Exercise for Kids with ADHD

As a family doctor, I am often asked about the role of exercise for children with ADHD. 

“He seems more manageable after soccer,” one mom told me. “I’m worried that if he wears himself out running around, he will be too tired to concentrate in school,” another mother told me. “Physical activity would probably help hyperactive kids, but my daughter’s problems are with attention. How would physical activity help her?” asked a dad.

Some people are more surprised than others, when I tell them that study after study has shown that physical activity improves ADHD and ADD symptoms!

From a physiologic stand point, exercise helping ADHD symptoms make a lot of sense.  The most popular drugs to treat ADHD and ADD are stimulant medications. When we exercise our brain naturally increases production of the stimulant neurotransmitters such as epinephrine and norepinephrine.  These natural stimulants help increase the brains ability to perform what doctors call “executive functions.”  

Executive Functions and ADHD

The term Executive Functions refers to the brain’s ability to perform cognitive processes such as:

• planning ahead,
• working memory,
• attention,
• problem solving,
• verbal reasoning,
• controlling inhibition,
• mental flexibility,
• multi-tasking, and
• monitoring of actions. 

Does that list look familiar? 

These executive functions are the exact cognitive processes that people with ADHD struggle with. This means that vigorous exercise does not just “tire the person out”.  It actually improves the very cognitive functions that people with ADHD struggle with!

Exercise Program for ADHD

With regard to ADHD, timing of the exercise is key. The beneficial neurotransmitters are released while exercising and then return to normal. 

For maximum benefit it would be best to have the exercise before the cognitive processes are needed (i.e. before school or work).  There are actually school systems (with forward thinking administrators) that have scheduled brief, but intense episodes of physical activity spread throughout that day. This way students’ cognitive functioning is given little boosts throughout the day.
Waking up early (and going to be early) to exercise might take some getting used to, but it can certainly make a difference for adults and children with ADHD!

Stay Healthy,

Dr. Jeff M.D.


Sources:

Gapin J, Etnier JL. The relationship between physical activity and executive function performance in children with attention-deficit hyperactivity disorder. J Sport Exerc Psychol. 2010 Dec;32(6):753-63.  PMID: 21282836

Hill LJ, Williams JH, Aucott L, Thomson J, Mon-Williams M.
How does exercise benefit performance on cognitive tests in primary-school pupils? Dev Med Child Neurol.  2011 Jul;53(7):630-5. doi:  PMID: 21649650

Medina JA, Netto TL, Muszkat M, Medina AC, Botter D, Orbetelli R, Scaramuzza LF, Sinnes EG, Vilela M, Miranda MC.  Exercise impact on sustained attention of ADHD children, methylphenidate effects. Atten Defic Hyperact Disord. 2010 Mar;2(1):49-58. Epub 2010 Mar 7.  PMID: 21432590

Katz DL, Cushman D, Reynolds J, Njike V, Treu JA, Walker J, Smith E, Katz C.
Putting physical activity where it fits in the school day: preliminary results of the ABC (Activity Bursts in the Classroom) for fitness program. Prev Chronic Dis. 2010 Jul;7(4):A82. PMID: 20550840

Chan, R. C. K., Shum, D., Toulopoulou, T. & Chen, E. Y. H. (2008). "Assessment of executive functions: Review of instruments and identification of critical issues". Archives of Clinical Neuropsychology. 2 23 (2): 201—216. doi:10.1016/j.acn.2007.08.010. PMID 18096360.

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tom@hk

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