Effects of Performing Arts on Attention-deficit/Hyperactivity Disorder (ADHD)

Participants were recruited from the greater Southwest Virginia and New River Valley regions through social media platforms (e.g., Facebook, Instagram, X), flyers distributed in the community, and in-person recruitment events. Interested individuals contacted the research team at [email protected] and were sent a brief screening questionnaire via REDCap along with an online screening consent form. Screening included the Physical Activity Readiness Questionnaire and questions assessing whether individuals had a formal ADHD diagnosis, relevant medical conditions or medications, and whether they met the study's age requirement (18-24 years). Individuals were also asked about exclusionary conditions such as neurological disorders, Tourette syndrome, epileptic disorders, and pregnancy. Those who met eligibility criteria were invited to review and sign the full informed consent form and were then asked to provide proof of their ADHD diagnosis, which was visually verified and retained in study files. Eligible participants were randomized to one of three intervention groups: a 30-minute dance exergaming session (experimental group), a 30-minute stationary biking session, or a 30-minute music-listening session (control groups). All study visits took place at the Science and Art of Movement Laboratory in the Center for the Arts at Virginia Tech.

Each participant completed two scheduled sessions. Availability was arranged through email or Microsoft Bookings, and participants were asked to abstain from caffeine on the day of testing due to its stimulant effects. The first visit served as a baseline assessment lasting approximately 90 minutes. During this session, participants completed questionnaires covering demographic information, medication use, recent food and drink intake, injury history, physical activity levels, and mental health constructs, including the Adult ADHD Self-Report Scale, Beck Depression Inventory, Beck Anxiety Inventory, and the DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure. Research staff then fitted participants with an EEG cap, after which participants completed a 5-minute resting-state recording of brain activity and heart rate while viewing a crosshair. Participants then performed four validated executive-function tasks on the INQUISIT platform-Color Word Stroop Task, Cued Go/No-Go Task, Wisconsin Card Sort Task, and Visual Digit Span Test-followed by six quiet-standing balance trials on a force plate (three with feet shoulder-width apart and three in tandem stance).

Approximately one week later, participants returned for their intervention session, which followed a parallel structure. They first completed the same questionnaire battery and resting EEG recording as during baseline. A 3-minute warm-up was completed prior to the assigned intervention. Participants then engaged in their randomized activity-dance exergaming, stationary biking, or music listening-for 30 minutes while wearing EEG and a Polar heart-rate monitor. Heart rate was continuously monitored, and research staff periodically checked in to ensure safety. Every 5 minutes, participants reported their perceived exertion using the Borg Rating of Perceived Exertion Scale. Following the intervention, all participants completed a 30-minute cool-down period with access to water, non-caffeinated tea, and comfortable seating. After cool-down, participants again completed a 5-minute resting EEG/heart rate recording, followed by the same executive-function and balance tasks they performed during the baseline visit.

Inclusion criteria

• Ages 18 to 24
• Formal diagnosis of ADHD (inattentive, hyperactive-impulsive, or combined)

Exclusion criteria

• Current comorbid neurological disorder (e.g. seizure disorder; multiple sclerosis), tourette syndrome, or epileptic disorder
• Contraindication to physical activity
• Pregnancy
• Incarceration
• Inability to consent on own behalf
• Non-ambulatory