Preliminary evidence suggests exercise enhances mental health and cognitive performance among typically developing children and children with attention deficit hyperactivity disorder (ADHD). The goal of this study was to determine whether improvements vary depending on exercise intensity (e.g., high vs. low) or outcome domains (e.g., mood, behavior, academic productivity), and whether effects vary over time. Participants were 130 children (73% in ADHD group) aged 6 to 13 who completed daily exercise (high or low intensity) across 15 days as well as daily measures of pre- and post-activity mood, behavior and academic productivity. Results indicated no differences in the effectiveness of low- versus high- intensity exercise for youth with and without ADHD on overall mood, behavior, or academic productivity. Moreover, although there were no differences in academic productivity over time among children with and without ADHD in the low or high intensity exercise conditions, there were differences in behavior and mood over time among children with and without ADHD in the high, but not low, intensity condition. Specifically, relative to children without ADHD, children with ADHD had a wider range of behavior problems immediately after high intensity exercise and showed worse initial moods and more negative change over time in mood. Findings suggest that high intensity exercise delivered in certain formats can be associated with worse mood and behavior over time among youth with ADHD. Future research is needed to draw firmer conclusions about the relative short- and long-term effectiveness of high and low intensity exercise for youth with and without ADHD.
Exercise is thought to have benefits for youth with ADHD but to date its effects, especially at various intensities, remain unknown.
There were no differences in effectiveness of low- versus high- intensity exercise for youth with and without ADHD on mood, behavior, or academic productivity.
Children with ADHD had more behavior problems and worse moods over time following high- but not low-intensity exercise.
High intensity exercise delivered in certain formats may be linked with worse mood and behavior for youth with ADHD.
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Ahmed, G., & Mohamed, S. (2011). Effect of regular aerobic exercise on behavioral, cognitive and psychological response in patients with attention-deficit/hyperactivity disorder. Life Science Journal, 8(2), 366–371.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth edition: DSM-5. Washington: American Psychiatric Association.
Annesi, J. (2005). Correlations of depression and total mood disturbance with physical activity and self-concept in preadolescents enrolled in an after-school exercise program. Psychological Reports, 96(3), 891–898.
Angold, A., Costello, E. J., Messer, S. C., Pickles, A., Winder, F., & Silver, D. (1995). The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237–249.
Arnold, L. E., Hurt, E., & Lofthouse, N. (2013). Attention-deficit/hyperactivity disorder: dietary and nutritional treatments. Child and Adolescent Psychiatry Clinics of North America, 22, 381–402.
Barlett, A. Litwin, B. & Rosenthal, R. (2010) “A home-based exercise program augmented by a self-management home health monitor for individuals with type 2 non-insulin dependent diabetes”. Department of Health Sciences Faculty Proceedings, Presentations, Posters, Speeches, Lectures, etc…218. https://nsuworks.nova.edu/hpd_hs_facpres/218
Barner, J. C., Khoza, S., & Oladapo, A. (2011). ADHD medication use, adherence, persistence and cost among Texas Medicaid children. Current Medical Research and Opinion, 27(2), 13–22.
Berwid, O. G., & Halperin, J. M. (2012). Emerging support for a role of exercise in attention-deficit/hyperactivity disorder intervention planning. Current Psychiatry Reports, 14(5), 543–551.
Biederman, J. (2005). Attention-deficit/hyperactivity disorder. Society of Biological Psychiatry, 57, 1215–1220.
Brinkman, W. B., Simon, J. O., & Epstein, J. N. (2018). Reasons why children and adolescents with attention-deficit/hyperactivity disorder stop and restart taking medicine. Academic Pediatrics, 18(3), 273–280. https://doi.org/10.1016/j.acap.2017.09.005.
Bunford, N., Evans, S. W., & Wymbs, F. (2015). ADHD and emotion dysregulation among children and adolescents. Clinical Child and Family Psychology Review, 18(3), 185–217.
Bunford, N., Evans, S. W., & Langberg, J. (2018). Emotion dysregulation is associated with social impairment among young adolescents with attention-deficit/hyperactivity disorder. Journal of Attention Disorders, 22(1), 66–82.
Burd, K. A., Margherio, S. K., & Wymbs, F. A. (2018). The effects of high intensity exercise and yoga on children with attention deficit/hyperactivity disorder. Poster presented at the 52nd Annual Association for Behavioral and Cognitive Therapies (ABCT), Washington, D.C.
Bustamante, E. E., Davis, C. L., Frazier, S. L., Rusch, D., Fodd, L. F., Atkins, M. S., & Marquez, D. X. (2016). Randomized controlled trial of exercise for ADHD and disruptive behavior disorders. Medicine Science Sports Exercise, 48(7), 1397–1407.
Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports, 100, 126.
Castelli, C., Hillman, C., Buck, S., & Erwin, H. (2007). Physical fitness and academic achievement in third- and fifth-grade students. Journal of Sport & Exercise Psychology, 29, 239–252.
