Exercise linked to better skills in children with ADHD, with caveats

This meta-analysis pooled 10 published studies. Together they covered 300 children and teens who had ADHD or clinical-level ADHD symptoms. All were 18 or younger, and their average age was 9.3 years. Girls made up 20% of the group. ADHD medication was used by 41% of the children.

The studies compared physical exercise programs with no exercise. The outcomes were executive functions, the thinking skills behind planning and self-control, combined with motor skills. Exercise was linked to a medium-sized improvement in these outcomes. The studies disagreed a lot with each other.

Longer programs were the only factor tied to larger effects. Exercise intensity, age and the share of girls did not make a clear difference. The authors call these extra analyses exploratory, since they rest on few studies.

There were signs of publication bias, meaning studies with weaker results may be missing. After a statistical correction for this, the effect shrank and was no longer clearly different from zero. The authors say the main result is likely an overestimation of the true effect.

The studies were small. Many lacked control groups or blinding. Most used only treadmill exercise done alone. Medication use could not be tested as a factor. The authors state the results are too weak to justify any clinical recommendations.