- 2026-05
- Research in developmental disabilities 172
- Xiang Gao
- Meng Zhang
- Changshuang He
- Zongyu Fan
- Keyu Pan
- Huan Huang
- Shanru Jin
- Yiting Wei
- Wanqun Xu
- Minghui Quan
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 703
- Population
- 703 participants aged 6-13 years with ADHD
- Methods
- Systematic search of seven databases from inception to March 2025 for randomized controlled trials; exercise interventions categorized by modality; doses harmonized to MET-min/week; Bayesian network meta-analysis and dose-response modeling
Background
Children with ADHD frequently face social dysfunction hindering neurodevelopment. While exercise shows promise, the relative efficacy of specific modalities and precise dose-response relationships remain undefined. This study compares exercise modalities to identify the optimal dose for enhancing social functioning.Methods
Seven databases were systematically searched from inception to March 2025 for randomized controlled trials of exercise interventions targeting social outcomes in children with ADHD. Exercise interventions were categorized by modality (closed-skill exercise, open-skill exercise, multicomponent exercise and mind-body therapy). Doses were harmonized to MET-min/week. Bayesian network meta-analysis (Hedges' g) synthesized relative efficacy, while a 4-knot natural-spline model identified the optimal dose-response range.Results
Thirteen trials including 703 participants aged 6-13 years were eligible. Closed-skill exercise produced the largest improvements in social functioning (Hedges' g = -0.96, 95% CrI: -1.18 to -0.75). Multicomponent exercise (Hedges' g = -0.74, 95% CrI: -1.13 to -0.34) and mind-body therapy (Hedges' g = -0.53, 95% CrI: -0.79 to -0.28) showed moderate, clinically meaningful effects, whereas open-skill exercise had small effects (Hedges' g = -0.16, 95% CrI: -0.36 to -0.04). Dose-response analysis indicated an inverted U-shaped relationship, with a minimum effective dose of 660 MET-min/week and an optimal dose of 1290 MET-min/week. Both age and gender had a significant impact on the outcomes.Conclusion
Closed-skill and multicomponent exercise appear most effective for improving social functioning in children with ADHD, with benefits maximised at around 1290 MET-min/week.