Effects of Physical Activity on Attention Deficit Hyperactivity Disorder Symptoms

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08/02/20 Medical Reference this

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Abstract

This paper is an attempt to explore there is a relationship between physical activity and attention deficit hyperactivity disorder in adolescent sample population. It reviews some literature on potential of physical activity for symptom management amongst Adolescents with ADHD. Research suggests there are some beneficial effects of physical activity on cognitive performance which might be particularly huge in children and adolescents. However, there is limited research amongst adolescent population because physical activity as a means of managing behavioral symptoms has not been thoroughly explored.

The Etiology of ADHD and what is generally considered to be the mechanisms for the effects of physical exercise on cognitive performance suggests that physical exercise is important for this population. Despite extensive literature and the challenges that children/adolescents with ADHD are facing, more research is advocated to explore the potential of physical activity and its impact on this population.

Objective: this paper reviews some literature regarding the potential of physical activity on ADHD symptom management in reference to behavioral and cognitive symptoms.  Methodology: Literature was reviewed on research done which specifically examined the effects of physical activity on cognitive and behavioral symptoms of ADHD with potential mechanisms addressed.  Results: Albeit limited, current research generally supports the potential for acute and chronic physical activity in mitigating ADHD symptoms.

Conclusion: However despite extensive literature reviews and the challenges faced by children and adolescents with ADHD more research needs to be done on the effects of physical activity as a means of managing behavioral symptoms and; improving cognitive performance on attention deficit hyperactivity disorder (ADHD) amongst adolescents.

Attention deficit hyperactivity (ADHD) is one of the leading childhood psychiatric disorders in the USA, affecting approximately 3-7 % of school age children (American Psychiatric Association, 2000). ADHD characteristics is diagnosed based upon symptoms of inattention, hyperactivity and or impulsivity which most occur for at least six months in at least two domains of  life and  which began to be observed  prior to age 7 years (American Psychiatric Association, 2000). These symptoms may sometimes persist into adult hood and can cause numerous impairments in social, academic, and occupational functioning.

 According to (Harlacher et al. 2006) ADHD behavior is indirect conflict with the demands of the classroom. While in the class rooms students are expected to be still and stay seated, pay attention, concentrate, be quiet, and follow directions which are all central to the learning process. Thus classroom environment itself is challenging for children with ADHD to navigate and behavioral symptoms of ADHD may limit a child’s ability to be successful in school.

(Castellanos and Tannock, 2002) Neurobiological mechanisms of ADHD suggests its multidimensional and complex nature where by models of ADHD presents a deficit in frontal lobe function which underlies its various cognitive and  behavioral manifestations According to Durston (2003), fronto-striatal and fronto-parietal networks are frequently cited as central to ADHD dysfunctions. (Bush et al., 2005) in his literature review of neuro imaging studies reported that the most substantial differences in cerebral structure between ADHD patients and healthy controls were evident in regions of the prefrontal cortex with results indicating hypo activity and structural abnormalities in the dorsolateral prefrontal cortex affecting vigilance, selective and divided attention, shifting, planning, executive controls and working memory.

According to (Dickstein et al.2006) further reviews in support of deficits in frontal lobe function, a recent meta- analysis of 16 neuro imaging studies contrasted patterns of neural activity in children and adults with ADHD and heavy controls. This review also supported a pattern of frontal lobe hypo activity in ADHD consistent with models implicating frontal lobe dysfunction in ADHD.  Additional MRI studies indicate that children with ADHD have significantly diminished blood, flow and reduced activation to the prefrontal, frontal lobe and striatal areas of the brain for behavioral control task (Konrad et al., 2006). These regions of the brain are involved in attention, working memory, response inhibition and planning.

According to (Madras et al., 2005) These functions are the identified core cognitive deficits relevant to children with ADHD as these regions are associated with the regulation of catecholaminergic pathways important for motor impulse control and cognitive functions, with  evidence that individuals with ADHD do not reload  these neurotransmitters effectively. Brain derived neurotrophic factor (BDNF) has been identified as a potential mechanism that is important in the etiology of ADHD Tasi (2007).

Cognitive performance reviews suggests that ADHD is characterized by deficits in  executive functions (EF) with ADHD individuals performing more poorly on a range of( EF) tasks relative to control participants (Shallice et al; 2002). Executive function refers to cognitive abilities that maintain an appropriate problem solving set in order to attain a future goal and is thought to be highly relevant to activities of daily living, appropriate behavior, academic and social functions. In the classroom setting EF deficits may interfere with the ability to process incoming information while listening to a teacher, to identify relevant information, to inhibit irrelevant thoughts, to hold information in mind while linking it to other relevant information and to stay focused on tasks. Clearly impacting a child’s ability to reach his or her potential.

Wilcutt et al; (2005) metaphysically reviewed 83 studies in which (EF) executive function measures were administered to children and adolescents with ADHD and without ADHD. They found that participants with ADHD exhibited significant impairment on response inhibition, vigilance, working memory, and planning with effect sizes generally in the moderate range (0.46-0.49). While EF deficits are not the only cognitive and behavioral problems in ADHD individuals they contribute significantly to symptoms of the disorder and are associated with substantial academic deficits. Thus a large discrepancy exists between achievement outcomes in ADHD children relative to controls.

