This study examined whether dance-based video gaming could help young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) improve attention, emotional wellbeing, and self-regulation. ADHD can affect focus, impulse control, coordination, and mood. Although medications are helpful for many individuals, they may produce side effects, may not lead to lasting improvement, or may not be accessible to everyone. Because of this, there has been growing interest in enjoyable, accessible, non-medication approaches to support symptom management. This research evaluated how different activities influenced the brain, body, and behavior. Participants were young adults ages 18-24 with a formal ADHD diagnosis. Each participant completed two visits: a baseline visit and an intervention visit. At baseline, participants completed questionnaires measuring ADHD symptoms, mood, and daily functioning. They also performed computer-based tasks assessing attention, inhibition, mental flexibility, and working memory while wearing an electroencephalography (EEG) cap to measure brain activity and a wearable heart rate monitor. Participants also completed balance assessments using a force plate that measured postural control. At the intervention visit, participants were randomly assigned to one of three 30-minute conditions:

• Dance exergaming (Just Dance video game) - active, dance-based movement
• Stationary biking - aerobic exercise while listening to music and watching dance gameplay videos
• Music listening - seated condition listening to the same music and watching the same videos

During these activities, EEG and heart rate were recorded. Afterward, participants repeated the same brain, cognitive, and balance assessments completed at baseline. A cool-down period was provided in all groups. This study allowed investigators to examine ADHD from multiple perspectives. The study assessed how movement, music, and dance influenced symptoms; how the brain responded during and after these activities; how the heart and nervous system adapted; and how balance and motor control changed. The study also evaluated how these systems (brain, body, and behavior) interacted with one another. By comparing dance exergaming with traditional aerobic exercise and a non-exercise condition, this study aimed to determine whether dance-based activity provided distinct benefits for young adults with ADHD. The goal was to better understand whether fun, creative, and widely accessible activities could support attention, emotional wellbeing, and physical regulation and whether they could complement existing treatment approaches.

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 embodiedbrainlab@gmail.com 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

De-identified behavioral, physiological, and electroencephalography (EEG) data from this study will be shared. Data will be made available beginning 12 months after publication of the primary results and will remain accessible for 5 years. Qualified researchers may request access by submitting a brief proposal to the Principal Investigator outlining study aims and data security procedures. Approved researchers will sign a data use agreement. Only de-identified data will be provided, and use will be restricted to scientific, non-commercial purposes.

Data will be made available beginning 12 months after publication of the primary results and will remain accessible for 5 years.

Qualified researchers may request access by submitting a brief proposal to the Principal Investigator outlining study aims and data security procedures. De-identified behavioral, physiological, and electroencephalography (EEG) data from this study will be shared.