Objective evaluation of attention-deficit/hyperactivity disorder medication effects using a load-cell-embedded chair in a simulated classroom
摘要
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition in children. Treatment outcomes are assessed using established tools such as the Swanson, Nolan, and Pelham (SNAP-IV) scale and the Vanderbilt ADHD Diagnostic Rating Scale, which primarily rely on subjective reporting. In a previous pilot study, we used load cells to evaluate the effects of ADHD medication in patients receiving Ritalin immediate-release (IR). In the present study, we analyzed the effects of both Ritalin IR and ORADUR-Methylphenidate on the basis of changes in the average trajectory length (ATL) at different time points during a 15-min learning session in a simulated classroom.
MethodsA simulated classroom was constructed to replicate a real-world educational environment, featuring a desk and chair facing a large display screen. Load cells measuring mechanical force through material deformation were installed on each chair leg to monitor body movement. A total of 56 children with ADHD (boys: 49) were enrolled. They received Ritalin IR (n = 37; 10 mg/day orally) or ORADUR-Methylphenidate (n = 19; 22 mg/day orally) for 1 month. During assessment, participants were instructed to remain seated and watch an age-appropriate mathematics video. The ATL, derived through continuous load cell recordings, was calculated to quantify participants’ postural movement while seated as a representation of the mean distance of body movement over time. Parents and teachers also completed the SNAP-IV scale before and after participants began treatment.
ResultsIn the Ritalin IR group, posttreatment ATL values decreased significantly from 0.0318 ± 0.0191 to 0.0180 ± 0.0126 (43.40% reduction, p < 0.0001). Parent-reported SNAP-IV scores decreased from 37.75 ± 14.24 to 28.08 ± 16.94 (25.62% reduction, p < 0.0001), and teacher-reported scores decreased from 40.68 ± 17.66 to 24.36 ± 18.87 (40.12% reduction, p < 0.0001). In the ORADUR-Methylphenidate group, posttreatment ATL values decreased from 0.0431 ± 0.0277 to 0.0304 ± 0.0258 (29.47% reduction, p = 0.0140). Parent-reported SNAP-IV scores decreased from 40.75 ± 16.44 to 29.17 ± 17.80 (24.42% reduction, p = 0.0053), and teacher-reported scores decreased from 42.91 ± 18.04 to 25.64 ± 17.44 (40.22% reduction, p = 0.0082). Pretreatment ATL values progressively increased over time, particularly during the latter part of the video, whereas posttreatment values remained consistently low throughout the session.
ConclusionThe load cell–embedded smart chair may serve as an objective tool for assessing pharmacological treatment efficacy in children with ADHD, allowing researchers to effectively quantify hyperactivity and behavioral changes across time points.
Clinical trial numberNot applicable.