注意力缺陷多动障碍儿童: History
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Contributor:
Yue Ye
,
Ke Ning
,
Bingjun Wan
,
Chunzi Shangguan

To explore the effect of exercise intervention on fundamental movement skills (FMS) of children with attention deficit hyperactivity disorder (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 ADHD/ASD (p < 0.00001). Aquatic therapy (SMD = 56.54, 95% CI = 38.83–74.25) has a better effect on stability skills, 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 tennis 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 best effect on the improvement in the FMS in children with ADHD/ASD (p < 0.00001). Exercise intervention 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/ASD Children

Meta-analysis studies have shown that exercise intervention can improve the gross motor skills in children with ADHD/ASD, which is consistent with the findings of Ruggeri et al. [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, exercise intervention can cause a series of biological reactions in the muscles and organs, promoting 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 ADHD/ASD [5][6]. On the other hand, exercise 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 the 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 ADHD/ASD children, and only two types [8][13][14] could improve the object control skills for both types of children. Of these, the FMS intervention [13][14] and the table 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 FMS intervention was better. Further analysis found that the FMS intervention could not only provide a goal-oriented, structured, and progressive guidance strategy, positively change the functional connection 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 create a positive self-perception and experience [13]. In addition, six types [9][10][11][15][16][17][19][20] of exercise interventions could improve the stability skills in children with ADHD/ASD, but 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/ASD Children

The findings that exercise intervention improves the fine motor skills in children with ADHD/ASD are not consistent with the results of Zhang et al. [22]. 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]. 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 ADHD/ASD. It may also promote 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 the studies included in the meta-analysis, only four studies [9][10][15][17] focused on the effect of exercise intervention on the 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 ADHD/ASD to perform repetitive exercises, conceal motor potential through different 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 are required to grasp the handle of the 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]. 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.

3. Effects of Moderator Variables in Exercise Intervention on FMS in ADHD/ASD Children

The results show that although both open-skill and closed-skill can improve FMS in children with ADHD/ASD, the improvement effect of closed-skill was better. The 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 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 FMS of both types of children [30][31].
In addition to the form of intervention, the FMS of ADHD/ASD children was also affected by the time, frequency, and duration of the intervention, which is consistent with previous meta-analysis studies [32]. This study found that an exercise intervention of 60 min each time, twice a week, for at least 12 weeks was the most beneficial for improving the FMS in children with ADHD/ASD. In terms of intervention time, each 60-min improvement effect was the best. For example, tai chi training [33] and the FMS intervention [3] implemented a 60-min structured intervention 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 with 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 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 FMS of both types of children lags behind that of normal children, and 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 12 weeks or more. Long-term exercise intervention may increase the brain growth factors in children with ADHD/ASD, promote brain activity, improve cognitive ability, and enhance the practice effect of the FMS [5]. Lourenço et al. pointed out that exercise intervention lasting at least 12 weeks may stimulate the long-term attention and FMS proficiency of the two types of children to a greater extent [35][36]. In conclusion, to maximize the benefits of exercise interventions, the potential effect of moderator variables should be considered.

