobiology, School of Basic Medical SciencesPeking UniversityBeijingChina,Neuroscience Research InstitutePeking UniversityBeijingChina,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning CommissionPeking UniversityBeijingChina,Autism Research Center of Peking University Health Science CenterBeijingChina
| | - Xiaoxi Wang
- Institute of Acupuncture and MoxibustionChina Academy of Chinese Medical SciencesBeijingChina
| | - Mingjuan Li
- Department of Neurobiology, School of Basic Medical SciencesPeking UniversityBeijingChina,Neuroscience Research InstitutePeking UniversityBeijingChina,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning CommissionPeking UniversityBeijingChina,Autism Research Center of Peking University Health Science CenterBeijingChina
| | - Xiaoyan Zhang
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Zhang Zhihao
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Yu Zhao
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Haodong Yang
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| | - Chen Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical SciencesPeking UniversityBeijingChina,Neuroscience Research InstitutePeking UniversityBeijingChina,Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning CommissionPeking UniversityBeijingChina,Autism Research Center of Peking University Health Science CenterBeijingChina,Department of Integration of Chinese and Western MedicineSchool of Basic Medical Sciences, Peking UniversityBeijingChina
| | - Zhiping Zhen
- College of P.E and SportsBeijing Normal UniversityBeijingChina
| |
Collapse
|
31
|
Sun W, Yu M, Zhou X. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis. Psychiatry Res 2022; 311:114509. [PMID: 35305344 DOI: 10.1016/j.psychres.2022.114509] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE To explore the effects of physical exercise intervention on the cardinal symptoms, motor skills and executive function among children with attention deficit hyperactivity disorder (ADHD). METHODS Literature searches for randomized controlled trials (RCTs) were performed in PubMed, The Cochrane Library, Web of Science, Embase, CNKI, CBM, VIP and Wanfang databases from the time of database construction to March 28, 2021. Screening was conducted based on inclusion and exclusion criteria. The Cochrane bias risk assessment tools were used to evaluate methodological quality. Relevant data were analyzed with RevMan5.3.5 software, and Stata16.0 was used for publication bias tests. RESULTS A total of 15 RCTs with 734 subjects were included. The meta-analysis showed that physical exercise can improve the attention of ADHD children (standardized mean difference [SMD] = -0.60, 95% confidence interval [CI] [-1.10, -0.11], p < 0.01), executive function (SMD = 1.22, 95% CI [0.61, 1.82], p < 0.01), and motor skills (SMD = 0.67, 95% CI [0.22, 1.12], p < 0.01). There were no significant effects on hyperactivity (SMD = 0.06, 95% CI [-0.26, 0.37], p = 0.72), depression (SMD = -0.72, 95% CI [-1.55, 0.11], p = 0.09), social problems (SMD = -0.27, 95% CI [-0.64, 0.09], p = 0.14), or aggressive behavior (SMD=-0.24, 95% CI [-0.69, -0.21], p = 0.30). Intervention duration and frequency might be the source of heterogeneity. CONCLUSION Physical exercise can help alleviate the symptoms of ADHD in children. Specifically, it can improve attention, executive function, and motor skills.
Collapse
Affiliation(s)
- Wenxin Sun
- Department of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China.
| | - Mingxuan Yu
- Department of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Xiaojing Zhou
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, 201620, China.
| |
Collapse
|
32
|
Seiffer B, Hautzinger M, Ulrich R, Wolf S. The Efficacy of Physical Activity for Children with Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials. J Atten Disord 2022; 26:656-673. [PMID: 34041952 PMCID: PMC8785285 DOI: 10.1177/10870547211017982] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
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.
