Alotaibi Mansour M, Stavrinos Despina, Motl Robert W, Bell Megan, Snyder Scott W, Hurt Christopher P, Singh Harshvardhan, Lein Donald H
Department of Physical Therapy, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.
Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
Gait Posture. 2023 May;102:146-158. doi: 10.1016/j.gaitpost.2023.03.019. Epub 2023 Mar 30.
Balance impairments are highly prevalent and underscreened in individuals with Attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications, used to treat ADHD symptoms, may improve balance performance in this population as demonstrated by a growing literature; however, there has not been a systematic investigation to understand the effects of psychostimulant medications on balance performance in individuals with ADHD. This systematic review examined the existing evidence to determine if psychostimulant medications improve balance performance in this population.
We searched PubMed, CINAHL, SPORTDiscus, Scopus, Embase and Cochrane in March 2021 and in January 2022 to locate articles relevant to the topic. Two reviewers evaluated the methodological quality of included articles using the Study Quality Assessment Tools and the PEDro scale. The reviewers rated articles for the level of evidence based on the American Academy of Neurology (AAN) criteria. The reviewers further offered recommendations for research and clinical practice based on the strength of the reviewed articles using the AAN criteria. Additionally, the reviewers gleaned important characteristics from each article, such as study design, balance domain and study results.
Nine articles addressed the role of psychostimulant medications on balance outcomes. These articles included two Class II studies, two Class III studies and five Class IV studies. Based on study quality, this systematic review indicated low confidence in the use of psychostimulant medications for improving balance performance based on AAN criteria.
Psychostimulant medications trends to enhance balance performance in individuals with ADHD. However, the lack of well-designed studies and heterogeneity of balance measures warrant additional research.
平衡功能障碍在注意力缺陷多动障碍（ADHD）患者中非常普遍且筛查不足。用于治疗ADHD症状的精神刺激药物可能会改善该人群的平衡能力，越来越多的文献证明了这一点；然而，尚未有系统的研究来了解精神刺激药物对ADHD患者平衡能力的影响。本系统评价审查了现有证据，以确定精神刺激药物是否能改善该人群的平衡能力。
我们在2021年3月和2022年1月检索了PubMed、CINAHL、SPORTDiscus、Scopus、Embase和Cochrane，以查找与该主题相关的文章。两名评审员使用研究质量评估工具和PEDro量表评估纳入文章的方法学质量。评审员根据美国神经病学学会（AAN）标准对文章的证据水平进行评分。评审员还根据AAN标准，基于所评审文章的强度，为研究和临床实践提供建议。此外，评审员从每篇文章中收集了重要特征，如研究设计、平衡领域和研究结果。
九篇文章探讨了精神刺激药物对平衡结果的作用。这些文章包括两项II级研究、两项III级研究和五项IV级研究。基于研究质量，本系统评价表明，根据AAN标准，对使用精神刺激药物改善平衡能力的信心较低。
精神刺激药物倾向于增强ADHD患者的平衡能力。然而，缺乏精心设计的研究以及平衡测量的异质性需要更多的研究。
