Exercise-Based Interventions for ADHD: A Review of Modalities, Mechanisms, and Practical Applications

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition marked by inattention, hyperactivity, and impulsivity. This narrative review examines the effects of various exercise modalities on ADHD symptoms, based on recent meta-analyses and randomized controlled trials with a focus on children and adolescents published between 2015 and 2025. Exercise modalities categorized as aerobic, open-skill, closed-skill, high-intensity interval training (HIIT), and cognitively demanding activities were examined in recent meta-analyses and clinical trials. Closed-skill exercises like swimming and yoga reduced hyperactivity and impulsivity, while open-skill sports improved attention. HIIT and cognitively engaging tasks enhanced executive function and increased neurochemicals such as BDNF and catecholamines. HIIT shows promise when intensity is individualized and recovery is adequate. Preliminary mechanistic links include catecholamine and BDNF modulation; PI3K-pathways remain hypothesis-generating. Although optimal exercise parameters remain to be determined, accumulating evidence supports the role of structured physical activity as a feasible and effective adjunct to conventional treatment. While many programs involved ~2-3 sessions/week for ≥30 min, heterogeneity in protocols and study quality precludes universal prescriptions. Future trials should report adherence, ADHD-specific outcomes, and risk-of-bias controls.