Table 5.

Studies addressing physical activity interventions

Study Title	Type of Study	Population	Intervention Framing	Aims	Intervention	Relevant Outcome Measures	Relevant Findings
Converse et al., 2020 [56]	RCT (between group comparisons)	N=21 (33% M), USA. 18-23 year olds undergraduates with a documented ADHD diagnosis.	Factors such as medication intolerance or risk of diversion mean non-pharmacological options are required for ADHD treatment.	The aims here were to study feasibility of maintaining a 7-week Tai Chi intervention.	Tai Chi sessions (2x1hrs/week) versus ‘box blast’ fitness class vs inactive trial	PSQI, SF-36 (physical functioning).	Significant improvements in physical functioning (SF-36) (p<0.0001), non-significant improvements in sleep as per PSQI. Mean attendance at tai chi 3.7/14 classes (not recorded for active control). Subjective feedback
Schoenfelder et al., 2017 [69]	Single group intervention study (pre vs post comparison)	N=11 (46% M), USA. 14-18a year olds with clinically-diagnosed ADHD	Low acceptability of pharmacological ADHD treatment in adolescents leaves them at risk of behavioural and functional impairment. Physical activity may help ADHD symptoms and mood.	The study aimed to see the feasibility and acceptability of an m-health intervention to increase daily physical activity amongst adolescents with ADHD.	Four weeks of wearing a FitBit and receiving individualised activity goal, with a Facebook group and SMS messages	Step count.	Significant increase in steps (p=0.005). Themes from qualitative interviews included increased awareness of activity levels and ADHD symptoms. Suggested improvement was reminders within the app.
Bjork et al., 2020 [54]	Single group intervention study (pre vs post comparison)	N=48 (mean age 36 (standard deviation, 11)a 40% M), Sweden. Adults with self-reported ADHD and a self-reported mental illness.	Physical comorbidity in ADHD may be related to behavioural and mental health.	The aim was to develop a lifestyle intervention and evaluate its mental/physical health impacts.	20 week health education programme exploring relationships, health education and cognitive support.	Body Mass Index (BMI), waist circumference, Lifestyle-Performance-Health Questionnaire (measuring sedentary habits, eating habits, tobacco use and weekly physical activity), VO2 max (a measure of aerobic fitness).	Slight improvements in weekly physical activity (p=0.019) and more physical activity, but no significant improvements in tobacco use or eating habits. General health significantly improved (p=0.025) as per Lifestyle Performance Health Questionnaire. No significant improvements in Vo2 max. No significant changes in bdoy habitus. At least 70% of sessions were attended by all participants.
Mayer et al., 2018 [70]	RCT (between /within group comparisons)	14-30 year olds, meeting DSM-V ADHD criteria for ADHD. Protocol Study, Germany	There is a significant association between ADHD and obesity. There is poor evidence around treatment.	The aim is to understand the efficacy of an exercise/bright light therapy intervention on depression and obesity.	Bright light therapy (6x/week, 30m exposure) and an app-facilitated exercise intervention around aerobic/muscle strength training.	Physical Activity Readiness Scale, questions on sleep behaviour, EuroQol-5 Dimensions-3 Levels (EQ-5D-3L; a measure of self-reported health), SF-36 (self-reported health), Munich Chronotype Questionnaire, lower limb explosive strength, grip strength, BMI, body composition, waist circumference, International Fitness Scale, concentrations of melatonin, cortisol, leptin, and ghrelin, Fagerström Test for Nicotine Dependence, Yale Food Addiction Scale.	Not recorded.
Lindvall et al., 2023 [71]	RCT Protocol	N=120 adults with diagnosed ADHD from an outpatient psychiatry clinic (Sweden) and internet/ social-media channels	Exercise has positive effects on ADHD symptoms. There is evidence that people with ADHD struggle with routines and being active. It is possible that a structured physical activity intervention may be beneficial.	This study aims to evaluate a 12 week mixed exercise programme (Stöd i Aktivitet, Rörelse och Träning (START) intervention), with or without cognitive skills training, in relation to ADHD symptoms, as well as physical/cognitive functions and experiences of daily living.	12 week physiotherapist-led physical training (START, 45 minute sessions, 3 per week) (N=40), +/- occupational therapist led person-centred intervention (6 sessions) (N=40), versus treatment as usual (i.e. continued normal pharmacological/non-pharmacological management) (N=40)	EQ-5D-5 L (EuroQol measure of health status and quality of life), Ekblom-Bak submaximal exercise test (VO2 max), Flamingo balance test, grip strength, Body Awareness Scale-Movement Quality and Experience	Prospective (estimated completion of trial in Autumn 2024)
Silva et al (2020) [72]	RCT (within group comparison)	N=33 children (aged 11-14) with previously diagnosed ADHD. Brazil.	Individuals with ADHD may have poorer executive function and higher levels of mood disorders/stress than peers. Medication may cause adverse side effects. Exercise has eben noted to be effective in modulated both mood and ADHD symptoms.	This study aimed to evaluate a swimming training intervention on physical/mental health outcomes.	Swimming training, (45 minute sessions, 2/week, 8 weeks). Control arm intervention ‘untrained’ (no further detail given).	Motor coordination tests and laterality of lower limbs, flexibility (sit and reach test), abdominal resistance test	Per protocol analysis shows significant improvements in motor coordination and laterality of lower limbs, flexibility and abdominal resistance measures in the trained group (p<0.05), but not in the untrained group. 14/18 had >70% intervention adherence in the trained group.

Under population, N denotes sample size, %M denotes the percentage of men in each study

^astudies which include an age range broader than 16-25