Effect of psychostimulant medications on functional balance performance in persons with Attention-Deficit/Hyperactivity Disorder: A systematic review

Mansour M Alotaibi; Despina Stavrinos; Robert W Motl; Megan Bell; Scott W Snyder; Christopher P Hurt; Harshvardhan Singh; Donald H Lein Jr

doi:10.1016/j.gaitpost.2023.03.019

Effect of psychostimulant medications on functional balance performance in persons with Attention-Deficit/Hyperactivity Disorder: A systematic review

Gait Posture. 2023 May:102:146-158. doi: 10.1016/j.gaitpost.2023.03.019. Epub 2023 Mar 30.

Authors

Mansour M Alotaibi¹, Despina Stavrinos², Robert W Motl³, Megan Bell⁴, Scott W Snyder⁵, Christopher P Hurt⁶, Harshvardhan Singh⁷, Donald H Lein Jr⁸

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 Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: dstavrin@uab.edu.
³ Department of Kinesiology and Nutrition, College of Applied Health Sciences, The University of Illinois Chicago. Chicago, IL, USA. Electronic address: robmotl@uic.edu.
⁴ UAB Libraries, Lister Hill Library of the Health Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: mmbell@uab.edu.
⁵ Department of Human Studies, School of Education, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: ssnyder@uab.edu.
⁶ Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: cphurt@uab.edu.
⁷ Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: hsingh@uab.edu.
⁸ Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: dlein@uab.edu.

PMID: 37018889
DOI: 10.1016/j.gaitpost.2023.03.019

Abstract

Rationale: Balance impairments are highly prevalent and underscreened in individuals with Attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications, used to treat ADHD symptoms, may improve balance performance in this population as demonstrated by a growing literature; however, there has not been a systematic investigation to understand the effects of psychostimulant medications on balance performance in individuals with ADHD. This systematic review examined the existing evidence to determine if psychostimulant medications improve balance performance in this population.

Methods: We searched PubMed, CINAHL, SPORTDiscus, Scopus, Embase and Cochrane in March 2021 and in January 2022 to locate articles relevant to the topic. Two reviewers evaluated the methodological quality of included articles using the Study Quality Assessment Tools and the PEDro scale. The reviewers rated articles for the level of evidence based on the American Academy of Neurology (AAN) criteria. The reviewers further offered recommendations for research and clinical practice based on the strength of the reviewed articles using the AAN criteria. Additionally, the reviewers gleaned important characteristics from each article, such as study design, balance domain and study results.

Results: Nine articles addressed the role of psychostimulant medications on balance outcomes. These articles included two Class II studies, two Class III studies and five Class IV studies. Based on study quality, this systematic review indicated low confidence in the use of psychostimulant medications for improving balance performance based on AAN criteria.

Conclusion: Psychostimulant medications trends to enhance balance performance in individuals with ADHD. However, the lack of well-designed studies and heterogeneity of balance measures warrant additional research.

Keywords: ADHD; Balance; Motor Control; Postural; Psychostimulant Medication; Sway.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Attention Deficit Disorder with Hyperactivity* / drug therapy
Central Nervous System Stimulants* / therapeutic use
Humans

Substances

Central Nervous System Stimulants