Comparative effectiveness of physical activity interventions on cognitive functions in children and adolescents with Neurodevelopmental Disorders: a systematic review and network meta-analysis of randomized controlled trials

Tao, Ruiyuan; Yang, Yijian; Wilson, Mark; Chang, Jeremy R.; Liu, Chang; Sit, Cindy H. P.

doi:10.1186/s12966-024-01702-7

International Journal of Behavioral Nutrition and Physical Activity

Table 2 Characteristics of included studies

From: Comparative effectiveness of physical activity interventions on cognitive functions in children and adolescents with Neurodevelopmental Disorders: a systematic review and network meta-analysis of randomized controlled trials

Study (year; country/region)	Participants; Diagnostic Methods	Sample Size	Age (years)	Gender (% male)	Medication	Treatment	Node	Length	Duration per session	Frequency	Intensity	Cognitive Function Outcomes
Ahmed & Mohamed, 2011 [68] Egypt	ADHD; Clinical	42	11.0–16.0	64.3	NI	Running	AE	10 weeks	40–50 min	3 sessions/week	Moderate	Attention: MCRS
Ahmed & Mohamed, 2011 [68] Egypt	ADHD; Clinical	42	11.0–16.0	64.3	NI	No treatment control	UC
Benzing & Schmidt, 2019 [69] Switzerland	ADHD; ICD-10	28	10.5 ± 1.3	86.4	Y	Xbox Kinect: workout games	Exergaming	8 weeks	30 min	3 sessions/week	MVPA	Memory: CSBT EF: Simon Task, Flanker Task
Benzing & Schmidt, 2019 [69] Switzerland	ADHD; ICD-10	23	10.4 ± 1.4	81.8	Y	Waiting-list control	UC					Memory: CSBT EF: Simon Task, Flanker Task
Borgi et al., 2016 [70] Italy	ASD; DSM-IV	15	9.2 ± 1.8	100.0	NI	Equine-assisted therapy	MPA	6 months	60–70 min	1 session/week	NI	EF: TOL
Borgi et al., 2016 [70] Italy	ASD; DSM-IV	13	8.0 ± 1.5	100.0	NI	Waiting-list control	UC					EF: TOL
Bustamante et al., 2016 [71] USA	ADHD; DSM-IV	19	9.4 ± 2.2	69.0	Y	Aerobic activity	AE	10 weeks	60 min	5 sessions/week	MVPA	Memory: AWMA-S EF: SST, BRIEF
Bustamante et al., 2016 [71] USA	ADHD; DSM-IV	16	8.7 ± 2.0	68.0	Y	Sedentary arts activity	UC					Memory: AWMA-S EF: SST, BRIEF
Chan et al., 2013 [72] Hong Kong SAR	ASD; DSM-IV	23	11.3 ± 3.9	95.0	N	Nei Yang Gong	MBE	4 weeks	18 min	3–6 sessions/week	Moderate	EF: TOL, CCTT-T2, FPT
Chan et al., 2013 [72] Hong Kong SAR	ASD; DSM-IV	23	12.4 ± 3.3	85.0	N	Progressive muscle relaxation	RT					EF: TOL, CCTT-T2, FPT
Chang et al., 2022 [73] Taiwan	ADHD; DSM-V	16	8.3 ± 1.3	81.3	Y	Table tennis	MPA	12 weeks	60 min	3 sessions/week	NI	EF: Stroop Task, WCST
		16	8.4 ± 1.2	81.3		Nintendo Wii fit training	Exergaming	12 weeks	60 min	3 sessions/week	NI
		16	8.4 ± 1.3	81.3		No treatment control	UC
Choi et al., 2015 [74] Korea	ADHD; DSM-IV	17	15.8 ± 1.7	100.0	Y	Running, rope-jumping, basketball	MPA	6 weeks	90 min	3 sessions/week	Moderate	EF: WCST
Choi et al., 2015 [74] Korea	ADHD; DSM-IV	18	16.0 ± 1.2	100.0	Y	Educational sessions	UC					EF: WCST
Damanpak & Sabzi., 2022 [75] Iran	DCD; DCDQ	15	10.8 ± 0.4	100.0	NI	Sensory-motor games	MPA	8 weeks	45–60 min	3 sessions/week	NI	EF: CEFS
Damanpak & Sabzi., 2022 [75] Iran	DCD; DCDQ	15	10.6 ± 0.5	100.0	NI	No treatment control	UC					EF: CEFS