Collapse
Affiliation(s)
- Britta Seiffer
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
- University of Tuebingen, Department of Education & Health Research, Tuebingen, Germany
| | - Martin Hautzinger
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
| | - Rolf Ulrich
- University of Tuebingen, Department of Cognition and Perception, Tuebingen, Germany
| | - Sebastian Wolf
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
- University of Tuebingen, Department of Education & Health Research, Tuebingen, Germany
| |
Collapse
|
33
|
Jackson M, Kang M, Furness J, Kemp-Smith K. Aquatic Exercise and Mental Health: A Scoping Review. Complement Ther Med 2022; 66:102820. [PMID: 35218906 DOI: 10.1016/j.ctim.2022.102820] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/23/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aims of this review were to 1) summarise the breadth and types of research regarding the impact of aquatic exercise on mental health completed to date, 2) provide a clear indication of the intervention type, volume, measurement tools used, and populations best served in relation to this activity and its effectiveness and 3) to identify domains within the literature that can be developed so recommendations can be made for future investigations. METHOD A scoping review was performed under the PRISMA guidelines. A systematic search of Pubmed, SPORTDiscus, PsycInfo and Google Scholar databases was conducted. Studies observing the effect of aquatic exercises on mental health and related parameters were considered for inclusion. The data from the selected studies were then extracted and analysed methodically. PRIMARY CONDITIONS MEASURED Depression, anxiety, mood, self-esteem, and psychological well-being were the primary mental states for which findings could be clearly extracted. RESULTS Of the 1635 articles that resulted from the search, 23 articles met all inclusion criteria. Of these, 12 were randomised controlled trials. Cumulatively, the findings of this review trend towards aquatic exercise being effective in generating positive changes in mental health. CONCLUSION Aquatic exercise, specifically winter swimming, leisure swimming, competitive swimming and aquatic aerobics, can be a promising conservative therapy for mental health management. However, it is recommended that further research be conducted to solidify these findings and establish the long-term effects of this intervention on mental health.
Collapse
Affiliation(s)
- Morgan Jackson
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland.
| | - Manjot Kang
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland
| | - James Furness
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
| | - Kevin Kemp-Smith
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
| |
Collapse
|
34
|
Guo C, Assumpcao L, Hu Z. Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis. J Atten Disord 2022; 26:508-524. [PMID: 33759605 DOI: 10.1177/10870547211001953] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The present meta-analysis aimed to evaluate the efficacy of various non-pharmacological interventions on comorbid emotional symptoms such as depression, anxiety, and emotional dysregulation (ED) in children and adults with ADHD. METHOD Forty-four randomized controlled trials (23 studies with ADHD children and 21 studies with ADHD adults) were included. Risk of bias, heterogeneity assessment, and subgroup analyses were conducted. RESULTS We found that therapies targeting the relationship between children and others (i.e., parent-training [on ED and depression] and social skills training [on ED]) were efficacious in the treatment of emotional symptoms in children with ADHD at post-intervention. As for adults with ADHD, cognitive behavioral therapy was found to be effective for the improvement of emotional symptoms at both post-intervention and follow-up. CONCLUSION Our findings demonstrate that the efficacy of non-pharmacological interventions varies substantially across children and adults with ADHD. These results provide important implications for the selection of non-pharmacological interventions for children with ADHD.
Collapse
Affiliation(s)
- Chao Guo
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Leonardo Assumpcao
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Zhiguo Hu
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| |
Collapse
|
35
|
Barudin-Carreiro AM, Camhi SM, Lindsay AC, Wright JA. Physical Activity and Executive Function in Children with ADHD: A Systematic Review. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
36
|
Qin X, Song Y, Zhang G, Guo F, Zhu W. Quantifying swimming activities using accelerometer signal processing and machine learning: A pilot study. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Tang Z, Wang Y, Liu J, Liu Y. Effects of aquatic exercise on mood and anxiety symptoms: A systematic review and meta-analysis. Front Psychiatry 2022; 13:1051551. [PMID: 36465296 PMCID: PMC9714032 DOI: 10.3389/fpsyt.2022.1051551] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Exercise has beneficial effects on mood and anxiety symptoms. However, the impact of aquatic exercise on mood and anxiety symptoms has not been clearly confirmed. Therefore, this study aimed to synthesize and systematically analyze evidence available on boosting mental health through aquatic exercise. METHOD A systematic review and meta-analysis were conducted under the PRISMA 2020 guidelines. PubMed, BIOSIS Previews, PsycINFO, Medline, SPORTDiscus, Education Source, and Web of Science Core Collection (WoSCC) were searched in May 2022. The research included the influence of aquatic exercises on mood and anxiety symptoms. After assessing trial quality and completing data extraction, a meta-analysis was carried out through R software. The results were presented as a standardized mean difference (SMD) and the corresponding 95% confidence interval. RESULTS A total of 18 original trials were included. People who received aquatic exercise intervention had a statistically significant reduction in mental disorder symptoms compared with before. The results were aquatic exercise [SMD = -0.77, 95% CI (-1.08, -0.47), I2 = 77%, P < 0.01], swimming [SMD = -0.51, 95% CI (-1.14, 0.12), I2 = 78%, P < 0.01], aquatic aerobics [SMD = -0.92, 95% CI (-1.32, -0.53), I2 = 78%, P < 0.01], moderate intensity [SMD = -0.75, 95% CI (-1.07, -0.43), I2 = 67%, P < 0.01], and low intensity [SMD = -1.07, 95% CI (-1.08, -0.47), I2 = 85%, P < 0.01]. CONCLUSION Aquatic exercise could statistically significantly improve mental health. Light aquatic aerobics probably has a better effect on mood and anxiety symptoms. However, given the number and quality of included research, verifying the aforementioned conclusions requires a larger sample of high-quality studies.
