Exercise combined with pediatric Tuina and auricular acupressure for children with attention-deficit/hyperactivity...

This study evaluated the clinical efficacy of three interventions for children with attention-deficit/hyperactivity disorder (ADHD): exercise alone, exercise combined with pediatric Tuina, and exercise combined with both pediatric Tuina and auricular acupressure.

Participants were recruited from one senior kindergarten and two primary schools in Weifang City, Shandong Province, between December 2023 and June 2024. The Swanson, Nolan, and Pelham Rating Scale, 4th Revision (SNAP-IV) was used to assess symptoms. A total of 120 children aged 5-12 years diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were selected. Using SPSS 26.0 software, a randomization list was generated, and the children were randomly assigned to three groups (n = 40 each). Group A received exercise (skipping, jogging, shuttlecock kicking, basketball, badminton). Group B received exercise combined with pediatric Tuina. Group C received exercise, pediatric Tuina, and auricular acupressure. The SNAP-IV scale was re-administered at 1, 3, and 6 months post-treatment, and generalized estimating equations were used for statistical analysis. At the 6-months endpoint, the overall response rate and clinical control rate were compared among the groups.

Generalized estimating equations revealed no significant main effect of group (P > 0.05), but significant main effects of time (P < 0.001) and group-by-time interaction (P < 0.001) were observed. No significant differences in SNAP-IV scores were found among the three groups at baseline or after 1 month of treatment (P > 0.05). At 3 months, intergroup differences became significant (P < 0.05), with both Group B and Group C showing significantly lower scores than Group A (P < 0.05). At 6 months, GEE-based pairwise comparisons showed that Group C had a significantly lower estimated SNAP-IV score than Group A (adjusted P < 0.05), whereas the differences between Groups A and B and between Groups B and C were not statistically significant (adjusted P > 0.05). No group showed significant differences from itself. All three groups exhibited significant reductions in SNAP-IV scores at 1, 3, and 6 months post-treatment relative to baseline (all P < 0.05). At the 6-months endpoint, no significant difference was observed among the groups in overall response rate (P > 0.05), whereas the clinical control rate differed significantly across groups (P < 0.001). Specifically, Group C demonstrated a significantly higher clinical control rate than Group A (P < 0.001).

All three interventions are effective in treating childhood ADHD. Compared with exercise alone, the exercise combined with pediatric Tuina and auricular acupressure intervention was associated with a greater reduction in SNAP-IV scores at 6 months and a higher clinical control rate; however, no statistically significant difference was observed between the exercise combined with pediatric Tuina intervention and exercise alone at 6 months.