Christ Tabea, Boström Kim Joris, Wagner Heiko, Bohn Christiane
Department of Movement Science, University of Münster, Münster, Germany.
Front Hum Neurosci. 2025 Aug 1;19:1630049. doi: 10.3389/fnhum.2025.1630049. eCollection 2025.
Many children with ADHD experience challenges with balance and postural control, unlike their unaffected peers. While postural sway has been extensively studied in this patient group, less is known about the postural strategies employed to maintain equilibrium. This study extends the examination of hip and ankle postural strategies by including an upper body strategy involving movements of the head, arms, and trunk to regain balance. The aim was to investigate the differences in postural control strategies between children with and without ADHD.
Forty one children (17 diagnosed with ADHD, 24 unaffected controls) with a mean age of 10.0 ± 1.4 years participated in the study. For the assessment of static balance, a 25-s one-leg stand was conducted. Dynamic balance was evaluated by balancing on a narrow wooden beam. Kinetic data was recorded using Kistler force plates. Kinematic data was collected with the Qualisys motion capture system. Joint torque amplitudes were calculated using an inverse-dynamics approach employing the Myonardo software.
Children with ADHD produced significantly higher joint torques during static and dynamic balancing compared to neurotypical children in the ankle and upper body joint group. Torque amplitudes of the upper body joints were 11% and 7.5% higher for the dynamic and static balance tasks, respectively, and 22% and 20% higher for the ankle joint. For hip joint torque variation, the ADHD group exhibited 25% and 34% lower joint torques for the dynamic and static balance tasks, respectively.
Impaired proprioception and neuromuscular control are common in children with ADHD and may present as reduced precision in muscle activation. Cerebellar deficits in this patient group negatively affect balance and coordination. Such deficits likely interfere with the adjustment of joint torques involved in maintaining balance and stability. Children with ADHD appear to struggle to efficiently employ and combine postural strategies as required by the given task. Assessments of balance and postural control in children with ADHD are indispensable for developing tailored interventions and thus reducing injury risk and promote wellbeing.
与未受影响的同龄人不同，许多患有注意力缺陷多动障碍（ADHD）的儿童在平衡和姿势控制方面面临挑战。虽然姿势摆动在该患者群体中已得到广泛研究，但对于用于维持平衡的姿势策略了解较少。本研究通过纳入涉及头部、手臂和躯干运动以恢复平衡的上身策略，扩展了对髋部和踝部姿势策略的研究。目的是调查患有和未患有ADHD的儿童在姿势控制策略上的差异。
41名平均年龄为10.0±1.4岁的儿童（17名被诊断为ADHD，24名未受影响的对照）参与了该研究。为评估静态平衡，进行了25秒的单腿站立测试。通过在狭窄的木梁上保持平衡来评估动态平衡。使用奇石乐测力板记录动力学数据。使用Qualisys运动捕捉系统收集运动学数据。采用Myonardo软件通过逆动力学方法计算关节扭矩幅度。
与神经典型儿童相比，患有ADHD的儿童在静态和动态平衡过程中，踝部和上身关节组产生的关节扭矩明显更高。上身关节的扭矩幅度在动态和静态平衡任务中分别高出11%和7.5%，踝关节分别高出22%和20%。对于髋关节扭矩变化，ADHD组在动态和静态平衡任务中的关节扭矩分别降低了25%和34%。
本体感觉和神经肌肉控制受损在患有ADHD的儿童中很常见，可能表现为肌肉激活的精度降低。该患者群体的小脑缺陷对平衡和协调产生负面影响。这些缺陷可能会干扰维持平衡和稳定性所涉及的关节扭矩的调整。患有ADHD的儿童似乎难以根据给定任务有效地运用和组合姿势策略。对患有ADHD的儿童进行平衡和姿势控制评估对于制定针对性的干预措施至关重要，从而降低受伤风险并促进健康。
