Esporte como Terapia Alternativa para Ansiedade e Déficit de Atenção

Introdução

hey everybody welcome back Russ sparkley here welcome to my channel again want to say how much I appreciate you viewing my lectures and subscribing to this channel in this particular post I want to address an issue that I continue to get a lot of questions about and that is whether or not exercise or physical activity might be of benefit to people with ADHD uh so let's go into this literature and see if we can't answer this question after all this is something I've been recommending in my talks for a few years now uh but it doesn't hurt to go back over the evidence yet again just to be sure that this is something that might be useful so uh let's take a look here uh starting back in 2015 there was a uh systematic review of the few studies that had been done by then so that's about eight years ago and this was published in the Journal of attention disorders and what it found is that uh although they identified seven studies of acute exercise and 14 studies of long-term effects when they put them all together into a metaanalysis uh they found that uh there were large differences across the studies in their designs and their results and so it was believed that we couldn't say much about exercise back then but it appeared promising there were Trends across these studies in seeing Improvement from physical exercise uh on ADHD symptoms uh and on Executive functioning uh so eight years ago we weren't sure okay next up we now have a paper that was P published a year later this is a metaanalysis also uh and it has gone through and looked at the literature uh it identified 10 Publications that met it criteria uh and they were looking at randomized assignments with control groups of the effective physical exercise on motor skills and executive functioning in ADHD kids this review concludes that there was a significant effect of exercise on ADHD functional outcomes the longer the exercise duration uh and the more consistent it was practiced the larger the effect sizes were an effect sizes the degree of improvement as measured in standard deviations uh so they did find that if excises were not related so much to exercise intensity or to the mean age of the participants or to gender th those are good things we don't want to see an awful lot of variability there um but it was of modest benefit on functional outcom so 2016 things are looking good let's move on here's another review published in 2015 excuse me 2016 this is over in the Journal of neural transmission of all places to publish such a revieww uh this review a metaanalysis as well uh separates the exercise into cardio and non- cardio exercises uh and what it found was that cardio exercise seemed to produce acute beneficial effects on Executive functioning particularly impulsivity on reaction time and on some other physical measures that they looked at in this review beneficial chronic effects of cardio were also found on various functional outcomes including executive functioning attention and behavior they did find that acute and chronic effects of non-c cardio exercise were questionable but did seem to have some predominantly positive effects so cardio seems to be better than non-c cardio though both seem to be of some help uh and acute and chronic both seem to be of benefit but chronic cardio seems to be a little better in producing a a greater degree of effect in cognitive behavioral and social functioning okay so that's 2016 next up is in 2017 there's a review of all of the literature including the new studies that have been published in the interim this is a review of 30 studies now with regard to children and teens mind you so far all the reviews are on children and teens the study finds that both short-term and long-term studies support the clinical benefits of physical activity for individuals with ADHD cognitive behavioral and physical symptoms of ADHD appeared to be alleviated bit of a strong word there I would have said improved uh in most instances uh and the largest intervention effects were reported for mixed exercise programs rather than the same exercise being done repeatedly so here's another review suggesting some benefits for kids and teens with ADHD from adding routine physical exercise of moderate to intense aerobic or cardio activity okay now we move on another two years it's 2019 we've got more research being done in the interim this paper identifies 14 studies that included 574 children and teens uh and they rolled it all together into their metaanalysis they found that about 276 participants were assigned to physical activity the other 298 were in some kind of control group the review concludes that there were benefits in the research on anxiety on depression from physical activity they also found some modest improvements in hyperactive and impulsive symptoms and in atttention symptoms but these were not statistically significant in their meta analysis they did find however Improvement in ratings of thought problems social problems and aggressive behavior in these participants so overall concluding that physical exercise does seem to be beneficial to kids with ADHD I'm surprised that they didn't see much in the way of inattention or hyperactive symptoms but it likely has to do with the measures that were being used in these particular studies that were reviewed here let's keep going we got a lot more to cover a lot out there all right so now we're up to 2022 another three years has transpired we've got much more research again to review this literature research uh reveals 14 excuse me 15 randomized control trials that met their criteria for inclusion now keep in mind there's a lot more research out there but some researchers don't want to include studies of very weak or poor scientific design instead focusing on the best of the trials which is sort of what this review wanted to do and this meta analysis showed that physical exercise did improve attention in ADHD children did improve executive functioning and motor skills in these children once again this review didn't seem to find much benefit on ratings of hyperactivity nor did it seem to find effects on depression or social problems uh but it did find effects on Executive functioning okay more reviews to come now we're looking at another review that was done at about the same time looking at physical interventions for ADHD children and teens uh and this review uh found that there were beneficial effects of physical activity again on Executive functioning uh as measured by rating scales and also so found that the cognitive demand of the physical activity did appear to differ in its impact the less cognitive demand that is the more repetitive the less the individual