Converse Alexander K, Barrett Bruce P, Chewning Betty A, Wayne Peter M
Waisman Center, University of Wisconsin-Madison, United States.
Department of Family Medicine and Community Health, University of Wisconsin-Madison, United States.
Complement Ther Med. 2020 Sep;53:102538. doi: 10.1016/j.ctim.2020.102538. Epub 2020 Aug 14.
Many young adults are affected by attention deficit hyperactivity disorder (ADHD) and often desire non-pharmacological treatment options. Mind-body techniques might serve as complementary therapies to first-line stimulant medications, but studies are limited. Tai Chi is an increasingly popular practice that integrates movement with cognitive skills relevant to ADHD. We performed a feasibility trial of Tai Chi training in undergraduates to inform the design of a fully powered randomized controlled trial (RCT).
Undergraduates with ADHD were recruited, screened, enrolled, and assessed at baseline. They were assigned to three parallel seven-week intervention arms, Tai Chi, Active Control (cardio-aerobic fitness), and Inactive Control (no contact), with follow-up assessments. Feasibility of a larger clinical trial was evaluated, especially with respect to enrollment and retention. Additionally, potential clinical outcome measures were examined for practicality and reliability.
21 participants were assessed at baseline and 19 at follow-up (90 % retention). The primary clinical outcome measure, self-reported inattention symptoms (Conners' CAARS-S:L DSM-IV Inattentive Symptoms subscale), exhibited good test-retest reliability in controls (r = 0.87, n = 10) and correlated with reduced mindfulness (FFMQ acting with awareness subscale) at baseline (r = -0.74, n = 20). Class attendance and self-reported daily practice time were variable. Randomization to group classes was hindered by the college students' restricted schedules.
The high retention rate and good data quality suggest that an RCT of Tai Chi for ADHD is feasible. Further measures are identified to improve enrollment rates, adherence, and randomization procedures. Future work might extend to other young adult populations and high school students.
许多年轻人受注意力缺陷多动障碍(ADHD)影响,常常希望获得非药物治疗方案。身心调节技巧或许可作为一线兴奋剂药物的辅助疗法,但相关研究有限。太极拳是一种越来越受欢迎的运动,它将动作与ADHD相关的认知技能相结合。我们对大学生进行了太极拳训练的可行性试验,以为一项充分有力的随机对照试验(RCT)的设计提供依据。
招募患有ADHD的大学生,在基线时进行筛选、入组和评估。他们被分配到三个平行的为期七周的干预组,即太极拳组、积极对照组(有氧健身)和消极对照组(无接触),并进行随访评估。评估了更大规模临床试验的可行性,尤其是在招募和保留方面。此外,还检查了潜在临床结局指标的实用性和可靠性。
21名参与者在基线时接受评估,19名在随访时接受评估(保留率90%)。主要临床结局指标,即自我报告的注意力不集中症状(康纳斯成人多动症评定量表 - 长版DSM-IV注意力不集中症状分量表),在对照组中显示出良好的重测信度(r = 0.87,n = 10),且在基线时与正念水平降低(五因素正念问卷有意识行动分量表)相关(r = -0.74,n = 20)。上课出勤率和自我报告的每日练习时间各不相同。大学生受限的日程安排阻碍了随机分组上课。
高保留率和良好的数据质量表明,针对ADHD进行太极拳的RCT是可行的。确定了进一步措施以提高招募率、依从性和随机化程序。未来的工作可能会扩展到其他年轻成年人群体和高中生。