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Please note this is a comparison between Version 1 by Yue Ye and Version 3 by Dean Liu.
CTo explore the effect of exercise intervention on fundamental movement skills (FMS) of children with attention deficit hyperactivity disorder are characterized by inattention, hyperactivity, impulsivity, difficulty in controlling behavior, or such comprehensive symptoms, while(ADHD) and/or autism spectrum disorder (ASD). Following the principle of PICOS, randomized controlled trials of the effect of exercise intervention on the FMS of ADHD/ASD children were searched. A total of 12 articles and 396 participants were included. Review Manager5.4 and Stata16.0 software were used to process and analyze the data. The results revealed that (1) exercise intervention can improve the gross motor skills of children with ASD ADHD/ASD (p < 0.00001). Aquatic therave apparent deficits in social communicationpy (SMD = 56.54, 95% CI = 38.83–74.25) has a better effect on stability skills and repetitive stereotyped behavior patterns. Despite significant differences in the core symptoms between, and FMS intervention (SMD = 17.58, 95% CI = 1.78–33.38) has a better effect on locomotor skills and object control skills. (2) Exercise intervention can improve the fine motor skills of children with ADHD /ASD (p = 0.001). Table tend ASD, clinical studies have supported the similarity of the behavioral disorders, annis exercise (SMD = 9.91, 95% CI = 0.23–19.59) and horse-riding program (SMD = 9.50, 95% CI = 5.20–13.80) have better effects on fine manual control and hand–eye coordination. (3) The closed-skill intervention for 60 min each time, twice a week, for at least 12 weeks had the findings suggest that the two types ofbest effect on the improvement in the FMS in children with ADHD/ASD (p < 0.00001). Exercise inotervent only have highly shared heritability, but also represent the performance of the same endophenotype and can be classified into the same diagnostic entityion may effectively improve FMS in children with ADHD/ASD. Intervention form, time, frequency, and duration are important moderator variables that positively impact the FMS of children with ADHD/ASD.
- ADHD
- ASD
- exercise intervention
- children
1. Exercise Intervention Has a Significant Effect on Gross Motor Skills of ADHD运动干预对多动症/ASD Children自闭症儿童粗大运动技能有显着影响
Meta-analysis studies荟萃分析研究表明，运动干预可以改善 have shown that exercise intervention can improve the gross motor skills in children with ADHD/ASD, which is consistent with the findings of 儿童的粗大运动技能，这与 Ruggeri et等人的研究结果一致。[ al.12 [1][2]. The underlying mechanism by which exercise intervention induces improvements in gross motor skills may be related to neuroanatomy [3][4]. On one hand, exercise36 intervention]。运动干预诱导粗大运动技能改善的潜在机制可能与神经解剖学有关 can[ cause9 a series of biological reactions in the muscles and organs, promoting37]. neurogenerative, neuroadaptive, and neuroprotective processes to favorably affect the structural development and functional neurocognitive development of the brain primarily through the regulation of the brain’s neural circuitry, mediation of executive function, and lasting impact on the developmental trajectory of gross motor skills in children with 一方面，运动干预可以引起肌肉和器官的一系列生物反应，促进神经生成、神经适应和神经保护过程，主要通过调节大脑的神经回路，有利地影响大脑的结构发育和功能性神经认知发育，执行功能的调解，以及对ADHD/ASD [5][6].儿童粗大运动技能发展轨迹的持久影响 On[ the38、39]. other另一方面，运动干预可能有助于大脑前额叶皮层制定和改善感知-运动相关技能任务，同时大脑前额叶皮层可以专注于认知和适应功能，从而逐步实现自动化粗大运动技能 hand,[ exercise40 intervention may help the prefrontal cortex of the brain to formulate and improve perception–motor related skill tasks, while the prefrontal cortex of the brain can get away to focus on cognitive and adaptive functions, allowing for the gradual automation of gross motor skills [7].]。
