OpenLB
Open Library of Bioscience
Advanced Search
World journal of pediatrics : WJP
Mar 10, 2025;

Effects of Qigong vs. routine physical exercise in school-aged children with attention-deficit hyperactivity disorder: a randomized controlled trial.

Yu Li, Yuan-Chen He, Yin Wang, Jing-Wei He, Meng-Yao Li, Wen-Qin Wang, Zhi-Heng Wu, Yun-Jia Xu, Wen-Nan He, Ya-Lan Dou, Duo-Lao Wang, Wei-Li Yan, Da-Qian Zhu
Author Information
  1. Yu Li: Department of Psychological Medicine, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  2. Yuan-Chen He: Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  3. Yin Wang: Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  4. Jing-Wei He: Department of Traditional Chinese Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.
  5. Meng-Yao Li: Department of Psychological Medicine, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  6. Wen-Qin Wang: Department of Traditional Chinese Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.
  7. Zhi-Heng Wu: Department of Psychological Medicine, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  8. Yun-Jia Xu: Department of Psychological Medicine, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  9. Wen-Nan He: Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  10. Ya-Lan Dou: Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
  11. Duo-Lao Wang: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
  12. Wei-Li Yan: Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China. yanwl@fudan.edu.cn. ORCID
  13. Da-Qian Zhu: Department of Psychological Medicine, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China. zhudaqian2003@163.com.
PMID: 40064759 DOI: 10.1007/s12519-025-00890-x

Abstract

BACKGROUND: Increased understanding of the etiology of attention-deficit hyperactivity disorder (ADHD) emphasizes the importance of non-pharmaceutical treatments. This study compares the effects of Baduanjin exercise, a Qigong-based body therapy from traditional Chinese medicine (TCM), with routine physical exercise on school-aged children diagnosed with ADHD.
METHODS: In this two-arm, single-blind, randomized controlled trial, eligible school-aged children with ADHD were randomly assigned (1:1) to Baduanjin exercise or regular physical exercise using a permuted block randomization procedure. Both groups performed the designated exercise for at least 30 minutes a day and were monitored for exercise quality at least 5 days a week for 3 months. The primary outcome was a doctor-assessed hyperactivity/impulsivity score change, using the Swanson, Nolan, and Pelham rating scale (DSNAP_HYP) at the end of the third month since intervention initiation.
RESULTS: Between October 2020 and January 2023, 120 eligible children were randomly allocated to two exercise interventions. After 3 months, the DSNAP_HYP decreased by 3.67��������4.81 and 4.68��������4.44 of Baduanjin exercise and regular physical exercise, respectively, with no significant between-group difference [mean difference���=���1.52; 95% confidence interval (CI)���=���-���0.08 to 3.13; P���=���0.06]. No adverse events were reported during the whole study period.
CONCLUSIONS: This study did not demonstrate the expected superiority of 3-month Baduanjin exercise in improving ADHD symptoms compared with routine physical exercise. However, the results suggest that both types of exercise may improve core symptom scores, providing preliminary evidence for Baduanjin as a potential supplementary intervention for children with ADHD.

Keywords

Attention-deficit hyperactivity disorder Baduanjin exercise Executive function Qigong Traditional Chinese medicine

