30 Nov ADHD and physical activity
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is estimated to affect about 1 in 20 Australians – which is about 1,000,000 people. Onset of ADHD commonly occurs during childhood, and is characterised by inattention, impulsivity, disorganisation, and forgetfulness.
People with ADHD experience a range of symptoms however the core symptoms are:
- Inattention – inability to focus on something for a sustained period of time unless urgent and important or of significant interest e.g., often fails to give close attention to details or makes careless mistakes; often does not seem to listen when spoken to directly; often easily distracted; often forgetful in daily activities.
- Impulsivity-Hyperactivity (Poor Inhibitory Control) – inability to inhibit a thought, action or movement e.g., often talks excessively; often blurts out an answer before a question has been completed; often interrupts or intrudes on others; often feels restless; often fidgets.
The precise cause of ADHD is a complex interaction between genetics and environmental factors that is still being studied. However, ADHD has a significant genetic component with the heritability estimated to be approximately 70-80%. For this reason, it is common to see ADHD running in families.
Unfortunately, adults with ADHD experience higher rates of a number of conditions including mental illness (i.e., depression, anxiety, bipolar), neurological disorders, respiratory conditions (e.g., asthma), cardiovascular and metabolic health conditions such as type 2 diabetes and hypertension, addiction and substance use disorders, sleep problems such as insomnia, hypermobility, poor coordination, and accidental injury.
BENEFITS OF EXERCISE
In children with ADHD, recent reviews have shown that regular exercise can improve attention, impulsivity, executive functions, motor skills, anxiety and mood. We also know from other studies in adults, that exercise and physical activity can play an important part in managing physical and mental health conditions that are common in ADHD.
An Accredited Exercise Physiologist can support you in developing a regular exercise routine that will provide a variety of benefits:
- improved attention
- improved inhibition and impulsivity
- improved executive functions (planning, organisation, reasoning)
- improved working memory (ability to hold and manipulate information in your mind
Exercise also plays a role in preventing and treating many conditions that are more prevalent in individuals with ADHD by:
- improving mood and anxiety
- helping regulate blood sugar and improve body composition to prevent and treat type 2 diabetes, obesity, and hypertension (high blood pressure)
- improving sleep which can help manage insomnia and other sleep conditions
- improving motor skills including the treatment of Developmental Coordination Disorder (DCD)
THINGS TO BE AWARE OF
Motor Control and Learning
Learning a new skill can be challenging for anyone, however, adults with ADHD often have greater difficulty learning motor skills due to atypical memory consolidation processes (making improvements permanent).
Research identified some strategies to help motor learning in adults with ADHD. It found that halving the amount of practice from 160 to 80 repetitions in one practice session and practicing a motor skill in the evening compared to in the morning resulted in better memory consolidation and learning.
Practical Tip: Shorter practice sessions and/or evening practice may help improve learning for adults with ADHD.
Sleep and Circadian Rhythm
Adults with ADHD experience high rates of sleep problems including insomnia and a delayed circadian rhythm (our bodies natural 24 hour clock).
Research investigated the effects of Bright Light Therapy on sleep, circadian rhythm (Delayed Sleep Phase Syndrome) and mood in adults with ADHD. It found that being exposed to 30 minutes of bright light (10,000 lux) every morning (before 8:00am in one study) for 2-3 weeks improved sleep and ADHD symptoms.
Practical Tip: A 30 minute walk (or some other activity) outside every morning within an hour of waking up may help improve sleep and ADHD symptoms. Research suggests that it is best to do this without wearing sunglasses, however, it’s best to check with your doctor or health professional.
TYPES OF EXERCISE RECOMMENDED
Any physical activity can be considered better than none, however, there are some more specific strategies and recommendations we can provide based on the available research.
Movement Facilitates Cognition
One study measured attention of two groups, one with ADHD and the other without, then had them walk on a treadmill and re-tested them while they were walking, not after. Unsurprisingly, the ADHD group performed significantly worse at baseline. However, while walking at 5km/h on a treadmill, the ADHD group showed improvements in their attention while the non-ADHD group did not. This meant that there was no difference in attention between the ADHD group and the non-ADHD group during walking.
Practical Tip: Moving may help to improve attention. Listen to a lecture while you walk. Don’t tell someone with ADHD to “sit still and pay attention”, as the evidence suggests the opposite may actually be true!
However, multiple studies have shown that symptoms of inhibition, mood and motivation improve after a single bout of aerobic exercise such as running on a treadmill or cycling on a stationary bike for 30 minutes. This effect lasts for about 1-2 hours.
Practical Tip: Go for a 20-30 minute run or ride at a moderate intensity before listening to a lecture or doing a task that requires better attention or impulse control.
SPEAK TO THE EXERCISE PROFESSIONALS
People with ADHD often require support starting and maintaining an exercise routine due to difficulties with organisation, motivation and attention.
Support from an Accredited Exercise Physiologist can be beneficial to implement a safe, effective and enjoyable exercise routine by facilitating changes in habits and behaviours, creating accountability, teaching new motor skills including proper technique, and addressing any other conditions that someone with ADHD may experience.
Click here to find an Accredited Exercise Physiologist near you.
Expert Contributor: Christopher Ewan Hanbury-Brown, Accredited Exercise Physiologist and PhD Candidate at the University of Sydney: Exercise in adults with ADHD