Introduction
Children and adolescents suffer from various types of mental health disorders that require behavioral, medical, and other types of intervention to restore cognitive and neurological functionality. Attention Deficit/Hyperactivity Disorder (ADHD) is a common disorder among children. The disorder is a well-known psychiatric and neurological disorders of childhood, but its complications continue during adolescence and adulthood. ADHD has various symptoms that manifest during childhood but might manifest later in life. The disorder might be accompanied by other mental health complications, such as “depression, oppositional defiant disorder, conduct disorder, obsessive-compulsive disorder, learning disabilities, anxiety disorders, and other significant psychological, psychiatric, and neurological problems” (Lubar, Swartwood, Swartwood, & Timmermann, 1995, p. 143). As a result, an effective intervention is necessary to help overcome the negative outcomes of the disorder and enable the affected person to live a productive life. Research shows that exercise might be effective in assisting individuals with ADHD (both children and adults) and EEG’s. Therefore, it is important to review the literature to establish whether exercise is a valid alternative to medication in the treatment of ADHD.
Review of literature is critical to establish what has been done on the topic and what should be done to increase the body of knowledge on the topic of ADHD. The literature review contains various sections, including what is ADHD, its signs and symptoms; how it’s diagnosed (such as DSM-5, ASRS, CAARS, EEG); treatments (looking at how medication works and how exercise can cause the same reactions), EEG’s used as proof of improvement of cognitive function with exercise. Although the literature will include other aspects of the disease, the focus will be on exercise for treatment instead of medication. While other forms of treatment are available, such as neurofeedback, behavioral modifications, and counseling, among other approaches, the study will focus only on exercise as a form of treatment for ADHD.
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a neurological disorder. The disorder is a deficiency of central catecholamines (CA), which is characterized through cognitive, biochemical, and physical examinations that help in the identification of the disease (Medina et al., 2010). The disorder affects children and adolescents and continues to affect the individual later in life during adulthood. The condition is the most common mental health and neurological condition in children. Those with the disorder exhibit various challenges, such as hyperactivity and inability to control their impulses. In essence, they also have challenges paying attention, a behavior that affects their school and home life.
Research shows different subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD), which affect children differently. Besides, the different types affect children, adolescents, and adults differently. EEG differences are evident in individuals with ADHD. The study revealed developmental deviation in the central nervous system. The study further revealed considerable differences in frontal activity in people with and without ADHD (Medina et al., 2010). Disruption of “typical developmental trajectories” are common issues in individuals who have ADHD. Archer and Kostrzewa (2012) suggested that individuals suffering from ADHD are disadvantaged due to heritability, emotional, cognitive, motor, and routine behavioral challenges that affect their everyday activities. The evidence of gene-environment interactive predisposition suggests that the condition in children and adolescents affect various areas of life and outcomes, such as academic and occupational achievement, as well as interpersonal relationships because of behavioral issues.
The Signs and Symptoms of ADHD
Research shows diverse signs and symptoms of ADHD in children, adolescents, and adults. Individuals with ADHD have been shown to have differences in the reactivity and response time, especially in cognitive functions. Chuang et al. (2017) conducted research to ascertain the connection between Response Time (RT) variability and dopamine transporter availability (DAT) concentration. Individuals with ADHD revealed a reduction in response time compared to those without the condition. Besides, individuals with the disorder have attention challenges. The study revealed many types of errors among people with ADHD, such as “Hit reaction time standard error, Variability of Standard Error, Hit Reaction Time Block Change, and Hit Standard Error Block Reaction Time change, as well as attention problems (omission errors) and cognitive inflexibility (perseveration) on the Connors’ Continuous Performance Test among adults with the condition” (Chuang et al., 2017, p. 522). People with the condition suffer from inadequate attention and hyperactivity.
Diagnosis of ADHD
Since there is no single test for diagnosing attention deficit hyperactivity disorder, various examinations may be conducted to confirm the condition. Experts use diverse diagnostic procedures for the ADHD once an individual exhibits some signs of the condition for more than six months. In most cases, the condition is diagnosed during childhood, but the symptoms might persist into adulthood (Duffy, Shankardass, Mcnulty, & Als, 2017). ADHD is a mental and neurological disorder, which is usually recognized using the Disease Statistical Mental-IV (DSM-IV) criteria. A study by Medina et al. (2010) established that central catecholamines play a role in increasing the speed reaction. Therefore, as part of the diagnosis, health care providers use various tests that establish the existence of the various signs and symptoms of ADHD. The tests consider the reaction time in physical activity (PA) as well as the high-intensity physical activity.
Besides, the American Academy of Pediatrics or the American Psychiatric Association developed a Diagnostic and Statistical Manual (DSM) guidelines for use in the diagnosis of ADHD. The diagnosis involves the collection of data from various aspects of the affected person’s life, including school and home, to determine whether the individual suits the criteria for the positive diagnosis. The provider considers the behavior of the child to ascertain whether the child has the condition and begin diagnosis as soon as possible. The organizations use standardized rating scales to determine the negative behavior based on the identified symptoms. Other diagnostic tests include physical examination, such as vision and hearing screenings (Faraone, Bonvicini, & Scassellati, 2014). The tests are usually performed in children because it is easier to identify the condition in adults since the signs and symptoms are easily noticeable.
