The Effect Of Aerobic-and Neurocognitive Exercise On Executive Functions And Sleep In Children With Adhd

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the neurodevelopmental disorders, affecting approximately 2%-7% of children. ADHD may experience significant impairments that go beyond the core symptoms of ADHD in sleep resistance and executive dysfunction. PURPOSE: To determine whether a combined type of exercise intervention (e.g., aerobic-and neurocognitive-exercise) with moderate-to-vigorous physical activity (MVPA) levels would improve multiple domains of executive functions (EFs) and sleep quality in children with ADHD experiencing sleep disturbances. METHODS: In a parallel two-group randomized controlled trial (RCT) design, 40 children between 6-12 years (M = 8.46; SD = 1.50) diagnosed with ADHD were assigned to a 12-week combined aerobic-and neurocognitive-exercise intervention group (three sessions per week for 60 mins) or a control group. A polar heart rate monitor was used to track the exercise intensity (60-80% predicted HRmax). Three core EFs (inhibitory control, working memory, and cognitive flexibility) and four sleep parameters (sleep efficiency, sleep latency, total sleep duration, and wake after sleep onset) were assessed. ANCOVAs using the baseline test values as covariates were used to compare the EFs and sleep quality between the two groups. Cohen's d was reported as an estimation of effect size. RESULTS: The 12-week combined aerobic-and neurocognitive-exercise revealed a significant improvement in inhibition (F (1, 36) = 5.13, P = 0.03, d = 0.49), working memory (F (1, 36) = 22.28, P < 0.00, d = 0.99), and cognitive flexibility (F (1, 36) = 10.40, P = 0.003, d = 0.92) in the intervention group but not in the control group. Regrading sleep quality, significant effects were only detected on the accelerometer measured sleep latency (F (1, 36) = 22.82, P < 0.00, d = 1.24) in intervention group but not in the control group. Moderate correlations were revealed between the changes in sleep efficiency and MVPA consumed in each session of intervention (r = 0.537, P = 0.039) in intervention groups. CONCLUSIONS: The findings provide potential support for the efficacy of exercise intervention for children with ADHD to improve their EFs performance and sleep quality.