Acute Effects of Exercise in College Students With ADHD
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 25 |
| Updated: | 3/8/2019 |
| Start Date: | October 8, 2018 |
| End Date: | August 31, 2019 |
| Contact: | Cynthia M Hartung, Ph.D. |
| Email: | chartung@uwyo.edu |
| Phone: | 307-314-2123 |
The overall objective of this study is to examine physical exercise as an intervention for
ADHD. The rationale for the proposed study is that physical exercise could serve as an
effective treatment for college students with ADHD that has low costs, low risks, and
ancillary health benefits and may address the limitations of existing treatments. The central
hypothesis is that college students with ADHD will exhibit greater degrees of improvement in
executive functioning (i.e., sustained attention, working memory) immediately following
sprint interval training (SIT), relative to non-ADHD peers. This hypothesis was formulated
based on preliminary studies demonstrating reduced ADHD symptoms and improved executive
functioning following physical exercise. Multiple 2 (ADHD vs. control) x 2 (male vs. female)
x 2 (exercise vs. none) repeated measures ANOVAs will be conducted to compare students with
ADHD (n = 24) to controls (n = 24).
The expected outcomes are to confirm this hypothesis and demonstrate the need for further
study of physical exercise. If confirmed, the results will provide pilot data for a larger
NIH grant proposal aimed at further examining the acute effects of physical exercise (i.e.,
improved cognitive functioning immediately following exercise) and also the chronic effects
of physical exercise (i.e., improved functioning after engaging in regular exercise for an
extended period). This outcome is expected to have an important positive impact because
physical exercise may serve as an effective treatment for college students with ADHD that is
less risky than stimulants, less time-consuming than therapy, and provides ancillary health
benefits (i.e., increasing physical fitness, decreasing obesity).
ADHD. The rationale for the proposed study is that physical exercise could serve as an
effective treatment for college students with ADHD that has low costs, low risks, and
ancillary health benefits and may address the limitations of existing treatments. The central
hypothesis is that college students with ADHD will exhibit greater degrees of improvement in
executive functioning (i.e., sustained attention, working memory) immediately following
sprint interval training (SIT), relative to non-ADHD peers. This hypothesis was formulated
based on preliminary studies demonstrating reduced ADHD symptoms and improved executive
functioning following physical exercise. Multiple 2 (ADHD vs. control) x 2 (male vs. female)
x 2 (exercise vs. none) repeated measures ANOVAs will be conducted to compare students with
ADHD (n = 24) to controls (n = 24).
The expected outcomes are to confirm this hypothesis and demonstrate the need for further
study of physical exercise. If confirmed, the results will provide pilot data for a larger
NIH grant proposal aimed at further examining the acute effects of physical exercise (i.e.,
improved cognitive functioning immediately following exercise) and also the chronic effects
of physical exercise (i.e., improved functioning after engaging in regular exercise for an
extended period). This outcome is expected to have an important positive impact because
physical exercise may serve as an effective treatment for college students with ADHD that is
less risky than stimulants, less time-consuming than therapy, and provides ancillary health
benefits (i.e., increasing physical fitness, decreasing obesity).
Participant enrollment will consist of forty-eight University of Wyoming (UW) and Laramie
County Community College (LCCC) students (24 ADHD group, 24 comparison group) with an even
distribution of men and women in each group. Power analyses (G*Power 3.1) indicated a sample
of at least this size is needed to provide 80% power to detect medium effects which have been
observed in samples of children with ADHD. Students taking medications that may confound
cognitive performance (e.g., antipsychotics, sedatives), are outside the age range (18-25
years), or are at an elevated risk for physical exercise contraindications will be excluded.
Prospective ADHD group participants will be recruited through four means. First, students who
complete a separate study and endorse five or more inattention (IA) symptoms or report being
previously diagnosed with ADHD will be invited for an eligibility assessment. Second,
recruitment flyers will be posted on campus. Third, participants will be contacted from
previous studies who were diagnosed with ADHD and consented to contact for future research.
Fourth, university medical and mental health staff will advertise the study to student
clients who have ADHD. Comparison group subjects will be composed of students who complete a
separate study, who disavow being diagnosed with ADHD, and endorse three or fewer IA
symptoms. As students enroll in the ADHD group, age- and sex-matched comparison subjects will
be enrolled. Prior to study enrollment, prospective participants must stratify as being at
low risk for physical exercise contraindications using a health history screening
questionnaire. Prospective ADHD participants must also meet diagnostic criteria for ADHD on a
structured clinical interview.
