A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis

Kleeren, Lize; Hallemans, Ann; Hoskens, Jasmine; Klingels, Katrijn; Smits-Engelsman, B.C.M.; Verbecque, Evi

doi:10.1177/10870547221146244

Cited by 6 publications

(8 citation statements)

References 72 publications

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“…Fine motor PC was loaded by scores on Visuomotor Precision of NEPSY-II and MABC2 Manual Dexterity, which included tasks such as pegboard, lacing blocks, nuts and bolts, and tracing tasks. Our findings differ from Biscaldi et al (2015), which showed no difference in pegboard test between ADHD children and TD peers, but are in line with earlier studies consistently reporting fine motor difficulties in school-aged ADHD children, especially in tracing/ drawing tests (e.g., Goulardins et al, 2017;Kleeren et al, 2023). With this regard, previous research has indicated that difficulties in fine motor control could be related to core ADHD characteristics, such as difficulty in inhibiting prepotent responses (Kaiser et al, 2015).…”

Section: Discussionsupporting

confidence: 88%

“…Previous works have formerly indicated that the motor skills of school‐aged autistic children could benefit from the reduction of the visual information speed and the concurrent increase of proprioceptive feedback (e.g., see Lidstone & Mostofsky, 2021). Concerning ADHD, our findings related to fine‐motor control difficulties highlight the potential of including training programs focused on executive functions, (such as inhibition and self‐monitoring) into standard motor‐based interventions (e.g., see Kleeren et al, 2023), given the potential role of these functions in tasks such as drawing and tracing. A strength of this study is the use of a multimodal approach to determine the specificity of motor difficulties in autism and ADHD.…”

Section: Discussionmentioning

confidence: 68%

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A multimodal approach can identify specific motor profiles in autism and attention‐deficit/hyperactivity disorder

De Francesco,

Morello,

Fioravanti

et al. 2023

Autism Research

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It is still unclear whether and to what extent the motor difficulties are specific to autism. This study aimed to determine whether a multimodal assessment of motor skills could accurately discriminate autistic children from attention‐deficit/hyperactivity disorder (ADHD) and typically developing (TD) peers. Seventy‐five children, aged 7–13, equally divided into three groups, were assessed with the developmental coordination disorder questionnaire (DCDQ), the movement assessment battery for children 2 (MABC2), the sensorimotor subtests of NEPSY‐II, and the kinematic analysis of a reach‐to‐drop task. Principal component analysis (PCA) on DCDQ subscales revealed one factor—Caregiver Report—, whereas MABC2/NEPSY‐II scores identified three factors—namely, Object Interception and Balance, Motor Imitation, and Fine‐Motor Skills—. Lastly, PCA on kinematic variables identified four factors: PC1, loaded by the parameters of velocity and acceleration throughout the task, PC2 and PC3 involved the temporal parameters of the two submovements, and PC4 accounted for the wrist inclination at ball drop. When comparing autistic and TD children, Caregiver Report and Motor Imitation factors predicted membership with 87.2% of accuracy. In the model comparing ADHD and TD groups, Caregiver Report and Fine‐Motor Skills predicted membership with an accuracy of 73.5%. In the last model, the Object Interception and Balance factor differentiated autistic children from ADHD with an accuracy of 73.5%. In line with our previous findings, kinematics did not differentiate school‐aged autistic children from ADHD and TD peers. The present findings show that specific motor profiles in autism and ADHD can be isolated with a multimodal investigation of motor skills.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 68%

A multimodal approach can identify specific motor profiles in autism and attention‐deficit/hyperactivity disorder

De Francesco,

Morello,

Fioravanti

et al. 2023

Autism Research

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“…This view is supported by meta-analysis showing that motor intervention provides the most promising treatment effects for improving motor skill relative to non-motor interventions (including medication; Kleeren et al, 2023).…”

Section: Discussionmentioning

confidence: 94%

“…Second, it indicates that standard treatments that address core ADHD symptoms may have limited impact on the motor symptoms of those with co‐occurring ADHD and DCD. This view is supported by meta‐analysis showing that motor intervention provides the most promising treatment effects for improving motor skill relative to non‐motor interventions (including medication; Kleeren et al, 2023 ).…”

Section: Discussionmentioning

confidence: 95%

Adolescents with ADHD and co‐occurring motor difficulties show a distinct pattern of maturation within the corticospinal tract from those without: A longitudinal fixel‐based study

