Effects of Aerobic Exercise on Executive Function in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background The benefits of aerobic exercise interventions on the executive function of children and adolescents have been fully confirmed. However, the effects of such interventions on the executive function of children and adolescents with attention deficit hyperactivity disorder (ADHD) require further exploration. This study is a systematic review of randomized controlled trials (RCTs) of aerobic exercise interventions for children and adolescents with ADHD, aiming to provide valuable intervention suggestions to enhance the executive function of children and adolescents with ADHD. Method A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, EMbase, Cochrane Library, ProQuest, Scopus, CNKI, Wanfang, and VIP databases, to identify relevant RCTs. Study screening, data extraction, quality assessment, and data analysis were independently performed by two researchers. Meta-analysis was performed using Reviewer Manager 5.4 software, and network meta-analysis was performed using Stata 17.0 software. A total of 12 studies involving 504 participants diagnosed with ADHD were included. Results The meta-analysis showed that aerobic exercise interventions positively affect the executive function of children and adolescents with ADHD. A large effect size was observed for inhibitory control (SMD= -0.91, 95% CI: -1.31, -0.51, p<0.05), moderate effect size for working memory (SMD= -0.50, 95% CI -0.86, 0.15, p<0.05) and cognitive flexibility (SMD= -0.65, 95% CI -0.87, 0.42, p<0.05). The network meta-analysis results showed that compared to the group without exercise intervention, combat aerobic exercise (SMD= -1.81, 95% CI -3.41, -0.20) and ball aerobic exercise (SMD= -1.26, 95% CI: -2.41, -0.12) significantly improved the inhibitory control of children and adolescents with ADHD. Combat aerobic exercise ranked the highest SUCRA (82.3%), followed by cycling (SUCRA = 72.8%) and ball aerobic exercise (SUCRA = 69.2%). Conclusion The research shows that aerobic exercise interventions can effectively enhance the executive function of children and adolescents with ADHD. However, the effect of the intervention is affected by factors like duration period, frequency, duration time, and intensity. In addition, combat aerobic exercise and ball aerobic exercise may provide the most optimal effects for improving inhibitory control. The specific choice of intervention should be flexibly adjusted based on individual needs.