This study pooled 39 randomized trials of exercise programs. They included 1836 children and adolescents diagnosed with ADHD, aged 6 to 16 in the included trials. Programs ran from 4 to 72 weeks, at 1 to 7 sessions per week. The findings are about young people, not adults.
Each exercise type was compared with control groups. For core ADHD symptoms, closed-skill exercise such as treadmill running ranked highest. For executive functions, open-skill exercise such as ball sports ranked highest. Mind-body therapy showed the smallest effect on executive functions.
The team modeled how much exercise went with a meaningful change: about 660 METs-min/week for core symptoms. For executive functions, it was about 740 METs-min/week. Beyond roughly 1210 METs-min/week, they saw no clear added benefit for executive functions.
In the core symptoms analysis, children doing closed-skill or open-skill exercise were less likely to drop out than controls.
The evidence has real limits. Most trials were small, short and run at a single site. The authors rated certainty as low or very low for most comparisons. The studies disagreed a lot with each other. There were also signs of small-study effects or publication bias.
The authors suggest approximately 600-800 METs-min/week (roughly 20-25 min/day of moderate-intensity exercise) as an exploratory benchmark for children and adolescents with ADHD, one that still needs testing in large trials. Anyone weighing this should talk to a clinician about their own situation.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Zhang, 2026: compared with control groups, closed-skill exercise on core symptoms Hedges' g = -0.54; open-skill exercise on executive functions Hedges' g = -0.68; mind-body therapy on executive functions g = -0.13. Disagreement between studies for core symptoms I2 = 78.2%.
What the terms mean:
- g is an effect size. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
- I2 shows how much the studies disagreed with each other, from 0% to 100%. Higher means more disagreement.
Source: Zhang M, He C, Gao X, et al.. Exercise for core ADHD symptoms and executive functions in children and adolescents with ADHD: A network and dose–response meta-analysis. Journal of Sport and Health Science (2026). doi:10.1016/j.jshs.2026.101157