Many children in Israel and around the world struggle with attention deficit disorders. The treatment of these disorders includes several elements, but a new large meta-analysis reveals that physical activity has a tremendous impact.
An international team of researchers conducted a comprehensive meta-analysis of 16 studies that examined the impact of physical activity on executive functions in children aged 6–13 with ADHD. The studies included 685 participants from five countries, most of them conducted in China, Switzerland, Iran, Germany, and the United States.
The researchers focused on three key cognitive areas:
• Self-control – the ability to stop impulsive reactions and stay focused.
• Working memory – the ability to temporarily store and process information.
• Cognitive flexibility – the ability to switch between tasks and adapt to changing situations.
The results were particularly impressive in two main areas:
Self-control: Physical activity led to a significant improvement in the children’s ability to inhibit impulsive responses and control their behavior.
Working memory: The children showed a substantial improvement in the ability to temporarily store and process information, a critical skill for learning and performing complex tasks.
Cognitive flexibility: Here, the results were more mixed. The improvement was limited and appeared mainly in certain specific measures. The researchers explain that cognitive flexibility requires complex integration of different brain regions, so more intensive and prolonged physical activity may be needed to significantly affect it.
Which activity is most beneficial?
The studies examined different types of physical activity:
• Aerobic: Running, swimming, and cycling.
• Ball games: Basketball, soccer, and tennis.
• Cognitive-motor training: Activities combining physical effort with cognitive challenges.
• Video games: Those that involve body movement (active games).
Most programs lasted between 4 and 12 weeks, with sessions of 15 to 90 minutes, 2–3 times a week. Research evidence indicates that activities combining cognitive challenges (like ball games) may be more effective for improving cognitive flexibility.
Why does it work?
The researchers point to several neurobiological mechanisms:
At the brain level: Physical activity increases activity in the prefrontal cortex, the area responsible for executive functions. It also strengthens connectivity between different brain regions, improving the efficiency of cognitive processing.
At the molecular level: Physical activity raises levels of dopamine and norepinephrine, which are typically low in children with ADHD. In addition, it increases the production of BDNF – a protein that promotes the growth of new neurons and strengthens synaptic connections in the brain.
Dr. Shirley Hershko, an expert in ADHD, researcher, and lecturer at the Hebrew University, diagnostician, and therapist, refers to the study’s findings: “The findings provide a solid scientific basis for recommending the inclusion of physical activity as part of a multi-dimensional treatment for ADHD. The main results clearly show that physical activity significantly improves the ability to inhibit impulsive responses and control behavior, as well as working memory, which is a critical ability for learning and performing tasks. These are exactly the functions in which children with ADHD struggle the most.
What is particularly interesting is that the interventions included diverse types of activities: Aerobic training, ball sports, cognitive-motor training, and even digital training games. The data indicate that complex physical activity, especially ball sports like basketball or tennis, may lead to more significant improvements, likely due to the additional cognitive challenge they require.
It is important to emphasize that physical activity does not replace medication or behavioral therapy when needed but complements them excellently. The great advantage is that it is a safe, accessible intervention without side effects. I recommend that parents look for an activity that brings enjoyment, especially group sports or ball games, because consistency is the key to success. Physical activity is a highly promising treatment for improving essential functions in children with ADHD,” concludes Dr. Hershko.