اثر تمرینات هوازی- توجه‌طلب بر کارکردهای توجهی و عملکرد تحصیلی در کودکان دارای اختلال نارسایی توجه/بیش‌فعالی: مطالعه‌ای با کوشش های تصادفی کنترل شده و دو سو کور

نوع مقاله : مطالعه پژوهشی اصیل

نویسندگان

1 دانش‌آموخته دکتری یادگیری حرکتی، دانشکده علوم ورزشی، دانشگاه فردوسی مشهد، مشهد، ایران

2 گروه علوم ورزشی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شیراز، شیراز، ایران

چکیده

هدف: هدف این مطالعه بررسی تأثیر تمرین ترکیبی بر کارکردهای توجهی و عملکرد تحصیلی در کودکان دارای ای.دی.اچ.دی بود.
مواد و روش ها: سی کودک ای.دی.اچ.دی به صورت تصادفی در دو گروه تجربی (میانگین سنی، 45/1±33/9 سال) و کنترل (میانگین سنی، 49/1±07/9 سال) جای گرفتند و 18 کودک دارای رشد طبیعی نیز به عنوان گروه کنترل (میانگین سنی، 25/1±17/9 سال) به‌کار گرفته شد. معیارهای ورودی شامل هوشبهر طبیعی و زیر نوع غلبه با بی‌توجهی اختلال و معیارهای خروجی شامل شرکت نکردن در بیش از یک سوم جلسات تمرینی و پس‌آزمون بود. مداخلۀ تمرینی شامل برنامۀ ترکیبی بود که به مدت هشت هفته (سه جلسۀ 60 دقیقه‌ای در هفته) انجام شد. گروه­های کنترل در این مدت به فعالیت‌های روزانۀ خود پرداختند. کارکردهای توجهی (درصد خطای توجه، درصد خطای تکانش‌گری و زمان واکنش) شرکت‌کنندگان توسط تکلیف برو/نرو و عملکرد تحصیلی از طریق نمرات ریاضی و املاء، قبل و بعد از مداخله مورد ارزیابی قرار گرفت.
یافته ها:  نتایج نشان داد که گروه تجربی در پس‌آزمون تفاوت معناداری در متغیرهای درصد خطای توجه، زمان واکنش و عملکرد تحصیلی نسبت به پیش‌آزمون دارد، در حالی که در گروه‌های کنترل تفاوت معناداری بین پیش‌آزمون و پس‌آزمون دیده نشد.
نتیجه گیری:  استفاده از برنامۀ تمرین ترکیبی به عنوان فعالیت ورزشی که ترکیبی از تمرین‌های هوازی و تقاضاهای توجهی اضافی می‌باشد، می تواند نشانه‌های توجهی و عملکرد تحصیلی در کودکان دارای ای.دی.اچ.دی را بهبود بخشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effect of Aerobic-Attentive Exercise on Attentional Functions and Academic Performance in Children with Attention Deficit/Hyperactivity Disorder: A Randomized Controlled Trials and Double-Blind Study

نویسندگان [English]

  • Maysam Beik 1
  • Davoud Fazeli 2
1 PhD graduate in Motor Learning, Faculty of Sport Sciences, Ferdowsi University, Mashhad, Iran
2 Department of Sport Sciences, Faculty of Psychology and Education, Shiraz University, Shiraz, Iran
چکیده [English]