All prospective participants will attend an in-lab appointment to confirm their eligibility,
including (a) stratifying as being at low risk for physical exercise contraindications and
(b) ADHD prospects meeting diagnostic threshold. After enrolling in the study, participants
will be scheduled for two in-lab experimental appointments: sprint interval training (SIT)
and Non-SIT. The ordering of experimental appointments will be counterbalanced. This will be
done to evaluate possible appointment ordering effects and minimize confounding effects. Both
appointments will be scheduled in the mornings, on the same day of the week and at the same
time of day. Participants will be asked to wear athletic clothing, as well as abstain from
exercise, alcohol, caffeine, and stimulant medication for 12 hours prior to their
experimental appointments to minimize the influence they may have on our independent
(exercise) and dependent variables (executive functioning). Participants will complete the
execute functioning tasks (i.e., Continuous Performance Task or CPT, Digit Span,
Letter-Number Sequencing, and Spatial Span or SS) during both the Non-SIT and SIT
appointments. They will also be sent a modified mood (i.e., Depression, Anxiety, and Stress
Scale or DASS) and ADHD symptoms (Barkley Adult ADHD Rating Scale or BAARS) questionnaire the
morning following all experimental appointments. High-intensity SIT was chosen for the
proposed study because moderate- to high-intensity aerobic exercises appears to lead to the
greatest improvements in cognitive performance among youth with ADHD. The researcher will
lead the participant through a set of stretches and 3 minutes of low-intensity cycling on a
Schwinn AD2 Airdyne leg-cycling and arm-cranking ergometer to warm up and increase blood flow
to active muscles. Participants will then complete 16 minutes of SIT, consisting of eight
bouts of 20 seconds of cycling followed by 100 seconds of rest. After each interval,
participants will be asked to provide their perceived exertion during the interval, and the
researcher will record participant's peak interval heart rate (HR). These measurements are
taken to validate that participants exercised at a high intensity. The experimenter will
provide encouragement to the participant to work towards ≥85% of their maximum HR. After the
eighth and last interval, the participant will rest for 15 minutes before completing the
cognitive tasks (i.e., CPT, Digit Span, Letter-Number Sequencing, and SS).
Prior to analyses, all variables will be screened. Violations of statistical assumptions will
be addressed through data transformations or nonparametric statistics. Relative improvements
on objective measurements of EF (i.e., CPT, Digit Span, Letter-Number Sequencing, and SS
performance indices) will be examined through 2 (ADHD vs. comparison) x 2 (men vs. women) x 2
(Non-SIT vs. SIT) repeated measures ANOVAs. When interaction effects are significant, paired
samples t-tests will be used to evaluate group differences. When interaction effects fail to
reach statistical significance, independent samples t-tests will be used to evaluate group
differences. The magnitude of omnibus effects for repeated measures ANOVAs will be calculated
using partial eta-squared (ηp2). Within-group effects (Cohen's d) and corresponding
confidence intervals for within-group effect sizes will be standardized using the variability
of non-SIT scores. Between-group effects will be calculated using Hedges g. Values for ηp2 of
.01, .06, and .14 will be considered small, medium, and large effects, respectively;
corresponding values for d and g are .20, .50, and .80.
County Community College (LCCC) students (24 ADHD group, 24 comparison group) with an even
distribution of men and women in each group. Power analyses (G*Power 3.1) indicated a sample
of at least this size is needed to provide 80% power to detect medium effects which have been
observed in samples of children with ADHD. Students taking medications that may confound
cognitive performance (e.g., antipsychotics, sedatives), are outside the age range (18-25
years), or are at an elevated risk for physical exercise contraindications will be excluded.
Prospective ADHD group participants will be recruited through four means. First, students who
complete a separate study and endorse five or more inattention (IA) symptoms or report being
previously diagnosed with ADHD will be invited for an eligibility assessment. Second,
recruitment flyers will be posted on campus. Third, participants will be contacted from
previous studies who were diagnosed with ADHD and consented to contact for future research.