Emami Kashfi et al., 2019 [76] Iran	SLD; Psychologist	15	8.7 ± 0.6	NI	NI	Perceptual-motor activities	MPA	8 weeks	55 min	3 sessions/week	NI	Attention: CPT Memory: N-Back test EF: TOL
Emami Kashfi et al., 2019 [76] Iran	SLD; Psychologist	15	8.5 ± 0.7	NI	NI	Regular educational services	UC					Attention: CPT Memory: N-Back test EF: TOL
Geladé et al., 2017 [77] Netherlands	ADHD; DSM-IV	37	9.8 ± 2.0	75.7	NI	Repetitive interval training	AE	28 sessions	45 min	3 sessions/week	MVPA	Attention: AOT Memory: VSWM EF: SST
Geladé et al., 2017 [77] Netherlands	ADHD; DSM-IV	39	10.0 ± 1.9	76.9	NI	Neurofeedback	NF					Attention: AOT Memory: VSWM EF: SST
Greco & De Ronzi, 2020 [78] Italy	ASD; ADOS-2	14	9.1 ± 1.0	85.7	NI	Karate	MBE	12 weeks	45 min	2 seesions/week	NI	EF: BRIEF
Greco & De Ronzi, 2020 [78] Italy	ASD; ADOS-2	14	9.4 ± 1.0	85.7	NI	Waiting-list control	UC					EF: BRIEF
Hashmi et al., 2022 [79] Iran	DCD; DSM-V	25	9.4 ± 2.1	100.0	NI	Nintendo Wii fit training	Exergaming	8 weeks	30 min	3 sessions/week	NI	Attention: CAS-attention Memory: TVPA-R EF: CAS-planning
Hashmi et al., 2022 [79] Iran	DCD; DSM-V	25	9.7 ± 2.4	100.0	NI	Usual care	UC					Attention: CAS-attention Memory: TVPA-R EF: CAS-planning
Hattabi et al., 2019 [80] Tunisia	ADHD; DSM-IV	20	10.0 ± 1.3	85.0	NI	Aquatic activities	MPA	12 weeks	90 min	3 sessions/week	Moderate	Memory: ROCF EF: Stroop, JHT
Hattabi et al., 2019 [80] Tunisia	ADHD; DSM-IV	20	9.8 ± 1.3	90.0	NI	No treatment control	UC					Memory: ROCF EF: Stroop, JHT
Ji & Yang, 2022 [81] China	ASD; ICD-10	49	13.1 ± 3.0	51.5	NI	Football	MPA	6 weeks	60 min	3 sessions/week	NI	Attention: MOT
Ji & Yang, 2022 [81] China	ASD; ICD-10	50	12.8 ± 2.7	54.6	NI	Psychological counseling	UC					Attention: MOT
Ji et al., 2023 [82] Republic of Korea	ADHD; Clinical	21	9.0 ± 1.5	88.0	Y	Alchemist’s Treasure	Exergaming	4 weeks	50 min	3 sessions/week	MVPA	Attention: FAIR
Ji et al., 2023 [82] Republic of Korea	ADHD; Clinical	19	8.9 ± 1.6	86.0	Y	Stationary bike exercise	AE	4 weeks	50 min	3 sessions/week		EF: GNG
Kadri et al., 2019 [83] Tunisia	ADHD; Psychologist	20	14.5 ± 3.5	90.0	N	Taekwondo	MBE	1.5 years	50 min	2 seesions/week	NI	Attention: Ruff 2 & 7 EF: Stroop Task
Kadri et al., 2019 [83] Tunisia	ADHD; Psychologist	20	14.2 ± 3.0	90.0	N	Usual PE class	UC					Attention: Ruff 2 & 7 EF: Stroop Task
Lee et al., 2017 [84] Republic of Korea	ADHD; DSM-IV	6	8.8 ± 1.0	100.0	N	Ball and Rope-jumping	MPA	12 weeks	60 min	3 sessions/week	MVPA	EF: Stroop
Lee et al., 2017 [84] Republic of Korea	ADHD; DSM-IV	6	8.8 ± 1.0	100.0	N	No treatment control	UC					EF: Stroop
Liang et al., 2022 [85] China	ADHD; DSM-V	40	8.4 ± 1.4	30.8	N	AE and ball games	MPA	12 weeks	60 min	3 sessions/week	MVPA	EF: TOL, Flanker Task, TMT
Liang et al., 2022 [85] China	ADHD; DSM-V	40	8.3 ± 1.3	32.8	N	Waiting-list control	UC					EF: TOL, Flanker Task, TMT
Ludyga et al., 2022 [86] Switzerland	ADHD; DSM-V	31	10.8 ± 1.2	62.1	NI	Judo	MBE	12 weeks	60 min	2 sessions/week	Moderate	Memory: CDT
Ludyga et al., 2022 [86] Switzerland	ADHD; DSM-V	32	10.0 ± 1.2	79.3	NI	Waiting-list control	UC					Memory: CDT