Collapse
Affiliation(s)
- Zhengyan Tang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Ye Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Jingmin Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yujie Liu
- Lang Ping Research Center for Sports Culture and Policy, Beijing Normal University, Beijing, China
| |
Collapse
|
38
|
Meng W, Xu D, Meng Y, Zhang W, Xue Y, Zhen Z, Gao Y. Changes in the urinary proteome in rats with regular swimming exercise. PeerJ 2021; 9:e12406. [PMID: 34760390 PMCID: PMC8567855 DOI: 10.7717/peerj.12406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose Urine can sensitively reflect early pathophysiological changes in the body. The purpose of this study was to explore the changes of urine proteome in rats with regular swimming exercise. Methods In this study, experimental rats were subjected to daily moderate-intensity swimming exercise for 7 weeks. Urine samples were collected at weeks 2, 5, and 7 and were analyzed by using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Results Unsupervised clustering analysis of all urinary proteins identified at week 2 showed that the swimming group was distinctively different from the control group. Compared to the control group, a total of 112, 61 and 44 differential proteins were identified in the swimming group at weeks 2, 5 and 7, respectively. Randomized grouping statistical analysis showed that more than 85% of the differential proteins identified in this study were caused by swimming exercise rather than random allocation. According to the Human Protein Atlas, the differential proteins that have human orthologs were strongly expressed in the liver, kidney and intestine. Functional annotation analysis revealed that these differential proteins were involved in glucose metabolism and immunity-related pathways. Conclusion Our results revealed that the urinary proteome could reflect significant changes after regular swimming exercise. These findings may provide an approach to monitor the effects of exercise of the body.
Collapse
Affiliation(s)
- Wenshu Meng
- Department of Biochemistry and Molecular Biology, Beijing Normal University, Gene Engineering Drug and Biotechnology Beijing Key Laboratory, Beijing, China
| | - Dan Xu
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Yunchen Meng
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Weinan Zhang
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Yaqi Xue
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Zhiping Zhen
- College of P.E and Sports, Beijing Normal University, Beijing, China
| | - Youhe Gao
- Department of Biochemistry and Molecular Biology, Beijing Normal University, Gene Engineering Drug and Biotechnology Beijing Key Laboratory, Beijing, China
| |
Collapse
|
39
|
Swim Training Ameliorates Hyperlocomotion of ALS Mice and Increases Glutathione Peroxidase Activity in the Spinal Cord. Int J Mol Sci 2021; 22:ijms222111614. [PMID: 34769048 PMCID: PMC8583724 DOI: 10.3390/ijms222111614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022] Open
Abstract
(1) Background: Amyotrophic lateral sclerosis (ALS) is an incurable, neurodegenerative disease. In some cases, ALS causes behavioral disturbances and cognitive dysfunction. Swimming has revealed a neuroprotective influence on the motor neurons in ALS. (2) Methods: In the present study, a SOD1-G93A mice model of ALS were used, with wild-type B6SJL mice as controls. ALS mice were analyzed before ALS onset (10th week of life), at ALS 1 onset (first symptoms of the disease, ALS 1 onset, and ALS 1 onset SWIM), and at terminal ALS (last stage of the disease, ALS TER, and ALS TER SWIM), and compared with wild-type mice. Swim training was applied 5 times per week for 30 min. All mice underwent behavioral tests. The spinal cord was analyzed for the enzyme activities and oxidative stress markers. (3) Results: Pre-symptomatic ALS mice showed increased locomotor activity versus control mice; the swim training reduced these symptoms. The metabolic changes in the spinal cord were present at the pre-symptomatic stage of the disease with a shift towards glycolytic processes at the terminal stage of ALS. Swim training caused an adaptation, resulting in higher glutathione peroxidase (GPx) and protection against oxidative stress. (4) Conclusion: Therapeutic aquatic activity might slow down the progression of ALS.
