To Örebro University

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by inattention and hyperactivity that impair everyday functioning. While pharmacotherapy remains the mainstay of treatment, clinical guidelines recommend a multimodal approach. However, evidence for physical exercise as an adjunctive treatment option remains scarce. Consequently, there is a large unmet need for the development and evaluation of non-pharmacological treatment options. START is a novel intervention for adults with ADHD that consists of a structured physical exercise programme. The overall aim of this thesis is to evaluate the START intervention as a treatment for adults with ADHD using an interdisciplinary approach. By integrating quantitative assessments of feasibility and clinical outcomes with qualitative analyses of lived experience, the thesis aims to provide a comprehensive understanding of the intervention’s feasibility, relevance and impact. The thesis is based on four papers. Paper I is a randomised pilot study evaluating the feasibility and tolerability of the START intervention; it shows that the intervention was feasible and indicated beneficial trends. Papers II and III are based on a randomised controlled trial of 63 participants. Paper II investigates the effects of the START intervention on core ADHD symptoms, sleep problems and quality of life; its results demonstrate moderate to large effects on all assessed outcomes. Paper III evaluates the effect of START on body awareness and movement quality; the findings show that body awareness was improved by the intervention. Paper IV is a qualitative study exploring participant experiences with the START intervention; its findings reveal multifaceted meanings of exercise and an increased sense of agency through participation. In conclusion, the findings of this thesis suggest that physical exercise in a health care context is a potent treatment option for adults with ADHD.