Sweat or Rest? The effects of physical exercise in adults with ADHD: A systematic review and Meta-analysis

Tony Cat Anh Hung A Nguyen

There is a growing body of evidence suggest the therapeutic effects of physical exercise on attention-deficit/ hyperactivity disorder (ADHD) symptoms and related health outcomes. Although there are a number of systematic reviews and meta-analyses attempt to summarise the effectiveness of exercising in treating ADHD among children and adolescents, there is hardly any research exerting such efforts for adults with ADHD in the current literature. The present systematic review and meta-analysis aimed to address this gap by (1) estimating the overall effectiveness of exercising for adults with ADHD, (2) summarising the examined outcomes in the current literature, and (3) exploring the moderators that modify the effectiveness of exercising in adults with ADHD. A total number of 10 relevant studies (N = 286) were identified for the present meta-analysis. A three-level random-effects analysis indicated that exercising had a small-to-medium impact (Hedge’s g = 0.34) for adults with ADHD across all outcome categories. A series of post-hoc meta-regression analysis was conducted to examine influence of four moderators including outcome category (ADHD symptoms, executive functioning, global functioning, mindfulness, motor functioning, negative mood, positive mood, and sleep quality); exercise type (aerobic exercises, coordinative exercises, cycling, kickboxing, Tai Chi, Walking, and Yoga); study design (independent groups pre-post design, single-group pre-post design, and studies are treated as single-group pre-post design); and session length. Among all four moderators, results indicated only exercise type can significantly modify the effectiveness of exercising for adults with ADHD, with aerobic exercises (Hedge’s g = 0.55) has the largest significant effect, cycling (Hedge’s g = 0.34) and walking (Hedge’s g = 0.46) has a smaller but also significant effect. Results yielded no significant effect for other exercise type including coordinative exercises (Hedge’s g = 0.46); kickboxing (Hedge’s g = 0.18); Tai Chi (Hedge’s g = -0.52); yoga (Hedge’s g = 0.09). A series of publication bias analyses were conducted but no evidence of publication bias were detected for the present meta-analysis. However, Cochrane risk-of-bias assessment indicated that a small amount of included studies may issues with concealing the randomisation process which consequently may not effectively prevent participants from understanding the true study’s purpose. Additionally, a small number of studies did not fully report the statistical details of measuring outcomes. Theoretical implications, practical implication for health and mental health practitioners, limitation and future research are also discussed.

Sweat or Rest? The effects of physical exercise in adults with ADHD: A systematic review and Meta-analysis

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