Effects of Different Physical Activity Approaches on Executive Functions in Primary School Children with ADHD: A Scoping Review with Methodological Reflections.

Children with attention deficit/hyperactivity disorder (ADHD) often exhibit deficits in executive functions (EFs), which are crucial for self-regulation and academic performance. Physical activity (PA) has emerged as a promising non-pharmacological approach to support EF development in this population. This scoping review, guided by the PRISMA-ScR framework, examined PA interventions aimed at improving EFs in children aged 6-12 diagnosed with ADHD. Evidence was synthesized narratively by categorizing interventions according to PA modality, intensity, and the specific EF domains targeted, whilst describing the methodological characteristics of existing studies. A systematic search of PubMed, Cochrane Library, Web of Science, Scopus, and PsycINFO up to the end of 2024 yielded 55 peer-reviewed empirical studies involving 3863 participants. Both acute and chronic PA interventions were associated with improvements in EFs, with inhibitory control most commonly enhanced, followed by working memory and cognitive flexibility. Structured sports such as swimming and football, as well as multimodal interventions including physical-cognitive training and exergames, demonstrated positive effects. Intervention efficacy was influenced by factors such as intensity, duration, cognitive engagement, and context. However, variability in study designs, small sample sizes, and lack of standardization limited comparability. These findings suggest that PA interventions can support EF development in children with ADHD, particularly when activities are cognitively engaging. Future research should address methodological limitations and explore mediators and moderators in ecologically valid and theory-driven designs.