Effect of psychostimulant medications on static balance performance in adults with attention deficit hyperactivity disorder: Within-subjects repeated-measure study

Mansour M Alotaibi; Robert W Motl; Despina Stavrinos; Scott W Snyder; Harshvardhan Singh; Donald H Lein Jr

doi:10.1016/j.humov.2023.103067

Effect of psychostimulant medications on static balance performance in adults with attention deficit hyperactivity disorder: Within-subjects repeated-measure study

Hum Mov Sci. 2023 Apr:88:103067. doi: 10.1016/j.humov.2023.103067. Epub 2023 Feb 13.

Authors

Mansour M Alotaibi¹, Robert W Motl², Despina Stavrinos³, Scott W Snyder⁴, Harshvardhan Singh⁵, Donald H Lein Jr⁵

Affiliations

¹ Department of Physical Therapy, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia. Electronic address: mansour.alotaibi@nbu.edu.sa.
² Department of Kinesiology and Nutrition, College of Applied Health Sciences, The University of Illinois, Chicago, Chicago, IL, USA.
³ Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Human Studies, School of Education, The University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.

PMID: 36780727
DOI: 10.1016/j.humov.2023.103067

Abstract

Objective: This study examined the effect of psychostimulant medications nPS) on balance and functional motor performance in adults with attention-deficit/hyperactivity disorder (ADHD).

Methods: Participants completed two sessions (off-medication and on-medication) in a within-subjects repeated-measure study design. There was a minimum of seven days between the two sessions. During both sessions, participants stood for 30 s per condition on a force platform. The conditions were: feet-apart with 1) eyes-open and 2) eyes-closed; feet-together with 3) eyes-open and 4) eyes-closed. Participants performed three trials of timed up and go (TUG) and lateral step-up test (LSUT) during both sessions. Outcome measures were sway area (SA [cm²]), average sway velocity (SV [cm/s]), TUG average time (s), and average number of LSUT repetitions. Data were analyzed using multivariate repeated measures analysis of variance and paired t-tests for examining PS effects on balance (SA and SV) and functional motor performance (TUG and LSUT), respectively.

Results: The sample included 45 adults (35 females; mean age = 28.4 ± 6.3 years). The repeated-measures MANOVA indicated that PS was associated with better SA [F(1,44) = 9.6; p = 0.003;η_p² = 0.18] but not with SV [F(1,44) = 1.0; p = 0.319;η_p² = 0.02]. PS was associated with significantly better SA with decreasing base-of-support [F(1,44) = 9.9; p = 0.003;η_p² = 0.18]. Additionally, PS use was associated with better TUG [t(1,44) = 2.65; p = 0.014;Cohen's d = 0.39] but not LSUT performances [t(1,44) = -0.68; p = 0.499;Cohen's d = -0.10].

Conclusions: PS was associated with better SA and TUG in adults with ADHD. Further studies are needed to investigate the effects of PS on balance performance using rigorous designs in this population.

Impact: Healthcare providers should screen for PS status and balance when treating adults with ADHD to enhance safe motor performance.

Keywords: Attention-deficit/hyperactivity disorder; Balance; Motor performance; Postural sway; Psychostimulant medication.

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity*
Case-Control Studies
Female
Humans
Physical Therapy Modalities
Postural Balance
Research Design
Young Adult