Background and Purpose
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common behavioral disorders in childhood, with long-term detrimental effects. This disorder is divided into three subtypes: predominantly inattentive, predominantly hyperactive/impulsive, and combined subtype. The predominantly inattentive subtype is more prevalent and, unlike the other two subtypes, increases from preschool through adulthood (47%). Previous research has utilized aerobic exercises, specific exercises like yoga, and combined exercises as intervention programs for children with ADHD. While both of these training approaches have shown positive results in improving the symptoms of this disorder, combined exercises appear to have more beneficial and lasting effects on the cognitive and motor performance of children with ADHD. Although the effects of aerobic activities and attention-demanding physical activities have been examined separately, it seems that no research has directly investigated the impact of attention-demanding aerobic exercises (aerobic exercises combined with specific attention needs) as combined exercises. There is a possibility that combined attention-demanding aerobic exercises, such as walking backward, zigzag running, jumping rope, advanced yoga movements, and goal-oriented free throw basketball practice, could improve attention symptoms and academic performance in children with ADHD, and this improvement may be greater than that of individual exercise types. Therefore, in the current study, the researchers aim to investigate whether an attention-demanding aerobic exercise program affects the attention functions and academic performance of children with ADHD.
Materials and Methods
The design of the current research was semi-experimental, employing a pre-test-post-test design with a control group, and it was applied in nature. Participants with ADHD were randomly assigned to two groups of 15 individuals each: the experimental group (mean age, 9.33 ± 1.45 years) and the control group (mean age, 9.07 ± 1.49 years). Additionally, 18 peers with normal development were used as a control group (mean age, 9.17 ± 1.25 years). The groups were matched based on age, anthropometric measures (height, weight, body composition), intelligence, and socio-economic status. The attention-demanding aerobic exercise intervention included backward walking, zigzag running, jumping rope, advanced yoga, and basketball free throw practice, conducted in a local park for 8 weeks (three one-hour sessions per week, totaling 24 sessions). Before and after the exercise intervention, the Go/No-Go task was used to measure attention functions (attention, impulsivity, and reaction time), and math and spelling test scores were used to assess academic performance. The repeated measures ANOVA was used to analyze attention functions, and a one-way ANCOVA was used to analyze academic performance. Analyses were performed using SPSS 24 at a significance level of 0.05.
Results
The results of ANOVA for the attention variable indicated that the experimental group showed significant improvement compared to the control groups (p < 0.05). The difference between the experimental and ADHD control groups was also significant (p < 0.05). Additionally, the reaction time variable showed similar results to the attention variable (p < 0.05). However, the impulsivity variable did not show a significant change between the ADHD groups (p > 0.05). ANCOVA results in academic performance showed that the experimental group had significant improvements in math and spelling performance compared to the control groups (p < 0.05). Furthermore, academic performance between the two ADHD groups was significant (p < 0.05).
Conclusion
The results of the study indicated that combined exercises (attention-demanding aerobic exercises) improve attention, reaction time, and academic performance in children with this disorder. It seems that these attention-demanding aerobic exercises specifically strengthen the attention networks of these children, as research has shown that the bi-directional connection between the respiratory center (locus coeruleus) and the attention center (anterior cingulate) can influence the attention of these children. Therefore, attention-demanding aerobic exercises can enhance the capacity and function of the attention network in children with ADHD. The use of the combined exercise protocol (attention-demanding aerobic exercises) in school physical education classes and clinical settings may improve the attention functions and academic performance of children with ADHD. Thus, teachers, psychologists, and psychiatrists are recommended to utilize attention-demanding aerobic exercises as a physical activity for children with ADHD.
Funding
This study has not received any financial support from funding organizations in the public, commercial, or non-profit sectors.
Authors' contributions
The authors have equally contributed to all the study sections.
Conflicts of Interest
The authors declared no conflict of interest.

کلیدواژه‌ها [English]

