Effect of Cognitive Rehabilitation Combined With Physical Exercise on Sustained, Selective, and Alternating attention in School-aged Girls Attention-Deficit/Hyperactivity Disorder

Objectives: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders in childhood. This study aims to assess the effect of cognitive rehabilitation combined with physical exercise on sustained, selective and alternating attention in ADHD children. Methods: This is a quasi-experimental study with a Pre-test/posttest design. The study population consists of all primary school girls with ADHD in Yazd, Iran. Of these, 40 aged 9-12 years were selected and randomly divided into four groups of cognitive rehabilitation, physical exercise, combined (exercise + rehabilitation), and control. The Conners’ Teacher Rating Scale (CTRS) was used for initial assessment of children, Goodenough- Harris Drawing Test (GHDT) to measure intelligence score, Integrated Visual and Auditory-Continuous Performance Test (IVA-CPT) to assess sustained attention, Wisconsin Card Sorting Test (WCST) to measure alternating attention, and Stroop test to measure selective attention. For cognitive rehabilitation, My Brain application was used. The intervention was presented at 16 sessions, each for 60 minutes. Posttest assessment was performed 24 and 72 hours after the end of intervention. ANCOVA was used for data analysis. All analyses were performed in SPSS v. 20, considering a significance level of P<0.05. Results: The results of ANCOVA showed that the combined group had significantly lower errors in sustained, selective and alternating attention tests compared to other groups. In the omission response variable, the mean score of the children in the combined group was significantly lower than in the control group (P<0.05). Conclusion: Cognitive rehabilitation combined with physical exercises can improve different types of attention in children with ADHD.