Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy, Selection Criteria and Process
- Cochrane Library
- Embase
- PsycInfo
- Scopus
- Web of Science
- Cinhal
- Clinicaltrials.gov
2.2. Data Extraction
- (1)
- Trial-related information included: First author, year of publication, kind of randomization, blinding, sample size and study groups, age, and gender of participants, participants’ description, study setting, task to imagine, measurement events, outcomes and outcome measures, study results, number of dropouts, recognition of an included participant flow chart and the risk of bias evaluation.
- (2)
- MIT-related information included: MI experience, MI familiarization, MI manipulation check, PETTLEP (physical, environment, timing, task, learning, emotion, perspective) approach used, MIT intervention and control interventions descriptions, MIT session and order of MIT and physical practice, location of MIT and position of the individual during MI, MI supervision and instructions’ medium, instruction individualization yes/no, perspective (internal/external), mode (kinesthetic/visual), eyes open/closed and temporal parameters: number and frequency of MIT sessions and duration and number of MI trials (per session and total).
2.3. Assessment of Risk of Bias and GRADE
First Author | Year | Country | Randomization and Kind of Randomization | Blinding | Study Groups | Number and Gender of Participants and per Group | Age of Participants and Per Group [Years] | Participants | Study Setting | Focus of Imagery | Measurement Events | Outcomes and Outcome Measures | Results EG vs. CG | Dropouts/ Flow Chart/ RoB Rating |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Abraham [73] | 2017 | IL | RCT, R. stratified for age and dancing level | Investigator and participants during pre-assessment | 2 | Total: 25 Females EG: 13 F CG: 12 | EG: 13.51 (± 0.49) CG: 13.63 (± 0.52) | Healthy dance students, at least 3 years of dancing experience | Dance studio | Elevé movement | Pretest Posttest | Ankle PF ROM in degrees Symmetry index in %: Kinematic data collected in 3-D using two digital video cameras Kinetic data were collected using the TETRAX© system MI ability: MIQ-R | No sign. between-group difference | Dropouts: 1 Flow chart: No RoB rating: SC |
Asa [74] | 2014 | BRA | RCT, R. stratified for gender | N.R. | 3 | Total: 36 (F = 13, M = 23) MIT: 12 (F = 4, M = 8) PP: 12 (F = 5, M = 7) NP: 12 (F = 4, M = 8) | MIT: 9.9 ± 0.2; PP: 10 ± 0.5; NP: 9.9 ± 0.4 | Healthy, right-handed pupils from a private school, average education [years]: MIT and NP: 4.4 ± 0.3 PP: 4.5 ± 0.4 | N.R. | FOS: TS 4-3-2-1 | BL T1: Day 1 T2: Day 4 T3: Day 7 T4: Day 28 | Speed and accuracy of TS and URS: Number of correct sequences per min. recorded by a computer-monitored device attached to fingertips | MIT and PP equally effective in immediate and long-term learning, MIT leads to more efficient transfer to URS | Dropouts: N.R. Flow chart: No RoB rating: SC |
Bahmani [75] | 2021 | IR | RCT, R. N.R. | N.R. | 2 | Total: 136 Males EMIT: 67 M IMIT: 71 F | Total: 10.13 ± 0.65 | Healthy boys, who were naïve to the purpose of the study | N.R. | Overarm tennis ball toss with non-dominant hand | Pretest: day 1 Posttest: day 2 | Tossing accuracy: Ratio of individual’s scoring for total score divided by number of completed trials MI ability: Persian MIQ-C | External imagery focus produced superior motor learning | Dropouts: No Flow chart: No RoB rating: SC |
Battaglia [76] | 2014 | Italy | RCT, R. N.R. | Assessor | 2 | Total: 72 Females EG: 36 F CG: 36 F | EG: 13.8 ± 1.3 CG: 14.2 ± 1.7 | Female rhythmic gymnasts, competing at national level | Summer training camp | Vertical jumps | Pretest Posttest | Vertical jump performance (FT, CT, HT, DJ, Counter Movement Jump): Optojump system MI ability—MIQ-R | FT and CT jumping parameters of the HT and DJ tests improved significantly in MIT compared to PP only. | Dropouts: N.R. Flow chart: No RoB rating: SC |