Among在粗大运动技能干预中，六种[ the24、26、27、28、29、30、31、33、34、35 gross motor skill interventions, six types [8][9][10][11][12][13][14][15][16][17] of exercise interventions could improve the locomotor skills of ]运动干预可以改善ADHD/ASD children,/ ASD儿童的运动技能，只有两种[ and24 only] two, types30 [8][13][14], could31 improve] the object control skills for both types of children. Of these, the FMS intervention可以提高两种类型儿童的物体控制技能。其中，FMS 干预 [13][14][ and30、31 ]和乒乓球运动 the[ table24 tennis]] exercise [8] had the potential to improve both the locomotor skills and object control skills in both types of children, but the enhancing effect of the 对两类儿童的运动技能和物体控制技能均有提高的潜力，但FMS intervention was better. 干预的增强效果更好。进一步分析发现，Further analysis found that the FMSMS干预不仅可以提供目标导向、结构化、渐进式的指导策略，积极改变大脑神经网络的功能连接，对大脑的神经发生、适应和保护产生影响[ intervention38 could not only provide a goal-oriented, structured,41 and progressive guidance strategy, positively change the functional connection]，但特别是，它在学习情境中创造了最佳的刺激环境，帮助 of the brain’s neural network and have an impact on the brain’s neurogenesis, adaptation, and protection [5][18], but in particular, it created the best stimulating environment in the learning situation and helped children with ADHD/ASD to儿童创造积极的自我认知和体验 create[ a30 positive]。此外，六种类型 self-perception[ and25 experience, [13]. In26 addition, six27 types,[28 [9][10][11][15][16][17][19][20], of32 exercise, interventions33 could, improve34 the, stability35 skills] in children with 运动干预可以提高ADHD/ASD,患儿的稳定性技能，但水中疗法的改善效果最好。水中疗法主要应用流体力学原理，通过水温、减重、前庭输入等多种感官刺激，促进粗大运动技能的执行[ but42 aquatic therapy had the best improvement effect. Aquatic therapy mainly applies the principles of hydrodynamics to provide multiple sensory stimulations through water temperature, weight reduction, and vestibular input to promote gross motor skill execution [21].]。
2. Exercise Intervention Has a Significant Effect on Fine Motor Skills of ADHD运动干预对多动症/ASD Children自闭症儿童精细运动技能有显着影响
The运动干预改善 findings that exercise intervention improves the fine motor skills in children with ADHD/ASD are not consistent with the results of 儿童精细运动技能的发现与 Zhang et等人的结果不一致。[ al.1 [22].]。这些差异可能是由于样本量、干预的形式和强度、触觉敏感性以及社会模仿的整体缺乏程度不同 These[ differences may be due to the sample size, the form and intensity of the intervention, the tactile sensitivity, and the overall lack of social imitation being different [23]43]]. It has been shown that exercise intervention may not only promote the brain to make connections in visual feedback and motor commands, but also form connectivity with both the visual network and the dorsomedial motor region, and most likely through visual imitation to improve the hand–eye coordination ability and upper limb motor skills in children with 研究表明，运动干预不仅可以促进大脑在视觉反馈和运动指令方面建立联系，还可以与视觉网络和背内侧运动区形成联系，最有可能通过视觉模仿来改善手眼ADHD/ASD. It may 儿童的协调能力和上肢运动技能。它还可以促进中枢神经系统的可塑性并增加神经递质的分泌，提高大脑唤醒水平，从而改善执行功能并增强两类儿童的精细手动控制 [44 also, promote45 central nervous system plasticity and increase neurotransmitter secretion, increasing the level of brain arousal, and thereby improving executive function and enhancing the fine manual control of both types of children [24][25].]。
Among在纳入荟萃分析的研究中，只有四项研究[ the26、27、33、35] studies included in the meta-analysis, only four studies [9][10][15][17] focused on the effect of exercise intervention on the关注运动干预对 fine motor skills of children with ADHD/ASD. The table tennis exercise and horse-riding program were important interventions to improve their fine motor skills, but the specific exercise patterns differed. The successful performance of table tennis exercises mainly depends on visual perception and executive function, that is, accurately predicting the spatial trajectory and arrival time of the table tennis ball, and immediately making the selection and execution of the ball response. Table tennis exercise is based on the principle of constraint-induced exercise therapy, which guides children with 儿童精细运动技能的影响。乒乓球运动和骑马项目是提高精细运动技能的重要干预措施，但具体的运动方式不同。乒乓球练习的成功执行主要取决于视觉感知和执行功能，即准确预测乒乓球的空间轨迹和到达时间，并立即做出球的选择和执行反应。乒乓球运动是基于约束诱发运动疗法的原理，引导ADHD/ASD儿童进行重复性运动，通过不同的策略和任务隐藏运动潜能，促进手眼协调、精细的手部控制、27 to perform repetitive exercises, conceal33 motor]。骑马程序通过主动视觉和体感控制，协调视觉与四肢的联系，正确执行四肢的动作。要求多动症/自闭症儿童在骑马项目中抓住骑马机的手柄，根据视觉信息和躯干运动不时改变上肢的姿势和速度，提高手眼协调和精细的手动控制 potential[ through26、35 different]。目前，大多数 strategies and tasks, and promote hand–eye coordination, fine manual control, and executive function of both types of children [10][15]. Through active vision and somatosensory control, the horse-riding program coordinated the connection between vision and the limbs and performed the movements of the limbs correctly. ADHD/ASD children儿童的精细运动技能表现出结构性缺陷，低于同龄儿童的水平 are[ required to grasp the handle of the5 horse-riding machine during the horse-riding program, and alter the posture and speed of their upper limbs from time to time according to the visual information and trunk movement, improving hand–eye coordination and fine manual control [9][17]46]. Currently, the fine motor skills of most children with ADHD/ASD show structural defects and are lower than the level of children of the same age [26][27]. Therefore, it is hoped that more appropriate exercise interventions can be used to improve the fine motor skills of both types of children.因此，希望可以通过更合适的运动干预来提高两类儿童的精细运动技能。
