身體活動對注意力缺失過動症兒童行為與認知之影響

Effect of Physical Activity on Behavior and Cognition in Children with Attention Deficit/Hyperactivity Disorder

10.6162/SRR.2017.141.06

黃瑞祥(Jui-Hsiang Huang)；葉啟斌(Chi-Pin Yeh)；詹元碩(Yuan-Shuo Chan)

運動 ； 神經心理 ； 有氧運動 ； exercise ； neuropsychology ； aerobic exercise

大專體育

141期（2017 / 06 / 30）

43 - 51

繁體中文

注意力缺失／過動症 (attention deficit/hyperactivity disorder, ADHD) 已被相關研究證實在額葉紋狀體呈現異常，這與多巴胺和正腎上腺素分泌不足有很大關聯。近期研究發現運動介入對於ADHD 兒童腦部神經機制具有正面效益，因此本文統整分析相關國內外文獻，目的是以認知神經科學觀點來切入，探討運動對於ADHD 兒童行為與認知之影響。首先藉由回顧運動與認知功能之相關研究，接著探討身體活動對於兒童認知發展影響，並分析運動介入對ADHD 兒童之行為情緒、知覺認知方面的效果，以及單次急性運動後所獲得的神經心理表現。結果發現單次急性與長期運動介入對於ADHD 兒童的行為症狀、知覺認知功能與生理機制都有正面影響，中高強度的有氧運動是必要條件，有助於促進ADHD 兒童腦部神經運作機制，進而改善行為與認知功能，運動計畫設計需多元化且結合認知任務需求，增進參與動機及挑戰性。最後，運動介入亦可以立即改善注意力控制，故建議ADHD 兒童進行認知課程前可予以合宜運動介入以促進學習效果。

Recently study revealed structural/functional abnormalities of the frontostriatal network, related to a deficiency of dopamine and Norepinephrine, is the core deficits of symptoms of attention deficit/hyperactivity disorder (ADHD). Exercise has positive effect on neural mechanism in Children with ADHD in rencently study. The purpose of this article is to examine the literature on effect of exercise on behavior and cognition in children with ADHD from the perspectives of neurocognition. We reviewed the articles about the benefits of physical activity (PA) on cognitive development during childhood, and discussed the effect of exercise intervention on behavioral problem, cognition, and discussed post-exercise performance of acute exercise on neuropsychological test. Based upon these scientific literatures, we propose an approach that employs moderate-high intensity and aerobic PA with cognitive demand to promote brain growth, which lead to the improvement of behavior inhibition and cognition deficit in children with ADHD. Otherwise, acute exercise may be helpful for attention control in children with ADHD before scholastic academic class.

