Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders

Eduardo Esteban Bustamante, Catherine Lucy Davis, Stacy Lynn Frazier, Dana Rusch, Louis F. Fogg, Marc S. Atkins, David Xavier Marquez

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Purpose The objective of this study is to test the feasibility and impact of a 10-wk after-school exercise program for children with attention deficit hyperactivity disorder and/or disruptive behavior disorders living in an urban poor community. Methods Children were randomized to an exercise program (n = 19) or a comparable but sedentary attention control program (n = 16). Cognitive and behavioral outcomes were collected pre-/posttest. Intent-To-Treat mixed models tested group-Time and group-Time-Attendance interactions. Effect sizes were calculated within and between groups. Results Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum HR. Group-Time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d = 0.47) and verbal working memory (d = 0.26), and controls on visuospatial working memory (d =-0.21) and oppositional defiant symptoms (d =-0.37). In each group, within-group effect sizes were moderate to large on most outcomes (d = 0.67 to 1.60). A group-Time-Attendance interaction emerged on visuospatial working memory (F[1,33] = 7.42, P < 0.05), such that attendance to the control program was related to greater improvements (r = 0.72, P < 0.01), whereas attendance to the exercise program was not (r = 0.25, P = 0.34). Conclusions Although between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features, such as routines, engaging activities, behavior management strategies, and adult attention, and highlight the potential for after-school programs to benefit children with attention deficit hyperactivity disorder and disruptive behavior disorder living in urban poverty where health needs are high and services resources few.

Original languageEnglish (US)
Pages (from-to)1397-1407
Number of pages11
JournalMedicine and Science in Sports and Exercise
Issue number7
StatePublished - Jul 1 2016


  • ADHD

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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