Cabral-Sequeira [77] | 2016 | BRA | RCT R. N.R. | N.R. | 4 | Total: 31 (F = 15, M = 16) EG: not reported CG: not reported | Total: 13.58 ± 1.74 EG: not reported, CG: not reported | Adolescents with mild cerebral palsy | N.R. | Aiming as fast and accurately as possible at a 2 cm diameter target | Day 1: Posttest 1 Day 2: Retention test, Posttest 2, Retention 2 | Movement time, Movement straightness, Frequency of sub-movement, Peak height, Average joint angular velocity, Radial error: Four opto-electronic cameras (Vicon, MX3+) | No effect associated with side of hemiparesis to achieve equivalent motor performance MIT induced faster and straighter movements in comparison with controls | Dropouts: 2 Flow chart: No RoB rating: SC |
de Sousa Fortes [78] | 2019 | BRA | RCT, R. stratified for passing decision-making performance at BL | N.R. | 2 | Total: 33 Males EG: 17 CG: 16 | Total: 16 ± 0.6 EG: 15.6 ± 1.9 CG: 15.6 ± 1.8 | Volleyball players with at least 2 years of experience, training for 89.7 ± 4.5 min/day, 5×/week, enrolled in the U-17 Volleyball State Championship | Training site | Passing decision-making performance in volleyball | T1: 48 h before Intervention T2: 48 h after intervention | Decision-making performance—Game Performance Assessment Instrument and Decision-making index Heart rate—heart rate monitor Video recording of EG and CG sessions | Moderate positive effect of MIT on passing decision-making performance of the young volleyball players | Dropouts: N.R. Flow chart: No RoB rating: SC |
de Sousa Fortes [79] | 2020 | BRA | RCT, R. stratified by website | Statistician | 2 | Total: 28 Males MIT: 14 CG: 14 | MIT: 15.37 ± 0.22 CG: 15.45 ± 0.33 | Tennis players (training 2 h/day, 4×/wk) enrolled in the State Tennis Championship | Tennis court | Tennis service performance | T1: 48 h before intervention T2: 48 h after intervention | Accuracy—total sum of achieved points Speed (km/h)—radar gun MI ability—MIQ- 3 | MIT might be an elective strategy to enhance tennis service performance among young male tennis players | Dropouts: No Flow chart: Yes RoB rating: SC |
Doussoulin [80] | 2011 | CL | RCT R. N.R. | Assessor | 3 | Total: 64 (N.R.) EG: 22 CG1: 21 CG2: 21 | Total: 9–10 | Elementary school students, fourth grade classes, absence of motor and/or sensory disturbances | Urban elementary school from Temuco (Chile) | Run and throw a ball towards a distant target | BL: pretest during first session T1: posttest after sixth training session | Learning—Score of Standardized Basic and Combined Movements Scale Distance reached on each ball throwing—outcome measure not mentioned | All training forms were effective in improving motor task performance, MIT and modelling were more effective to obtain a significantly higher final performance than PP | Dropouts: N.R. Flow chart: No RoB rating: High |
Fekih_a [81] | 2020 | TUN | RCT R. N.R. | N.R. | 2 | Total: 38 Males MIT: 18 CG: 20 | MIT: 16.9 ± 0.6 CG: 16.7 ± 0.8 | Young male tennis players, volunteered, training regularly in tennis clubs for 2 h/day, on average 3×/wk | Usual training session | Tennis service | T0: 48 h before Ramadan T1: end of first week of Ramadan T2: end of second week of Ramadan T3: end of fourth week of Ramadan | Tennis service performance as a product of accuracy and speed, measured with total scores of the Service Performance Test and radar gun MI ability with MIQ-RS | MIT could be effective strategy to optimize tennis service performance during Ramadan fasting, MIT could counteract/mitigate negative and detrimental effects of fasting on tennis service performance | Dropouts: N.R. Flow chart: No RoB rating: SC |
