Dikkat eksikliği hiperaktivite bozukluğu olan çocuklarda kombine egzersiz eğitiminin fiziksel uygunluk, akademik başarı ve sosyal ilişkiler üzerine etkisinin incelenmesi

Yıl 2023, Cilt: 10 Sayı: 3, 194 - 210, 29.12.2023

Arzu Demircioğlu Karagöz Songül Atasavun Uysal Osman Dağ Gülser Şenses Dinç Halime Tuna Çak Esen

https://doi.org/10.15437/jetr.1258411

Öz

Amaç: Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) yaşa ve gelişim düzeyine uygun olmayan dikkatsizlik, hiperaktivite ve dürtüsellik ile karakterize nörogelişimsel bir bozukluktur. Okul çağı çocuklarda kliniklere başvuru sıklığı oldukça artmaktadır. Bu araştırma okul çağı DEHB’li çocuklarda kombine egzersiz eğitiminin fiziksel uygunluk, yürüme hızı, akademik başarı ve sosyal ilişkiler üzerine etkisinin incelenmesi amacıyla yürütüldü.
Yöntem: Çocuklar kapalı zarf yöntemi ile randomize olarak fizyoterapist gözetimindeki egzersiz grubu (n=10), ebeveyn gözetimindeki egzersiz grubu (n=10) ve kontrol grubu (n=10) olmak üzere üç gruba ayrıldı. Katılımcıların fiziksel uygunlukları Münih Fiziksel Uygunluk Testi, yürüme hızları 10 metre yürüme testi, akademik başarı ve sosyal ilişkileri açık uçlu sorularla değerlendirildi.
Bulgular: Egzersiz eğitimi sonrası normal hızda yapılan 10 metre yürüme testi dışında kalan sonuç ölçümlerinde istatistiksel olarak anlamlı düzeyde iyileşme olduğu bulundu (p<0,05). Özellikle fizyoterapist gözetiminde yapılan egzersiz grubunda çocuk, ebeveyn ve öğretmen tarafından verilen cevaplarda kombine egzersiz eğitiminin akademik başarı ve sosyal ilişkiler üzerine etkili olduğu gösterildi.
Sonuç: DEHB’li çocuklarda kombine egzersiz eğitiminin fiziksel uygunluk, akademik başarı ve sosyal ilişkiler üzerine olumlu etkilerinin olduğu gösterildi. Okullarda, özel eğitim okullarında ve rehabilitasyon merkezlerinde DEHB’li çocuklara özel fiziksel aktivite ve egzersiz programları geliştirilmesinin gerekliliği bu araştırma ile desteklenmektedir.

Anahtar Kelimeler

Dikkat eksikliği hiperaktivite bozukluğu, çocuk, fiziksel uygunluk, akademik başarı

Destekleyen Kurum

Hacettepe Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi

Proje Numarası

THD-2020-18912

Teşekkür

Yazarlar bu araştırmanın yürütülmesinde desteğini esirgemeyen Dr. Muratberk Ada’ya ve Hacettepe Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi’ne teşekkür eder.

Investigation of the effect of combined exercise training on physical fitness, academic achievement and social relations in children with attention deficit hyperactivity disorder

Öz

Purpose: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity that are inappropriate for age and developmental level. The frequency of admission to clinics is increasing in school-age children. This study was conducted to examine the effects of combined exercise training on physical fitness, walking speed, academic achievement and social relations in school-age children with ADHD.
Methods: The children were randomly divided into three groups: the exercise group under the supervision of a physiotherapist (n=10), the parent-supervised exercise group (n=10), and the control group (n=10). The physical fitness of the participants was evaluated by Munich Physical Fitness Test, walking speed by 10 meters walking test, academic achievement and social relations were evaluated with open-ended questions.
Results: It was found that there was a statistically significant improvement in the results except the 10-meter walking test performed at normal speed after the exercise training (p<0.05). Especially in the exercise group under the supervision of a physiotherapist, the answers given by the child, parent and teacher showed that combined exercise training was effective on academic achievement and social relations.
Conclusion: It has been shown that combined exercise training has positive effects on physical fitness, academic achievement and social relations in children with ADHD. The necessity of developing special physical activity and exercise programs for children with ADHD in schools, special education schools and rehabilitation centers is supported by this research.

Anahtar Kelimeler

Attention deficit hyperactivity disorder, child, physical fitness, academic success

