Song Yagang, Jia Shuqi, Wang Xing, Wang Aiwei, Ma Tao, Li Shufan, Chen Jiwei, Guo Zhaohui, Ding Feng, Ren Yuxi, Qin Man
Department of Physical Education Teaching, Shanghai Sanda University, Shanghai, China.
Physical Education, Shanghai University of Sport, Shanghai, China.
Front Pediatr. 2025 Jan 7;12:1479615. doi: 10.3389/fped.2024.1479615. eCollection 2024.
This systematic review and meta-analysis aimed to comprehensively evaluate the impact of physical exercise interventions on anxiety, depression, and emotional regulation in children diagnosed with attention deficit hyperactivity disorder (ADHD).
A comprehensive search was conducted across multiple databases, including Embase, Web of Science (WOS), PubMed, The Cochrane Library, Wanfang Data, VIP Information, and China National Knowledge Infrastructure (CNKI), from their inception up to July 2024. The search aimed to identify randomized controlled trials (RCTs) investigating the impact of physical exercise on anxiety, depression, and emotional regulation in children diagnosed with ADHD. The Physiotherapy Evidence Database (PEDro) scale was employed to assess the quality of the literature, while the revised Cochrane risk-of-bias tool (ROB-2) was used to evaluate the overall risk of bias. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) profiler method was utilized to further assess the quality of evidence. Meta-analysis, sensitivity analysis, and publication bias testing were performed using Stata 18.0 software. Effect sizes were calculated using the standardized mean difference (SMD) and 95% confidence intervals (CI).
The analysis included 18 RCTs, encompassing 830 participants. Physical exercise exhibited a significant positive effect on anxiety (SMD = -0.58, < 0.05), depression (SMD = -0.57, < 0.05), and emotional regulation (SMD = 1.03, < 0.05) in children diagnosed with ADHD. Subgroup analysis revealed that exercise programs with monotypic and mixed modalities, short duration, high frequencies, medium duration, and moderate intensities were the most efficacious in ameliorating anxiety symptoms. The mixed exercise program, when conducted for short duration, with low frequencies, medium duration, and moderate intensity was the most effective in alleviating depression symptoms. Exercise programs featuring mixed modalities, longer duration, moderate to high frequencies, shorter duration, and low intensity yielded the most significant improvements in emotional regulation.
Research demonstrates that physical exercise mitigates anxiety and depression and improves emotional regulation in children with ADHD. A dose-response relationship is evident, correlating with the type, duration, intensity, frequency, and overall exercise duration.
https://www.crd.york.ac.uk/prospero/, PROSPERO identifier (CRD42024571577).
本系统评价和荟萃分析旨在全面评估体育锻炼干预对被诊断为注意力缺陷多动障碍（ADHD）儿童的焦虑、抑郁和情绪调节的影响。
对多个数据库进行全面检索，包括Embase、科学网（WOS）、PubMed、考克兰图书馆、万方数据、维普资讯和中国知网，检索时间从各数据库建库至2024年7月。检索旨在识别调查体育锻炼对被诊断为ADHD儿童的焦虑、抑郁和情绪调节影响的随机对照试验（RCT）。采用物理治疗证据数据库（PEDro）量表评估文献质量，同时使用修订的考克兰偏倚风险工具（ROB-2）评估总体偏倚风险。运用推荐分级、评估、制定与评价（GRADE）剖析器方法进一步评估证据质量。使用Stata 18.0软件进行荟萃分析、敏感性分析和发表偏倚检验。效应量采用标准化均数差（SMD）和95%置信区间（CI）计算。
分析纳入18项RCT，共830名参与者。体育锻炼对被诊断为ADHD的儿童的焦虑（SMD = -0.58，<0.05）、抑郁（SMD = -0.57，<0.05）和情绪调节（SMD = 1.03，<0.05）有显著的积极影响。亚组分析显示，单一类型和混合模式、短时长、高频率、中等时长和中等强度的锻炼计划在改善焦虑症状方面最有效。短时长、低频率且中等时长和中等强度的混合锻炼计划在缓解抑郁症状方面最有效。具有混合模式、较长时长、中等到高频率、较短时长和低强度的锻炼计划在情绪调节方面产生的改善最为显著。
研究表明体育锻炼可减轻ADHD儿童的焦虑和抑郁，并改善其情绪调节。剂量反应关系明显，与锻炼的类型、时长、强度、频率和总锻炼时长相关。
https://www.crd.york.ac.uk/prospero/，PROSPERO标识符（CRD42024571577）。
