Original studyFrontiers in Psychology, 2026Read the paper →
Attention deficit hyperactivity disorder (ADHD) affects around 8% of children and teenagers worldwide, and many also struggle with anxiety, low mood and problems at school. Medication remains the first-line treatment, but side effects such as headaches and stomach upsets limit its use. A new review suggests that physical exercise may help young people with ADHD stop and think before they act, though the evidence is still weak.
Wenzeng Wang, an author of the study at Shenyang Sport University, said of the team’s motivation: “Physical exercise is a low-cost, accessible, non-pharmacological supplementary intervention”.
Researchers at Shenyang Sport University in China pooled the results of 25 randomised controlled trials involving 1,116 children and teenagers with ADHD. The findings appear in Frontiers in Psychology. Each trial compared exercise with a non-exercise control. In many studies that control was daily activities, sitting or watching a video; a few used other programmes such as neurofeedback, mindfulness or usual care.
The trials had between 12 and 94 participants each, aged 6 to 15 where age was reported. Programmes included aerobic exercise, exercise combined with thinking tasks, and mixed training, with sessions of 15 to 120 minutes. Three sessions a week was the most common frequency, and 12 weeks the most common programme length.
The review looked at three parts of executive function, the mental skills that help people plan and control their behaviour. Inhibitory control is the ability to hold back an automatic or impulsive response, working memory is the capacity to hold and use information for a short time, and cognitive flexibility is the ability to switch between tasks or ways of thinking. The team also looked at internalising symptoms such as anxiety and low mood, and externalising symptoms such as aggression and defiance.
Exercise had a small but statistically significant effect on inhibitory control. It was also linked to a larger improvement in internalising symptoms. However, the evidence was rated low in certainty for inhibitory control and very low for internalising symptoms, mainly because of weaknesses in the trials and wide differences between them.
No significant effect was found for working memory, cognitive flexibility or externalising symptoms, although the result for cognitive flexibility came close to the usual threshold. The researchers stress that a non-significant result does not mean exercise was ineffective, because the range of likely effects was wide. When single trials were left out one at a time, the working memory result became statistically significant after either of two trials was dropped, while cognitive flexibility stayed non-significant. The authors say neither finding is stable.
Wang stressed the limits of the findings: “It is important to stress that exercise cannot replace standard clinical treatment”.
Session length appeared to matter for inhibitory control. Short and long sessions both showed benefits while medium-length sessions did not, and studies whose participants had a higher average body mass index tended to report smaller effects. The authors treat these patterns as exploratory and say they are not enough to set out the best exercise programme.
The study has clear limits. Only one of the 25 trials was judged at low risk of bias, 18 raised some concerns, and six were at high risk, often because randomisation was poorly described. Most participants were boys, ADHD was identified in different ways across trials, children with other conditions such as anxiety, depression or autism were excluded, and only studies in English were included.
Looking ahead, Wang said: “We plan to continue this line of work. Our follow-up research aims to identify the optimal exercise prescription, including session format, duration and intensity. We also hope to recruit more female participants and more diverse clinical samples to improve the stability and generalisability of findings”.
Earlier reviews have also found benefits for inhibitory control, though some reported gains in working memory and mental flexibility that this one did not reproduce. The authors also argue that relying on exercise alone is far from enough to ease the full range of ADHD symptoms, and that it should be combined with other support such as behaviour programmes, family guidance and psychological counselling.