Catalá-Lopez, F., Hutton, B., Núñez-Beltrán, A., Page, M. J., Ridao, M., Macías Saint-Gerons, D., & Moher, D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomized trials. PLoS ONE, 12(7), e0180355.
Chacko, A., Kofler, M., & Jarret, M. (2014). Improving outcomes for youth with ADHD: A conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical Child and Family Psychology Review, 17, 368–384.
Chang, Y., Liu, S., Yu, H., & Lee, Y. (2012). Effect of acute exercise on executive function in children with attention deficit hyperactivity disorder. Archives of Clinical Neuropsychology, 27, 225–237.
Chang, Y., Tsai, Y., Chen, T., & Hung, T. (2013). The impacts of coordinative exercise on executive function in kindergarten children: an ERP study. Experimental Brain Research, 225(2), 187–196.
Chang, Y., & Etnier, J. (2015). Acute exercise and cognitive function: emerging research issues. Journal of Sport and Health Science, 1(4), 1–3.
Choi, J., Han, D., Kang, K., Jung, H., & Renshaw, P. F. (2015). Aerobic exercise and attention deficit hyperactivity disorder: Brain research. Medicine Science Sports Exercise, 47(1), 33–39.
Chimiklis, A. L., Dahl, V., Spears, A. P., Goss, K., Fogarty, K., & Chacko, A. (2018). Yoga, mindfulness, and meditation interventions for youth with ADHD: Systematic review and meta-analysis. Journal of Child and Family Studies, 27(10), 3155–3168.
Dishman, R. K., Berthoud, H., Booth, F. W., Cotman, C. W., Edgerton, V. R., Fleshner, M. R., & Zigmond, M. J. (2006). Neurobiology of exercise. Obesity, 14(3), 345–356.
Elbe, A., Wikman, J. M., Zheng, M., Larsen, M. N., Nielsen, G., & Krustrup, P. (2016). The importance of cohesion and enjoyment for the fitness improvement of 8 10-year-old children participating in a team and individual sport school-based physical activity intervention. Psychology, Social Sciences and Humanities, 17(3), 343–350.
Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, R. (2018). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 47(2), 157–198.
Fabiano, G. A., Pelham, W. E., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., & Burrows-MacLean, L. (2006). A practical measure of impairment: psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child & Adolescent Psychology, 35(3), 369–385.
Fabiano, G. A., Schatz, N. K., & Pelham, W. E. Jr. (2014). Summer treatment programs for youth with ADHD. Child and Adolescent Psychiatric Clinics of North America, 23(4), 757–773. https://doi.org/10.1016/j.chc.2014.05.012.
Flohr, J. A., Saunders, M. J., Evans, S. W., & Raggi, V. (2004). Effects of physical activity on academic performance and behavior in children with ADHD. Medicine Science Sports Exercise, 36, S145–S146.
Gapin, J., & Etnier, J. L. (2010). The relationship between physical activity and executive function in children with attention-deficit/hyperactivity disorder. Journal of Sport and Exercise Psychology, 32(6), 753–763.
Goldfield, G., Mallory, R., Parker, T., Cunningham, T., Legg, C., Lumb, A., & Adamo, K. (2007). Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children. Journal of Pediatric Psychology, 32(7), 783–793.
Grassmann, V., Alves, M. V., Santos-Galduróz, R. F., & Galduróz, J. C. F. (2017). Possible cognitive benefits of acute physical exercise in children with ADHD: a systematic review. Journal of Attention Disorders, 21(5), 367–371.
Haranto, T. A., Krafft, C. E., Iosif, A. M., & Schweitzer, J. B. (2015). A trial-by-trial analysis reveals more intense physical activity is associated with better cognitive control performance in attention-deficit/hyperactivity disorder. Child Neuropsychology, 22(5), 618–626.
Hoza, B., Smith, A. L., Shoulberg, E. K., Linnea, K. S., Dorsch, T. E., Blazo, J. A., & McCabe, G. P. (2014). A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children. Journal of Abnormal Child Psychology, 43(4), 655–67.
Jacobson, R. (2019). ADHD and exercise. https://childmind.org.
Jensen, P. S., Garcia, J. S., Glied, M., Crowe, M., Foster, M., Schlander, M., & Hinshaw, S. (2005). Cost-effectiveness of ADHD treatments: findings from the MTA study. American Journal of Psychiatry, 162(9), 1628–16236.
Koda, K., Ago, Y., Cong, Y., Kita, Y., Takuma, K., & Matsuda, T. (2010). Effects of acute and chronic administration of atomoxetine and methylphenidate on extracellular levels of noradrenaline, dopamine and serotonin in the prefrontal cortex and striatum of mice. Journal of Neurochemistry, 114, 259–270.
Ma, Q. (2008). Beneficial effects of moderate voluntary physical exercise and its biological mechanisms on brain health. Neuroscience Bulletin, 24(4), 265–270.
Medina, J. A., Netto, T. L., Muszkat, M., Medina, A. C., Botter, D., Orbetelli, R., & Miranda, M. C. (2010). Exercise impact on sustained attention of ADHD children, methylphenidate effects. Attention Deficit Hyperactivity Disorder, 2, 49–58.
