TY - JOUR
T1 - Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders
AU - Bustamante, Eduardo Esteban
AU - Davis, Catherine Lucy
AU - Frazier, Stacy Lynn
AU - Rusch, Dana
AU - Fogg, Louis F.
AU - Atkins, Marc S.
AU - Marquez, David Xavier
N1 - Publisher Copyright:
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - 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.
AB - 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.
KW - ADHD
KW - BEHAVIOR DISORDERS
KW - EXECUTIVE FUNCTION
KW - PHYSICAL ACTIVITY
KW - URBAN POVERTY
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U2 - 10.1249/MSS.0000000000000891
DO - 10.1249/MSS.0000000000000891
M3 - Article
C2 - 26829000
AN - SCOPUS:84975477200
SN - 0195-9131
VL - 48
SP - 1397
EP - 1407
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 7
ER -