研究目的：

      探讨羽毛球运动干预对ADHD 儿童执行功能及粗大动作能力的影响，为促进 ADHD 儿童的运动疗法提供借鉴。

研究方法:

      从北京市某专科医院儿童精神科门诊募集确诊的ADHD 儿童 10名，随机分为实验组和等待组各5 名，实验组儿童年龄范围（7.81-8.52）岁，3名为注意缺陷型，2名为混合型；等待组年龄范围（7.75-8.73）岁，3名注意缺陷型，2名混合型。按年龄相差不超过半岁从某普通小学募集正常对照组学生 5 名，等待组和正常对照组以常规体育教学内容进行体育活动，实验组则接受自行编制的个性化的羽毛球运动干预方案进行干预，内容包括技能学习模块A-E、技能学习模块A1-E2、专项运动模块、羽毛球游戏四部分，为期10周，每周3次，线下1次90分钟，线上2次30分钟。采用线上线下共同干预方式。实验前后采用大肌肉动作发展测试量表（Test of Gross Motor Development-Third Version,TGMD-3）评估被试的动作发展水平；实验前后测试采用执行功能中Stroop色词测验、Rey-Osterrich 复杂图形测验（complex figure test，CFT）、连线测验（trail making test，TMT）评估被试的抑制控制、工作记忆和认知灵活性能力。利用单因素方差分析、配对样本 t 检验等比较三组干预前后组间和组内的各指标变化情况，显著性水平为 P＜0.05。

研究结果：

（1）干预前：Stroop色词测试中， A、B和C测试的时间和C测试的错误数三组之间均无显著差异（P均>0.05);ADHD实验组和等待组Stroop-A、B、D测试的错误数、D时间以及颜色干扰时、字义干扰时均显著高于正常对照组（P均<0.05），但两组之间无显著性差异（P均>0.05)。

       ADHD实验组在工作记忆测试的即时细节记忆、延时结构记忆和延时细节记忆得分均低于正常对照组，差异具有统计学意义（P均<0.05）。各项得分与等待组相当（P均>0.05）。

       正常对照组的儿童的TGMD-3得分显著高于ADHD实验组和ADHD等待组（P<0.05），ADHD实验组和ADHD等待组在TGMD-3得分中则无显著性差异（P>0.05）。

干预后：ADHD实验组Stroop-A、B、D测验时间和B错误数和颜色干扰时均显著减少（P<0.05）；ADHD等待组和正常对照组各项指标均无显著差异（P>0.05）；ADHD实验组Stroop-A、B、D测试时间以及Stroop-B的错误数均低于等待组（P<0.05）。

      ADHD实验组的即时结构、即时细节以及延时细节记忆的得分均得到显著提升（P<0.05）,延时结构无明显提升（P>0.05）；等待组和正常对照组儿童各项得分无显著变化（P>0.05）；实验组的即时结构和即时细节的得分均高于ADHD等待组（P<0.05），并与正常对照组相当；而ADHD等待组的Rey-Osterrich测试得分仍低于正常对照组，差异具有统计学意义（P<0.05)。

      TGMD-3方面三组组间比较显示，ADHD实验组的TGMD-3得分与正常对照组相当，但显著高于ADHD等待组（P<0.05）。

个案结果

      个案A干预前Stroop-D时间67.51秒，D错误数为7，字义干扰时为29.41秒。B数字字母连线时间156.2秒，B错误数为8。即时结构记忆和延时结构记忆得分分别为3分和2分。粗大动作总分63，总体水平为及格，位移和物控均低于标准水平。通过10周线下线上羽毛球运动干预后，Stroop-D时间和D错误数分别减少了26%和29%，颜色干扰时和字义干扰时分别缩短了59%和42.2%。B数字字母连线错误数降低幅度50%。延时细节记忆提升62.5%。粗大动作方面，总分提升16分，等级水平从及格提升到良好水平，其中位移提升了12分，等级提升至优秀等级；物控提升了10分，等级从及格提升到良好。

     个案B干预前Stroop-D时间62.1秒，D错误数为6，字义干扰时为24.8秒；数字字母连线时间B 186.28秒，B错误数为3；即时结构记忆和延时结构记忆得分分别为4分和2分。粗大动作总分为49，等级为不及格，物控和位移得分分别为22分和27分。羽毛球运动干预后其Stroop-B错误数提升幅度50%，Stroop-D时间和错误数分别2%和33%，字义干扰时提升51.1%。A数字连线时间提升幅度51.9%，B数字字母连线错误数减低33%。延时细节记忆提升幅度60%，即时结构记忆和即时细节记忆均提升50%。粗大动作方面总分提升18分，等级水平从不及格提升到良好水平。其中位移提升了12分，等级从及格提升至良好。物控提升了6分，等级从不及格提升到及格水平。

