Multi-Component Training Versus Motor Learning Techniques in Adults With ADHD (MCT-MLT)

Background and Rationale

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, persisting into adulthood in a significant proportion of individuals. Adults with ADHD commonly experience deficits in executive function, attention, working memory, and motor coordination, leading to reduced occupational performance, impaired social relationships, and decreased quality of life.

Although pharmacological treatments such as stimulant medications are widely used, they may not be suitable for all individuals due to side effects, contraindications, or limited long-term effectiveness. Therefore, there is increasing interest in non-pharmacological interventions such as structured physical exercise and motor learning techniques, which may enhance neuroplasticity and improve cognitive and motor outcomes.

Multi-component training integrates aerobic, resistance, balance, and flexibility exercises and has been associated with improvements in executive function, attention, and emotional regulation. Motor learning techniques focus on task-oriented training, repetition, feedback, and cognitive-motor integration to improve coordination and functional performance. However, limited research has directly compared these two approaches in adults with ADHD.

Objective

To compare the effects of multi-component training and motor learning techniques on attention, cognitive performance, and motor coordination in adults with ADHD.

Study Design

This study will be a single-blind, randomized clinical trial.

Participants

A total of 44 participants aged 18-30 years with clinically diagnosed ADHD will be recruited using non-probability convenience sampling. Participants must meet inclusion criteria including confirmed ADHD diagnosis and ability to participate in moderate physical activity.

Randomization and Blinding

Participants will be randomly assigned to one of two groups using a computer-generated randomization method. Allocation will be concealed using sealed opaque envelopes. The outcome assessor will remain blinded to group allocation.

Interventions

Group A: Multi-Component Training

Participants will undergo a structured exercise program including:

Aerobic training (moderate intensity) Resistance training using light weights or bands Balance and flexibility exercises Sessions will be conducted three times per week for 8 weeks.

Group B: Motor Learning Techniques

Participants will receive:

Task-oriented motor training Cognitive-motor dual-task activities Feedback-based motor learning strategies Sessions will be conducted three times per week for 8 weeks. Outcome Measures

Primary and secondary outcomes will be assessed at baseline and post-intervention using standardized tools:

Adult ADHD Self-Report Scale (ASRS) Montreal Cognitive Assessment (MoCA) Conners' Adult ADHD Rating Scales (CAARS) Stroop Color and Word Test Trail Making Test (Parts A and B) Digit Span Test Behavior Rating Inventory of Executive Function (BRIEF-A) Data Analysis

Data will be analyzed using SPSS version 27. Descriptive statistics will summarize participant characteristics. Normality will be assessed using the Shapiro-Wilk test.

Within-group comparisons: Paired t-test or Wilcoxon signed-rank test Between-group comparisons: Independent t-test or Mann-Whitney U test Statistical significance set at p < 0.05 Expected Outcome

This study is expected to determine whether multi-component training or motor learning techniques are more effective in improving attention, cognitive performance, and motor coordination in adults with ADHD. Findings may contribute to evidence-based, non-pharmacological rehabilitation strategies for ADHD management.