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed mental health disorder in children, teens and adolescents. ADHD affects a significant number of adolescents and requires treatment planning and further research to achieve positive outcomes.  

    Attention deficit hyperactivity disorder is a medical condition where by differences in brain development and brain activity affect attention, ability to sit still, and self-control. Symptoms usually manifest at home, school and in friendships and the struggles are harder and very obvious with impulsivity, inattentiveness, restlessness and hyperactivity which affect aspects of their lives at home and at school. It is a leading cause of disability and it is important to continue researching ways of combating this disorder. This paper attempts to explain the effects of physical activity on attention deficit hyperactivity disorder symptoms showing an inverse relationship.

Physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity encompasses all activities, at any intensity, performed during a 24 hour day.  Physical activity includes exercise and incidental activity integrated into daily activity. This integrated activity may not be planned, structured, repetitive or purposeful for the improvement of fitness, and may include activities such as walking to the local shop, cleaning, working, active transport WHO (2013).

 Exercise or physical activity helps in the alleviation of ADHD symptoms, within adolescent population. It does not establish causality but to an extent establishes the inverse relationship between physical activity and its effects on ADHD symptoms in adolescents.

Physical activity as treatment option for ADHD has moderate support but more research has to be done in adolescent sample population. Health care professionals are called upon to be at the fore front promoting public health policies that recognize the importance of physical activity in mitigating ADHD symptoms in children and adolescent population with a higher predisposition.

Physical activity provides a wide range of beneficial effects against daily stressors. Effects of exercise have been reported to improve mental health symptoms of anxiety, depression, negative affect, ADHD symptoms, behavior, poor impulse control, and compulsiveness with some significant improvement in functioning, working memory and positive affect (Amari et al 2010). The effects of physical activity on cognitive performance and behavior amongst children and adolescents suggest that physical activity might be especially important for this population.

 Physical activity has an inverse relationship on attention deficit hyperactivity disorder symptoms in adolescents. Healthcare providers are obviously faced with the challenge of educating parents and their adolescents about the inverse relationship between physical activity and ADHD symptoms as a form of primary and secondary prevention. Therefore as a best practice effort health care providers must screen adolescents for mental health disorders such as anxiety, depression, bipolar and ADHD and talk to parents and their adolescents about the strong inverse correlation between  ADHD, depressive symptoms and physical activity WHO (2012).

Health care providers can utilize this knowledge proactively in promoting policies that create an environment that supports safe and effective physical activity.

 Health promotion, open communication with parents, adolescents and communities that involve knowledge building on recommended physical activity guide lines of at least 60 minutes per day is a crucial start to protecting adolescents and encouraging the narrative regarding the strong inverse relationship between physical activity and depressive ADHD symptoms (CDC 2013).                                                                  

        Literature review on potential role of physical activity and ADHD mechanisms

  The potential role of physical activity as a possible treatment for ADHD is supported by research on older adults and animal studies which indicate the positive impact that physical activity has on the same neuro biological factors that are implicated in ADHD. A few studies have been conducted to test the effects of physical activity on mechanisms that underlie ADHD symptoms. Wigal et al (2003) observed that children with combined type ADHD (have both inattention and hyperactivity-impulsivity symptoms) exhibited a smaller increase in catecholamine in response to acute exercise as compared to healthy aged matched controls. This research result lends indirect evidence to the idea that ADHD symptoms are related to a catecholamine dysfunction within the hypothalamic-pituitary axis.

 According to (Colcombe and Kramer, 2003) There is also evidence that physical activity benefits executive function (EF) specifically and cognitive function in general thus providing  indirect support for the hypothesis that physical activity may impact the cognitive  symptoms of ADHD in  children and adolescents.  Another Meta-analytical review results from acute chronic and cross-sectional studies demonstrated an overall significant positive effect of physical activity on cognition in children according to ( Sibley and Etnier , 2003). The largest results were observed for the tower of London planning task in which children that were more physically active also performed better on tasks that assessed their working memory, inhibition and information processing speed.

       In another acute exercise study (Medina et al.2009) examined the impact of high intensity physical activity on sustained attention in boys diagnosed with ADHD. Participants performed high intensity exercises on thread mill for about thirty minutes and sustained attention was tested pre and post exercise. Results of the study showed that there was a significant increase in sustained attention following exercise irrespective of medication use. Interestingly children improved more on response time and vigilance while decreasing impulsivity.

 Despite these promising results more research needs to be done specifically examining the effects of a single session of physical activity on cognition in adolescents and children with ADHD. However there are enough literature reviews suggesting that acute physical activity may be particularly beneficial for adolescents and children diagnosed with ADHD according to (Medina et al.2009).  Recent animal models show that physical activity increase cerebral blood flow. (Endres et al., 2003; Swain et al., 2003) suggests that physical activity increases the availability of dopamine and nor epinephrine in synaptic clefts of the central nervous system.

                                                          References

  • Amiri S, Fakhari A, Maheri M, Mohammad poor Asl A (2010) Attention deficit/hyperactivity disorder in primary school children of Tabriz, North-West Iran. Paediatr Perinat Epidemiol 24:597–601
  • Centers for Disease Control and Prevention: National Center for Health Statistics. (2013).   

National health and nutrition examination survey. Retrieved from http://www.cdc.gov/nchs/nhanes.htm

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