Abstract
Purpose: To explore the effects of physical activity (PA) intervention on executive function (EF) and motor skills (MS) among children with attention deficit hyperactivity disorder and/or autism spectrum disorder (ASD).Methods: Relevant studies were sourced from PubMed, Web of Science, EMBASE, Cochrane Library, CNKI and Wanfang Data. Only randomized controlled trials (RCT) were included based upon the following criteria: (1) participants were children and clinically diagnosed with ADHD/ASD, (2) intervention strategies were identified as chronic physical activity, and (3) EF (e.g., cognitive flexibility) and/or MS (e.g., gross motor skills) were measured at baseline and post-intervention and compared with an eligible control group.Results: Eleven studies involving 346 participants were finally identified. PA elicited significant improvements in EF and MS in children with ADHD/ASD. Regarding changes in the EF of participants, PA showed a great improvement in overall EF [standardized mean difference (SMD): 0.90, 95% confidence interval (CI) 0.49–1.30, p < 0.00001], inhibitory control (SMD: 1.30, 95% CI 0.58–2.02, p = 0.0004) and cognitive flexibility (SMD: 0.85, 95% CI 0.42–1.29, p = 0.0001), but no significant improvement in working memory (SMD: 0.28, 95% CI −0.15–0.71, p = 0.20). Significant improvements were also found with respect to gross motor skills (SMD: 0.80, 95% CI 0.30–1.30, p = 0.002), but no significant changes were found in fine motor skills (SMD: 0.30, 95% CI −0.91–1.52, p = 0.62).Conclusion: Chronic PA interventions may promote EF and MS in children with ADHD/ASD, especially in inhibitory control, cognitive flexibility, and gross motor skills. However, PA interventions seemed to have insignificant effects on working memory and fine motor skills to children with ADHD/ASD.PROSPERO registration number: CRD42019118622
Highlights
Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are the most common neurodevelopmental disorders in children (AmericanPsychiatric-Association, 2013)
Regarding changes in the executive function (EF) of participants, physical activity (PA) showed a great improvement in overall EF [standardized mean difference (SMD): 0.90, 95% confidence interval (CI) 0.49–1.30, p < 0.00001], inhibitory control (SMD: 1.30, 95% CI 0.58–2.02, p = 0.0004) and cognitive flexibility (SMD: 0.85, 95% CI 0.42–1.29, p = 0.0001), but no significant improvement in working memory (SMD: 0.28, 95% CI −0.15–0.71, p = 0.20)
Significant improvements were found with respect to gross motor skills (SMD: 0.80, 95% CI 0.30–1.30, p = 0.002), but no significant changes were found in fine motor skills (SMD: 0.30, 95% CI −0.91–1.52, p = 0.62)
Summary
Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are the most common neurodevelopmental disorders in children (AmericanPsychiatric-Association, 2013). Children with ASD have apparent deficits in social communication and repetitive patterns of behaviors (Fombonne, 2009), while children with ADHD have manifested symptoms such as difficulty paying attention, excessive activity, or difficulty controlling behavior in a developmentally inappropriate manner (Dunn and Kronenberger, 2003; Cormier, 2008; Lange et al, 2010; American-Psychiatric-Association, 2013). These problems are significantly detrimental to their quality of life (Ross, 2006; Mayes et al, 2008) and even persist in their later life (Klassen et al, 2004; Agranat-Meged et al, 2005; Birnbaum et al, 2005). A range of MS impairments have been identified in children with ADHD/ASD (Bhat et al, 2011; Pan, 2014); this might be related to the insufficient level of neurotransmitters (Kaiser et al, 2015), which indicated the critical need for interventions to promote optimal motor and overall development
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