Background: Children with ADHD frequently experience motor deficits impacting functional performance. While physical activity offers cognitive benefits, evidence regarding its efficacy on standardized motor domains remains limited. This study evaluated a 12-week structured physical activity intervention on fine and gross motor skills in children with ADHD.

Methods: In this quasi-experimental study, 40 children (aged 7–10 years) with clinical ADHD (DSM-5) were assigned to an intervention group (n=20) or a control group (n=20). The intervention involved 12 weeks of structured physical activity (three 45-minute sessions/week; moderate-to-vigorous intensity) targeting coordination, balance, and precision. Motor performance was assessed at baseline and Week 13 using the Bruininks–Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Data were analyzed via ANCOVA, adjusting for baseline scores and medication status.

Results: All participants completed the trial (mean adherence: 92.8%). After adjusting for baseline and medication, the intervention group showed significant improvements over controls in fine motor standard scores (adjusted posttest mean=52.30, 95% CI [50.28, 54.32] vs. 44.05, 95% CI [42.02, 46.08]; adjusted difference=8.25, 95% CI [5.82, 10.68]; F(1,37)=20.18, P<.001, η2p=.35) and gross motor standard scores (adjusted posttest mean=55.25, 95% CI [53.27, 57.23] vs. 46.10, 95% CI [44.12, 48.08]; adjusted difference=9.15, 95% CI [6.62, 11.68]; F(1,37)=23.45, P<.001, η2p=.39). No adverse events occurred.

Conclusion: A 12-week structured physical activity intervention significantly improved fine and gross motor skills in children with ADHD. Integrating structured motor activities into pediatric care may provide meaningful benefits for this population.