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013. [DOI: 10.1176/appi.books.9780890425596]
  2. Jin W, Du Y, Zhong X, David C. Prevalence and contributing factors to attention deficit hyperactivity disorder: a study of five- to fifteen-year-old children in Zhabei District, Shanghai. Asia Pac Psychiatry. 2014;6:397���404. [PMID: 24302704]
  3. Cortese S. The neurobiology and genetics of attention-deficit/hyperactivity disorder (ADHD): what every clinician should know. Eur J Paediatr Neurol. 2012;16:422���33. [PMID: 22306277]
  4. Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, et al. The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neurosci Biobehav Rev. 2021;128:789���818. [PMID: 33549739]
  5. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull. 1997;121:65���94. [PMID: 9000892]
  6. Jensen PS, Hinshaw SP, Kraemer HC, Lenora N, Newcorn JH, Abikoff HB, et al. ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry. 2001;40:147���58. [PMID: 11211363]
  7. Wolraich ML, Hagan JF Jr, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144:e20192528. [PMID: 31570648]
  8. Cortese S, Holtmann M, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, et al. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry. 2013;54:227���46. [PMID: 23294014]
  9. Brinkman WB, Simon JO, Epstein JN. Reasons why children and adolescents with attention-deficit/hyperactivity disorder stop and restart taking medicine. Acad Pediatr. 2018;18:273���80. [PMID: 28919571]
  10. Sibley MH, Bruton AM, Zhao X, Johnstone JM, Mitchell J, Hatsu I, et al. Non-pharmacological interventions for attention-deficit hyperactivity disorder in children and adolescents. Lancet Child Adolesc Health. 2023;7:415���28. [PMID: 36907194]
  11. Watson SM, Richels C, Michalek AP, Raymer A. Psychosocial treatments for ADHD: a systematic appraisal of the evidence. J Atten Disord. 2015;19:3���10. [PMID: 22647286]
  12. Me��ler CF, Holmberg HC, Sperlich B. Multimodal therapy involving high-intensity interval training improves the physical fitness, motor skills, social behavior, and quality of life of boys with ADHD: a randomized controlled study. J Atten Disord. 2018;22:806���12. [PMID: 27013028]
  13. Lee SK, Lee CM, Park JH. Effects of combined exercise on physical fitness and neurotransmitters in children with ADHD: a pilot randomized controlled study. J Phys Ther Sci. 2015;27:2915���9. [PMID: 26504324]
  14. Seiffer B, Hautzinger M, Ulrich R, Wolf S. The efficacy of physical activity for children with attention deficit hyperactivity disorder: a meta-analysis of randomized controlled trials. J Atten Disord. 2022;26:656���73. [PMID: 34041952]
  15. Choi JW, Han DH, Kang KD, Jung HY, Renshaw PF. Aerobic exercise and attention deficit hyperactivity disorder: brain research. Med Sci Sports Exerc. 2015;47:33���9. [PMID: 24824770]
  16. Xie Y, Gao X, Song Y, Zhu X, Chen M, Yang L, et al. Effectiveness of physical activity intervention on ADHD symptoms: a systematic review and meta-analysis. Front Psychiatry. 2021;12:706625. [PMID: 34764893]
  17. Huang H, Jin Z, He C, Guo S, Zhang Y, Quan M. Chronic exercise for core symptoms and executive functions in ADHD: a meta-analysis. Pediatrics. 2023;151:e2022057745. [PMID: 36510746]
  18. Ni X, Zhang-James Y, Han X, Lei S, Sun J, Zhou R. Traditional Chinese medicine in the treatment of ADHD: a review. Child Adolesc Psychiatr Clin N Am. 2014;23:853���81. [PMID: 25220091]
  19. Ying J, Han X. Research of the treatment by traditional Chinese medicine of attention deficit hyperactivity disorder. J Liaoning Univ Tradit Chin Med. 2016;18:108���10 (in Chinese).
  20. Guo YQ, Han XM, Zhu XK, Zhou Z, Ma BX, Zhang BQ, et al. Analysis of applying Chinese medical clinical pathway for treating attention-deficit hyperactivity disorder. Chin J Integr Tradit West Med. 2015;35:1469���73 (in Chinese).
  21. Zou L, Pan Z, Yeung A, Talwar S, Wang C, Liu Y, et al. A review study on the beneficial effects of Baduanjin. J Altern Complement Med. 2018;24:324���35. [PMID: 29227709]
  22. Leng Q. An experimental study in the influence of baduanjin exercise on the physical fitmess of primary school students. Shijiazhuang: Hebei Normal University; 2017 (in Chinese).
  23. Hong Y, Tian Z, Ji Z, Yang J, Wang C. A systematic review of the effect and mechanism of Daoyin therapy on improving mild cognitive impairment in older adults. Ageing Res Rev. 2024;101:102526. [PMID: 39368667]
  24. Su Y. Influence of the Baduanjin on psychological health of underclassman in a university of TCM. Fuzhou: Fujian University of Traditional Chinese Medicine; 2017 (in Chinese).
  25. Ye Y, Wan M, Lin H, Xia R, He J, Qiu P, et al. Effects of Baduanjin exercise on cognitive frailty, oxidative stress, and chronic inflammation in older adults with cognitive frailty: a randomized controlled trial. Front Public Health. 2024;12:1385542. [PMID: 38846613]
  26. Wolraich ML, Chan E, Froehlich T, Lynch RL, Bax A, Redwine ST, et al. ADHD diagnosis and treatment guidelines: a historical perspective. Pediatrics. 2019;144:e20191682. [PMID: 31570649]