This entry is adapted from the peer-reviewed paper 10.3390/su15065206

References

  1. Ruggeri, A.; Dancel, A.; Johnson, R.; Sargent, B. The effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder: A systematic review. Autism Int. J. Res. Pract. 2020, 24, 544–568.
  2. Den Heijer, A.E.; Groen, Y.; Tucha, L.; Fuermaier, A.B.; Koerts, J.; Lange, K.W.; Thome, J.; Tucha, O. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: A systematic literature review. J. Neural Transm. 2017, 124, 3–26.
  3. Wang, Y.; Zuo, C.; Xu, Q.; Hao, L.; Zhang, Y. Attention-deficit/hyperactivity disorder is characterized by a delay in subcortical maturation. Prog. Neuropsychopharmacol. Biol. Psychiatry 2021, 104, 110044.
  4. Pontifex, M.B.; Saliba, B.J.; Raine, L.B.; Picchietti, D.L.; Hillman, C.H. Exercise improves behavioral, neurocognitive, and scholastic performance in children with attention-deficit/hyperactivity disorder. J. Pediatr. 2013, 162, 543–551.
  5. Dishman, R.K.; Berthoud, H.R.; Booth, F.W.; Cotman, C.W.; Edgerton, V.R.; Fleshner, M.R.; Gandevia, S.C.; Gomez-Pinilla, F.; Greenwood, B.N.; Hillman, C.H. Neurobiology of exercise. Obesity 2006, 14, 345–356.
  6. Berwid, O.G.; Halperin, J.M. Emerging support for a role of exercise in attention-deficit/hyperactivity disorder intervention planning. Curr. Psychiatry Rep. 2012, 14, 543–551.
  7. Blyth, S.G. The Well Balanced Child Movement and Early Learning; Nanjing Normal University Press: Nanjing, China, 2021.
  8. Pan, C.-Y.; Tsai, C.-L.; Chu, C.-H.; Sung, M.-C.; Huang, C.-Y.; Ma, W.-Y. Effects of physical exercise intervention on motor skills and executive functions in children with ADHD: A pilot study. J. Atten. Disord. 2019, 23, 384–397.
  9. Pan, C.-Y.; Chang, Y.-K.; Tsai, C.-L.; Chu, C.-H.; Cheng, Y.-W.; Sung, M.-C. Effects of physical activity intervention on motor proficiency and physical fitness in children with ADHD: An exploratory study. J. Atten. Disord. 2017, 21, 783–795.
  10. Pan, C.-Y.; Chu, C.-H.; Tsai, C.-L.; Lo, S.-Y.; Cheng, Y.-W.; Liu, Y.-J. A racket-sport intervention improves behavioral and cognitive performance in children with attention-deficit/hyperactivity disorder. Res. Dev. Disabil. 2016, 57, 1–10.
  11. Kosari, S.; Hemayat-Talab, R.; Arab-Ameri, E.; Keyhani, F. The effect of physical exercise on the development of gross motor skills in children with attention deficit/hyperactivity disorder. Zahedan J. Res. Med. Sci. 2013, 15, e93113.
  12. Ahmed, G.M.; Mohamed, S. Effect of regular aerobic exercises on behavioral, cognitive and psychological response in patients with attention deficit-hyperactivity disorder. Life Sci. J. 2011, 8, 366–371.
  13. Dong, L.S.; Bo, J.; Shen, B.; Pang, Y.L.; Song, Y.; Xing, Y. The Effect of Ten-week Exercise Intervention on Fundamental Motor Skills and Social Ability of Children with Autism Spectrum Disorders. Chin. J. Sport Med. 2021, 40, 171–180.
  14. Bremer, E.; Lloyd, M. Baseline behaviour moderates movement skill intervention outcomes among young children with autism spectrum disorder. Autism Int. J. Res. Pract. 2021, 25, 2025–2033.
  15. Pan, C.-Y.; Chu, C.-H.; Tsai, C.-L.; Sung, M.-C.; Huang, C.-Y.; Ma, W.-Y. The impacts of physical activity intervention on physical and cognitive outcomes in children with autism spectrum disorder. Autism Int. J. Res. Pract. 2017, 21, 190–202.
  16. Arzoglou, D.; Tsimaras, V.; Kotsikas, G.; Fotiadou, E.; Sidiropoulou, M.; Proios, M.; Bassa, E. The effect of tradinional dance training program on neuromuscular coordination of individuals with autism. J. Phys. Educ. Sport 2013, 13, 563–569.
  17. Wuang, Y.-P.; Wang, C.-C.; Huang, M.-H.; Su, C.-Y. The effectiveness of simulated developmental horse-riding program in children with autism. Adapt. Phys. Act. Q. 2010, 27, 113–126.
