The effect of physical activity on quality of life and parenting stress in children with ADHD: A randomised controlled trial
Abstract
Background
Poorer quality of life (QoL) is commonly observed in children with Attention-deficit/Hyperactivity Disorder (ADHD). Parents of children with ADHD also perceived elevated levels of parenting stress. Previous research has documented the positive effects of physical activity (PA) on managing ADHD symptoms. It is critical to implement ADHD management with broader functioning from both children's and parents' perspectives.
Objective
This study aimed to examine whether PA would exert an influence on the QoL of children with ADHD and parenting stress of their parents.
Methods
Forty-three children with ADHD (6–12 years) were randomly assigned to the PA intervention and waitlist control groups. Children in the intervention group participated in a 12-week PA program. Parent-reported QoL and parenting stress were assessed before and immediately after the intervention. Analysis of covariance with a mixed factorial design of 2 (time: before vs. after intervention) × 2 (group: PA intervention vs. waitlist control) was conducted to examine changes in QoL and parenting stress over the 12 weeks.
Results
Compared to the control group, parents of children in the intervention group reported significant reduced overall parenting stress (p = .021, η2 = 0.142) and child domain of parenting stress (p = .024, η2 = 0.138) after the intervention. No significant improvement in QoL was documented in either group.
Conclusions
The participation of PA intervention positively impacts parenting stress perceived by parents of children with ADHD, which provides further evidence of the family-wide benefits of the PA intervention.
Section snippets
Participants
We recruited participants from the outpatient of Children's Healthcare & Mental Health Center at Shenzhen Children's Hospital in Shenzhen, China between August 2020 and September 2020. Participants and their parents underwent a standard structured interview by an experienced psychiatrist using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime (K-SADS-PL).29The inclusion criteria include: (1) aged 6–12 years attending regular primary
Sample characteristics and protocol adherenc
A total of 43 children met the inclusion criteria and participated in this study. Table 2 demonstrates the baseline characteristics of the sample. Most of the children were boys, were medication-naïve, and were diagnosed as inattentive or combined subtype of ADHD. We found no differences between groups at baseline (T1) on all demographic data (all ps > .08, Table 2), QoL (all ps > .10, Table 3), and parenting stress (all ps > .29, Table 3).
Discussion
The main purpose of the present study was to evaluate the effectiveness of a PA intervention program on the QoL of children with ADHD and the parenting stress of their parents. The findings documented significant decreases in overall parenting stress following participation in the program. The use of PSI-SF-15 allowed for analysis of three aspects of parenting stress and addressed that decreases in parenting stress were mainly specific to the child domain (i.e., difficult child). PA
Conclusions
The present study provides preliminary evidence that participation in PA intervention positively impacts on parenting stress, and with a particular influence on stress in relation to the child domain. Continued research may help to clarify whether nonsignificant changes on QoL are linked to perception bias of parents or inadequate PA volumes. This study sets the scene for future research to investigate the wide-reaching effects of PA intervention for parents and families of children with ADHD.
Acknowledgments
We thank for all participants and their parents for their great contribution to this study. We also appreciate the research staff and graduate research assistants, including Dr. Xiao Liang, Ms. Fang Liu, Ms. Rongsang Fu, Ms. Yiman Yu, Ms. Qingqing Jiang, Ms. Siyi Yan, Ms. Zhuo Wang, Ms. Danping Li, Mr. Jian Lin, Mr. Henian Li, Mr. Yongshen Lu, Mr. Peng Wang, for their great help in the intervention. The authors declared no conflicts of interest.