Cognitively combined/engaged physical activity for the executive function, symptomology, and motor competence of children and adolescents with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis

BACKGROUND: Cognitively combined/engaged physical activity (CC/CE-PA) has been used as an intervention for children/adolescents with attention-deficit/hyperactivity disorder (ADHD). METHOD: This review aimed to quantify the effects of CC/CE-PAs on enhancing executive and physical function and alleviating ADHD symptoms in children/adolescents with ADHD. An extensive literature search of online databases identified 32 studies (75% high-quality studies), of which 22 (pooled n=968) were included in the meta-analysis. RESULTS: The included studies covered five PA types with varying intervention periods, frequencies, and exercise durations. The CC/CE-PAs showed an overall significant effect on improving executive function (standardized mean difference [SMD]: 1.10) and motor competence (SMD: 0.52) and alleviating ADHD symptoms (SMD: -0.75). Program design and participants' medication status were found to significantly moderate the effect of CC/CE-PA. CONCLUSION: More evidence is needed to support the effect of CC/CE-PA by comparing it with other interventions and using a rigorous experimental design.