1. 王駿濠、蔡佳良(2011)。急性運動對認知表現的影響。大專體育，112，31-39。
   連結：
2. 詹元碩、何金山、吳湘涵(2011)。注意力不足過動症兒童的心理生理機轉與運動訓練效益。大專體育，114，69-75。
   連結：
3. American Psychiatric Association(2000).Diagnostic and statistical manual of mental disorders: DSM-IVTR.Washington, DC:Author.
4. Banaschewski, T.,Besmens, F.,Zieger, H.,Rothenberger, A.(2001).Evaluation of sensorimotor training in children with ADHD.Perceptual and Motor Skills,92(1),137-149.
5. Barkley, R. A.(1997).Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD.Psychological Bulletin,121(1),65-94.
6. Barkley, R. A.,Grodzinsky, G.,DuPaul, G. J.(1992).Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report.Journal of Abnormal Child Psychology,20(2),163-188.
7. Best, J. R.(2010).Effects of physical activity on children's executive function: Contributions of experimental research on aerobic exercise.Developmental Review,30(4),331-351.
8. Biederman, J.(2005).Attention-deficit/hyperactivity disorder: A selective overview.Biological Psychiatry,57(11),1215-1220.
9. Castellanos, F. X.,Giedd, J. N.,Marsh, W. L.,Hamburger, S. D.,Vaituzis, A. C.,Dickstein, D. P.,Rapoport, J. L.(1996).Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder.Archives of General Psychiatry,53(7),607-616.
10. Castellanos, F. X.,Lee, P. P.,Sharp, W.,Jeffries, N. O.,Greenstein, D. K.,Clasen, L. S.,Rapoport, J. L.(2002).Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder.Journal of the American Medical Association,288(14),1740-1748.
11. Chan, Y. S.,Jang, J. T.,Pakzad-Mayer, Y.,Ho, C. S.(2012).Effekt des Aquatrainings auf Reaktionszeit bei ADHS-Kindern.Deutsche Zeitschrift für Sportmedizin,63(7-8),216.
12. Coch, D.(Ed.),Dawson, G.(Ed.),Fische, K.(Ed.)(2007).Human behavior, learning, and the developing brain: Atypical development.New York, NY:Guilford Press.
13. Etnier, J. L,Smith, A. L.,Gapin, J. I.,Labban, J.(2009).Physical activity and cognitive performance in children with attention deficit hyperactivity disorder (ADHD) - Symposium overview.Journal of Sport & Exercise Psychology,31(Suppl.),S11-S13.
14. Gapin, J. I.,Etnier, J. L.(2010).The relationship between physical activity and executive function performance in children with attention-deficit hyperactivity disorder.Journal of Sport &Exercise Psychology,32(6),753-763.
15. Gapin, J. I.,Labban, J. D.,Etnier, J. L.(2011).The effects of physical activity on attention deficit hyperactivity disorder symptoms: The evidence.Preventive Medicine,52(Suppl. 1),S70-S74.
16. Halperin, J. M.,Healey, D. M.(2011).The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD?.Neuroscience & Biobehavioral Reviews,35(3),621-634.
17. Hill, D. E.,Yeo, R. A.,Campbell, R. A.,Hart, B.,Vigil, J.,Brooks, W.(2003).Magnetic resonance imaging correlates of attention-deficit/hyperactivity disorder in children.Neuropsychology,17(3),496-506.
18. Hillman, C. H.(2011).Aerobic fitness affects on brain health, cognition, and achievement.2011 International Conference of Exercise for 2013Q,Taipei, Taiwan:
19. Hynd, G. W.,Hern, K. L.,Novey, E. S.,Eliopulos, D.,Marshall, R.,Gonzalez, J. J.,Voeller, K. K.(1993).Attention deficit-hyperactivity disorder and asymmetry of the caudate nucleus.Journal of Child Neurology,8(4),339-347.
20. Johnson, J.,Reid, R.(2011).Overcoming executive function deficits with students with ADHD.Theory Into Practice,50(1),61-67.
21. Maddigan, B.,Hodgson, P.,Heath, S.,Dick, B.,John, K. S.,McWilliam-Burton, T.,White, H.(2003).The effects of massage therapy & exercise therapy on children/adolescents with attention deficit hyperactivity disorder.The Canadian Child and Adolescent Psychiatry Review,12(2),40-43.
