Exercise as it relates to Disease/The effects of exercise on ADHD

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Effect of Exercise as a Treatment for Attention Deficit Hyperactivity Disorder (ADHD)[edit]


Brief Background

Neurobehavioral disorder [1] causing patterns of inattention & hyperactivity caused by the imbalance of Catecholamines (Norepinephrine and Epinephrine) in the Prefrontal Cortex & Striatal Brain regions [2]

Explanation/ Diagnosis of ADHD

There are two main criteria's used to diagnose ADHD, the Diagnostic & Statistical Manual of Mental Disorders & the International Classification of Disease.[3] Once diagnosed clinical patience are then interviewed & observed by a medical specialist [4] who look for a number of the following symptoms to help confirm the clinical diagnosis:[2][5][6][7]

  • Inattention
  • Hyperactivity
  • Abnormalities in Prefrontal Cortex
  • Impeded maturation & growth of brain
  • Poor self esteem
  • Social Impairments
  • Temper outbursts
  • Depression


The above symptoms are not the only ones associated with ADHD, however are those that are more common, with varying degrees of severity for each individual basis.[8] Furthermore, in order to be diagnosed with ADHD prominent symptoms must be present for at least six months, be excessive for the developmental age of the individual and cause impaired functioning [9]

Treatment

Pharmacotherapy

The use of pharmaceutical treatment is the most common method of limiting/decreasing symptoms of ADHD. The two major stimulant medications being Methylphenidate(1) and Dexamphetamine, [8] Both have a rapid , consistent and predictable effect on patience with an effective duration time of approximately 4 hours[10] however both effect the body differently.

Methylphenidate; releases stored dopamine[11]

Dexamphetamine; releases synthesised dopamine and blocks synaptic uptake [12]

Adverse side effects of these drugs include but are not limited to:[11][12]

  • High Blood Pressure
  • Sleep problems
  • Mood disturbances
  • Increased chance of psychotic events
  • Decreased growth rates


Exercise
As a treatment method for ADHD patients exercising has recently proved to be quite effective, acting in a number of positive ways ;[5][13][14][15][16]

  • Increases levels of synaptic proteins
  • Elevation of hormone levels (insulin like growth factor, neurotropic factor)
  • Improved learning ability
  • Improved brain plasticity in children
  • Decreased behavioural issue
  • Improved executive functioning (adults)
  • Enhanced cognitive functioning
  • Improved inhibition


Recommendations[17]

  • People with ADHD should spend time doing activities outdoors as studies found in the American Journal of Public Health show that out door activities cause a reduction in ADHD symptoms after being outside.
  • A minimum of 30 minutes 4 -5 times a week of moderate activity should be spent participating in physical activity as it helps improve chemical imbalances in the brain corresponding with the recommendations provided by the Heart Association & ADHD draft guidelines presented by the Australian government.
  • Heart Association also recommends that sports involving teamwork and/or attention to body stance is helpful for ADHD patients sufferering from focusing issues especially at a young age.


Recommended Readings

  • Attention Deficit Hyperactivity Disorder (ADHD)[18]
  • Draft Australian Guidelines on ADHD[19]



Reference List

  1. Medina, J., et al. (2010) Exercise impact on sustained attention of ADHD children, Methylphenidate effects. Attention Deficit Hyperactivity Disorder, 2(1), 49-58.
  2. a b Wigal, S., et al. (2012) Exercise: Applications to Childhood ADHD. Journal of Attention Disorders, XX(X), 1-12.
  3. Sill, F. (2006) Some abnormal psychical conditions in children, Journal of Attention Disorders, 10(2), 126 - 136.
  4. Zwi, M., et al. (2000) Evidence and Belief in ADHD, British Medical Journal, 321, 975 – 978.
  5. a b Halperin, J., & Healey, D. (2011) The influence of environmental, cognitive enhancement, and physical education on brain development : can we alter the development trajectory of ADHD, Neuron science and behavioural reviews, 35, 621 – 634.
  6. Mulrine, C., et al.(2008) The Active Classroom: Supporting Students With Attention Deficit Hyperactivity Disorder Through Exercise. TEACHING Exceptional Children, 40(5), 16-22.
  7. Kiluk, B., et al. (2009) Sport Participation and Anxiety in Children with ADHD. Journal of Attention Disorders, 12, 499 – 506.
  8. a b Corrigan, B. (2003) Attention Deficit Hyperactivity Disorder in Sport: A review. International Journal of Sports Medicine, 24(7), 535 – 540.
  9. Goldman, S., et al. (1998) Diagnosis and treatment of attention deficit hyperactivity disorder in children and adolescence. The Journal for the American Medical Association, 279(14), 1100-1107.
  10. Swanson, J., et al. (1998) Attention deficit and hyperkinetic disorder. Lancet, 353, 429 – 433.
  11. a b Solanto, V. (2002) Dopamine dysfunction in AD/HD: integrating clinical and basic neuroscience research. Behavioural Brain Research, 10, 65-71.
  12. a b Shenker, A. (1992) The mechanism of action of drugs used to treat attention deficit hyperactivity disorder: focus on catecholamine receptor pharmacology. Advances in Paediatrics, 39, 337-382.
  13. Gapin, J., et al. (2011) The effects of physical activity on attention deficit hyperactivity disorder symptoms : The evidence. Preventive Medicine, 52, S70 – 74.
  14. Etnier, J,. (2009) Physical activity and cognitive performance in children with attention deficit hyperactivity disorder (ADHD). Journal of Sport & Exercise Psychology, 31, S11 – S13.
  15. Lipnicki, D., et al. (2009) Bed Rest and Cognition: Effects on Executive Functioning and Reaction Time. Aviation, Space & Environmental Medicine, 80(12), 1018 – 1024.
  16. Robinson, A., et al. (2011) Effects of physical exercise on ADHD-like behaviour in male and female adolescent spontaneously hypertensive rats. Developmental Psychobiology, 53(4), 383 – 390.
  17. Roth, E,. (2011). Reasearch on ADHD and Exercise. October 2012, http://www.livestrong.com/article/393998-research-on-adhd-exercise/#ixzz29vjdjsJt
  18. National Institute of Medical Health (2012). Attention Deficit Hyperactivity Disorder (ADHD). October 2012, http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml
  19. Royal Australasian College of Physicians (2009). Draft Australian Guidelines on ADHD. Australian Government: National Health and Medical Research Council. October 2012, http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ch54_draft_guidelines.pdf