Hyde,

Fuelscher,

Efron

et al. 2023

Human Brain Mapping

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It is well documented that attention‐deficit hyperactivity disorder (ADHD) often presents with co‐occurring motor difficulties. However, little is known about the biological mechanisms that explain compromised motor skills in approximately half of those with ADHD. To provide insight into the neurobiological basis of poor motor outcomes in ADHD, this study profiled the development of white matter organization within the cortico‐spinal tract (CST) in adolescents with ADHD with and without co‐occurring motor problems, as well as non‐ADHD control children with and without motor problems. Participants were 60 children aged 9–14 years, 27 with a history of ADHD and 33 controls. All underwent high‐angular resolution diffusion MRI data at up to three time points (115 in scans total). We screened for motor impairment in all participants at the third time point (≈14 years) using the Developmental Coordination Disorder Questionnaire (DCD‐Q). Following pre‐processing of diffusion MRI scans, fixel‐based analysis was performed, and the bilateral CST was delineated using TractSeg. Mean fiber density (FD) and fiber cross‐section (FC) were extracted for each tract at each time‐point. To investigate longitudinal trajectories of fiber development, linear mixed models were performed separately for the left and right CST, controlling for nuisance variables. To examine possible variations in fiber development between groups, we tested whether the inclusion of group and the interaction between age and group improved model fit. At ≈10 years, those with ADHD presented with lower FD within the bilateral CST relative to controls, irrespective of their prospective motor status. While these microstructural abnormalities persisted into adolescence for individuals with ADHD and co‐occurring motor problems, they resolved for those with ADHD alone. Divergent maturational pathways of motor networks (i.e., the CST) may, at least partly, explain motor problems individuals with ADHD.

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“…However, medication treatment may be accompanied by side effects such as headaches, stomach pain, and decreased appetite (Pang and Sareen, 2021). Because of the potential side effects associated with medication treatment, nonpharmacological treatments with relatively lower side effects have developed rapidly in recent years (Cortese et al, 2022), such as physical activity interventions (Kleeren et al, 2023), neurofeedback interventions (Garcia Pimenta et al, 2021), and cognitive interventions (Pauli-Pott et al, 2021). Among them, physical activity interventions have become widely used nonpharmacological interventions due to their low cost, ease of operation, improvement of physical fitness, and long-lasting benefits including the acquisition of sports skills such as baseball techniques, equestrianism, basketball techniques, improvements in physical qualities such as strength, speed, flexibility, as well as a reduction in psychological issues and behavioral problems such as depression, anxiety, hyperactivity, and impulsivity (Kandola et al, 2019;Li et al, 2023a;Kleeren et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Effect of physical activity on attention in school-age children with ADHD: a systematic review and meta-analysis of randomized controlled trials

Li,

Zang

et al. 2023

Front. Physiol.

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Background: Attention problems are one of the core symptoms of Attention-deficit/hyperactivity disorder (ADHD) in children. Previous studies have shown that physical activity intervention has a positive impact on executive function in children and adolescents with ADHD, but there is limited research on attention problems in school-aged children with ADHD. There are still uncertainties about the appropriate physical activity interventions to improve attention problems in this population. This study conducted a Meta-analysis of randomized controlled trials (RCTs) related to physical activity intervention for attention problems in school-aged children with ADHD, providing a certain reference for precise intervention in attention problems for this population.Methods: We systematically searched the following databases up to October 2022: PubMed, Embase, Web of Science, and Cochrane Library, to identify RCTs that investigated the effects of physical activity interventions on children with ADHD. Two investigators independently conducted literature screening, extraction, and quality assessment. We performed a meta-analysis using Stata 15.1.Results: In total, we included 10 studies in this meta-analysis. The results indicated that physical activity intervention had a moderate effect in improving attention problems in school-aged children with ADHD (SMD = −0.48, 95% CI: 0.85, −0.07, p < 0.05). Furthermore, subgroup analysis showed that the effect of physical activity intervention was moderated by intervention type, frequency, and period, rather than the physical activity environment or single intervention time.Conclusion: Our study suggests that cognitively engaging exercise is more effective in improving attention problems in school-aged children with ADHD. Specifically, when cognitive-engaging exercise is used as the type of physical activity and the intervention frequency is less than 3 times per week, with an intervention period of less than weeks, it is most beneficial for improving attention problems in school-aged children with ADHD. However, we should also consider individual differences in children with respect to their ADHD symptoms and accurately evaluate each child’s specific symptoms before intervention.Systematic Review Registration: identifier (CRD42022363255).

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A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis

Cited by 6 publications

References 72 publications

A multimodal approach can identify specific motor profiles in autism and attention‐deficit/hyperactivity disorder

A multimodal approach can identify specific motor profiles in autism and attention‐deficit/hyperactivity disorder

Adolescents with ADHD and co‐occurring motor difficulties show a distinct pattern of maturation within the corticospinal tract from those without: A longitudinal fixel‐based study

Effect of physical activity on attention in school-age children with ADHD: a systematic review and meta-analysis of randomized controlled trials

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