Effect of Telerehabilitation-Based Exercise and Motor Imagery Training in Children With ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders with heterogeneous clinical features such as inattention, hyperactivity, and impulsivity. It has been shown that one-third of children with ADHD have problems with tasks that require fine and gross motor skills. In addition, it was stated that the motor skill problems experienced during dynamic balance tasks were more pronounced than typically developing children. The motor problems seen in children with ADHD may be caused by dysfunction in some related brain regions that delayed or impaired cerebellar development may contribute to the pathophysiology of ADHD. Motor imagery skills have been investigated as the underlying cause of motor impairment in children with ADHD and Developmental Coordination Disorder (DCD). Although it has shown that motor imagery is markedly impaired in children with DID; It has been stated that this situation is not clear in children with ADHD. Motor imagery is the mental thinking of a movement without actual movement being revealed. It has been reported that combined physical and mental programs applied at different rates, as well as motor imagery training without physical exercise, are effective in improving postural control. In a study conducted with children with DCD, it was shown that motor imagery training improves children\'s movement skills. In the treatment of ADHD, there are multidimensional treatment approaches that include medical and psychosocial interventions. Pharmacological treatments, including stimulant and non-stimulant drugs, are highly effective in reducing ADHD symptoms and the disruptive behaviours associated with them. Also, physical exercises are known to reduce ADHD symptoms. Exercise methods enable patients receiving drug therapy to respond better to drugs, it has been shown to improve cognitive functions in ADHD cases. In conclusion, the underlying aetiology of motor imagery skills and motor coordination and balance problems in ADHD is not clear. The use of telerehabilitation methods has become widespread due to the difficulties in conducting face-to-face treatment and follow-up processes during the pandemic process. In addition, there is no exercise program based on telerehabilitation and motor imagery in children with ADHD. This study aims to examine the effects of telerehabilitation-based exercise and motor imagery practices on ADHD symptoms and balance skills in children with ADHD.