ADHD and exercise physiology.
Exercise has a measurable effect on attention, and stimulants change how it should be prescribed. ADHDme’s exercise physiologist is on the Gold Coast.
Exercise physiology in the network
Sees people in person.
What the evidence supports
Twenty to thirty minutes of moderate aerobic exercise gives a small to moderate lift in attention and executive function for about an hour afterwards. That hour is useful directly before study or demanding work. Aerobic exercise has the strongest evidence. Mind-body exercise shows a small effect, and there are too few studies of coordination exercise to say.
Exercise adds to treatment and does not replace it. The effect is modest and short-lived, and decisions about medication stay with your prescriber.
How stimulants change the prescription
Stimulants raise resting heart rate, so standard age-based heart-rate zones overstate effort. A good exercise physiologist uses perceived exertion and the talk test instead. Appetite suppression means many people start a session under-fuelled. Pre-workout caffeine adds to the stimulant’s effect on heart rate and blood pressure, so it is best dropped.
If you have chest pain, fainting, sustained palpitations or unusual breathlessness on a stimulant, stop and see a doctor. An exercise physiologist who works with ADHD should ask for your medication list, including when you take it, and record your resting heart rate and blood pressure at the start.
Making exercise stick
Dropping out usually comes down to executive function more than motivation, so the design of the program matters. Short sessions at a fixed time, little set-up, variety, quick feedback and someone expecting you all help. A minimum session you can always manage, and a rule of never missing twice, does more than an ambitious plan.
How to fund it
You can see an exercise physiologist under a GP’s chronic condition management plan. It gives a partial Medicare rebate on up to five allied health sessions a calendar year, shared across all allied health. Your GP decides whether ADHD can be the chronic condition on the plan; it is lifelong, so it is worth asking. The NDIS, DVA and private health extras are other common routes, and the Gold Coast practice accepts all three.
To find an exercise physiologist elsewhere, ESSA’s public directory lists accredited exercise physiologists by suburb: essa.org.au. The network’s GPs can write the plan.
In the network
Sarah Savage is the senior exercise physiologist at Atlantis Recovery Centre in Bundall. She takes an “exercise as medicine” approach using Pilates, Functional Range Conditioning and hydrotherapy, and has a particular interest in older adults. The practice quotes its fee when you book.
Common questions
Can exercise replace ADHD medication?
No. Exercise gives a modest lift in attention for about an hour after a session, and medication decisions stay with your prescriber.
Is exercise physiology covered by Medicare for ADHD?
It can be, under a GP chronic condition management plan, which gives a partial rebate on up to five allied health sessions a year. Your GP decides whether ADHD is the qualifying condition.
Is it safe to exercise on stimulant medication?
For most people, yes, with some changes: go by effort instead of heart-rate zones, eat before training and skip caffeine pre-workouts. Stop and see a doctor if you have chest pain, fainting or sustained palpitations.
Does ADHDme have an exercise physiologist?
Yes: Sarah Savage at Atlantis Recovery Centre in Bundall, on the Gold Coast. Elsewhere, ESSA’s directory lists accredited exercise physiologists near you.
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