Child Care Health Dev. 2015 Nov;41(6):779-88.
The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials.

Cerrillo-Urbina AJ1, García-Hermoso A2, Sánchez-López M1,3, Pardo-Guijarro MJ1,3, Santos Gómez JL4, Martínez-Vizcaíno V1.


Abstract
OBJECTIVE:
The aim of this systematic review and meta-analysis was to examine the evidence for the effectiveness of exercise interventions on attention deficit hyperactivity disorder (ADHD)-related symptoms such as inattention, hyperactivity/impulsivity, anxiety and cognitive functions in children and adolescents.
METHOD:
Five databases covering the period up to November 2014 (PubMed, Scopus, EMBASE, EBSCO [E-journal, CINAHL, SportDiscus] and The Cochrane Library) were searched. Methodological quality was assessed using the Cochrane tool of bias. Standardized mean differences (SMD) and 95% confidence intervals were calculated, and the heterogeneity of the studies was estimated using Cochran's Q-statistic.
RESULTS:
Eight randomized controlled trials (n = 249) satisfied the inclusion criteria. The studies were grouped according to the intervention programme: aerobic and yoga exercise. The meta-analysis suggests that aerobic exercise had a moderate to large effect on core symptoms such as attention (SMD = 0.84), hyperactivity (SMD = 0.56) and impulsivity (SMD = 0.56) and related symptoms such as anxiety (SMD = 0.66), executive function (SMD = 0.58) and social disorders (SMD = 0.59) in children with ADHD. Yoga exercise suggests an improvement in the core symptoms of ADHD.
CONCLUSIONS:
The main cumulative evidence indicates that short-term aerobic exercise, based on several aerobic intervention formats, seems to be effective for mitigating symptoms such as attention, hyperactivity, impulsivity, anxiety, executive function and social disorders in children with ADHD.

ＡＤＨＤの子どもに対する運動療法の有効性についての論文です。８つの無作為化比較試験をメタ解析した結果、有酸素運動はＡＤＨＤの不注意、多動、衝動性の中核症状に対してエフェクトサイズは中～大程度であり、有効性を認めています。ヨガもＡＤＨＤのコア症状へ対する改善効果があると示唆されています。

ＡＤＨＤに対する薬物療法、心理療法以外の治療に対しても少しずつですが、エビデンスレベルの高い臨床試験が行われてきており、有意にＡＤＨＤ症状が改善するという報告がでてきていることは非常に重要な意味を持ちます。

実臨床でも、運動、リラクゼーション、を行うとＡＤＨＤ症状の改善は、薬物療法単独で行っている場合よりも高いことが多いと思います。薬物療法以外の選択肢が増えることは非常に重要ですので、実際に実践できる場を提供していこうとしています。


記事作成：加藤晃司（医療法人永朋会）
　　　　　専門：児童精神科（日本児童青年期精神医学会認定医、子どものこころ専門医）