      个案C干预前Stroop-D测验时间和错误数分别为78秒和6个，颜色干扰时为18秒，字义干扰时为40秒。B数字字母连线时间为196秒，B错误数为3个。即时结构记忆和延时结构记忆得分均为1分。粗大动作总分为47分，等级为不及格，物控和位移得分分别为21分和26分。干预后Stroop-C时间减少33.1%，StroopA-D测试错误数均有减少，颜色干扰时提升50.5%，字义干扰时提升47.9%。认知灵活性方面，B数字字母连线错误数降低66%。工作记忆方面，即时构记忆提升幅度最高。粗大动作后测得分为64，提升17分，位移提升了9分，等级上升为良好，物控成绩提升了8分，等级上升为及格。

      个案D干预前Stroop-D测验时间和错误数分别为64.34秒和4个，颜色干扰时为12.7秒，字义干扰时为37.49秒。B数字字母连线时间、错误数分别为165.16秒和4个。延时结构记忆和即时细节记忆为最低和最高，分别为2分和7分。粗大动作总分为68分，初始等级为良好，物控、位移成绩分别为40分和28分。干预后， StroopB、D错误数降低幅度均为50%，颜色干扰时减低9.21%，字义干扰时减少38.9%。B数字字母连线错误降低75%，延时细节记忆提升最高为128%。粗大动作总分88，提升了20分，等级为优秀，其中位移成绩提升了12分，等级由及格提升到良好，物控成绩提升了8分，等级提升到优秀。

      个案E干预前Stroop-D时间57.48秒，StroopC、D错误数均为5个，颜色干扰时为6.36秒，字义干扰时为33.48秒。B数字字母连线时间132秒，错误数为5个。延时结构记忆得分1分。粗大动作总分为55，等级为不及格，位移成绩低于物控成绩。干预后Stroop-A、B错误数降低幅度50%，颜色干扰时减少34.1%，字义干扰时减少20.3%。A、B数字字母连线错误数分别提高100%和60%。工作记忆方面，即时细节记忆提升幅度最高。粗大动作后测得分为73分，提升了18分等级提升2级，为良好，其中位移成绩提升了8分，等级提升2级，为良好，物控成绩提升了10分，等级提升1级，到良好。

研究结论：

      10周个性化羽毛球运动干预可有效提升ADHD儿童的执行功能，尤其能改善抑制控制和认知灵活性；羽毛球干预还能促进包括位移和物控动作在内的粗大动作能力。

Research objectives:

   To explore the influence of badminton intervention on executive function and gross motor ability of ADHD children, and to provide reference for promoting exercise therapy for ADHD children.

Research methods:

  Ten children diagnosed with ADHD were recruited from the child psychiatric clinic of a special hospital in Beijing and randomly divided into the experimental group and the waiting group with 5 children in each group. The children in the experimental group ranged in age from 7.81-8.52 years old, with 3 children of attention deficit type and 2 children of mixed type. The waiting group ranged in age from 7.75 to 8.73 years, with 3 cases of attention deficit type and 2 cases of mixed type. Five students in the normal control group were recruited from an ordinary primary school with an age difference of less than half a year. The waiting group and the normal control group were treated with regular physical education content for physical activities, while the experimental group was treated with personalized badminton intervention program prepared by themselves. The content includes four parts: skill learning module A-E, skill learning module A1-E2, special sports module and badminton game. It lasts for 10 weeks, three times A week, 90 minutes once offline and 30 minutes twice online. Adopt online and offline joint intervention method. Test of Gross Motor Development-third Version (TGMD-3) was used to evaluate the Motor Development level of the subjects before and after the experiment. Before and after the experiment, Stroop color word test in executive function, Rey-Osterrich complex figure test (CFT) and trail making test (TMT) were used to evaluate the inhibitory control, working memory and cognitive flexibility of the subjects. One-way analysis of variance and paired sample t test were used to compare the inter-group and intra-group changes of each index before and after the intervention of the three groups, and the significance level was P < 0.05.

Research results:

(1) Before intervention: in Stroop color word test, the time of A, B and C test and the number of errors of C test were not significantly different among the three groups (all P >0.05); The number of Stroop-A, B and D test errors, D time, color interference time and meaning interference time of ADHD experimental group and waiting group were significantly higher than those of normal control group (P <0.05), but there was no significant difference between the two groups (P >0.05).

The scores of immediate detail memory, delayed structural memory and delayed detail memory in the ADHD experimental group were lower than those in the normal control group in the working memory test, the differences were statistically significant (P <0.05). The scores were similar to those of the waiting group (all P >0.05).

The TGMD-3 scores of children in the normal control group were significantly higher than those in the ADHD experimental group and the ADHD waiting group (P<0.05), but there was no significant difference in TGMD-3 scores between the ADHD experimental group and the ADHD waiting group (P>0.05).

(2) After intervention: Stroop-A, B, D test time, B errors and color interference were significantly reduced in ADHD experimental group (P<0.05); There were no significant differences between ADHD waiting group and normal control group (P>0.05). The Stroop-A, B, D test time and Stroop-B error number of ADHD experimental group were lower than those of waiting group (P<0.05).