3. Effects运动干预中调节变量对 of Moderator Variables in Exercise Intervention on FMS in ADHD/ASD Children儿童 FMS 的影响
The results show that although both open-skill and closed-skill can improve FMS in children with 结果表明，虽然开放式技能和封闭式技能均能改善ADHD/ASD,儿童的FMS，但封闭式技能的改善效果更好。运动环境被认为是区分开放式技能和封闭式技能的主要标志。封闭式技能（跑步、骑自行车、游泳等）在相对一致、可控和自我调节的环境中进行；开放式技能（乒乓球、足球、篮球等）是指在动态的、不可预测的、受外部因素影响的环境中做出反应。一般来说，开放式技能干预往往更复杂 the[ improvement effect of closed-skill was better47、48]. The本研究的分析表明，患有 motor environment is considered to be the main sign that distinguishes open-skill from closed-skill. Closed-skill (running, cycling, swimming, etc.) are performed in a relatively consistent, controllable, and self-regulating environment; open-skill (table tennis, football, basketball, etc.) refer to responding in an environment that is dynamic, unpredictable, and influenced by external factors. In general, open-skill interventions tend to be more complex [28][29]. The analysis of this study demonstrates that children with ADHD/ASD have的儿童在复杂任务、适应行为和运动发育方面存在缺陷，并且在 defects in complex tasks, adaptive behavior, and motor development, and that performance on the FMS is significantly poorer than that of children of the same age. Therefore, simple, regular, and predictable closed-skill are more suitable for the development of FMSFMS 上的表现明显差于同龄儿童。因此，简单、规律、可预测的封闭式技能更适合两类儿童FMS的发展[ of49 both, types50 of children [30][31].]。
In addition to the form of intervention, the FMS of 除了干预形式外，ADHD/ASD儿童的FMS还受到干预时间、频率和持续时间的影响，这与以往的荟萃分析研究一致[16 children was also affected by the time, frequency, and duration of the intervention, which is consistent with previous meta-analysis]。本研究发现，每次 studies [32]. This study found that an exercise intervention of 60 min分钟、每周两次、持续至少 each time, twice a week, for at least 12 weeks was the most beneficial for improving the FMS in children with 12 周的运动干预对改善 ADHD/ASD. In terms of intervention time, each 60-min improvement effect was the best. For example, tai chi training [33] and the F 儿童的 FMS intervention [3] implemented a 最有益。在干预时间方面，以每次60-min分钟的改善效果最好。例如，太极拳训练 structured[ intervention51 program] to effectively improve the children’s movements and skills. With regard to the frequency of intervention, exercise intervention once or twice a week may improve FMS in children和 FMS 干预 [ with9]] 实施了60分钟的结构化干预计划，有效提高了孩子们的动作和技能。在干预频率方面，每周1～2次运动干预可改善ADHD/ASD, and the improvement effect was better twice a week, which is consistent with the aquatic therapy of Pan [34]. Exercise intervention three times or more per week had no significant effect on improving the 患儿的FMS，改善效果以每周2次为佳，这与Pan[52]的水上疗法一致。每周3次及以上的运动干预对两类儿童FMS of the two types of children, indicating that intensive exercise intervention may not be suitable for the development of both types of children, probably because the development of 的改善无显着影响，说明强化运动干预可能不适合两类儿童的发展，可能是由于两类FMS的发展儿童的发育落后于正常儿童，干预频率应与其实际发育能力相符[ of both types of children lags behind that of normal children29, and34 the frequency of intervention should be consistent with their actual developmental abilities [12][16]. In terms of intervention duration, the improvement effect is better for ]。从干预持续时间来看，12 weeks or more. Long-term exercise intervention may increase the brain growth factors in children with 周以上改善效果较好。长期的运动干预可能会增加ADHD/ASD, promote brain activity, improve cognitive ability, and enhance the practice effect of the FMS患儿的脑生长因子，促进大脑活动，提高认知能力，增强FMS的练习效果[ [5].38 Lourenço]。洛伦索等人。指出持续至少 et al. pointed out that exercise intervention lasting at least 12 weeks may stimulate the long-term attention and FMS proficiency of12 周的运动干预可能会更大程度地激发两类儿童的长期注意力和 FMS 熟练程度 [ the53 two types of children to a greater extent [35][36]. In conclusion, to54 maximize the benefits of exercise interventions, the potential effect of moderator variables should be considered.]。总之，为了最大限度地发挥运动干预的益处，应考虑调节变量的潜在影响。
