Existing ADHD Treatments
Attention-deficit/hyperactivity disorder (ADHD) is characterized by deficits in executive functioning (e.g., working memory, response inhibition, and organization. Inattention and hyperactivity/impulsivity result in impairments in academic, occupational, and social functioning. The primary treatments for ADHD include psychosocial, pharmacological, and combined treatments. Despite the well-documented effectiveness of these interventions, there are limitations to their use. Although both pharmacotherapy and psychosocial treatments are efficacious during active treatment, few individuals receive long-term treatment, resulting in limited, if any, sustained effects. One explanation for the transient benefits of current treatments are that they target symptoms and functional impairments rather than the neural mechanisms that underlie the disorder. In response to this, researchers have begun to consider other forms of interventions to directly impact these underlying deficits.
Benefits of Physical Exercise
Physical exercise has received increasing attention with the current obesity epidemic. The benefits of physical exercise include improving medical problems (e.g., obesity, diabetes) and psychological difficulties (e.g., anxiety, depression. A growing body of research suggests physical exercise has powerful effects on neurocognitive, psychological, and academic functioning. Emerging from this burgeoning evidence, mental health researchers have begun to explore exercise as an avenue by which mental health treatment outcomes can be enhanced.
Physical Exercise for ADHD
Among individuals with ADHD, exercise may not only improve cognitive performance but ameliorate comorbid anxiety and depression, and serve as a protective factor for adverse health outcomes–all of which commonly co-occur with ADHD. Indeed, initial results with children and adolescents have been promising. Findings from these studies provided preliminary evidence that exercise may improve motor, cognitive, social, and behavioral functioning for school-aged children with ADHD. While investigations on interventions involving exercise for school-aged children with ADHD advance, there are no known studies examining the use of such interventions for ADHD among young adults.
Although tempting, before generalizing school-aged treatment research to emerging adults, there are several important developmental and environmental differences that must be considered. For example, emerging adults experience higher demands for self-regulation, have greater autonomy, diminished external support (e.g., parents, schools), and their neurological structures are near their peak maturity. Thus, tailoring school-aged interventions to the developmental and environmental context of emerging adulthood is warranted to evaluate possible treatment effects.
The Study: High-Intensity Physical Exercise for ADHD
To elucidate the therapeutic benefits of physical exercise, a group of university students with ADHD and age- and sex-matched non-ADHD peers were recruited for two in-lab sessions spaced approximately one week apart. Across two counter-balanced sessions, participants in both groups completed outcome measures without any exercise and following high-intensity interval training (HIIT). The primary outcome measures included executive functioning measures from computerized tasks and ratings of depression, anxiety, stress, inattention, and hyperactivity/impulsivity from questionnaires.
The Findings & Implications
We found that the degree of improvement on ADHD and depressive symptomatology, as well as several aspects of executive functioning (i.e., processing speed and response variability) following physical exercise was significantly greater for the ADHD group than the comparison group.
Further investigations such as randomized controlled trials focusing on the chronic effects of sustained physical exercise interventions are needed to substantiate the potential feasibility and efficacy of physical exercise as an intervention. Physical exercise may be a useful adjunct to psychosocial and/or pharmacological treatments for college students with ADHD because it: (a) yields immediate, acute improvements in executive functioning, ADHD, and mood; (b) promotes improved physical and mental health; (c) poses a relatively low risk of deleterious effects in apparently healthy college students.
Even with the need for additional research, current data suggest a single, brief, high-intensity bout of aerobic exercise can yield immediate significant short-term improvements. These improvements may enhance functioning and improve outcomes for college students with ADHD.
The Science
LaCount, P.A., & Hartung, C.M. (2018). Physical exercise interventions for emerging adults with attention-deficit/hyperactivity disorder (ADHD). The ADHD Report, 26(5), 1-11. https://doi.org/10.1521/adhd.2018.26.5.1 — Full-Text of Article
LaCount, P.A., Hartung, C.M., Vasko, J.M., Serrano, J.W., Wright, H.A., & Smith, D.T. (in press). Acute effects of physical exercise in college students with attention-deficit/hyperactivity disorder. Mental Health and Physical Activity. https://doi.org/10.1016/j.mhpa.2022.100443 — Full-Text of Article
*These projects were supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under Grant # 2P20GM103432, the Ksir Research Fellowship, and Lillian Portenier Dissertation Award.