The scores of immediate structure, immediate detail and delayed detail memory of ADHD experimental group were significantly improved (P<0.05), while the delayed structure was not significantly improved (P>0.05). There were no significant changes in scores between waiting group and normal control group (P>0.05). The scores of instant structure and instant details in the experimental group were higher than those in the ADHD waiting group (P<0.05), and were similar to those in the control group. The Rey-Osterrich test score of ADHD waiting group was still lower than that of normal control group, and the difference was statistically significant (P<0.05).

Comparison of TGMD-3 among the three groups showed that the TGMD-3 score of the ADHD experimental group was similar to that of the normal control group, but significantly higher than that of the ADHD waiting group (P<0.05).

(3) Case results

In case A, the Stroop-D time before intervention was 67.51 seconds, the number of D errors was 7, and the number of meaning interference was 29.41 seconds. B The connection time between digits and letters is 156.2 seconds. The number of B errors is 8. The scores of immediate structural memory and delayed structural memory were 3 points and 2 points respectively. The total score of gross movement is 63, the overall level is pass, the displacement and matter control are lower than the standard level. After 10 weeks of offline and online badminton intervention, Stroop-D time and D errors were reduced by 26% and 29% respectively, while color interference and word interference were shortened by 59% and 42.2% respectively. B The number of incorrect alphanumeric connections is reduced by 50%. Delayed detail memory improved by 62.5%. In the aspect of gross movements, the total score was increased by 16 points, and the grade level was raised from pass to good level. The displacement was increased by 12 points, and the grade was raised to excellent level. Matter Control has been upgraded by 10 points, from Pass to good.

In case B, the Stroop-D time before intervention was 62.1 seconds, the number of D errors was 6, and the number of word interference was 24.8 seconds. Alphanumeric connection time B 186.28 seconds, B error number is 3; The scores of immediate structural memory and delayed structural memory were 4 points and 2 points respectively. Gross moves receive an overall score of 49 and a failing grade, while object control and displacement scores are 22 and 27, respectively. After badminton intervention, Stroop-B errors increased by 50%, Stroop-D time and errors increased by 2% and 33% respectively, and meaning interference increased by 51.1%. A number connection time increased by 51.9%, B number error reduced by 33%. Delayed detail memory increased by 60%, and both immediate structural memory and immediate detail memory increased by 50%. Gross moves up 18 points, grade level from failing to good. Displacement increased by 12 points, from pass to good. Matter Control went up 6 points, from failing to passing.

Before the intervention of case C, the Stroop-D test time and number of errors were 78 seconds and 6 seconds respectively, 18 seconds for color interference and 40 seconds for word interference. The connection time of B digits and letters is 196 seconds, and the number of B errors is 3. Both immediate structural memory and delayed structural memory scored 1 point. Gross movements were given an overall score of 47, a failing grade, while object control and displacement scores were 21 and 26, respectively. After intervention, Stroop-C time was reduced by 33.1%, StroopA-D test errors were reduced, color interference increased by 50.5%, meaning interference increased by 47.9%. In terms of cognitive flexibility, the number of B-number letter errors decreased by 66 percent. In terms of working memory, immediate structural memory improved the most. Gross movement post-test score was 64, improved by 17 points; displacement was improved by 9 points, and the grade was improved to good; material control score was improved by 8 points, and the grade was improved to pass.

In case D, the Stroop-D test time and number of errors were 64.34 seconds and 4 seconds, respectively, in case of color interference, 12.7 seconds, and in case of word interference, 37.49 seconds. B The number of letters connected in 165.16 seconds and the number of errors are 4. Delayed structural memory and immediate detail memory were the lowest and highest, scoring 2 and 7 points respectively. Gross motion score is 68 points, the initial rating is good, object control and displacement scores are 40 points and 28 points respectively. After intervention, the number of StroopB and D errors decreased by 50%, 9.21% in color interference and 38.9% in word interference. B Alphanumeric alignment errors reduced by 75%, and delayed detail memory improved by up to 128%. The total score of gross movement was 88 points, which increased by 20 points, and the grade was excellent. The displacement score was increased by 12 points, and the grade was improved from pass to good. The material control score was increased by 8 points, and the grade was improved to excellent.

In case E, the Stroop-D time before intervention was 57.48 seconds, and the StroopC and D errors were both 5, 6.36 seconds in the case of color interference and 33.48 seconds in the case of word interference. B The number and letter connection time is 132 seconds, and the number of errors is 5. Delayed structural memory score 1 point. Gross movement total score is 55, grade is failing, displacement score is lower than the object control score. After intervention, the number of Stroop-A and B errors decreased by 50%, color interference by 34.1%, and meaning interference by 20.3%. The number of incorrect connection of letters A and B is increased by 100% and 60% respectively. In terms of working memory, immediate detail memory improved the most. The gross movement post-test score was 73 points, 18 points higher and 2 levels higher to good. The displacement score was 8 points higher and the grade was 2 levels higher to good. The object control score was 10 points higher and the grade was 1 level higher to good.

Research conclusion:

      The 10-week individualized badminton sports intervention can effectively improve the executive function of ADHD children, especially the inhibitory control and cognitive flexibility. The badminton intervention also promotes gross motor abilities, including displacement and object control.