Memarmoghaddam et al., 2016 [87] Iran	ADHD; Psychiatrist	20	8.3 ± 1.3	100.0	N	Running and ball games	MPA	8 weeks	90 min	3 sessions/week	MVPA	EF: Stroop Task, GNG
Memarmoghaddam et al., 2016 [87] Iran	ADHD; Psychiatrist	20	8.3 ± 1.3	100.0	N	No treatment control	UC					EF: Stroop Task, GNG
Nejati & Derakhshan, 2021 [88] Iran	ADHD; DSM-V	15	9.4 ± 1.4	86.7	NI	Goal-directed exercise	MPA	4–5 weeks	40–50 min	3 sessions/week	NI	Memory: One-Back Task EF: GNG, WCST
Nejati & Derakhshan, 2021 [88] Iran	ADHD; DSM-V	15	9.7 ± 2.4	86.7	NI	Running	AE	4–5 weeks	40–50 min	3 sessions/week		Memory: One-Back Task EF: GNG, WCST
Pan et al., 2016 [89] Taiwan	ADHD; DSM-IV	16	8.9 ± 1.5	100.0	Y	Racket sport	MPA	12 weeks	70 min	2 sessions/week	NI	EF: Stroop Task
Pan et al., 2016 [89] Taiwan	ADHD; DSM-IV	16	8.9 ± 1.6	100.0	Y	Waiting-list control	UC					EF: Stroop Task
Pan et al., 2017 [90] Taiwan	ASD; DSM-IV	11	9.7 ± 1.6	100.0	Y	Racket sport	MPA	12 weeks	70 min	2 sessions/week	NI	EF: WCST
Pan et al., 2017 [90] Taiwan	ASD; DSM-IV	11	8.5 ± 1.8	100.0	Y	Waiting-list control	UC					EF: WCST
Phung & Goldberg, 2019 [91] USA	ASD; ADOS-2	14	9.1 ± 1.1	100.0	NI	Martial Arts	MBE	13 weeks	45 min	2 seesions/week	LMPA	EF: Hearts & Flowers test
Phung & Goldberg, 2019 [91] USA	ASD; ADOS-2	20	9.5 ± 1.1	70.0	NI	Waiting-list control	UC					EF: Hearts & Flowers test
Rafiei Milajerdi et al., 2021 [92] Iran	ASD; ADOS-2	20	8.2 ± 1.5	95.0	Y	SPARK	MPA	8 weeks	35 min	3 sessions/week	LMPA	EF: WCST
		20	8.0 ± 1.6	95.0		Exergaming	Exergaming	8 weeks	35 min	3 sessions/week	LMPA
		20	8.5 ± 1.4	95.0		No treatment control	UC
Rezaei et al., 2018 [93] Iran	ADHD; DSM-V	7	7.0–11.0	NI	NI	Yoga	MBE	8 weeks	45 min	3 sessions/week	NI	Attention: CPT Memory: WISC-LNST
		7		NI		Neurofeedback	NF
		7		NI		No treatment control	UC
Sani et al., 2022 [94] Iran	ADHD; DSM-V	25	7.5 ± 1.3	80.0	NI	Perceptual-motor exercises	MPA	20 sessions	40–45 min	3 sessions/week	NI	Attention: CPT
Sani et al., 2022 [94] Iran	ADHD; DSM-V	25	7.8 ± 1.3	65.0	NI	Neurofeedback	NF					Attention: CPT
Silva et al., 2020 [95] Brazil	ADHD; DSM-IV	18	12.0 ± 2.0	80.0	Y	Aquatic activities	MPA	8 weeks	45 min	2 seesions/week	NI	Attention: CAT EF: The Test of Trails
Silva et al., 2020 [95] Brazil	ADHD; DSM-IV	15	12.0 ± 1.0	60.0	Y	No treatment control	UC					Attention: CAT EF: The Test of Trails
Tse et al., 2019 [96] Hong Kong SAR	ASD; DSM-V	25	10.1 ± 1.2	73.7	Y	Basketball	MPA	12 weeks	45 min	2 sessions/week	Moderate	Memory: CBTT, DSFBT EF: GNG
Tse et al., 2019 [96] Hong Kong SAR	ASD; DSM-V	25	9.8 ± 1.2	85.7	Y	No treatment control	UC					Memory: CBTT, DSFBT EF: GNG
Tse et al., 2021 [35] Hong Kong SAR	ASD; DSM-V	22	9.6 ± 1.6	80.0	Y	Stationary cycling	AE	2 weeks	60 min	5 sessions/week	LMPA	Memory: CBTT, DSFBT EF: TOL, GNG, SCWT
		22	10.2 ± 1.7	86.4	Y	Mobile cycling	MPA	2 weeks	60 min	5 sessions/week	LMPA
		22	9.9 ± 1.3	75.0	Y	No treatment control	UC
Tse et al., 2023 [97] Hong Kong SAR	ASD;	25	9.6 ± 1.4	87.0	Y	Mobile cycling	MPA	2 weeks	60 min	5 sessions/week	LMPA	EF: SCWT, GNG
Tse et al., 2023 [97] Hong Kong SAR	SRS-2	25	10.2 ± 1.4	68.4	Y	Stationary cycling	AE	2 weeks	60 min	5 sessions/week	LMPA	EF: SCWT, GNG