Fourth, university medical and mental health staff will advertise the study to student
clients who have ADHD. Comparison group subjects will be composed of students who complete a
separate study, who disavow being diagnosed with ADHD, and endorse three or fewer IA
symptoms. As students enroll in the ADHD group, age- and sex-matched comparison subjects will
be enrolled. Prior to study enrollment, prospective participants must stratify as being at
low risk for physical exercise contraindications using a health history screening
questionnaire. Prospective ADHD participants must also meet diagnostic criteria for ADHD on a
structured clinical interview.
All prospective participants will attend an in-lab appointment to confirm their eligibility,
including (a) stratifying as being at low risk for physical exercise contraindications and
(b) ADHD prospects meeting diagnostic threshold. After enrolling in the study, participants
will be scheduled for two in-lab experimental appointments: sprint interval training (SIT)
and Non-SIT. The ordering of experimental appointments will be counterbalanced. This will be
done to evaluate possible appointment ordering effects and minimize confounding effects. Both
appointments will be scheduled in the mornings, on the same day of the week and at the same
time of day. Participants will be asked to wear athletic clothing, as well as abstain from
exercise, alcohol, caffeine, and stimulant medication for 12 hours prior to their
experimental appointments to minimize the influence they may have on our independent
(exercise) and dependent variables (executive functioning). Participants will complete the
execute functioning tasks (i.e., Continuous Performance Task or CPT, Digit Span,
Letter-Number Sequencing, and Spatial Span or SS) during both the Non-SIT and SIT
appointments. They will also be sent a modified mood (i.e., Depression, Anxiety, and Stress
Scale or DASS) and ADHD symptoms (Barkley Adult ADHD Rating Scale or BAARS) questionnaire the
morning following all experimental appointments. High-intensity SIT was chosen for the
proposed study because moderate- to high-intensity aerobic exercises appears to lead to the
greatest improvements in cognitive performance among youth with ADHD. The researcher will
lead the participant through a set of stretches and 3 minutes of low-intensity cycling on a
Schwinn AD2 Airdyne leg-cycling and arm-cranking ergometer to warm up and increase blood flow
to active muscles. Participants will then complete 16 minutes of SIT, consisting of eight
bouts of 20 seconds of cycling followed by 100 seconds of rest. After each interval,
participants will be asked to provide their perceived exertion during the interval, and the
researcher will record participant's peak interval heart rate (HR). These measurements are
taken to validate that participants exercised at a high intensity. The experimenter will
provide encouragement to the participant to work towards ≥85% of their maximum HR. After the
eighth and last interval, the participant will rest for 15 minutes before completing the
cognitive tasks (i.e., CPT, Digit Span, Letter-Number Sequencing, and SS).
Prior to analyses, all variables will be screened. Violations of statistical assumptions will
be addressed through data transformations or nonparametric statistics. Relative improvements
on objective measurements of EF (i.e., CPT, Digit Span, Letter-Number Sequencing, and SS
performance indices) will be examined through 2 (ADHD vs. comparison) x 2 (men vs. women) x 2
(Non-SIT vs. SIT) repeated measures ANOVAs. When interaction effects are significant, paired
samples t-tests will be used to evaluate group differences. When interaction effects fail to
reach statistical significance, independent samples t-tests will be used to evaluate group
differences. The magnitude of omnibus effects for repeated measures ANOVAs will be calculated
using partial eta-squared (ηp2). Within-group effects (Cohen's d) and corresponding
confidence intervals for within-group effect sizes will be standardized using the variability
of non-SIT scores. Between-group effects will be calculated using Hedges g. Values for ηp2 of
.01, .06, and .14 will be considered small, medium, and large effects, respectively;
corresponding values for d and g are .20, .50, and .80.
Inclusion Criteria:
- Age between 18 and 25 years.
- University of Wyoming (UW) or Laramie County Community College (LCCC) student.
Exclusion Criteria:
- Predominantly hyperactive/impulsive presentations of ADHD (ADHD-HI), as this
presentation is unusual in adulthood.
- Use of medications that negatively affect cognitive performance (e.g., sedatives,
antipsychotics).
- Pregnancy or trying to become pregnant.
- Non-ambulatory or relying on walking aids for ambulation.
- History of a stroke or an aneurysm.
- High risk for physical exercise contraindications due to genetic/medical conditions
(e.g., cardiovascular or pulmonary disease).
- Exercise or physical activity restrictions imposed by a health provider.
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