Treatment for ADHD
ADHD has diverse treatments depending on the type of the disorder. EEG findings determine the classification of ADHD, which inform the treatment. Besides, treatment depends on the attention deficit as well as the associated behavioral problems in individuals with the disorder. Pharmacological treatments play an important role in the treatment of ADD in children depending on the patterns of abnormality, as revealed in quantitative EEG methods. Behavioral treatment methods are also effective in the treatment of ADHD (Sterman, 2000). The study revealed a positive effect of both interventions in the treatment of the disorder in children. Medina et al. (2010) also revealed the effect of pharmaceutical intervention in the treatment of the disorder. However, the intervention is ineffective if not combined with changes in the environment within which the person lives. Stimulant medications are the commonly used treatment procedures and interventions for attention-deficit/hyperactivity disorder (ADHD). Clarke et al. (2003) placed 20 ADHD and 20 control subjects to conduct a study to establish the effect of stimulant medication and a second EEG in the treatment of the condition. The results indicated that the medication is effective in treating ADHD compared to the control group that did not undergo the treatment.
The Impact of Exercise on ADHD
Research has established the effectiveness of exercise as a treatment producer for ADHD in children. Chang, Liu, Yu, and Lee (2012) performed a study to establish the impact of acute aerobic exercise as a treatment for ADHD. The study of 40 children with ADHD revealed that acute exercise facilitates improvement in performance in neurological tests following the moderate-intensity aerobic exercise program. The results indicated the potential for improvement in executing functions for children with ADHD. Archer and Kostrzewa (2012) revealed that exercise has a myriad of beneficial impact against various psychological comorbidities, such as “stress, anxiety, depression, negative affect and behavior, poor impulse control, and compulsive behavior” (p. 195). Exercise has particular benefits, including better executive functioning, and working memory. It helps in improving functional, regional, and biomarker deficiencies. It also helps in addressing hypothalamic-pituitary-adrenal disruptions. Regular physical exercise should be part of a healthy lifestyle to promote the health and wellbeing of individuals who have ADHD.
Research reviews have also revealed similar findings on the efficacy of exercise as a treatment regime for individuals with ADHD. The treatment has attracted attention among researchers on the use of the exercise in the treatment of the disorder among adults and children. A systematic review of previous studies has revealed a positive impact on cognition, social-emotional, and motor development through effectively implemented exercise programs (Neudecker, Mewes, Reimers, & Woll, 2019). However, the study revealed differences in the outcome of the effect of exercise due to diversity in study designs. Therefore, the review would not provide an adequate evidence-based recommendation to formulate programs on the frequency, intensity, or duration of exercises for the treatment of ADHD. However, the study revealed important trends in the use of some forms of exercises in improving the symptoms of ADHD. It also helps in addressing other ADHD with comorbidities, such as obesity (Archer & Kostrzewa, 2012), and hence, bring major physical and mental health benefits (Silva et al., 2015).
A study by Medina et al. (2010) established that central catecholamines play a role in increasing the speed reaction evident following physical activity. High-intensity PA was shown in the study to be effective in the management of ADHD. Besides, the research revealed that physical activity is most effective in the treatment of the disorder when used in combination with central catecholamines. Medina et al. (2010) performed an RCT using two groups, users (US) and non-users (NUS) of methylphenidate (MTP) in children diagnosed with ADHD. The study was a comparison of the two groups to determine the effect of the drug. The drug, along with physical activity, was revealed to have a positive effect on response time and improvement in attention after treatment. However, the study revealed that the improvement was dependent on the drug, but physical activity played an instrumental role. Therefore, the study concluded that exercise might have a positive effect in mitigating the negative symptoms of ADHD.
Research shows the need to develop interventions and therapy based on exercise and physical activity to help in the treatment and management of ADHD. Choi, Han, Kang, Jung, and Renshaw (2015) revealed the efficacy of adjuvant therapy to improve the impact of stimulants. The use of the therapy is necessary and effective to reduce the need for medications in the treatment regime, thereby reducing the incidence of adverse effects of drugs. Aerobic exercise could be a useful adjunctive therapy to improve the dangerous signs of the disease and enhance cognitive functionality as well as a neurological activity among children and adolescents.
Conclusion
As it is evident from the literature, the review covers important aspects on the impact of exercise or physical activity in the treatment of ADHD. There are various other treatments, including medication and behavior change. However, exercises prove to be a positive and low-risk treatment regime for the condition. The results from the reviewed studies revealed the efficacy of exercise in the treatment of ADHD among children, adolescents, and adults. Exercise has been shown to have long-term health benefits as ADHD treatment. For example, qualitative exercise characteristics have a positive impact on the treatment of the condition. However, the reviewed studies did not cover the particular types of exercise and the duration expected, which would treat the condition. Therefore, there is a need for additional research to establish the nature of the exercise and physical activity that will have a positive effect in the treatment of ADHD and related comorbidities.
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