The effects of practicing target-shooting sport on the severity of inattentive, hyperactive, and impulsive symptoms in children: a non-randomised controlled open-label study in Denmark

Abstract

Purpose: Target-shooting sport requires mental effort and concentration. Training may reduce inattentiveness and distractibility. There is little knowledge if children with symptoms of attention-deficit/hyperactivity disorder (ADHD) benefit from practicing target-shooting sport.

Materials and methods: Our study aims to investigate this in a non-randomised controlled open-label study of 128 children, 10–14 years of age, with ADHD-symptoms. The intervention-group (n = 64) practiced target-shooting in local shooting associations once a week for 6 months. The control group (n = 64) received treatment as usual. Primary outcome: teacher-rated ADHD-RS-IV-total score. Secondary outcomes: (a) parent-rated ADHD-RS-IV-total score; (b) teacher- and parent-rated Strengths-and-Difficulties-Questionnaire (SDQ); (c) self-rated quality of life (KIDSCREEN-27-total score); and (d) four objective measurements of ADHD-symptoms using the QbTest^™. The data were collected at baseline and after 6 months.

Results: When estimating the marginal effect of the intervention on our primary outcome, the teacher-rated ADHD-RS-IV, we found no significant effect (mean change between groups (contrast)=2.23; p = 0.193). However, we did find significant beneficial effects on four of the eight secondary outcomes, including the parent-rated ADHD-RS-IV-total score (contrast = 4.76; p = 0.024), the parent-rated SDQ-total score (contrast = 2.09; p = 0.027), and on the QbTest^™ measurements of the Reaction Time Variation (RTVar) (contrast = 36.96; p = 0.013), and of Omission Errors (contrast = 7.57; p = 0.019).

Conclusions: Despite the negative result on the primary outcome, the robust findings on these secondary outcomes in this open-label study indicate proof of concept that practicing target-shooting sport may have some beneficial effects on the severity of ADHD-symptoms in children. No adverse events were reported. Randomised trials of this non-pharmacological intervention are needed.

Keywords:

• Children
• ADHD
• hyperactivity
• inattention
• physical activity
• non-pharmacological interventions

Acknowledgments

We thank the Danish foundation TrygFonden for funding the study, the QbTech for support to the QbTest^™, and we thank the Danish sports organisation DGI for the cooperation.

Declarations

This study was approved by The National Committee on Health Research Ethics, Denmark (S-20130134), and the Danish Data Protection Agency (Current Controlled Trials NCT02898532. Retrospectively registered 14 September 2016). The data were handled in accordance with the Personal Data Protection Act. The included children participated on a voluntary and anonymous basis and participation in the target-shooting intervention was not dependent on participation in the research study. All participants provided a consent statement to participate in research.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by The Danish foundation TrygFonden under Grant ID number 109399. TrygFonden is a Danish non-profit foundation, whose core areas include safety, health and well-being. The foundation had no role in the study, did not have an influence on the design and had no commercial interests in the study. In addition, Dr. Dalsgaard’s research is supported by grants from Aarhus University Research Foundation [AUFF-E-2015-FLS-8-61], The Lundbeck Foundation [iPSYCH grant no. R102-A9118 and R155-2014-1724], National Institute of Health [R01, grant no. ES026993], Novo Nordisk Foundation [grant no. 22018] and the European Commission [Horizon 2020, grant no. 667302]. The dataset is available from the corresponding author on reasonable request.

Notes on contributors

Annegrete Gohr Månsson

Annegrete Gohr Månsson is doing a PhD at the Department of Psychology, University of Southern Denmark. Her background is in physiotherapy with a master’s degree in Sports and welfare, and she has an education in cognitive therapy. Annegrete has worked in psychiatry, and in sports organisations where she was a project manager at a sports project for children with ADHD and ADHD-symptoms.

Mette Elmose

Mette Elmose is MSc in Psychology, Authorized psychologist, PhD and Associate Professor and head of the research group CH:LD, at the Department of Psychology, University of Southern Denmark. Her main research area pertains to autism and other developmental difficulties. A current focus is understanding the developmental mechanisms related to the mental health of autistic people and their families and how to support well-being and quality of life throughout the lifespan.

Anna Mejldal

Anna Mejldal is currently a PhD Student at the Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark. She has a MSc in Mathematics and Computer Science and several years of work experience as data analyst in different governmental organizations. Her doctoral research interests include alcohol use and abuse, definitions of alcohol abuse, statistical methods in psychiatric research, and national registries.

Søren Dalsgaard

Søren Dalsgaard is MD, PhD, professor of psychiatric epidemiology at Aarhus University (AU), Denmark and a senior clinical consult of child and adolescent psychiatry at Hospital of Telemark, Norway. He leads the research-team on studies of ADHD at the National Centre for Register-based Research (NCRR) at AU. His epidemiological research is focused on psychopharmacology, environmental and genetic causes of ADHD and other mental disorders diagnosed in childhood and adolescence and on long-term outcomes of these disorders.

Kirsten K. Roessler

Kirsten K. Roessler is professor in Health and Environmental Psychology. She has clinical educations in psychodynamic group analysis and cognitive therapy. She received her phd. In 1996, and her dr.phil. in 2016 with a thesis on chronic pain and physical activity. She has published more than 150 research papers, books, and proceedings in the field of medical psychology, environmental psychology and sports science.