had to think during exercise the better it appeared to be it found that there were benefits of physical activity even in individuals taking methylphenidate a stimulant medication though the degree of improvement was modest in those children makes sense medication's going to produce a big Improvement there's not much left for physical activity to do but it was found to be of benefit even in the kids taking medication all right let's move on up now this is going to be in 2022 yet another systematic review and meta analysis this one pretty much reaching the same conclusions as the other ones physical activity particular cardio aerobic activity particularly that's done frequently uh is of benefit to children and teens in their ADHD symptoms and especially measures of executive functioning uh they found that uh 20 minute sessions of physical activity sport or exercise led to improvements but that the more frequent the activity uh the better things were in the improvements okay now we're up to this year this is going to be 2023 here is yet one more meta analysis of all the research that's out there now we've got 22 randomized trials in this particular review and the authors find that the um chronic exercise interventions that are done routinely and chronically had beneficial small but beneficial effects on the overall symptom ratings of ADHD specifically they found effects on inattention uh as well uh as the overall ratings of ADHD uh they did find that the closed skill exercise that is where you repeating the same activity over and over again chronically uh is that that was better than what they called open skill exercise which is doing a variety of different things so they did find overall beneficial effects on ADHD particularly on in attention they also found improvements in executive functioning in populations that received exercise versus those that were in the control group interestingly they did not find that there was much of any difference between children or teens both benefited whether the exercise was less than 50 minutes or more than 50 minutes per session that didn't seem to matter too much and also the number of sessions of exercise studies that had 24 or less seemed to do just as well as studies with 24 sessions or more uh so that's all good exercise does seem to be helping here so there you have it up through 2023 lots of research which seems to show certainly beneficial effects on measures of executive functioning both ratings and cognitive tests of executive functioning especially impulsivity uh but also in atttention we also have some modest benefits on ADHD symptoms particularly on inattention there's also Improvement in motor skills as measured in some of these studies uh a of an inconsistent effect on whether it helps with anxiety and depression some earlier studies finding it some later reviews not finding that to be the case not much benefit on social functioning across most of these studies uh but that's okay nobody thought exercise was going to help you socially uh and it looks like aerobic is better than non- aerobic activity and the more consistent the more chronically extent the better the benefits seem to be now mind you this is all with kids and teens there's hardly been any research on adults I did find a couple of papers no reviews uh there was one article that was published let's see in uh this year 2023 looking at the effects of exercise on the mental health cognitive functioning and ADHD symptoms uh oh excuse me that's not the right one here it is um this is a the effects of uh aerobic exercise on Executive function in adults with ADHD sorry for the confusion a lot of research up here on my screen uh this was a single study uh and it looked at acute exercise between 23 adult patients with ADHD and 23 matched controls and it is simply looking at cognitive testing within the lab it's also looking at brain activation it found that exercise improved reaction times uh in individuals with ADHD but not in healthy controls so it looks like the more deficient you are in your attention and reaction time and that's ADHD the more likely you are to benefit the more typical you are in those areas of cognitive functioning you're probably not going to see much further benefit from physical exercise and doesn't that make sense I mean how how far can you go you already at the norm so what we call a sealing effect so adding an exercise might not be as beneficial to typical people but it does appear to be beneficial to ADHD adults there was one more paper here that I found using adults with ADHD this was published last year it's also looking at just acute exercise sort of like one session of intense exercise on the ADHD group versus non-adhd groups and also looking at those who U Got the high-intensity exercise and those who didn't get high-intensity exercise so four different conditions being compared here they say we found that the Improvement in ADHD and depressive symptomatology as well as in processing speed and in Reaction Time response variability followed the high-intensity Intervention Program and it was significantly greater for the ADHD group than the comparison group so once again exercise seems to be preferentially beneficial for ADHD not as beneficial for those without ADHD and by the way this was done with college students so they're arguing that uh high-intensity exercise may be of benefit to these young adults uh as an adjunct to their pharmacological interventions so awful lot that's going on out there to summarize it looks like yes physical exercise is helpful for kids and teens with ADHD we have evidence going all the way back back to 2015 and that it benefits them in a variety of ways particularly executive functioning in attention motor skills uh and to a lesser extent some other aspects of ADHD but not of much benefit for comorbid depression anxiety maybe maybe not uh and certainly not of much benefit in Social functioning but the evidence for adult ADHD is still open to challenge only a couple of studies mainly looking at a acute exercise and they finding in both studies there were benefits to the adults with ADHD of an acute exercise trial versus no exercise but not of benefit to the typical individuals who aren't ADHD so that's my summation of the literature looks like we do have uh evidence for benefits with kids and teens the jury is out on the benefits for adults but the few studies are looking very promising there as well thanks for joining me for this video hope to see you again on another video of mine uh if you're not a subscriber Please Subscribe recommend my channel to others too if you like and do have a look at my books over on my website if you think they might be of help to you thanks for joining me everybody be well