ADHD
Conditions
Keywords
Physical exercise, Cognitive support, Group intervention
Brief summary
Studies in children and adolescents with Attention-Deficit-Hyperactivity-Disorder (ADHD) have shown that physical exercise can improve the core symptoms of ADHD; inattention and hyperactivity. For adults, the evidence is deficient and there is a great need to investigate whether adults have the same effect on ADHD symptoms of physical exercise, as children and young people have. Adults with ADHD often have a sedentary lifestyle and suffer from obesity and have sleep problems. In a normal population, these problems have been shown to be affectable with physical exercise. START (Support in Activity, Movement and Exercise) is a randomized controlled intervention study where physical exercise is given for 12 weeks, with or without cognitive support. The effect is measured with rating scales as well as cognitive and physical tests. The purpose is to investigate whether START works as a treatment for ADHD in terms of ADHD symptoms and disability, and what impact the intervention has on mental health, physical condition and activity level, body awareness and everyday functioning. Outcome measures are registered within 3 weeks before and after the end of treatment, after 6 months and 12 months. The randomization takes place in three groups; physical exercise (i), physical exercise and extra cognitive support (ii), and control group on waiting list (iii).
Interventions
BEHAVIORALPhysical training
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks, consisting of fitness, strength and mobility exercises with a target level of 60-90% of maximum heart rate. Two sessions per week take place in a group led by a physiotherapist and once a week the training consists of self-chosen training individually or in group.
BEHAVIORALPhysical training combined with cognitive support.
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks, consisting of fitness, strength and mobility exercises with a target level of 60-90% of maximum heart rate. Two sessions per week take place in a group led by a physiotherapist and once a week the training consists of self-chosen training individually or in group. The cognitive support consists of person centred individual occupational therapy with focus on daily time management skills and planning and organisation in daily life, i.e. make time for physical exercise. The number of session during the intervention period depend on the participants needs and is estimated to 4-6 sessions.
Sponsors
Region Örebro County
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with ADHD.
Exclusion criteria
* Ongoing depression with points on MADRS-S over 21 * Suicidality * Bipolar disorder * Psychosis * Ongoing addiction * Reported threatening behavior. * Severe autism that makes group participation impossible * Inability to read and understand the Swedish language
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Adult ADHD Self-Report Scale (ASRS-v.1.1) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 0-72, higher scores mean worse outcome |
| Changes in Clinical Global Impression-Improvement (CGI-I) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Assess total improvement on a Richter scale. Range 1-7, Higher scores mean worse outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Balance | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measured with Flamingo test. The test person is standing on the preferred leg on a low balance profile for 60 seconds. The number of times that the test person puts his/her foot to the ground is counted. Lower value means better outcome |
| Changes in Body Mass Index | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Weight and height will be measured in kilograms and centimeters, and combined to report BMI in kg/m\^2. Lower value means better outcome |
| Changes in Abdominal Circumference | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measured with a measuring tape in centimeters. Lower value means better outcome |
| Changes in Body Awareness | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Body Awareness Scale - movement quality and experience (BAS MQ-E). Higher value means better outcome. |
| Changes in Blood pressure | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Both systolic and diastolic blood pressure will be measured in mm Hg with a blood pressure monitor on the arm. |
| Changes in Satisfaction with Daily Occupations-Occupational Balance (SDO-OB) activity score | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 0-17, higher scores are better |
| Changes in Satisfaction with daily occupations and occupational balance (SDO-OB) satisfaction score | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Global satisfaction score, range 1-5, lower scores are better |
| Changes in Canadian Occupational Performance Measure (COPM) perfomance score | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 5-50, higher scores are better |
| Changes in Canadian Occupational Performance Measure (COPM) satisfaction score | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 5-50, higher scores are better |
| Changes in Self Efficacy Scale (GSE-10) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 0-40, higher scores are better |
| Changes in Assessment of Time Management Skills-Swedish (ATMS-S) Time management subscale | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | 11 items, reported as 0-100 ATMS units, higher scores are better |
| Changes in Assessment of Time Management Skills-Swedish (ATMS-S), Organization and planning sub scale | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | 11 items, reported as 0-100 ATMS units, higher scores are better |
| Change in Assessment of Time Management Skills-Swedish (ATMS-S), Regulation of emotions sub scale | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | 5 items, reported as 0-100 ATMS units, higher scores are better |
| Changes in EuroQuality of Life - 5 dimensions - 5 levels (EQ-5D-5L): item scores | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | 5 items scored 1-5 |
| Change in EuroQuality of Life - 5 dimensions - 5 levels (EQ-5D-5L): global score | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | One visual-analogue-scale answer (range 0-100), higher scores are better |
| Changes in Continuous Performance Test (AX-CPT) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measures cognitive flexibility. Will be done in conjunction with functional Magnetic resonance imaging (fMRI). |
| Changes in GO/NoGO | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measures impulse control. Will be done in conjunction with functional Magnetic resonance Imaging (fMRI) |
| Changes Affective Picture series (IAPS) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measures emotion regulation. Will be done in conjunction with functional Magnetic resonance imaging (fMRI) |
| Changes in Adult ADHD Quality of Life Measure (AAQoL) | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Range 29-145, higher scores are better |
| Changes in Cardio Respiratory Fitness | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Measured in millilitre per kilogram per minute with the Ekblom-Bak test, a submaximal exercise test. Higher value means better outcome |
Other
| Measure | Time frame | Description |
|---|---|---|
| Changes in Cortical thickness | Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start | Structural Magnetic resonance imaging (MRI) |
Countries
Sweden
Outcome results
None listed