  • ADHD
  • Attention
  • Aerobic-Attentive Exercise

مراجع

  1. Achenbach T. M., Rescorla L. A. (2007). Mulicultural understanding of child and adolescent sychopathology: Implications for mental health assessment (4th ed). New York: Guilford Press. P. 253-72. https://doi.org/10.1007/s10964-007-9229-8
  2. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5™. VA American Psychiatric Publishing. https://doi.org/10.1007/springerreference_179660
  3. Beery, S. H., Quay, H. C., & Pelham Jr, W. E. (2017). Differential response to methylphenidate in inattentive and combined subtype ADHD. Journal of attention disorders, 21(1), 62-70. https://doi.org/10.1177/1087054712469256
  4. Beik, M., NezakatAlhosseini, M., & Abedi, A. (2019). Validity and reliability measurement of the cognitive-motor functions test in attention deficit/hyperactivity disorder (ADHD). Journal of Paramedical Sciences & Rehabilitation, 8(1), 66-75. In Persian https://doi.org/10.22038/jpsr.2019.25981.1692
  5. Beik, M., Nezakatalhosseini, M., & Abedi, A. (2018). Effects of yoga practice on motor functions of children with attention deficit hyperactivity disorder. Sport Psychology Studies, 7(24), 1-15. In Persian https://doi.org/10.22089/spsyj.2017.4288.1444
  6. Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment, 15(3), 317-328. https://doi.org/10.1177/1073191107313888
  7. Chan, Y. S., Jang, J. T., & Ho, C. S. (2022). Effects of physical exercise on children with attention deficit hyperactivity disorder. Biomedical journal, 45(2), 265-270. https://doi.org/10.1016/j.bj.2021.11.011
  8. Chang, Y. K., Liu, S., Yu, H. H., & Lee, Y. H. (2012). Effect of acute exercise on executive function in children with attention deficit hyperactivity disorder. Archives of clinical neuropsychology, 27(2), 225-237. https://doi.org/10.1093/arclin/acr094
  9. Choi, J. W., Han, D. H., Kang, K. D., Jung, H. Y., & Renshaw, P. F. (2015). Aerobic exercise and attention deficit hyperactivity disorder: brain research. Medicine and science in sports and exercise, 47(1), 33. https://doi.org/10.1249/mss.0000000000000373
  10. Chou, C. C., & Huang, C. J. (2017). Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder. PeerJ, 5, e2883. https://doi.org/10.7717/peerj.2883
  11. Christiansen, L., Beck, M. M., Bilenberg, N., Wienecke, J., Astrup, A., & Lundbye-Jensen, J. (2019). Effects of exercise on cognitive performance in children and adolescents with ADHD: potential mechanisms and evidence-based recommendations. Journal of clinical medicine, 8(6), 841. https://doi.org/10.3390/jcm8060841
  12. Clavenna, A., & Bonati, M. (2014). Safety of medicines used for ADHD in children: a review of published prospective clinical trials. Archives of disease in childhood, 99(9), 866-872. https://doi.org/10.1136/archdischild-2013-304170
  13. Cohen, S. C., Harvey, D. J., Shields, R. H., Shields, G. S., Rashedi, R. N., Tancredi, D. J., ... & Schweitzer, J. B. (2018). The effects of yoga on attention, impulsivity and hyperactivity in pre-school age children with ADHD symptoms. Journal of developmental and behavioral pediatrics, 39(3), 200. https://doi.org/10.1097/dbp.0000000000000552
  14. Cortese, S. (2012). The neurobiology and genetics of attention-deficit/hyperactivity disorder (ADHD): what every clinician should know. European journal of paediatric neurology, 16(5), 422-433. https://doi.org/10.1016/j.ejpn.2012.01.009
