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For the author of the study, it is important to encourage physical activity for all children, not just those with symptoms of the disorder, because the sedentary lifestyle is a great enemy of health.

Also according to him, the sport of competition is not recommended in childhood.

Be very interested in a study of UNIFESP (Federal University of São Paulo) on the possibility of intense physical activity contribute to improve the concentration level of children with Attention Deficit Disorder and Hyperactivity Disorder (ADHD).

According to the doctor Arthur Joseph Medina, a pediatric sports medicine specialist, author of the master’s thesis reported the research activities such as soccer, martial arts and team sports could bring benefits for hyperactive children and adolescents.

Doctors and researchers followed 25 boys Unifesp aged between seven and 15 years diagnosed with ADHD, divided between users and nonusers of methylphenidate (brand name Ritalin), the main drug used to curb hyperactivity and attention deficit.

The participants underwent a battery of physical tests at the Centre for Medicine, Physical Activity and Sport (CEMAF), linked to Unifesp in order to individualize loads of effort with the measurement of heart rate and breathing.

Later we applied a protocol in participants 30 minutes of intense physical activity (ten loads of three minutes, two minutes of intense race interspersed with one minute of rest). After the physical test individualized attention tests were applied and compared with the attention shown after a stretching session held after 30 days.

The findings, which indicated no significant changes related to the use of methylphenidate or not, raising the prospect that the symptoms can be minimized by the practice of physical activities monitored.

The study guidance of Prof. Dr. Toribio Leite de Barros Neto, the CEMAF, and Prof. Dr. Mauro Muszkat, the Center for Interdisciplinary Child Care neuropsychological (NANI), both linked to the UNIFESP. It was published in the Journal of Attention Deficit and Hyperactivity Disorders in early March.

Based on information from the Communication Department of UNIFESP, I requested the interview with Dr Arthur Joseph Medina, a pediatric specialist in sports medicine. It deals with issues important to the health of all children in development, with or without diagnosis of ADHD.

Educating and Caring – The activities which the patients underwent intense?

Arthur Joseph Medina – The activities chosen were based on the intensities usually found in most common sports: soccer, judo, basketball, ie, exercises with an aerobic base, but also with moments of intense anaerobic-moments interspersed with moments of relative calm.
The children were 10 loads of two minutes interspersed with one minute of active rest \ passive, according to the wishes of the child. The running speed was individualized depending on heart rate shown in his ventilatory threshold (LV1), determined by a cardiopulmonary exercise test, performed in the previous month.
The LV1 is a physiological marker of intensity of aerobic effort, determines the LV1, from the firing of minute ventilation, respiratory rate, in relation to the concomitant rise in oxygen consumption. When we started running the oxygen consumption increases with the number of breaths per minute. After a certain exercise intensity, which we call LV1, oxygen consumption continues to have the same rate of climb in relation to the effort, while the respiratory rate rises exponentially. From this increase in respiratory rate in relation to oxygen consumption, determines the LV1. The LV1 is due to the buffering of excess H + produced by lactic acid, which turns into CO2. This CO2 stimulates ventilation so the additional CO2 produced by aerobic metabolism. Typically, each person has, by virtue of their aerobic fitness, a certain LV1, athletes have background ventilatory threshold only at high speeds, while the sedentary present at lower speeds.
It is known that during this LV1 trigger is a trigger of a catecholamine, the same chemicals that children with ADHD have a deficiency during testing physical, cognitive or biochemical.

Educating and Caring – Based on this study, we can say that children with ADHD should play sports?

Arthur Joseph Medina – Except for rare exceptions, no scientific study gives us absolute certainty. Usually, scientific papers give us arguments to defend a thesis or other, science quantifies events under certain circumstances. Several studies suggest finding similar data under the various circumstances of these various studies, these results are repeated. What gives strength to the argument advanced by the authors.
Our work is mostly a drop in an ocean of research showing that cognition, mental health and academic performance go hand in hand with physical activity. Our research has the merit of being the first to find improvement in symptoms in children with attentional formal diagnosis of ADHD. If it allows us to assume that hyperactive children should play sports? No, we can affirm that the numerous jobs that are associated with ours, suggest that the sport should be encouraged. Both children and asymptomatic children with ADHD should be physically active, inactivity is a major threat to health.

Educating and Caring – What is the effect of exercise on the brain of the child?

