Effects of Physical Activity on Core Symptoms, Executive Functions, and Sleep in Children and Adolescents with ADHD: A Systematic Review and Three-level Meta-analysis of Randomized Controlled Trials
- Forfatter(e)
- Dai, X., Shen, H. Q., Guan, Y. S., Bao, J.
- År
- 2026
- Tidsskrift
- Adolescent Research Review
- Sider
- 23
- Kategori(er)
- ADHDSøvn (inkl. søvnforstyrrelser)
- Tiltakstype(r)
- Fysisk aktivitet
- Abstract
Physical activity has been increasingly recognized as a promising non-pharmacological approach for managing attention-deficit/hyperactivity disorder (ADHD), yet evidence regarding its effects on core symptoms, executive functions, and sleep remains inconsistent. This systematic review and three-level meta-analysis of randomized controlled trials (RCTs) aimed to clarify these effects and identify potential moderators that may explain variability in outcomes. Following a comprehensive search across eight English and Chinese databases up to August 31, 2025, 42 RCTs (45 publications) were included. Data were analyzed using a three-level random-effects model with subgroup, meta-regression, and meta-CART analyses to explore moderators. Across studies, physical activity was associated with significant improvements in core symptoms and executive functions, as well as subjective sleep quality, whereas no significant overall effect was observed for objectively measured sleep. Importantly, effect estimates were characterized by substantial heterogeneity and wide prediction intervals, indicating considerable variability in magnitude and direction across studies. Subgroup analyses suggested that motor skill type significantly moderated effects on core symptoms, while intervention type, control condition, and exercise dose influenced executive function outcomes. Statistically significant effects were observed across multiple symptom and executive function domains. Meta-CART analysis further revealed interactive effects among intervention length, total sessions, and total duration for both core symptoms and executive functions. Overall, these findings suggest that physical activity is associated with beneficial outcomes across several functional domains in youth with ADHD, while also underscoring marked heterogeneity within the current evidence base.