  15. Dastamooz, S., Sadeghi-Bahmani, D., Farahani, M. H., Wong, S. H., Yam, J. C., Tham, C. C., & Sit, C. H. (2023). The efficacy of physical exercise interventions on mental health, cognitive function, and ADHD symptoms in children and adolescents with ADHD: an umbrella review. EClinicalMedicine, 62. https://doi.org/10.1016/j.eclinm.2023.102137
  16. Dietz, V. (1996). Interaction between central programs and afferent input in the control of posture and locomotion. Journal of biomechanics, 29(7), 841-844. https://doi.org/10.1016/0021-9290(95)00175-1
  17. Faber Taylor, A., & Kuo, F. E. (2009). Children with attention deficits concentrate better after walk in the park. Journal of attention disorders, 12(5), 402-409. https://doi.org/10.1177/1087054708323000
  18. Faraone, S. V. (2014). Advances in the genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry, 76(8), 599-600. https://doi.org/10.1016/j.biopsych.2014.07.016
  19. Ghodratnama, A., Heidarinejad, S., & Davoodi, I. (2013). The relationship between socio–economic status and the rate of physical activity in Shahid Chamran University Students of Ahwaz. Sport Management Journal, 5(16), 5-20. In Persian
  20. Hagen, I., & Nayar, U. S. (2014). Yoga for children and young people’s mental health and well-being: research review and reflections on the mental health potentials of yoga. Frontiers in psychiatry, 5, 78607. https://doi.org/10.3389/fpsyt.2014.00035
  21. Huang, H., Jin, Z., He, C., Guo, S., Zhang, Y., & Quan, M. (2023). Chronic exercise for core symptoms and executive functions in ADHD: A meta-analysis. Pediatrics, 151(1), e2022057745. https://doi.org/10.1542/peds.2022-057745
  22. Hillman, C. H., Erickson, K. I., & Kramer, A. F. (2008). Be smart, exercise your heart: exercise effects on brain and cognition. Nature reviews neuroscience, 9(1), 58-65. https://doi.org/10.1038/nrn2298
  23. Hooper et al. (2004). The effect of graded forward and backward walking on heart rate and oxygen consumption. journal of Orthopaedic & sport physical therapy, 34(2), 65-71. https://doi.org/10.2519/jospt.2004.0883
  24. Isaac, V., Lopez, V., & Escobar, M. J. (2024). Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD). Frontiers in Psychiatry, 14, 1336040. https://doi.org/10.3389/fpsyt.2023.1336040
  25. Ivanenko, Y. P., Cappellini, G., Poppele, R. E., & Lacquaniti, F. (2008). Spatiotemporal organization of α‐motoneuron activity in the human spinal cord during different gaits and gait transitions. European Journal of Neuroscience, 27(12), 3351-3368. https://doi.org/10.1111/j.1460-9568.2008.06289.x
  26. Janthi, S., Arumugam, N., & Parasher, R. K. (2021). Effectiveness of structured exercises on motor skills, physical fitness and attention in children with ADHD compared to typically developing children-A pilot study. Eneurologicalsci, 24, 100357. https://doi.org/10.1016/j.ensci.2021.100357
  27. Jiang, K., Xu, Y., Li, Y., Li, L., Yang, M., & Xue, P. (2022). How aerobic exercise improves executive function in ADHD children: A resting‐state fMRI study. International Journal of Developmental Neuroscience, 82(4), 295-302. https://doi.org/10.1002/jdn.10177
  28. Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel psychology, 28(4).

