The impacts of a combined exercise on executive function in children with ADHD: A randomized controlled trial

PURPOSE: The purpose of this study was to examine the effects of aerobic and neurocognitive exercise with moderate-to-vigorous physical activity levels on executive functions (EFs) and sleep quality in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: In a parallel two-group randomized controlled trial (RCT) design, 80 children with ADHD aged 6-12 years (Mage = 8.46 ± 1.50) were assigned to either a 12-week combined aerobic-and neurocognitive-exercise experimental group (EG; three sessions per week for 60-min) or a wait-list control group (CG). Forty children with typical development aged 6-12 years (Mage = 8.49 ± 1.51) were recruited as healthy controls (HC). A Polar heart rate (HR) monitor was used to track the exercise intensity (60%-80% predicted HRmax) throughout the intervention. Three core EFs (inhibitory control [IC], working memory [WM], and cognitive flexibility [CF]) were assessed by computer-based neurocognitive tasks, and sleep quality and physical activity (PA) levels were assessed by self-report questionnaires. RESULTS: The results showed that the exercise intervention was beneficial for improving three core EFs, shortening sleep latency and decreasing sleep disturbances. The intervention effects on EFs and sleep quality appeared to be sustained for at least 12 weeks in EG. In addition, children with ADHD after intervention showed non-significant differences in IC, CF and multiple sleep quality outcomes compared with HC. Furthermore, a significant PA-EFs-sleep correlation was found in children with ADHD after the intervention. CONCLUSION: The findings suggest that a 12-week combined aerobic and neurocognitive exercise intervention appears to be an effective treatment program for EFs and sleep quality in children with ADHD.