- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05049239
Structured Physical Training With and Without Cognitive Support for Adults With ADHD
Support in Activity, Movement and exercise-for Adults With ADHD. A Randomized Controlled Trial Intervention Study With 12 Weeks of Physical Training With and Without Cognitive Support.
Studies in children and adolescents with Attention-Deficit-Hyperactivity-Disorder (ADHD) have shown that physical exercise can improve the core symptoms of ADHD; inattention and hyperactivity. For adults, the evidence is deficient and there is a great need to investigate whether adults have the same effect on ADHD symptoms of physical exercise, as children and young people have. Adults with ADHD often have a sedentary lifestyle and suffer from obesity and have sleep problems. In a normal population, these problems have been shown to be affectable with physical exercise. START (Support in Activity, Movement and Exercise) is a randomized controlled intervention study where physical exercise is given for 12 weeks, with or without cognitive support. The effect is measured with rating scales as well as cognitive and physical tests. The purpose is to investigate whether START works as a treatment for ADHD in terms of ADHD symptoms and disability, and what impact the intervention has on mental health, physical condition and activity level, body awareness and everyday functioning.
Outcome measures are registered within 3 weeks before and after the end of treatment, after 6 months and 12 months. The randomization takes place in three groups; physical exercise (i), physical exercise and extra cognitive support (ii), and control group on waiting list (iii).
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Mussie Msghina, Assoc.prof
- Phone Number: +46 19 6025659
- Email: mussie.msghina@regionorebrolan.se
Study Contact Backup
- Name: Kajsa Lidström Holmqvist, PhD
- Phone Number: +46 70 5554587
- Email: kajsa.lidstrom-holmqvist@regionorebrolan.se
Study Locations
-
-
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Örebro, Sweden, 70116
- Recruiting
- Öppenvårdspsykiatrisk mottagning, Universitetssjukhuset Örebro
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Contact:
- Mussie Msghina, Assoc.prof
- Phone Number: +46 19 6025659
- Email: mussie.msghina@regionorebrolan.se
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Contact:
- Lena Axelsson Svedell, PhD stud
- Phone Number: +46 19 6029251
- Email: lena.axelsson-svedell@regionorebrolan.se
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosed with ADHD.
Exclusion Criteria:
- Ongoing depression with points on MADRS-S over 21
- Suicidality
- Bipolar disorder
- Psychosis
- Ongoing addiction
- Reported threatening behavior.
- Severe autism that makes group participation impossible
- Inability to read and understand the Swedish language
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Physical training
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks.
|
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks, consisting of fitness, strength and mobility exercises with a target level of 60-90% of maximum heart rate.
Two sessions per week take place in a group led by a physiotherapist and once a week the training consists of self-chosen training individually or in group.
|
Active Comparator: Physical training combined with cognitive support
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks. The cognitive support consists of person centred individual occupational therapy. |
Medium-high-intensity physical training 3 times a week, 60 min / time for 12 weeks, consisting of fitness, strength and mobility exercises with a target level of 60-90% of maximum heart rate. Two sessions per week take place in a group led by a physiotherapist and once a week the training consists of self-chosen training individually or in group. The cognitive support consists of person centred individual occupational therapy with focus on daily time management skills and planning and organisation in daily life, i.e. make time for physical exercise. The number of session during the intervention period depend on the participants needs and is estimated to 4-6 sessions. |
No Intervention: Control group
The control group receive no intervention.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Clinical Global Impression-Improvement (CGI-I)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assess total improvement on a Richter scale.
Range 1-7, Higher scores mean worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Adult ADHD Self-Report Scale (ASRS-v.1.1)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 0-72, higher scores mean worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Cardio Respiratory Fitness
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Measured in millilitre per kilogram per minute with the Ekblom-Bak test, a submaximal exercise test. Higher value means better outcome |
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Grip Strength
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Measured in kilogram with JAMAR hand dynamometer.
Higher value means better outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Balance
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Measured with Flamingo test.
The test person is standing on the preferred leg on a low balance profile for 60 seconds.
The number of times that the test person puts his/her foot to the ground is counted.
Lower value means better outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Body Mass Index
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Weight and height will be measured in kilograms and centimeters, and combined to report BMI in kg/m^2. Lower value means better outcome |
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Abdominal Circumference
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Measured with a measuring tape in centimeters.
Lower value means better outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Body Awareness
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Body Awareness Scale - movement quality and experience (BAS MQ-E).
Higher value means better outcome.
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Blood pressure
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Both systolic and diastolic blood pressure will be measured in mm Hg with a blood pressure monitor on the arm.