Proje Numarası

THD-2020-18912

Kaynakça

• Gül H, Öncü B. Dikkat eksikliği hiperaktivite bozukluğunun etyolojisinde çevresel etkenler. Psikiyatr Güncel Yaklaşımlar. 2018;10:138-175.
• Ercan ES, Kandulu R, Uslu E, et al. Prevalence and diagnostic stability of ADHD and ODD in Turkish children: a 4-year longitudinal study. Child Adolesc Psychiatry Ment Health. 2013;7:1-10.
• Ercan ES. Dikkat eksikliği hiperaktivite bozukluğunda epidemiyolojik veriler. Turkiye Klinikleri J Pediatr Sci. 2010;6:1-5.
• Khalife N, Kantomaa M, Glover V, et al. Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence. J Am Acad Child Adolesc Psychiatry. 2014;53:425-436.
• Kaiser ML, Schoemaker MM, Albaret JM, et al. What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Res Dev Disabil. 2015;36:338-357.
• Fliers EA, Buitelaar JK, Maras A, et al. ADHD is a risk factor for overweight and obesity in children. J Dev Behav Pediatr. 2013;34:1-15.
• Taraldsen K, Helbostad JL, Follestad T, et al. Gait, physical function, and physical activity in three groups of home-dwelling older adults with different severity of cognitive impairment–a cross-sectional study. BMC Geriatr. 2021;21:1-8.
• Naruse H, Fujisawa TX, Yatsuga C, et al. Increased anterior pelvic angle characterizes the gait of children with Attention Deficit/Hyperactivity Disorder (ADHD). PLoS One. 2017;12:e0170096.
• Möhring W, Klupp S, Grob A. Effects of dual tasking and methylphenidate on gait in children with attention deficit hyperactivity disorder. Hum Mov Sci. 2018;62:48-57.
• Bustos L, Schneider A, Wright A. Gait and attention deficit/hyperactivity disorder: A review. J Low Limb Med. 2019;6:10-13.
• Balcı G. Dikkat eksikliği ve hiperaktivite bozukluğu olan çocuklarda duyu profilleri ve fiziksel aktivite kapasitesinin katılım üzerine olan etkisinin incelenmesi. Hacettepe Üniversitesi. Yüksek Lisans Tezi.
• Arnold LE, Hodgkins P, Kahle J, et al. Long-term outcomes of ADHD: academic achievement and performance. J Atten Disord. 2020;24:73-85.
• De Boo GM, Prins PJ. Social incompetence in children with ADHD: Possible moderators and mediators in social-skills training. Clin Psychol Rev. 2007;27:78-97.
• Buck SM, Hillman CH, Castelli DM. The relation of aerobic fitness to stroop task performance in preadolescent children. Med Sci Sports Exerc. 2008;40:166-172.
• Meßler 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;22:806-812.
• Halperin JM, Bédard ACV, Curchack-Lichtin JT. Preventive interventions for ADHD: a neurodevelopmental perspective. Neurotherapeutics. 2012;9:531-541.
• Pan CY, Chang YK, Tsai CL, et al. Effects of physical activity intervention on motor proficiency and physical fitness in children with ADHD: An exploratory study. J Atten Disord. 2017;21:783-795.
• Harvey WJ, Reid G. Attention-deficit/hyperactivity disorder: A review of research on movement skill performance and physical fitness. Adapt Phys Activ Q. 2003;20:1-25.
• Doig GS, Simpson F. Randomization and allocation concealment: a practical guide for researchers. J Crit Care. 2005;20(2):187-191.
• Dulcan M. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1997;36:85-121.
• Atasavun Uysal S, Ekinci Y, Çoban F, et al. Edinburgh el tercihi anketi Türkçe güvenirliğinin araştırılması. J Exerc Ther Rehabil. 2019;6:112-118.
• Rusch H, Bradfisch J, Irrgang W. Auswahltest Sportförderunterricht. Haltung und Bewegung. 1994;14:4-17.
• Ammann-Reiffer C, Bastiaenen C, Meyer-Heim AD, et al. Effectiveness of robot-assisted gait training in children with cerebral palsy: a bicenter, pragmatic, randomized, cross-over trial (PeLoGAIT). BMC Pediatr. 2017;17:1-9.
• Sharma A, Couture J. A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Ann Pharmacother. 2014;48:209-225.
• Verret C, Guay MC, Berthiaume C, et al. A physical activity program improves behavior and cognitive functions in children with ADHD: an exploratory study. J Atten Disord. 2012;16:71-80.
• Pan CY, Tsai CL, Chu CH, et al. Effects of physical exercise intervention on motor skills and executive functions in children with ADHD: A pilot study. J Atten Disord. 2019;23:384-397.
• Madsen KB, Ersbøll AK, Olsen J, et al. Geographic analysis of the variation in the incidence of ADHD in a country with free access to healthcare: a Danish cohort study. Int J of Health Geogr. 2015;14:1-13.
• Özaslan TU, Bilaç Ö. Dikkat eksikliği hiperaktivite bozukluğu epidemiyolojisi. Turkiye Klinikleri J Child Psychiatry-Special Topics. 2015;1:1-5.
• Bauermeister JJ, Shrout PE, Chávez L, et al. ADHD and gender: are risks and sequela of ADHD the same for boys and girls? J Child Psychol Psychiatry. 2007;48:831-839.
• Gizer IR, Ficks C, Waldman ID. Candidate gene studies of ADHD: a meta-analytic review. Hum Genet. 2009;126:51-90.
• Azeredo A, Moreira D, Barbosa F. ADHD, CD, and ODD: Systematic review of genetic and environmental risk factors. Res Dev Disabil. 2018;82:10-19.
• Kamp CF, Sperlich B, Holmberg HC. Exercise reduces the symptoms of attention‐deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters. Acta Paediatr. 2014;103:709-714.
• Jeyanthi S, Arumugam N, Parasher RK. Effectiveness of structured exercises on motor skills, physical fitness and attention in children with ADHD compared to typically developing children-A pilot study. Eneurologicalsci. 2021;24:100357-62.
• 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;27:2915-2919.
• Tsai Y. Effect of rope jumping training on the health related physical fitness of students with amblyopia. Unpublished Master's Thesis Taipei: National Taiwan Normal University. 2009.
• Hillman CH, Castelli DM, Buck SM. Aerobic fitness and neurocognitive function in healthy preadolescent children. Med Sci Sports Exerc. 2005;37:1967-1976.
• Kiluk BD, Weden S, Culotta VP. Sport participation and anxiety in children with ADHD. J Atten Disord. 2009;12:499-506.