Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


Objective: The objective of this selective EBM review is to determine “Is exercise effective in improving the cognitive and behavioral functions in children diagnosed with ADHD?”

Study Design: A systematic review of three randomized control trials (RCTs). All three of these studies were published between 2011 and 2016.

Data Sources: All three of the RCTs were found using PubMed. All of the studies were published in English in peer-reviewed journals and selected based on their relevance to the clinical question.

Outcome Measured: The outcome measured in these studies is the measurable improvement in executive functions related to the effects of exercise in ADHD. In the study by Memarmoghaddam et al., cognitive and behavioral inhibitions were measured using the Stroop Test and Go-No-Go Tests. In the study by Ziereis et al., working memory was measured with Digit span and the letter-number sequencing test of HAWIK-IV. In the study by Change et al., attention, cognitive and behavioral inhibitions were measured using the Stroop and Wisconsin Card Scoring Test (WCST).

Results: In the RCT by Memarmoghaddam et al., there were significant differences in the experimental exercising group in comparison to the control group who did not exercise. The p-value of p = 0.000 indicates statistical significance with a large treatment effect. In the RCT led by Ziereis et al., there was a significant improvement in executive functions in the experimental group compared to the control group as indicated by p < 0.001. In the RCT led by Chang et al., the improvement in executive functions was significant as seen with the p-values of p<0.01 in the Stroop test and p<0.05 in WCST.

Conclusions: All three of the RCT’s showed that participation in exercise programs led to improvement in executive functions in children with ADHD as evidenced by F-score and p-values. These studies suggest that structured exercise programs are effective in improving the executive functions in children with ADHD. Further studies should explore exercise in comparison to pharmacologic agents, should include bigger samples sizes and explore different means of exercise therapies.