Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and is marked not only by inattention, hyperactivity, and impulsivity, but also by weaknesses in executive functions such as inhibition, working memory, and cognitive flexibility. Medication remains the primary treatment, yet some children respond poorly, experience side effects, or struggle with long-term adherence. Exercise has emerged as a promising non-pharmacological option, but most programs have focused on aerobic activity and paid less attention to the motor and cognitive challenges that many children with ADHD face together. Based on these challenges, deeper research is needed on exercise approaches that simultaneously train cognition and movement.
On February 11, 2026, researchers from Beijing Normal University, Beijing Sport University, Xuzhou Rehabilitation Hospital affiliated with Xuzhou Medical University, and Peking University Sixth Hospital published (DOI: 10.1007/s12519-026-01019-4) a study in World Journal of Pediatrics showing that a 12-week integrated cognitive-motor exercise program reduced core ADHD symptoms in children and produced stronger improvements in inhibitory control and immediate working memory than aerobic exercise alone, pointing to a promising non-pharmacological strategy for more comprehensive ADHD management.
This multicenter trial enrolled 107 children with ADHD aged 6 to 10 and assigned them to one of three groups for 12 weeks: integrated cognitive-motor exercise, aerobic exercise, or a wait-list control. Both exercise groups trained three times a week in 45-minute sessions. The integrated program combined locomotor, object-control, balance, and fine-motor tasks with built-in challenges targeting inhibition, working memory, and cognitive flexibility, such as stop-go signals, reverse commands, multistep movement sequences, and rule switching. The aerobic group completed moderate-intensity treadmill or cycling sessions matched for frequency and duration. Researchers assessed ADHD symptoms with the SNAP-IV scale and measured executive functions using the Stroop test, Rey–Osterrieth complex figure test, and trail making test. Both exercise groups significantly reduced inattention and hyperactivity-impulsivity compared with the control group. But the integrated program showed a larger reduction in Stroop color-word interference time than aerobic exercise and the control group, and it also outperformed both groups in immediate working memory. Exercise groups improved cognitive flexibility, while no adverse events were reported.
This study suggests that not all exercise works in the same way for children with ADHD. When movement is paired with tasks that require remembering rules, stopping responses, and adapting quickly, the training may more directly strengthen the mental systems that support self-control. The researchers consider that this "high-cognitive-load" format may help explain why integrated cognitive-motor exercise produced extra gains beyond standard aerobic activity, particularly in inhibitory control and immediate memory, which are central to daily functioning at school and home.
These findings point to a practical model that could be adapted for schools, clinics, and community programs. Rather than relying on exercise as a generic outlet for energy, educators and therapists may be able to design structured play that deliberately trains attention, memory, and behavioral control during movement. The intervention was safe, feasible, and well received by parents, it may serve as a valuable adjunct to medication or an alternative for families seeking non-drug support. This study also opens a door to future work on long-term outcomes and brain-based mechanisms, including how integrated exercise reshapes neural circuits involved in attention and executive control.
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References
DOI
10.1007/s12519-026-01019-4
Original Source URL
https://doi.org/10.1007/s12519-026-01019-4
Funding information
This study was funded by the Social Science Foundation of Beijing (23YTB035) and National Social Science Foundation (24BTY041).
About World Journal of Pediatrics
World Journal of Pediatrics is a monthly, peer-reviewed academic journal that publishes original research articles, reviews, and special reports covering all aspects of pediatrics. It welcomes contributions from pediatricians and researchers worldwide, focusing on the latest developments in pediatric clinical practice, pediatric surgery, preventive child healthcare, pharmacology, stomatology, and biomedicine, as well as basic and experimental sciences. The journal provides an international platform for academic exchange and dissemination of medical research findings. All submissions undergo rigorous peer review by at least two experts. Committed to efficient manuscript processing, the journal aims to deliver final decisions within two months, with outstanding papers or special reports potentially accepted within one month for priority publication.