The effects of practicing target-shooting sport on the severity of inattentive, hyperactive, and impulsive symptoms in children: a non-randomised controlled open-label study in Denmark

Nord J Psychiatry. 2019 May-Jul;73(4-5):233-243. doi: 10.1080/08039488.2019.1612467. Epub 2019 May 20.


Purpose: Target-shooting sport requires mental effort and concentration. Training may reduce inattentiveness and distractibility. There is little knowledge if children with symptoms of attention-deficit/hyperactivity disorder (ADHD) benefit from practicing target-shooting sport. Materials and methods: Our study aims to investigate this in a non-randomised controlled open-label study of 128 children, 10-14 years of age, with ADHD-symptoms. The intervention-group (n = 64) practiced target-shooting in local shooting associations once a week for 6 months. The control group (n = 64) received treatment as usual. Primary outcome: teacher-rated ADHD-RS-IV-total score. Secondary outcomes: (a) parent-rated ADHD-RS-IV-total score; (b) teacher- and parent-rated Strengths-and-Difficulties-Questionnaire (SDQ); (c) self-rated quality of life (KIDSCREEN-27-total score); and (d) four objective measurements of ADHD-symptoms using the QbTest. The data were collected at baseline and after 6 months. Results: When estimating the marginal effect of the intervention on our primary outcome, the teacher-rated ADHD-RS-IV, we found no significant effect (mean change between groups (contrast)=2.23; p = 0.193). However, we did find significant beneficial effects on four of the eight secondary outcomes, including the parent-rated ADHD-RS-IV-total score (contrast = 4.76; p = 0.024), the parent-rated SDQ-total score (contrast = 2.09; p = 0.027), and on the QbTest measurements of the Reaction Time Variation (RTVar) (contrast = 36.96; p = 0.013), and of Omission Errors (contrast = 7.57; p = 0.019). Conclusions: Despite the negative result on the primary outcome, the robust findings on these secondary outcomes in this open-label study indicate proof of concept that practicing target-shooting sport may have some beneficial effects on the severity of ADHD-symptoms in children. No adverse events were reported. Randomised trials of this non-pharmacological intervention are needed.

Keywords: ADHD; Children; hyperactivity; inattention; non-pharmacological interventions; physical activity.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Child
  • Denmark / epidemiology
  • Female
  • Firearms*
  • Follow-Up Studies
  • Humans
  • Impulsive Behavior* / physiology
  • Male
  • Parents / psychology
  • Psychomotor Agitation / epidemiology
  • Psychomotor Agitation / psychology
  • Psychomotor Agitation / therapy
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Sports / physiology
  • Sports / psychology*
  • Treatment Outcome