  27. Friedberg JP, Lipsitz SR, Natarajan S. Challenges and recommendations for blinding in behavioral interventions illustrated using a case study of a behavioral intervention to lower blood pressure. Patient Educ Couns. 2010;78:5���11. [PMID: 19525084]
  28. Peterson BS, Trampush J, Maglione M, Bolshakova M, Rozelle M, Miles J, et al. Treatments for ADHD in children and adolescents: a systematic review. Pediatrics. 2024;153:e2024065787. [PMID: 38523592]
  29. Qiu H, Liang X, Wang P, Zhang H, Shum DHK. Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: a systematic review and meta-analysis. Asian J Psychiatr. 2023;87:103692. [PMID: 37450981]
  30. Swanson JM, Kraemer HC, Hinshaw SP, Arnold LE, Conners CK, Abikoff HB, et al. Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. J Am Acad Child Adolesc Psychiatry. 2001;40:168���79. [PMID: 11211365]
  31. Zhou J, Guo L, Chen Y. Reliability and validity of the Chinese version of Swanson, Nolan, and Pelham Version IV Rating Scale-Parent Form for attention-deficit/hyperactivity disorder. Chin Ment Heal J. 2013;27:424���8 (in Chinese).
  32. State Administration of Traditional Chinese Medicine. The criteria for the diagnosis and efficacy of TCM diseases and syndromes. Nanjing: Nanjing University Publishing House; 1994 (in Chinese).
  33. Han X, Ma R, Lei S, Qian Z. Guideline for TCM pediatrics clinical diagnosis and treatment children with hyperactivity (amendment). J Pediatr TCM. 2017;13:1���6 (in Chinese).
  34. Moher D, Hopewell S, Schulz KF, Montori V, G��tzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869. [PMID: 20332511]
  35. Cerrillo-Urbina AJ, Garc��a-Hermoso A, S��nchez-L��pez M, Pardo-Guijarro MJ, Santos G��mez JL, Mart��nez-Vizca��no V. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child Care Health Dev. 2015;41:779���88. [PMID: 25988743]
  36. Liang X, Li R, Wong SHS, Sum RKW, Sit CHP. The impact of exercise interventions concerning executive functions of children and adolescents with attention-deficit/hyperactive disorder: a systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2021;18:68. [PMID: 34022908]
  37. Vysniauske R, Verburgh L, Oosterlaan J, Molendijk ML. The effects of physical exercise on functional outcomes in the treatment of ADHD: a meta-analysis. J Atten Disord. 2020;24:644���54. [PMID: 26861158]
  38. Malik AA, Williams CA, Weston KL, Barker AR. Perceptual and prefrontal cortex haemodynamic responses to high-intensity interval exercise with decreasing and increasing work-intensity in adolescents. Int J Psychophysiol. 2018;133:140���8. [PMID: 30044953]
  39. Yu CL, Hsieh SS, Chueh TY, Huang CJ, Hillman CH, Hung TM. The effects of acute aerobic exercise on inhibitory control and resting state heart rate variability in children with ADHD. Sci Rep. 2020;10:19958. [PMID: 33203958]
  40. Schaeffer DJ, Krafft CE, Schwarz NF, Chi L, Rodrigue AL, Pierce JE, et al. An 8-month exercise intervention alters frontotemporal white matter integrity in overweight children. Psychophysiology. 2014;51:728���33. [PMID: 24797659]
  41. Li M, Fang J, Gao Y, Wu Y, Shen L, Yusubujiang Y, et al. Baduanjin mind-body exercise improves logical memory in long-term hospitalized patients with schizophrenia: a randomized controlled trial. Asian J Psychiatr. 2020;51:102046. [PMID: 32315965]
  42. Xia R, Qiu P, Lin H, Ye B, Wan M, Li M, et al. The effect of traditional Chinese mind-body exercise (Baduanjin) and brisk walking on the dorsal attention network in older adults with mild cognitive impairment. Front Psychol. 2019;10:2075. [PMID: 31551895]
  43. Doll A, H��lzel BK, Mulej Bratec S, Boucard CC, Xie X, Wohlschl��ger AM, et al. Mindful attention to breath regulates emotions via increased amygdala-prefrontal cortex connectivity. Neuroimage. 2016;134:305���13. [PMID: 27033686]
  44. Cabana-Dom��nguez J, Torrico B, Reif A, Fern��ndez-Castillo N, Cormand B. Comprehensive exploration of the genetic contribution of the dopaminergic and serotonergic pathways to psychiatric disorders. Transl Psychiatry. 2022;12:11. [PMID: 35013130]
  45. Koirala S, Grimsrud G, Mooney MA, Larsen B, Feczko E, Elison JT, et al. Neurobiology of attention-deficit hyperactivity disorder: historical challenges and emerging frontiers. Nat Rev Neurosci. 2024;25:759���75. [PMID: 39448818]
  46. Volkow ND, Wang GJ, Kollins SH, Wigal TL, Newcorn JH, Telang F, et al. Evaluating dopamine reward pathway in ADHD: clinical implications. JAMA. 2009;302:1084���91. [PMID: 19738093]
  47. Halperin JM, Healey DM. The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: can we alter the developmental trajectory of ADHD? Neurosci Biobehav Rev. 2011;35:621���34. [PMID: 20691725]
  48. Berchtold NC, Chinn G, Chou M, Kesslak JP, Cotman CW. Exercise primes a molecular memory for brain-derived neurotrophic factor protein induction in the rat hippocampus. Neuroscience. 2005;133:853���61. [PMID: 15896913]

