Exercise as it relates to Disease/Exercise as a prescribed treatment for ADHD

Background
Attention Deficit Hyperactive Disorder (ADHD) is a neurobehavioral developmental disorder characterised by symptoms of inattention, hyperactivity and impulsivity that is more frequent and severe than are typically seen at a given stage of development. ADHD is mostly observed in children, however it often persists into adolescence and adulthood, with some changes in symptoms.

Pathophysiology
ADHD is believed to be a dysfunction of three catecholamines: epinephrine, norepinephrine and dopamine. Low concentrations of these catecholamines have been associated with impairments in working cognitive and executive functioning.

Identification/Diagnosis
For an individual to be diagnosed with the disorder, they must have symptoms observed by a health professional for 6 or more months and to a degree that is judged to be beyond the extent that is normal for the person’s age. This should be carried out according to the symptoms defined by the Diagnostic & Statistical Manual of Mental Disorders criteria (DSM-5).



Stimulant Medication
Treatments for ADHD are predominantly via stimulant medication. These medications help normalize the production of dopamine, epinephrine, and norepinephrine. The two most common medications are Methylphenidate (Ritalin) and Amphetamine salts (Adderall).


 * Methylphenidate, the most commonly prescirbed medication, works though inhibiting dopamine reuptake.
 * Amphetamin Salts works as a dopamine releaser, a dopamine reuptake inhibitor, monoamine oxidase inhibitor (deaminates epinephrine, norepinephrine and dopamine).

However the pharmacological treatment of ADHD may have negative and unintended side effects that compromise learning and attention:

Exercise
Due to the side effects of medication treatment, Exercise should be used as another way to treat the disorder to reduce the amount of medication that is used.

Exercise has been found to be beneficial to ADHD patients. Physical exercise may be used in multiple ways to complement current therapeutic approaches in the treatment of ADHD by increasing the availability of catecholamines in the brain and regulating stress hormones and antioxidant production. Exercise may be advantageous in managing the symptoms of ADHD because the physiological effects of physical activity influences the same systems that stimulant medications for ADHD target (Catecholamines).

Physical exercise reduces stress, anxiety, and depression, negative behaviour, poor impulse control and inattentiveness. Exercise also improves attention, social behaviour, cognitive function and overall learning ability. and has thereby proved beneficial for the relief of ADHD symptoms.

Recommendations
Several studies demonstrate and confirm the effectiveness of exercise as a treatment for ADHD:


 * Participants completed a 10-week physical activity program, of 45-min periods of moderate-vigorous exercise 3 times per week. This was found to be significantly beneficial to the management of ADHD.
 * Participants completed a short 6-week physical activity program of 20-min moderate exercise 5 times per week. Results also showed a significantly beneficial effect on ADHD symptoms.

Therefore, individuals diagnosed with ADHD should spend up a minimum of 30 minutes moderate intensity exercise 5–7 days of the week in accordance to the National Physical Activity Guildelines. This would not only assist in the management of ADHD, it would provide the individual other major health benefits.