{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:17:41Z","timestamp":1788171461224,"version":"build-2803163510"},"reference-count":44,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"2024 Yangzhou \u2018Lvyang Jinfeng\u2019 Outstanding PhD Program","award":["None"],"award-info":[{"award-number":["None"]}]},{"name":"2024 Jiangsu Provincial Science & Technology Deputy Program","award":["None"],"award-info":[{"award-number":["None"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This meta-analysis aimed to evaluate effects of physical exercises on gross and fine motor skills in children and adolescents with attention deficit hyperactivity disorder (ADHD), and to explore the influencing factors and dose\u2013response relationships for optimizing exercise parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>Six electronic databases were searched from inception to 20 June 2025, with an updated search performed on 27 January 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The effect sizes were estimated using Hedge's\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      within three-level random-effects modeling frameworks. Subgroup analyses were performed to examine potential moderators, while restricted cubic splines were employed to characterize dose\u2013response relationships.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-one studies with 850 participants were included. Physical exercises showed moderate positive effects on both gross motor skills (Hedge's\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      \u2009=\u20090.62, 95% CI: 0.48\u20130.76) and fine motor skills (Hedge's\n                      <jats:italic toggle=\"yes\">g<\/jats:italic>\n                      \u2009=\u20090.72, 95% CI: 0.54\u20130.90). Significant improvements were observed in subcomponents of gross motor skills (locomotion, object control, body coordination, and strength) and fine motor skills (manual dexterity, hand-eye coordination, and handwriting). Moderator analyses indicated that longer session durations (&gt;45\u2005min) and higher frequencies (\u22653 sessions\/week) were associated with greater benefits. Fine motor skills (\u223c1350\u2005min) appeared to require greater cumulative exercise exposure than gross motor skills (\u223c810\u2005min) to achieve substantial gains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Physical exercise is an effective intervention for improving motor skills in children and adolescents with ADHD. However, the effectiveness of interventions appears to be moderated by motor subcomponents and dose parameters. Tailored programs, specific motor skill targets and dose parameters, should be integrated into clinical and educational practices to maximize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261428944","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:10:50Z","timestamp":1773252650000},"page":"1177-1194","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing exercise interventions for motor skills enhancement in attention deficit hyperactivity disorder: Evidence from meta-analysis"],"prefix":"10.1177","volume":"40","author":[{"given":"Yuxuan","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Yangzhou Polytechnic University, Yangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoman","family":"Che","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Yangzhou Polytechnic University, Yangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenghao","family":"Dong","sequence":"additional","affiliation":[{"name":"The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxing","family":"Shen","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Yangzhou Polytechnic University, Yangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Sejong University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Cui","sequence":"additional","affiliation":[{"name":"Yangzhou Guangling Bai Xingtang Traditional Chinese Medicine Clinic, Yangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0241-5188","authenticated-orcid":false,"given":"Feilong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Beijing Sport University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)33004-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2014.09.023"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.10.904"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1744-9081-1-12"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-012-0297-4"},{"key":"e_1_3_2_7_2","first-page":"1","article-title":"Focus on fitness: incorporating exercise into the treatment of children and adolescents with attention-deficit hyperactivity disorder","volume":"25","author":"Lulich K","year":"2018","unstructured":"Lulich K, Terry M. 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