Collapse
|
40
|
Yu CC, Muggleton NG, Chen CY, Ko CH, Liu S. The comparisons of inhibitory control and post-error behaviors between different types of athletes and physically inactive adults. PLoS One 2021; 16:e0256272. [PMID: 34398917 PMCID: PMC8366960 DOI: 10.1371/journal.pone.0256272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/03/2021] [Indexed: 11/26/2022] Open
Abstract
To properly behave and correct mistakes, individuals must inhibit inappropriate actions and detect errors for future behavioral adjustment. Increasing evidence has demonstrated that athletes are superior in cognitive functions and this benefit varied dependent on the types of sport that individuals involved in, but less is known on whether athletes have a different error-related behavioral pattern. The purpose of this study was to compare the behavioral performance of inhibition and error monitoring between individuals who participated in an open-skill sport (n = 12), a closed-skill sport (n = 12), and a sedentary lifestyle (n = 16). A combined flanker/stop signal task was presented and the derived stop signal reaction time (SSRT), post-correct accuracy and reaction time (RT), as well as post-error accuracy and RT were compared across groups. Our findings indicated there was no difference in SSRT between groups. Surprisingly, significant post-error slowing (PES) was observed only in controls but not in sport groups, the controls also exhibited significantly longer post-error RT compared with the open-skill group. However, there was no difference in the post-error accuracy between groups, indicating a higher efficiency in the post-error processing among open- and closed-skill groups by requiring comparatively less time for behavioral adjustments. The present study is the first to disclose the discrepancies in PES between different types of athletes and controls. The findings suggest that sport training along with higher amounts of physical activity is associated with a more efficient behavioral pattern for error processing especially when the sport requires open skills in nature.
Collapse
Affiliation(s)
- Chia-Chuan Yu
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, United States of America
| | - Neil G. Muggleton
- Institute of Cognitive Neuroscience, National Central University, Taoyuan City, Taiwan
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Chiao-Yun Chen
- Department and Graduate Institute of Criminology, National Chung Cheng University, Chiayi, Taiwan
| | - Cheng-Hung Ko
- Integrated Drug Addiction Treatment Center of the Jianan Psychiatric Center, Ministry of Health and Welfare in Taiwan, Tainan, Taiwan
| | - Suyen Liu
- Department of Athletic Sports, National Chung Cheng University, Chiayi, Taiwan
- * E-mail:
| |
Collapse
|
41
|
Skalski S, Pochwatko G, Balas R. Effect of
HEG
biofeedback on selected cognitive functions—Randomized study in children with
ADHD
and neurotypical children. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
| | | | - Robert Balas
- Polish Academy of Sciences Institute of Psychology Warsaw Poland
| |
Collapse
|
42
|
Liang X, Li R, Wong SHS, Sum RKW, Sit CHP. The impact of exercise interventions concerning executive functions of children and adolescents with attention-deficit/hyperactive disorder: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:68. [PMID: 34022908 PMCID: PMC8141166 DOI: 10.1186/s12966-021-01135-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/05/2021] [Indexed: 12/30/2022] Open
Abstract
Background Previous studies found that exercise interventions have positive effects on executive functions of the general population. However, studies seldom target executive functions of children and adolescents with attention-deficit hyperactivity disorder (ADHD). This study aimed to synthesise empirical studies regarding the effects of exercise interventions on executive functions of children and adolescents with ADHD. Methods A systematic search of the relevant literature was conducted in March 2020 through six electronic databases: CINAHL Complete, Eric, MEDLINE, PsychINFO, SPORTDiscus with Full Text, and Web of Science. Randomised controlled trials/quasi-experimental designs that applied exercise interventions and assessed executive functions through neurocognitive tasks among children and adolescents with ADHD were included. Altogether, 314 studies were identified, from which 31 full texts were independently assessed by two authors for eligibility. Finally, 21 studies underwent systematic reviews and 15 were selected for meta-analysis. Data extraction procedures and risk of bias analysis were conducted by two independent authors using the Physiotherapy Evidence Database (PEDro) scale. Results The findings indicated that exercise interventions improved overall executive functions of children and adolescents with ADHD (SMD = 0.611, 95% CI [0.386 to 0.836], p < 0.01). Exercise interventions had a moderate-to-large positive effect on inhibitory control (g = 0.761, 95% CI [0.376 to 1.146], p < 0.01) and cognitive flexibility (g = 0.780, 95% CI [0.331 to 1.228], p < 0.001). Likewise, during the subgroup analysis, intervention intensity and sessions of exercise (acute vs chronic) significantly moderated exercise intervention rather than intervention type. Conclusions Chronic sessions of exercise interventions with moderate intensity should be incorporated as treatment for children with ADHD to promote executive functions. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01135-6.