22. Madras, B. K.,Miller, G. M.,Fischman, A. J.(2005).The dopamine transporter and attention-deficit/hyperactivity disorder.Biological Psychiatry,57(11),1397-1409.
23. Majorek, M.,Tüchelmann, T.,Heusser, P.(2004).Therapeutic eurythmy-movement therapy for children with attention deficit hyperactivity disorder (ADHD): A pilot study.Complementary Therapies in Nursing and Midwifery,10(1),46-53.
24. McKune, A. J.,Pautz, J.,Lomjbard, J.(2003).Behavioural response to exercise in children with attention-deficit/hyperactivity disorder.South African Journal of Sports Medicine,15(3),17-21.
25. Medina, J. A.,Netto, T. L. B.,Muszkat, M.,Medina, A. C.,Botter, D.,Orbetelli, R.,Miranda, M. C.(2010).Exercise impact on sustained attention of ADHD children, methylphenidate effects.ADHD Attention Deficit and Hyperactivity Disorders,2(1),49-58.
26. Piek, J. P.,Pitcher, T. M.,Hay, D. A.(1999).Motor coordination and kinaesthesis in boys with attention deficit-hyperactivity disorder.Developmental Medicine & Child Neurology,41(3),159-165.
27. Sadock, B. J.,Kaplan, H. I.,Sadock, V. A.(2007).Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry.Philadelphia, PA:Lippincott Williams &Wilkins.
28. Seidman, L. J.,Valera, E. M.,Makris, N.(2005).Structural brain imaging of attention-deficit/hyperactivity disorder.Biological Psychiatry,57(11),1263-1272.
29. Smith, A. L.,Hoza, B.,Linnea, K.,McQuade, J. D.,Tomb, M.,Vaughn, A. J.,Hook, H.(2013).Pilot physical activity intervention reduces severity of ADHD symptoms in young children.Journal of Attention Disorders,17(1),70-82.
30. Spencer, S. V.,Hawk, L. W.,Richards, J. B.,Shiels, K.,Pelham, W. E.,Waxmonsky, J. G.(2009).Stimulant treatment reduces lapses in attention among children with ADHD: The effects of methylphenidate on intra-individual response time distributions.Journal of Abnormal Child Psychology,37(6),805-816.
31. Tantillo, M.,Kesick, C. M.,Hynd, G. W.,Dishman, R. K.(2002).The effects of exercise on children with attention-deficit hyperactivity disorder.Medicine & Science in Sports &Exercise,34(2),203-212.
32. Tomporowski, P. D.,Davis, C. L.,Miller, P. H.,Naglieri, J. A.(2008).Exercise and children's intelligence, cognition, and academic achievement.Educational Psychology Review,20(2),111-131.
33. Tsai, C. L.(2009).The effectiveness of exercise intervention on inhibitory control in children with developmental coordination disorder: Using a visuospatial attention paradigm as a model.Research in Developmental Disabilities,30(6),1268-1280.
34. Wigal, S. B.,Nemet, D.,Swanson, J. M.,Regino, R.,Trampush, J.,Ziegler, M. G.,Cooper, D. M.(2003).Catecholamine response to exercise in children with attention deficit hyperactivity disorder.Pediatric Research,53(5),756-761.
35. 杭榮華、劉新民、王瑞權、吳義高(2010)。感覺統合訓練改善注意缺陷多動障礙兒童行為、智力及執行功能的對照研究。中國心理衛生雜誌，24(3)，219-223。
36. 林素君、林瑞興(2010)。12 週體適能遊戲介入對國小低年級學生學習成效之影響。屏東教大運動科學學刊，6，67-79。
37. 洪肇基(2010)。桃園縣=Taoyuan, Taiwan，長庚大學=Chang Gung University。
38. 楊立強、胡憶蘭(2005)。兒童多動症的經顱多譜勒腦血流學研究。職業與健康，21(11)，1813-1815。
39. 鄭信雄、葉子成、盧信宏、莊銘爐、顏樂美、方慧琴、林麗慎(2006)。功能性磁振造影顯示密集式感覺運動訓練對注意力缺陷過動症學童的療效。特殊教育季刊，101，9-16。
40. 羅鈞令、陳威勝(2002)。注意力不足過動症兒童之平衡功能。臺灣醫學，6(6)，815-821。

1. 陳東韋,林昕翰,江勝山(2022)。不同運動參與程度之越野自行車者對幸福感之差異分析。運動與遊憩研究，16(3)，15-24。
2. 潘正宸,陳怡婷,陳志軒,何永彬(2021)。急性有氧運動介入對國中學習障礙學生工作記憶與識字學習成效之研究。身心障礙研究季刊，19(3&4)，182-198。
3. 詹元碩,黃嘉怡(2023)。運動對幼兒神經發展與認知功能影響之文獻回顧。臺灣體育學術研究，74，155-174。