title: Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders.
abstract: The objective of this study is to test the feasibility and impact of a 10-wk after-school exercise program for children with attention deficit hyperactivity disorder and/or disruptive behavior disorders living in an urban poor community.
  
  
  
  Children were randomized to an exercise program (n = 19) or a comparable but sedentary attention control program (n = 16). Cognitive and behavioral outcomes were collected pre-/posttest. Intent-to-treat mixed models tested group-time and group-time-attendance interactions. Effect sizes were calculated within and between groups.
  
  
  
  Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum HR. Group-time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d = 0.47) and verbal working memory (d = 0.26), and controls on visuospatial working memory (d = -0.21) and oppositional defiant symptoms (d = -0.37). In each group, within-group effect sizes were moderate to large on most outcomes (d = 0.67 to 1.60). A group-time-attendance interaction emerged on visuospatial working memory (F[1,33] = 7.42, P < 0.05), such that attendance to the control program was related to greater improvements (r = 0.72, P < 0.01), whereas attendance to the exercise program was not (r = 0.25, P = 0.34).
  
  
  
  Although between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features, such as routines, engaging activities, behavior management strategies, and adult attention, and highlight the potential for after-school programs to benefit children with attention deficit hyperactivity disorder and disruptive behavior disorder living in urban poverty where health needs are high and services resources few.
authors.affiliation: 1Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL; 2Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA; 3Center for Children and Families, Department of Psychology, Florida International University, Miami, FL; 4Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; and 5Department of Community Systems and Mental Health Nursing, College of Nursing, Rush University, Chicago, IL.
authors.forename: Eduardo Esteban
authors.initials: EE
authors.lastname: Bustamante
authors.forename: Catherine Lucy
authors.initials: CL
authors.lastname: Davis
authors.forename: Stacy Lynn
authors.initials: SL
authors.lastname: Frazier
authors.forename: Dana
authors.initials: D
authors.lastname: Rusch
authors.forename: Louis F
authors.initials: LF
authors.lastname: Fogg
authors.forename: Marc S
authors.initials: MS
authors.lastname: Atkins
authors.forename: David Xavier
authors.initials: DX
authors.lastname: Marquez
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D056344:Executive Function; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term
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