Collapse
Affiliation(s)
- Xiao Liang
- Department of Sports Science and Physical Education, The Chines University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Ru Li
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chines University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Raymond K W Sum
- Department of Sports Science and Physical Education, The Chines University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, The Chines University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| |
Collapse
|
43
|
Ganjeh P, Meyer T, Hagmayer Y, Kuhnert R, Ravens-Sieberer U, von Steinbuechel N, Rothenberger A, Becker A. Physical Activity Improves Mental Health in Children and Adolescents Irrespective of the Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)-A Multi-Wave Analysis Using Data from the KiGGS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2207. [PMID: 33668090 PMCID: PMC7967688 DOI: 10.3390/ijerph18052207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
Physical activity (PA) may have positive effects on mental health in children and adolescents. This post hoc study aimed to further investigate the relationship between different frequency levels of PA and general mental health as well as specific hyperactivity/inattention symptoms in children and adolescents. METHODS The analyses were based on data drawn from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, a regularly conducted large-scale, epidemiological investigation of somatic and mental health of children and adolescents in Germany. Parents were asked about their children's attention deficit hyperactivity disorder (ADHD) records and answered questionnaires concerning any mental health problem behavior of the children and adolescents using the Strengths and Difficulties Questionnaire (SDQ). The overall problem score as well as the hyperactivity/inattention symptoms subscale (SDQ-H/I) were entered as outcomes in a regression model controlling for parental socio-economic status and participants' sex, age, and body mass index (BMI). Cross-sectional analyses were conducted at three time points of the KiGGS study (baseline, wave 1, and wave 2) using general linear models (GLM). This was performed for different age groups (4-5, 6-9, 10-17 years). RESULTS Significant negative relationships were found between PA and general mental health problems. For the relationship between PA and SDQ-H/I, different patterns emerged at the three time points. There was no interaction between PA frequency levels and diagnosis of ADHD (ADHD vs. non-ADHD controls) regarding the SDQ total score. CONCLUSION This study underlines the importance of a high frequency level of PA for a good mental health status among children and adolescents, irrespective of the diagnosis of ADHD.
