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This study will explore the feasibility, acceptability, and potential benefits of a group-based tailored yoga programme designed for adults experiencing symptoms of attention-deficit hyperactivity disorder. The yoga intervention will be compared to an active control (group-based functional movement classes).
The primary aim of the study is to test the feasibility and acceptability of a tailored, group-based yoga intervention for adults with attention-deficit hyperactivity disorder, by monitoring recruitment, engagement, and completion rates, and through obtaining qualitative feedback from participants at the end of the intervention.
A secondary aim is to explore whether the yoga intervention is associated with improvements in attention-deficit hyperactivity disorder and related symptoms (i.e., anxiety, depression), quality of life, and general functioning, compared to a control intervention (group-based functional movement sessions). The secondary outcomes will be assessed with self-report questionnaires at the start, middle and end of the yoga and control interventions, and three months after completion of the interventions.
The investigators will also examine aspects of cognitive and physiological functioning through laboratory testing at the start and end of the intervention, focusing on measures of autonomic activation (e.g., the 'fight or flight response), bodily awareness, attention, and response inhibition. Physiological functioning, such as sleep quality, activity levels, and heart rate, will be monitored throughout the six-week study with wearable devices (e.g., Fitbit activity trackers), to provide longer-term, real-world insights into the possible benefits of the intervention.
The investigators will explore whether the yoga intervention is associated with improvements in attention-deficit hyperactivity disorder and related symptoms/abilities, including emotional regulation, social behaviour, attention, focus, interoception and stress reactivity. The investigators will also explore whether the yoga intervention is linked with improved bodily stress markers (heart rate variability), sleep, and physical activity.
This feasibility randomised controlled trial will include 20 participants who will be randomly allocated (1:1) to either the group-based tailored yoga therapy intervention (n=10), or a group-based functional movement class (n=10). The latter will be a structured class focusing on light strength, mobility and flexibility.
All participants will attend an initial in-person laboratory testing session at the start and end of the 6-week intervention. Each week, both intervention group and control group will attend an in-person one-hour group session. Each week, participants will be asked to practice at least twice, using a 20-minute video recording on demand from home. Outcomes will be measured using self-report, lab-based, and digital wearable measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tailored yoga | Experimental | A 6-week group-based yoga programme designed for people experiencing attention-deficit hyperactivity disorder symptoms. |
|
| Functional movement | Other | Participants will receive an active control of functional movement. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tailored yoga therapy. | Behavioral | Participants in this arm will participate in a six-week study. They will attend one hour-long group-based in-person session per week, as well as practising from home at least twice weekly following along an online video (which will be a practice of what was learnt in-person that week). Each group yoga session will start with some Pranayama (yogic breathwork) to engage participants' attention and to help them focus. The intervention will progress from purely activating yogic breathwork techniques, to some calming and grounding techniques to aid relaxation, bodily awareness and to reduce stress. Sessions will also involve some faster movements to align the body with typically faster mental activities as seen within individuals with ADHD. Some sessions may progress to include some mindful somatic movements and some longer held poses to enhance relaxation and tension release. Towards the end of the intervention there will be longer opportunities for mindful awareness through meditation. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility outcomes. | The investigators will monitor recruitment, engagement and completion rates to assess feasibility, and will obtain qualitative participant feedback at the end of the intervention. | From enrolment to the 3-month follow-up. |
| Measure | Description | Time Frame |
|---|---|---|
| Exploratory assessment of self-reported change in attention-deficit hyperactivity disorder. | The outcomes will be assessed with self-report questionnaires at the start, middle and end of the yoga and control interventions, and 3-months after completion of the intervention. | From enrolment to the 3-month follow-up. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in self-reported general health symptoms. | The investigators will assess anxiety levels (Generalized Anxiety Disorder - 7), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness), health (Patient Health Questionnaire - 8), quality of life (36-item Short Form survey), and social functioning (Work & Social Adjustment Scale). | From enrolment to the 3-month follow-up. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Susannah Pick, PhD | King's College London | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| King's College London | London | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35764793 | Background | Yildiz S, Grinstead J, Hildebrand A, Oshinski J, Rooney WD, Lim MM, Oken B. Immediate impact of yogic breathing on pulsatile cerebrospinal fluid dynamics. Sci Rep. 2022 Jun 28;12(1):10894. doi: 10.1038/s41598-022-15034-8. | |
| 20031097 | Background | Wilens TE, Biederman J, Faraone SV, Martelon M, Westerberg D, Spencer TJ. Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD. J Clin Psychiatry. 2009 Nov;70(11):1557-62. doi: 10.4088/JCP.08m04785pur. |
| Label | URL |
|---|---|
| ADHD UK Charity, used for accessing data on diagnoses in the UK. | View source |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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Feasibility randomised controlled trial.
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|
| Functional movement. | Behavioral | Participants in this arm will similarly participate in a six-week study. They will attend one hour-long group-based in-person session per week, as well as practising from home at least twice weekly following along an online video (which will be a practice of what was learnt in-person that week). The functional movement control sessions will serve as an exercise class, with educational aspects. All sessions will follow a similar structure of light strength exercises, mobility exercises and end with some flexibility exercises. This control condition was selected to control for the physical aspects the yoga intervention, allowing us to isolate the possible benefits of yoga due to breathwork and mindfulness. |
|
| Laboratory-based assessments to test changes in autonomic arousal. | The investigators will examine aspects of physiological functioning through laboratory testing at the start and end of the intervention, focusing on measures of autonomic activation (e.g., the 'fight or flight response), through electrocardiogram and skin conductance. | Baseline to post-intervention. |
| Laboratory-based assessments to test changes in executive functioning attention. | The investigators will test attention through The Sustained Attention Task. | Baseline to post-intervention. |
| Laboratory-based assessments to test changes in executive functioning inhibition control. | The investigators will test response inhibition through the Stop Signal Task. | Baseline to post-intervention. |
| Wearable-derived measures of physiological functioning. | Physiological functioning will be monitored throughout the six-week study and follow-up period with wearable devices (Fitbit Inspire 3 activity tracker watches). | From enrolment to the 3-month follow-up. |
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