Molina, B. S. G., Hinshaw, S. P., Swanson, J. M., Arnold, E., Vitiello, B., Jensen, P. S., & Houck, P. R. (2009). The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 484–500.
Meeusen, R., & De Meirleir, K. (1995). Exercise and brain neurotransmission. Sports Medicine, 20(3), 160–188.
Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide. Sixth edn Los Angeles, CA: Muthén & Muthén.
Muthén, L. K., & Muthén, B. O. (2012). Mplus User’s Guide. Seventh edn. Los Angeles, CA: Muthén & Muthén.
Nagy, M. R., O’Sullivan, M. P., Block, S. S., Tooley, T. R., Robinson, L. E., Colabianchi, N., & Hasson, R. E. (2017). Affective responses to intermittent physical activity in healthy weight and overweight/obese elementary school-age children. Journal of Physical Activity and Health, 14(11), 845–851.
Ng, Q., Ho, C., Chan, H., Yong, B., & Yeo, W. (2017). Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: a systematic review. Complementary Therapies in Medicine, 34, 123–128.
Norris, R., Carroll, D., & Cochrane, R. (1992). The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. Journal of Psychosomatic Research, 36(1), 55–65.
Pelham, W. E., Fabiano, G., & Massetti, G. (2005). Evidence-based assessment of ADHD in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34(3), 449–476.
Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-3-R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 31(2), 210–218.
Pelham, W. E., Gnagy, E. M., & Greiner, A. R. (1992). Summer Treatment Program Manual. Buffalo, NY: Comprehensive Treatment for Attention Deficit Disorders, Inc.
Pliszka, S. R. (2005). The neuropsychopharmacology of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 1385–1390.
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365.
Pontifex, M. B., Saliba, B. J., Raine, L. B., Picchietti, D. L., & Hillman, C. H. (2013). Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. Journal of Pediatrics, 162, 543–551.
Rhew, I., Simpson, K., Tracy, M., Lymp, J., McCauley, E., Tsuang, D., & Vander Stoep, A. (2010). Criterion validity of the Short Mood and Feelings Questionnaire and one- and two-item depression screens in young adolescents. Child and Adolescent Psychiatry and Mental Health, 4(8), 4–8.
Smith, A. L., Hoza, B., Linnea, K., McQuade, J. D., Tomb, M., Vaughn, A. J., & Hook, H. (2013). Pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of Attention Disorders, 17(1), 70–82.
Strong, W. B., Malina, R. M., Blimkie, C. J., Daniels, S. R., Dishman, R. K., Gutin, B., & Trudeau, F. (2005). Evidence based physical activity for school-age youth. Journal of Pediatrics, 146(6), 732–737.
Tamminga, H. G. H., Reneman, L., Huizenga, H. M., & Geurts, H. M. (2016). Effects of methylphenidate on executive functioning in attention-deficit/hyperactivity disorder across the lifespan: a meta-regression analysis. Psychological Medicine, 46, 1791–1807.
Tantillo, M., Kesick, C. M., Hynd, G. W., & Dishman, R. K. (2002). The effects of exercise on children with attention-deficit hyperactivity disorder. Medicine & Science in Sports & Exercise, 34(2), 203–212.
Thabrew, H., Stasiak, K., Bavin, L. M., Frampton, C., & Merry, S. (2018). Validation of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in New Zealand help-seeking adolescents. International Journal of Methods in Psychiatric Research, 27(3), 1–9.
U.S. Department of Health and Human Services. (2018). Physical guidelines for Americans. 2nd edn. Washington, DC: U.S. Department of Health and Human Services.
Verret, C., Guay, M. C., Berthiaume, C., Gardiner, P., & Béliveau, L. (2010). A physical activity program improves behavior and cognitive functions in children with ADHD: an exploratory study. Journal of Attention Disorders, 16(1), 71–80.
Waschbusch, D. A., Cunningham, C. E., Pelham, W. E., Rimas, H. L., Greiner, A. R., Gnagy, E. M., & Hoffman, M. T. (2011). A discrete choice conjoint experiment to evaluate parent preferences for treatment of young, medication naïve children with ADHD. Journal of Clinical Child & Adolescent Psychology, 40(4), 546–561.
Wigal, S. B., Nemet, D., Swanson, J. M., Regino, R., Trampush, J., Ziegler, M. G., & Cooper, D. M. (2003). Catecholamine response to exercise in children with attention deficit hyperactivity disorder. Pediatric Research, 53, 756–761.
Winter, B., Breitenstein, C., Mooren, F. C., Voelker, K., Fobker, M., Krueger, K., & Knecht, S. (2007). High impact running improves learning. Neurobiology of Learning and Memory, 87(4), 597–609.
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Wymbs, F.A., Wymbs, B., Margherio, S. et al. The Effects of High Intensity versus Low Intensity Exercise on Academic Productivity, Mood, and Behavior among Youth with and without ADHD. J Child Fam Stud 30, 460–473 (2021). https://doi.org/10.1007/s10826-020-01880-5