https://doi.org/10.1111/j.1744-6570.1975.tb01393.x

  1. Liang, X., Qiu, H., Wang, P., & Sit, C. H. (2022). The impacts of a combined exercise on executive function in children with ADHD: a randomized controlled trial. Scandinavian journal of medicine & science in sports, 32(8), 1297-1312. https://doi.org/10.1111/sms.14192
  2. Ludyga, S., Gerber, M., Mücke, M., Brand, S., Weber, P., Brotzmann, M., & Pühse, U. (2020). The acute effects of aerobic exercise on cognitive flexibility and task-related heart rate variability in children with ADHD and healthy controls. Journal of attention disorders, 24(5), 693-703. https://doi.org/10.1177/1087054718757647
  3. Mahone, E. M. (2011). ADHD: Volumetry, motor, and oculomotor functions. Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment, 17-47. https://doi.org/10.1007/7854_2011_146
  4. Medina, J. A., Netto, T. L., Muszkat, M., Medina, A. C., Botter, D., Orbetelli, R., ... & Miranda, M. C. (2010). Exercise impact on sustained attention of ADHD children, methylphenidate effects. ADHD Attention Deficit and Hyperactivity Disorders, 2(1), 49-58. https://doi.org/10.1007/s12402-009-0018-y
  5. Melnychuk, M. C., Dockree, P. M., O'Connell, R. G., Murphy, P. R., Balsters, J. H., & Robertson, I. H. (2018). Coupling of respiration and attention via the locus coeruleus: Effects of meditation and pranayama. Psychophysiology, 55(9), e13091. https://doi.org/10.1111/psyp.13091
  6. Neudecker, C., Mewes, N., Reimers, A. K., & Woll, A. (2019). Exercise interventions in children and adolescents with ADHD: a systematic review. Journal of attention disorders, 23(4), 307-324. https://doi.org/10.1177/1087054715584053
  7. Pan, C. Y., Chang, Y. K., Tsai, C. L., Chu, C. H., Cheng, Y. W., & Sung, M. C. (2017). Effects of physical activity intervention on motor proficiency and physical fitness in children with ADHD: An exploratory study. Journal of attention disorders, 21(9), 783-795. https://doi.org/10.1177/1087054714533192
  8. Prince, J. (2008). Catecholamine dysfunction in attention-deficit/hyperactivity disorder: an update. Journal of clinical psychopharmacology, 28(3), S39-S45. https://doi.org/10.1097/jcp.0b013e318174f92a
  9. Regnaux, J. P., Robertson, J., Smail, D. B., Daniel, O., & Bussel, B. (2006). Human treadmill walking needs attention. Journal of neuroengineering and rehabilitation, 3(1), 1-7. https://doi.org/10.1186/1743-0003-3-19
  10. Rommel, A. S., Halperin, J. M., Mill, J., Asherson, P., & Kuntsi, J. (2013). Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), 900-910. https://doi.org/10.1016/j.jaac.2013.05.018
  11. Shams, A., Eslami Nosratabadi, M., Sangari, M., & Mirmoezzi, M. (2021). Effect of Cognitive Rehabilitation Combined With Physi-cal Exercise on Sustained, Selective, and Alternating attention in School-aged Girls Attention-Deficit/Hyperactivity Disorder. Iranian Journal of Psychiatry and Clinical Psychology, 27 (3): 276-287. In Persian https://psycnet.apa.org/doi/10.32598/ijpcp.27.3.3342.1
  12. van Deursen, R. W., Flynn, T. W., McCrory, J. L., & Morag, E. (1998). Does a single control mechanism exist for both forward and backward walking? Gait & Posture, 7(3), 214-224. https://doi.org/10.1016/s0966-6362(98)00007-1
  13. Viggiano, D., Travaglio, M., Cacciola, G., & Di Costanzo, A. (2015). Effect of backward walking on attention: possible application on ADHD. Translational Medicine, 11, 48.
  14. Wigal, S. B., Emmerson, N., Gehricke, J. G., & Galassetti, P. (2013). Exercise: applications to childhood ADHD. Journal of attention disorders, 17(4), 279-290. https://doi.org/10.1177/1087054712454192
  15. Wigal, S. B., Nemet, D., Swanson, J. M., Regino, R., Trampush, J., Ziegler, M. G., & Cooper, D. M. (2003). Catecholamine response to exercise in children with attention deficit hyperactivity disorder. Pediatric research, 53(5), 756-761. https://doi.org/10.1203/01.pdr.0000061750.71168.23
  16. Wilcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics, 9(3), 490-499.

https://doi.org/10.1007/s13311-012-0135-8

  1. Zuo, E., Zhang, Y., Yu, Q., Guo, T., Jiao, C., Yu, Y., ... & Zou, L. (2020). Mind-body exercises (Yoga/Tai Chi) for attention-deficit/hyperactivity disorder: A quantitative evidence of experimental studies. International Journal of Mental Health Promotion, 22(4), 221-231. https://doi.org/10.32604/ijmhp.2020.014552
مطالعات روان‌شناسی ورزشی
دوره 13، شماره 50
دی 1403
صفحه 127-144

فایل ها

سابقه مقاله

  • تاریخ دریافت: 03 تیر 1403
  • تاریخ بازنگری: 03 مهر 1403
  • تاریخ پذیرش: 06 آبان 1403

هم رسانی

ارجاع به این مقاله

آمار