Collapse
Affiliation(s)
- Parisa Ganjeh
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, 37073 Göttingen, Germany
| | - York Hagmayer
- Department of Cognitive Science and Decision Psychology, Georg Elias Müller Institute of Psychology, University of Göttingen, 37073 Göttingen, Germany;
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13353 Berlin, Germany;
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, 37073 Göttingen, Germany;
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
| |
Collapse
|
44
|
Xie Y, Gao X, Song Y, Zhu X, Chen M, Yang L, Ren Y. Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:706625. [PMID: 34764893 PMCID: PMC8575983 DOI: 10.3389/fpsyt.2021.706625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/13/2021] [Indexed: 01/27/2023] Open
Abstract
Objective: To assess the effectiveness of physical activity (PA) intervention on attention-deficit/hyperactivity disorder (ADHD)-related symptoms. Method: Studies that investigated PA intervention for ADHD-related symptoms were identified through searching PubMed, Web of Science, Cochrane Library, and Embase databases from inception through June 2021. Standardized mean difference (SMD) with 95% confidence interval (CI) was used to assess the effectiveness of PA intervention on improving ADHD-related symptoms. The meta-analyses were conducted using fixed-effect or random-effect models according to the heterogeneity of the studies. Results: Nine before-after studies (232 participants) and 14 two-group control studies (162 participants/141 controls) were included in this meta-analysis. Combined results for before-after studies indicated significant improvements on all studied ADHD-related symptoms (inattention: SMD = 0.604, 95% CI: 0.374-0.834, p < 0.001; hyperactivity/impulsivity: SMD = 0.676, 95% CI: 0.401-0.950, p < 0.001; emotional problems: SMD = 0.416, 95% CI: 0.283-0.549, p < 0.001; behavioral problems: SMD = 0.347, 95% CI: 0.202-0.492, p < 0.001). Meta-analyses for two-group control studies further confirmed that PA intervention significantly improved the inattentive symptom (SMD = 0.715, 95% CI: 0.105, 1.325, p = 0.022). Subgroup analyses suggested significant beneficial effect on inattention symptoms in children. Moreover, closed motor skills were beneficial for hyperactive/impulsive problems (SMD = 0.671, p < 0.001), while open motor skills were beneficial for attention problems (SMD = 0.455, p = 0.049). When excluding studies with combined medication, the studies in unmedicated participants in before-after studies still showed significant results in all studied ADHD-related symptoms as in the overall analysis. Given the limited sample size, the best frequency and intensity of PA intervention need further investigation. Conclusion: Our results suggested that PA intervention could possibly improve ADHD-related symptoms, especially inattention symptoms. Closed-skill and open-skill activities could be beneficial for hyperactivity/impulsivity and inattention symptoms, respectively. Further high-quality randomized clinical trials with large sample size are needed.
Collapse
Affiliation(s)
- Yongtao Xie
- College of Physical Education and Sports, Beijing Normal University, Beijing, China.,Department of Human Movement Science, Hebei Sports University, Shijiazhuang, China
| | - Xuping Gao
- Department of Child & Adolescent Psychiatry, National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health (Peking University Sixth Hospital), Peking University Sixth Hospital (Institute of Mental Health), Beijing, China
| | - Yiling Song
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xiaotong Zhu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Mengge Chen
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Li Yang
- Department of Child & Adolescent Psychiatry, National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health (Peking University Sixth Hospital), Peking University Sixth Hospital (Institute of Mental Health), Beijing, China
| | - Yuanchun Ren
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| |
Collapse
|
45
|
Bone Mineral Density in Adolescent Boys: Cross-Sectional Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010245. [PMID: 33396391 PMCID: PMC7795160 DOI: 10.3390/ijerph18010245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 01/10/2023]
Abstract
Physical inactivity of children can be a precursor of reduced bone mineral density, considered to be a typical problem only in old age. The aim of this study was to evaluate bone mineral density in 96 Polish boys aged 14–17 years with varied physical activity (swimmers, track and field athletes, non-athletes) and the effect of bone composition, birth weight and breastfeeding during infancy on bone parameters. Anthropometric and body composition measurements were performed according to the kinanthropometric standards. Bone parameters of the forearm were measured by means of dual-energy X-ray absorptiometry. Data on the infant’s birth weight and the length of breastfeeding were collected during direct interviews with mothers. The strongest links with bone parameters were found for the type of physical activity and birth weight. Regardless of birth weight, track and field athletes had the most advantageous bone parameters (mainly sT-score prox values). Swimmers with normal or low birth weight had less favourable sT-score prox values than non-athletes. The type of physical activity proved to be an important determinant of bone parameters. Childhood and adolescence are important periods of bone development and increasing the content of bone mineral components, and the bone status in later years of life depends to a large extent on this period. The perinatal period, especially the correct birth weight of the child, not only has a significant effect on general health, but also on bone status.
