Investigating the role of sensory load and rhythm on sensorimotor integration on gait cadence in adults with ADHD

Sensory processing differences are increasingly recognized as a clinically meaningful feature of Attention-Deficit/Hyperactivity Disorder (ADHD), with implications for motor control and gait. This study examined how sensory load and rhythmic cues affect gait cadence in adults with ADHD using a virtual reality (VR) paradigm. 28 adults with ADHD and 28 non-ADHD controls walked under systematically varied auditory and visual sensory loads, as well as rhythmic versus non-rhythmic conditions. Analyses revealed a significant interaction between sensory load and diagnosis: individuals with ADHD exhibited a greater decrease in cadence with increasing sensory load than their non-ADHD controls. Auditory load produced the strongest effects, consistent with evidence of atypical auditory filtering in ADHD. Rhythmic cues facilitated gait entrainment in controls to a greater extent than in those with ADHD, reflecting documented deficits in temporal processing and beat perception. These findings highlight that high sensory loads disrupt, rather than support, gait in ADHD, and that rhythm’s positive effect on cadence is not observed in ADHD to the same extent as in those without ADHD. By leveraging VR, this study extends motor findings in pediatric ADHD to adults, underscoring the role of sensory integration in everyday motor function.