OBJECTIVE: To conduct a network meta-analysis comparing the effects of various long-term non-pharmacological treatments on inhibitory control in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) to provide theoretical support for non-pharmacological interventions in ADHD management.
METHODS: Randomized controlled trials (RCTs) on the effects of long-term non-pharmacological treatments on inhibitory control in children and adolescents with ADHD published up to November 11, 2024, were searched in databases such as CNKI, Web of Science, APA PsycInfo, Embase, PubMed and Cochrane Library.
RESULTS: A total of 42 studies, including seven non-pharmacological types, were included, involving 1981 children and adolescents with ADHD, with a mean age of 10.04 +/- 1.82 years. Both traditional and network meta-analyses based on post-test data revealed that physical exercise, cognitive training, behavior therapy, and neurofeedback significantly improved inhibitory control (P < 0.05), with physical exercise showing the best improvement (SUCRA: 85.9 %). At the same time, board games, EMG feedback, and meditation had no significant effect (P > 0.05). Follow-up analysis showed that behavior therapy and cognitive training had a good maintenance effect (P < 0.05), with behavior therapy demonstrating the best sustained effect (SUCRA: 95.1 %). In contrast, physical exercise, board games, and neurofeedback showed diminishing effects over time and had no significant long-term effect (P > 0.05).
CONCLUSION: Existing evidence shows that physical exercise, cognitive training, behavior therapy, and neurofeedback all have a positive effect on improving inhibitory control in children and adolescents with ADHD, with physical exercise showing the best effect, though with poor maintenance, while cognitive training and behavior therapy had a slightly lower effect, but their maintenance was better.
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