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Satisfaction with Daily Occupations-Occupational Balance (SDO-OB) activity score
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 0-17, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in Satisfaction with daily occupations and occupational balance (SDO-OB) satisfaction score
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Global satisfaction score, range 1-5, lower scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Canadian Occupational Performance Measure (COPM) perfomance score
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 5-50, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Canadian Occupational Performance Measure (COPM) satisfaction score
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 5-50, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Adult ADHD Quality of Life Measure (AAQoL)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 29-145, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in Self Efficacy Scale (GSE-10)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Range 0-40, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in Assessment of Time Management Skills-Swedish (ATMS-S) Time management subscale
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
11 items, reported as 0-100 ATMS units, higher scores are better
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in Assessment of Time Management Skills-Swedish (ATMS-S), Organization and planning sub scale
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
11 items, reported as 0-100 ATMS units, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Change in Assessment of Time Management Skills-Swedish (ATMS-S), Regulation of emotions sub scale
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
5 items, reported as 0-100 ATMS units, higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in EuroQuality of Life - 5 dimensions - 5 levels (EQ-5D-5L): item scores
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
5 items scored 1-5
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Change in EuroQuality of Life - 5 dimensions - 5 levels (EQ-5D-5L): global score
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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One visual-analogue-scale answer (range 0-100), higher scores are better
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in Continuous Performance Test (AX-CPT)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Measures cognitive flexibility.
Will be done in conjunction with functional Magnetic resonance imaging (fMRI).
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in GO/NoGO
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Measures impulse control.
Will be done in conjunction with functional Magnetic resonance Imaging (fMRI)
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes Affective Picture series (IAPS)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Measures emotion regulation.
Will be done in conjunction with functional Magnetic resonance imaging (fMRI)
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in blood hemoglobin levels (Hb)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Used to assess general health and to screen for conditions that affect red blood cells.
Is measured in g/L.
Low and high balus indicate worse outcome.
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in blood platelet count (PC/TBK)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Used to assess general health and screen for conditions that affect blood platelets.
Is measued in10*9/L.
Low and high values indicate worse outcome.
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in blood leukocyte count (WBC / LPK)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Used to Asses general health and screen for changes in white blood count.
Is measured in 10*6/L.
Low and high values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in plasma alanine transaminase levels (ALT /ALAT)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Part of the hepatic panel used to assess general health related to liver disease.
Is measured in microkat/L.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in plasma aspartate aminotransferase levels (AST /ASAT)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Part of hepatic panel used to assess general health related to liver disease.
Is measured in microkat/L.
High values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in plasma thyroid-stimulating hormone levels (TSH)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Part of general health screening to assess the function of the thyroid hormone.
Is measured in mIE/L.
Low and high values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in plasma creatinine levels (Krea)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Part of a general health screening to assess the function of the kidneys.
Is measured in micromol/L.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in serum sodium leves (s-Na)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Part of a general health screening to assess electrolyte balance.
Is measured in mmol/L.
Low and high values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in serum potassium levels (s-K)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Part of a general health screening to assess electrolyte balance.
Is measured in mmol/L.
Low and high values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in blood phosphatidylethanol levels (PeTH)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
A test to assess alcohol overconsumption.
Is measured in micromol/L.
High values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in high-sensitivity plasma C-reactive protein levels (CRP-high sensitive).
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assesses general levels of inflammation in the body.
Is measured in mg/L.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in blood interleukin- 6 levels (IL-6)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
A marker of immune system activation.
Is measured in ng/L.
High values indicate worse outcome.
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in blood hemoglobin A1c levels (HbA1c)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assesses the level of sugar attached to hemoglobin and indicates the level of blood sugar of the past 2-3 months.
Is measured in mmol/mol.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in total plasma cholesterol levels (cholesterol)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assesses cardiovascular disease risk.
Is measured in mmol/L.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Changes in HDL plasma cholesterol levels (HDL-cholesterol)
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assesses cardiovascular disease risk.
Is measured in mmol/L.
High values indicate worse outcome
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in LSL plasma cholesterol levels (LDL-cholesterol
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Assesses cardiovascular disease risk.
Is measured in mmol/L.
High values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
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Changes in plasma triglyceride levels
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Assesses cardiovascular disease risks.
Is measured in mmol/L.
High values indicate worse outcome
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Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Cortical thickness
Time Frame: Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Structural Magnetic resonance imaging (MRI)
|
Pre-intervention, post-intervention (12 weeks) and 3, 6 and 12 months after intervention start
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Mussie Msghina, Assoc.Prof, Örebro University and Regional Örebro County
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- OLL-274569
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Analytic Code
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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