Open assessment of the therapeutic and rate-dependent effects of brain balance center® and interactive metronome® exercises on children with attention deficit hyperactivity disorder.

The aim of this open study was to delineate domains of benefit and effect size measures to design an appropriately powered randomized control trial to assess the efficacy of Brain Balance ^@ exercises and Interactive Metronome ^@ training (BB/IM) on ADHD symptoms in children. Participants underwent an extensive 15-week, 5 time per week, at-home training program. Results were assessed in 16 youths with ADHD (14M/2F, 10.8±1.7 years) who completed the program and compared to 8 typically developing controls (4M/F4, 11.0±1.8 years). BB/IM was associated with a significant reduction of 8.3 and 8.2 points on the Conner's Parent Rating Scale - Revised and the ADHD Rating Scale - IV. BB/IM was not associated with improvement on the Quotient ADHD System but with rate-dependent effects on hyperactivity and attention that were similar to previously reported effects of low dose methylphenidate. Both therapeutic and rate-dependent effects were observed on the Tower of London. The study provides information that could be used to design a randomized control trial, which is required for proof of efficacy. A key limitation is that 59% of the 39 enrolled participants with ADHD dropped out of the study and a new study should include multiple ratings during the course of treatment.
Competing Interests: Declaration of Competing Interest Dr. Teicher was provided with travel and accommodation to present at a Brain Balance Center annual meeting but did not receive an honorarium. He has received de minimis consulting fees from Brain Balance and Interactive Metronome. Dr. Teicher developed the Quotient ADHD System that was licensed to BioBehavioral Diagnostics/Pearson and received royalties for its use in accordance with conflict of interest policies at Harvard Medical School and Partners Health Care. Quotient ceased being licensed on January 1, 2019. None of the other authors have any declarations of interest to disclose.
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