ADHD attention-deficit/hyperactivity disorder, ASD autism spectrum disorder, DCD developmental coordination disorder, SLD specific learning disorder; ADOS-2 Autism Diagnostic Observation Schedule-2nd Edition, DCDQ The Developmental Coordination Disorder Questionnaire, DSM-IV/V Diagnostic and Statistical Manual of Mental Disorders-4th/5th editions, ICD-10 International Classification of Diseases, 10th edition, SNAP-IV Swanson, Nolan, and Pelham-4th edition, SRS-2 Social Responsiveness Scale-2nd Edition; Y yes, N no, NI no information; LMPA light-to-moderate physical activity, MVPA moderate-to-vigorous physical activity; AE aerobic exercise, MBE mind–body exercise, MPA multicomponent physical activity, RT relaxation techniques, NF neurofeedback, UC usual care; EF executive functions; AOT Auditory Oddball Task, AWMA-S Automated Working Memory Assessment System—Short version, CAS Cognitive Assessment System, CAT Cancellation Attention Test, CBTT Corsi block tapping task, CCTT-T2 Children’s Color Trails Test-Second Trial, CDT Change Detection Task, CEFS Coolidge Executive Functioning Scale, CPT Continuous Performance Test, CSBT Color Span Backward Task, DSFBT Digit Span Forward and Backward Test, FAIR Frankfurter Aufmerksamkeits-Inventar, FPT Five Point Test, GNG Go/No-Go Task, JHT Junior Hayling Test, LNST Letter-Number Sequencing Test, MCRS Modified Conner’s Rating Scale, MOT Multiple Object Tracking Paradigm, NEPSY-II Developmental Neuropsychological Assessment, ROCF Rey Complex Figure, SCWT Stroop Color and Word Test, SPARK Sports, Play and Active Recreation for Kids, SST Stop-Signal Task, TMT Trail Making Test, TOL Tower of London, TVPA-R Test of Visual-Perceptual Skills-Revised, VSWM Visual Spatial Working Memory Task, WCST Wisconsin Card Sorting Test, WISC Wechsler Intelligence Scale for Children

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