Postural control among children with and without attention deficit hyperactivity disorder in single and dual conditions

Given the known deficits in attention in attention deficit hyperactivity disorder (ADHD) and the evidence suggesting that postural control requires attention, this study aimed to investigate the mechanisms of postural control of children with and without ADHD in single-(ST) and dual-task (DT) conditions. Postural sway and stabilogram diffusion analysis (SDA) were performed on the Center of Pressure trajectories on 24 ADHD children and 17 age-gendermatched healthy controls. The subjects were instructed to stand as stable as possible on a force platform in two task conditions: (1) single task (ST) and (2) dual task (DT) -an auditory-memory attention-demanding cognitive task. During ST and DT conditions, the ADHD children showed significantly greater ML-sway, short-and long-term effective diffusion coefficients, and critical displacement of SDA compared with controls. The effects of DT were somewhat unexpected; the control group indicated a significant decrease in ML-sway, AP-sway, sway area, and critical displacement of SDA; the ADHD group showed a significant decrease in ML-sway range and critical displacement. It is concluded that a greater sway displacement before closed-loop mechanisms is called into play in ADHD children. The DT enhanced balance control by reinforcing balance automaticity and minimizing sway in both healthy and ADHD children.