All ETDs from UAB

Advisory Committee Chair

Donald H Lein Jr

Advisory Committee Members

Robert W Motel

Despina Stavrinos

Scott Snyder

Harshvardhan Singh

Document Type

Dissertation

Date of Award

2022

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition prevalent in children globally and continues to persist into adulthood. Executive function (EF) impairments are core ADHD deficits, specifically response inhibition, and believed to drive ADHD symptoms. Psychostimulant medications (PS) is the first line treatment to manage ADHD symptoms. Overall, individuals with ADHD are at greater risk of falls and physical injuries compared to healthy individuals. Perhaps adults with ADHD balance impairments are secondary to ankle plantarflexor (PF) spasticity. Using psychostimulant medications (PS) improves PF spasticity and postural control in children with ADHD, but the effects on adults with ADHD are unclear. Furthermore, moderate-to-vigorous physical activity (MVPA) has also been found associated with static balance in healthy adults. We designed a within-subject repeated measure study to assess PS effects on static balance and muscle tone and to identify if MVPA and response inhibition are associated with static balance in adults with ADHD. The findings of this dissertation are intended to guide future research concerning the improvement of balance in adults with ADHD. Study 1 documented that using PS medication was associated with improved static balance and functional motor performance compared to off medication state in adults with ADHD. Study 2 determined that adults with ADHD exhibited a slight increased PF spasticity (measured by the Modified Ashworth Scale). In addition, this study demonstrated that using PS was ii associated with reduced the reflex mediated component spasticity (measured by a dynamometer) only among adults with the predominantly Inattentive subtype of ADHD. Study 3 identified significant associations between MVPA and response inhibition with static balance during off medication state only. In summary, this dissertation demonstrates the effects of using PS on static balance and PF spasticity, and associations between MVPA and EF with static balance performance in adults with ADHD during off and on medication status. The findings of this research project may guide clinicians and researchers who work with this population to attend to PS use and develop interventional programs that aim to improve static balance.

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