Arthur Joseph Medina – We do not have absolute answers to this question. When we rely on animal models, the practice of aerobic physical activity can induce elevation of central catecholamines in the same brain structures of these neurotransmitters impaired in hyperactive children. Some authors believe that the human brain, the elevation of these catecholamines (dopamine and norepinephrine) in the cerebral cortex, are responsible for the improvement of attention normally seen among asymptomatic persons immediately to the practical efforts. Based on the high degree of correlation between peripheral levels of adrenaline and speed of reaction in tests of attention, observed in asymptomatic after physical activity.
Our research attempted to clarify this issue, children with ADHD have a deficiency of catecholamines during physical and cognitive tests, both peripherally, as shown by lactate values, either centrally, as shown by imaging studies during attentional tests.
If exercise induces increases in speed of reaction, consequent to increased central catecholamine, probably would not find these improvements in children with ADHD who are deficient of these neurotransmitters.
Found no difference between the pattern shown by children with ADHD, dysfunctional in dopamine and norepinephrine, the pattern shown by children with no complaints.
Functional MRI studies during aerobic efforts, not found in human central elevation of dopamine in the basal ganglia, on the other hand, a job that did serum from the jugular vein during the course of work, found no elevation of catecholamines. Thus, it is unclear the mechanism responsible for cognitive improvement acutely induced by stress.
The effects of chronic exercise, these seem more established. The practice of regular physical activity correlates with improvement in almost all comorbidity of ADHD, and various aspects of cognition. Doubts still exist if the exercise is a cause or effect of all the goodies described. A well conducted study by Dr. Colcombe (2006) in the elderly, suggests that in fact the real trigger of the exercise benefits.
After six months of an aerobic exercise program, he was able to observe induction of neuroplasticity, brain swelling, in the anterior cingulate, a region responsible for much of the symptoms of ADHD. The measures form made before and after training.

Educating and Caring – What is the difference between physical activity and sport?

Arthur Joseph Medina – Physical activity refers to volunteer activities, inducing metabolic and physiological variables, in which the induced breakdown of homeostasis, the body is positively restorable. Aims at maintaining the health and well being. Sports physical activity would be focused on performance, with performance in the first plan, health, often is mistakenly left out.

Educating and Caring – The sport of competition is suitable for children?

Arthur Joseph Medina – No, it is not. Children need physical activities consistent with their possibilities. The games in play grounds, catch, hopscotch etc.. are good ways to avoid being sedentary. As for soccer, for example, is the ideal common sense. Play ball with your colleagues on a beach or lawn, so playful, it is one thing. Now similar to the training offered to adults, primarily in the audience of parents, can be extremely deleterious. The early specialization exposes children to typical lesions, acute or chronic, the sport in question. The presence of parents put pressure for results, which stresses the child. The practice of a sport, at any age, should be monitored closely by professionals.

Educating and Caring – At what age is recommended physical activity?

Arthur Joseph Medina – Determine a specific age is quite difficult. Crawling is an old effort, the child who crawls is different in several aspects of the child being placed in the walker. The child can practice physical activities such as kicking a ball, cycling, running, at the age where she can. The younger, more parents should be close and lower the intensity and frequency with which these games are developed.

Educating and Caring – What kind of medical evaluation is recommended for children before they start playing sports?

Arthur Joseph Medina – Clinical Pediatrician: cardio-respiratory, skeletal muscles, posture and nutrition. However, prohibit an asymptomatic child in the backyard playing football or ride a bike for the absence of such assessments, does not make sense.

Educating and Caring – What are the recommended physical activity according to age?

Arthur Joseph Medina – Two to five years can run, climb, play, team games are very complex at this age. Six years old and upward, can freely participate in any sporting activity, except the contact, which should be practiced over eight years. Intense workouts twice a week.
The important thing is caring for injuries, physical therapy assessments, nutritional and medical. Both children with ADHD, as well as asymptomatic, can physically active at the same age. Special care should be taken during the practice of sports, hyperactive children show greater emotional reactivity, are expelled more often show delays in motor coordination, and poor performance sports. The child may be segregated by their colleagues, so it is important to a slightly different approach by physical educators, because after all, is not unusual for elite athletes who are suffering from ADHD. Often, the social acceptance of a child is dependent on your sports performance.

Educating and Caring – The inappropriate practice can worsen the symptoms of ADHD?

Arthur Joseph Medina – The inappropriate practice, leading to overtrainig certainly worsen various systems in the body, and perhaps symptoms of ADHD. However, I know of no scientific study that shows negative symptoms in patients with ADHD, with the sport.

Educating and Caring – The UNIFESP has a service that interested parties can look for?

Arthur Joseph Medina – Yes, CEMAF UNIFESP is an industry related to cardiology, there were conducted our evaluations and analysis.

Disorder and Attention Deficit Hyperactivity
Known as ADHD, the disorder is most common mental health in children and affects mainly males. Its main symptoms are difficulty in holding the attention, hyperactivity and impulsivity. It is estimated that the problem affects around 3% to 5% of school-age children. These signs are usually present before seven years of life and may persist into adolescence or even adulthood.
There is no single cause for the problem, assuming that there is influence of heredity and neurochemistry of the immaturity of brain centers related to attentional control.
Often, they can be associated with other disorders such as conduct, oppositional and defiant behavior, depression and anxiety. Holders of ADHD may have higher rates of behavioral problems in adolescence, and even alcoholism are prone to drug use. (Source: Press Office UNIFESP)

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