Collapse
|
46
|
Safari MA, Koushkie Jahromi M, Rezaei R, Aligholi H, Brand S. The Effect of Swimming on Anxiety-Like Behaviors and Corticosterone in Stressed and Unstressed Rats. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186675. [PMID: 32937768 PMCID: PMC7558513 DOI: 10.3390/ijerph17186675] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/03/2020] [Accepted: 09/08/2020] [Indexed: 02/05/2023]
Abstract
This study assessed the effect of swimming training on anxiety-like behaviors and corticosterone. Thirty adult male Wistar rats were randomly assigned to five study conditions: swimming training (ST); exposure to chronic mild stress (CS); exposure to chronic mild stress followed by swimming training (CS + ST); exposure to chronic mild stress followed by a recovery period (CS + recovery); control. The exercise training consisted of 60 min of swimming exercise per day, for five days a week, and four consecutive weeks. A chronic mild stress program (CMS) was applied for a period of four weeks. Anxiety-like behaviors were measured by open field test (OFT). The number of excrements and blood corticosterone were used as physiological parameters of anxiety. To assess corticosterone, blood samples were taken 48 h after the last session of experiments. Compared to other study conditions, the lowest anxiety-like behaviors and corticosterone concentrations were observed in the ST condition in unstressed rats. In stressed rats, as in the ST + CS group, swimming training probably reduced some anxiety behaviors, but the results showed increased corticosterone compared to control and CS + Recovery. Anxiety parameters and corticosterone concentrations were greatest in the CS condition. In the ST group, anxiety parameters were less than for the ST + CS group. In the CS + Recovery group, anxiety parameters were less than for the CS group. In summary, self-paced swimming training could attenuate some anxiety parameters in both stressed and non-stressed rats. The effect of swimming training in unstressed rats was more prominent than in stressed rats. In stressed rats, a period of recovery was more effective than swimming training in reducing corticosterone. Mechanisms of anxiety reduction other than cortisol should be investigated in future research.
Collapse
Affiliation(s)
- Mohammad Amin Safari
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz 71946-84334, Iran; (M.A.S.); (M.K.J.); (R.R.)
| | - Maryam Koushkie Jahromi
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz 71946-84334, Iran; (M.A.S.); (M.K.J.); (R.R.)
| | - Rasoul Rezaei
- Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz 71946-84334, Iran; (M.A.S.); (M.K.J.); (R.R.)
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran;
| | - Serge Brand
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6719851115, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6719851115, Iran
- Department, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1416753955, Iran
- Correspondence: ; Tel.: +98-4161-32-55-097
| |
Collapse
|
47
|
van Loon AWG, Creemers HE, Beumer WY, Okorn A, Vogelaar S, Saab N, Miers AC, Westenberg PM, Asscher JJ. Can Schools Reduce Adolescent Psychological Stress? A Multilevel Meta-Analysis of the Effectiveness of School-Based Intervention Programs. J Youth Adolesc 2020; 49:1127-1145. [PMID: 32034632 PMCID: PMC7237523 DOI: 10.1007/s10964-020-01201-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/24/2020] [Indexed: 12/11/2022]
Abstract
Increased levels of psychological stress during adolescence have been associated with a decline in academic performance, school dropout and increased risk of mental health problems. Intervening during this developmental period may prevent these problems. The school environment seems particularly suitable for interventions and over the past decade, various school-based stress reduction programs have been developed. The present study aims to evaluate the results of (quasi-)experimental studies on the effectiveness of school-based intervention programs targeting adolescent psychological stress and to investigate moderators of effectiveness. A three-level random effects meta-analytic model was conducted. The search resulted in the inclusion of k = 54 studies, reporting on analyses in 61 independent samples, yielding 123 effect sizes (N = 16,475 individuals). The results indicated a moderate overall effect on psychological stress. Yet, significant effects were only found in selected student samples. School-based intervention programs targeting selected adolescents have the potential to reduce psychological stress. Recommendations for practice, policy and future research are discussed.
Collapse
Affiliation(s)
- Amanda W G van Loon
- Utrecht University Child and Adolescent Studies, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Hanneke E Creemers
- University of Amsterdam Forensic Child and Youth Care Sciences, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| | - Wieke Y Beumer
- Utrecht University Child and Adolescent Studies, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Ana Okorn
- Utrecht University Child and Adolescent Studies, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Simone Vogelaar
- Leiden University Developmental and Educational Psychology, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Nadira Saab
- Leiden University Graduate School of Teaching (ICLON), Kolffpad 1, 2333 BN, Leiden, The Netherlands
| | - Anne C Miers
- Leiden University Developmental and Educational Psychology, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - P Michiel Westenberg
- Leiden University Developmental and Educational Psychology, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Jessica J Asscher
- Utrecht University Child and Adolescent Studies, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,University of Amsterdam Forensic Child and Youth Care Sciences, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| |
Collapse
|