Attention Deficit Hyperactivity Disorder (ADHD) Clinical Trial
Official title:
The Relative Efficacy of Aerobic Exercise in the Treatment of Adults With Attention Deficit Hyperactivity Disorder (ADHD) Versus Medication Only and the Combination of the Two: A Pilot Study
The purpose of this project is to evaluate the effectiveness of a structured aerobic exercise intervention for adults with Attention-Deficit/Hyperactivity Disorder (ADHD) with and without medication and compare it to medication alone. Participants will be randomly assigned to medication only + education, aerobic exercise intervention only, and combined aerobic exercise and medication groups. Participants will be evaluated at baseline, following medication optimization (for medicated groups), following 8 weeks of intervention, after 3 months of follow-up, and after 6 months of follow-up. The investigators hypothesize that the combined group will have the best outcome at all evaluation points and that treatment gains will be maintained throughout the follow-up period if the assigned treatments are continued.
Background: Several interventional studies have shown improvement in core symptoms of
Attention-Deficit Hyperactivity Disorder (ADHD) with aerobic exercise as an add-on therapy
for children with ADHD treated with stimulants. Studies in the general population have shown
that aerobic exercise in adults may improve cognitive function in general and executive
function in particular. Although non-medication treatment for ADHD has focused on cognitive
training in addition to medication, some evidence indicate that intense aerobic exercise
impacts brain structure, improves brain function, and has effects similar to stimulant
medication.
Objectives: To assess the effectiveness, regarding ADHD symptoms, of an eight week aerobic
exercise intervention, medication, and the combination of both aerobic exercise and
medication treatments for adults with ADHD. The secondary objectives are to determine the
effectiveness of these treatments on social skills, as measured by functioning in work,
social, and family situations; anxiety symptoms; depressive symptoms; self-esteem; and the
effect of motivation for exercise on adherence to exercise treatment.
Hypothesis: Investigators hypothesize that the combined group which receives aerobic exercise
and medication intervention will have the greatest improvement in both primary and secondary
outcome measures; that treatment gains will be maintained at follow-up only if treatments are
continued.
Methods: Participants will be randomly assigned to one of three groups:
1. Aerobic exercise intervention only. Participants of this group will meet twice a week
for 8 consecutive weeks. Each meeting will involve 1 hour of moderate-vigorous intensity
aerobic exercise.
2. Medication treatment only. Participants of this group will receive optimal medication
for them and will gradually be titrated up to their optimal dose. Once they are
optimally titrated, they will attend 8 weekly sessions of an education class, which will
focus on different topics of adult ADHD. These meetings will last 1 hour each week.
Educational meetings are meant to control for group effects of the exercise group
intervention.
3. Medication combined with aerobic-exercise intervention. Participants of this group will
receive optimal medication for them and will gradually be titrated up to their optimal
dose. When the participants of this group will be at their optimal medication dose, they
will begin the aerobic exercise classes twice a week for 8 weeks. They will not receive
the educational sessions.
Randomization will be stratified by sex, age and the degree of physical activity per week.
Power analyses indicate that 23 participants are needed per each treatment arm, accounting
for a dropout rate of 20%. Therefore initial enrollments should be at minimum 69 patients for
all three arms, at least 23 patients per arm. There will 2 groups in each arm of the study,
accounting for 10-15 participants per group at any one time.
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