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SYSTEMATIC REVIEW article

Front. Pediatr.
Sec. Children and Health
Volume 12 - 2024 | doi: 10.3389/fped.2024.1479615

Effects of physical exercise on anxiety depression and emotion regulation in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis

Provisionally accepted
Yagang Song Yagang Song 1shuqi Jia shuqi Jia 2Xing Wang Xing Wang 2Aiwei Wang Aiwei Wang 3Tao Ma Tao Ma 4*ShuFan Li ShuFan Li 2Ji-Wei Chen Ji-Wei Chen 2Zhaohui Guo Zhaohui Guo 2*Feng Ding Feng Ding 2*Yuxi Ren Yuxi Ren 2Man Qin Man Qin 5*
  • 1 Sanda University, Shanghai, China
  • 2 Physical Education , Shanghai University of Sport, Shanghai, China, Shanghai, China
  • 3 Physical Education, Yangzhou University, Yangzhou, China, Yangzhou, China
  • 4 Faculty of Sports Science Ningbo University, Ningbo, China, Ningbo, China
  • 5 School of Sports and Health,Shanghai Lixin Accounting and Finance University, Shanghai, China, Shanghai, China

The final, formatted version of the article will be published soon.

    Objective: 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). Methods: 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. Metaanalysis, 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). Results: The analysis included 18 RCTs, encompassing 830 participants. Physical exercise exhibited a significant positive effect on anxiety (SMD = -0.58, p<0.05), depression (SMD = -0.57, p<0.05), and emotional regulation (SMD = 1.03, p<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. Conclusions: Research demonstrates that physical exercise mitigates anxiety and depression and improves emotional regulation in children with ADHD. A doseresponse relationship is evident, correlating with the type, duration, intensity, frequency, and overall exercise duration. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, PROSPERO(CRD42024571577).

    Keywords: Attention Deficit Hyperactivity Disorder, physical exercise, Anxiety, Depression, emotional regulation, Meta-analysis

    Received: 12 Aug 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Song, Jia, Wang, Wang, Ma, Li, Chen, Guo, Ding, Ren and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tao Ma, Faculty of Sports Science Ningbo University, Ningbo, China, Ningbo, China
    Zhaohui Guo, Physical Education , Shanghai University of Sport, Shanghai, China, Shanghai, China
    Feng Ding, Physical Education , Shanghai University of Sport, Shanghai, China, Shanghai, China
    Man Qin, School of Sports and Health,Shanghai Lixin Accounting and Finance University, Shanghai, China, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.