Exercise as it relates to Disease/Exercise As A Tool For Managing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder that typically presents in childhood, and is caused by an imbalance of central catecholamines (norepinepherine and dopamine) identified by biochemical, physical and cognitive tests. ADHD has 3 subtypes:
 * Attention Deficit/ Hyper Activity Disorder Predominantly Inattentive Type
 * Attention Deficit/ Hyper Activity Disorder Predominantly Hyperactive-Impulsive Type
 * Attention Deficit/ Hyper Activity Disorder Combined Type

Prevalence
ADHD is the most common behavioural disorder in children and is more prevalent in boys than girls. It is estimated a worldwide prevalence of 5.29% in those aged 18 years or under with significant variability.

Symptoms/Diagnosis
ADHD is characterised by a certain behaviour pattern that is present in more than one environment and creates social issues for those with the disorder. Symptoms include: Patients are diagnosed by the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and must meet a minimum six persistent symptoms from the last six months, that are more severe than normally observed in that developmental stage.
 * Inattentiveness
 * Hyperactivity
 * Impulsivity
 * Social Difficulty
 * Forgetfulness/Disorganisation
 * Lack of Self Control
 * Pre Frontal Cortex Abnormalities

Pharmacotherapy
ADHD is primarily managed by a range of prescription drugs that are controlled, administered and managed by a referring doctor or psychiatrist. ADHD drugs can be classified into two categories, stimulants and non stimulants with stimulants being the most common type to prescribe, however different drugs can be prescribed depending on the age and developmental status of the patient.

Psychotherapy
Psychotherapy can be used in conjunction with drug therapy, and is generally conducted by a psychologist. There have been successful studies conducted using Cognitive Behaviour Therapy (CBT) for management, but were not sustainable for longer durations. Using this technique on children also has proved validity by the therapist working on creating and developing a connection with the patient, and then focusing on changing the mental process used by the child.

Exercise
Using exercise as management for ADHD has been praised by many researchers due to the success it has seen through various studies. It has been shown that aerobic exercise can improve inhibition in children, which results in improved behavioural self-regulation. Furthermore, some longitudinal studies have seen improvements through frequent exercise and social interaction in reducing deviant behaviour and improving social interactions. Further benefits of exercise for those with ADHD include:
 * Improved physical fitness
 * Increased levels of norepinepherine, dopamine and serotonin in Pre Frontal Cortex and Hippocampus
 * Increased levels of attention and focus and reduced distractibility
 * Decreased aggressive behaviour
 * Increased feeling of well being due to endorphins
 * Assistance in goal setting
 * Reduced symptoms of anxiety and depression

Recommendations
It is important for those with ADHD to follow daily physical activity guideline which recommends a minimum 60 minutes of moderate to vigorous intensity exercise every day, with a combination of aerobic and strength exercises. Studies conducted involving exercise for ADHD patients have returned positive findings for mostly aerobic exercise, mainly due to the exercise induced release of dopamine. It is also beneficial for ADHD patients to be involved in team based exercise to enhance social skills and discipline control in an exercise and sport setting and give them a non-academic related goal setting task to work towards.