Grants

  1. NO.19401931200/Science and Technology Commission of Shanghai Municipality
Journal Article

Word Cloud

Created with Highcharts 10.0.0exerciseBaduanjinADHDphysicalchildrenhyperactivitystudyroutineschool-agedattention-deficitdisorderChinesemedicinerandomizedcontrolledtrialeligiblerandomlyregularusingleast3 monthsDSNAP_HYPintervention3QigongBACKGROUND:Increasedunderstandingetiologyemphasizesimportancenon-pharmaceuticaltreatmentscompareseffectsQigong-basedbodytherapytraditionalTCMdiagnosedMETHODS:two-armsingle-blindassigned1:1permutedblockrandomizationproceduregroupsperformeddesignated30 minutesdaymonitoredquality5 daysweekprimaryoutcomedoctor-assessedhyperactivity/impulsivityscorechangeSwansonNolanPelhamratingscaleendthirdmonthsinceinitiationRESULTS:October2020January2023120allocatedtwointerventionsdecreased67��������481468��������444respectivelysignificantbetween-groupdifference[meandifference���=���15295%confidenceintervalCI���=���-���00813P���=���006]adverseeventsreportedwholeperiodCONCLUSIONS:demonstrateexpectedsuperiority3-monthimprovingsymptomscomparedHoweverresultssuggesttypesmayimprovecoresymptomscoresprovidingpreliminaryevidencepotentialsupplementaryEffectsvsdisorder:Attention-deficitExecutivefunctionTraditional

Similar Articles

Cited By

No available data.