  18. Verret, C.; Guay, M.-C.; Berthiaume, C.; Gardiner, P.; Béliveau, L. A physical activity program improves behavior and cognitive functions in children with ADHD: An exploratory study. J. Atten. Disord. 2012, 16, 71–80.
  19. Silva, L.A.D.; Doyenart, R.; Henrique Salvan, P.; Rodrigues, W.; Felipe Lopes, J.; Gomes, K.; Thirupathi, A.; Pinho, R.A.D.; Silveira, P.C. Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. Int. J. Environ. Health Res. 2020, 30, 584–592.
  20. Feng, Y.Q.; Hou, X.H.; Pan, H.L.; Wu, Y.D.; Ma, Z.M.; Zhu, Z.P. Effects of Aquatic Therapy on Behaviors of Children with Autism: Based on Halliwick Technology. J. Tianjin Univ. Sport 2017, 32, 429–433.
  21. Mortimer, R.; Privopoulos, M.; Kumar, S. The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: A systematic review. J. Multidiscip. Healthc. 2014, 7, 93–104.
  22. Zhang, M.; Liu, Z.; Ma, H.; Smith, D.M. Chronic Physical Activity for Attention Deficit Hyperactivity Disorder and/or Autism Spectrum Disorder in Children: A Meta-Analysis of Randomized Controlled Trials. Front. Behav. Neurosci. 2020, 14, 564886.
  23. Lloyd, M.; MacDonald, M.; Lord, C. Motor skills of toddlers with autism spectrum disorders. Autism Int. J. Res. Pract. 2013, 17, 133–146.
  24. Nebel, M.B.; Eloyan, A.; Nettles, C.A.; Sweeney, K.L.; Ament, K.; Ward, R.E.; Choe, A.S.; Barber, A.D.; Pekar, J.J.; Mostofsky, S.H. Intrinsic visual-motor synchrony correlates with social deficits in autism. Biol. Psychiatry 2016, 79, 633–641.
  25. Lin, T.-W.; Kuo, Y.-M. Exercise benefits brain function: The monoamine connection. Brain Sci. 2013, 3, 39–53.
  26. Kaiser, M.-L.; Schoemaker, M.; Albaret, J.-M.; Geuze, R. What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Res. Dev. Disabil. 2015, 36, 338–357.
  27. Caputo, G.; Ippolito, G.; Mazzotta, M.; Sentenza, L.; Muzio, M.R.; Salzano, S.; Conson, M. Effectiveness of a multisystem aquatic therapy for children with autism spectrum disorders. J. Autism Dev. Disord. 2018, 48, 1945–1956.
  28. Voss, M.W.; Kramer, A.F.; Basak, C.; Prakash, R.S.; Roberts, B. Are expert athletes ‘expert’ in the cognitive laboratory? A meta-analytic review of cognition and sport expertise. Appl. Cogn. Psychol. 2010, 24, 812–826.
  29. Wang, C.-H.; Chang, C.-C.; Liang, Y.-M.; Shih, C.-M.; Chiu, W.-S.; Tseng, P.; Hung, D.L.; Tzeng, O.J.; Muggleton, N.G.; Juan, C.-H. Open vs. closed skill sports and the modulation of inhibitory control. PLoS ONE 2013, 8, e55773.
  30. Jeyanthi, S.; Arumugam, N.; Parasher, R.K. Effectiveness of structured exercises on motor skills, physical fitness and attention in children with ADHD compared to typically developing children-A pilot study. eNeurologicalSci 2021, 24, 100357.
  31. Najafabadi, M.G.; Sheikh, M.; Hemayattalab, R.; Memari, A.-H.; Aderyani, M.R.; Hafizi, S. The effect of SPARK on social and motor skills of children with autism. Pediatr. Neonatol. 2018, 59, 481–487.
  32. Sun, W.; Yu, M.; Zhou, X. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis. Psychiatry Res. 2022, 311, 114509.
  33. Sarabzadeh, M.; Azari, B.B.; Helalizadeh, M. The effect of six weeks of Tai Chi Chuan training on the motor skills of children with Autism Spectrum Disorder. J. Bodyw. Mov. Ther. 2019, 23, 284–290.
  34. Pan, C.-Y. The efficacy of an aquatic program on physical fitness and aquatic skills in children with and without autism spectrum disorders. Res. Autism. Spectr. Disord. 2011, 5, 657–665.
  35. Lourenço, C.; Esteves, D.; Corredeira, R.; Seabra, A. The effect of a trampoline-based training program on the muscle strength of the inferior limbs and motor proficiency in children with autism spectrum disorders. J. Phys. Educ. Sport 2015, 15, 592–597.
  36. Huang, J.; Du, C.; Liu, J.; Tan, G. Meta-analysis on intervention effects of physical activities on children and adolescents with autism. Int. J. Environ. Res. Public Health 2020, 17, 1950.
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