Fekih_b [82] | 2020 | TUN | RCT R. N.R. | N.R. | 2 | Total: 27 Males | EG: 16.9 ± 0.64 CG: 16.7 ± 0.59 | Tennis players for at least 2 years who train in clubs for 2 h/day, 3×/wk | Tennis club sessions | Agility, speed, reaction time | T0: 48 h before Ramadan T1: end of first week of Ramadan T2: end of second week of Ramadan T3: end of fourth week of Ramadan | Agility—MAT- Agility Test Speed—ZIG-ZAG test Reaction time—video recordings MI ability—MIQ-RS for MITG only | Fasting during Ramadan reduced all performance outcomes. MIT after regular workouts may be an effective strategy to reduce the effect of fasting during Ramadan and stabilize physical performance outcomes in terms of agility, speed and reaction time for male tennis players. | Dropouts: N.R. Flow chart: No RoB rating: SC |
Hemayattalab [83] | 2010 | IR | RCT, R. N.R. | N.R. | 5 | Total: 40 (N.R.) PP: 8 MIT: 8 PP + MIT: 8 MIT + PP: 8 CG: 8 | Total: 12–15 | Adolescents with mental retardation (AWMR) | School for mentally retarded pupils of Tehran | Basketball free throws | T1: pretest T2: posttest T3: retention test 10 days later | Basketball free throw performance: Free throw test (10 attempts) MI ability: EMG | In adolescents with mental retardation MIT by itself is less effective than PP for motor task learning enhancement, MIT + PP is more effective than MP alone | Dropouts: N.R. Flow chart: No RoB rating: SC |
Kanthack [84] | 2014 | BRA | RCT, R. N.R: | N.R. | 2 | Total: 22 (N.R) EG: 11 CG:11 | EG: 17.6 ± 0.5 CG: 17.6 ± 0.5 | Young basketball players from one team in the junior league of the Federação Paulista de Basquete | Room near basket-ball court, and basketball court | Basket-ball free throws | T1: pretest T2: posttest | Basketball throwing performance: Scoring in 10 free throws Self-efficacy: General Perceived Self-Efficacy Scale Imagination level: customized scale ranging (0–3) | There was no significant difference between groups’ median SWC statistic indicated an 84% likelihood that MIT had a beneficial effect on performance in the first two free throws | Dropouts: N.R. Flow chart: No RoB rating: SC |
Mohammadhasani [85] | 2017 | IR | RCT, R. N.R. | N.R. | 3 | Total: 36 Females MIT-CI: 11 PP-CI: 12 PP: 13 | Total: 12 years old | Sixth-grade elementary school pupils | A school of Shiraz city | Kata skill (the first kata: Taikyoku Sono Ichi) | T1: pretest T2: posttest = last training session T3: 48 h after last training session T4: in a competitive condition | Kata skill learning and performance: Kata evaluation form scores 0–20 | The systematic increase in the CI had highest effectiveness, MIT + PP with a systematic increase in CI had long-term positive effects on performance and learning a kata skill | Dropouts: N.R. Flow chart: No RoB rating: High |
Norouzi [86] | 2019 | IR | RCT, R. computer-genera-ted random-number sequence | N.R. | 3 | Total: 45 Males MIT1: 15 MIT2: 15 CG:15 | Total: 14.65 ± 1.34 | Adolescent novice players in a summer camp | Football summer camp from Farhang Football School in Jahrom | Football pass skill performance | Pretest Posttest | Football pass skill performance: Mor and Christian’s test MI ability: MIQ | Among adolescent novice football players, external PETTLEP imagery led to the highest improvement in football passing skill performance | Dropouts: 0 Flow chart: No RoB rating: SC |
Porretta [87] | 1995 | USA | RCT, R. N.R. | N.R. | 2 | Total: 32 (F = 17, M = 15) PP + MIT: 16 PP: 16 | PP + MIT: 15 years 4 months ± 1 year 8 months PP: 14 years 7 months ± 1 years 6 months | Adolescents with mild mental retardation | N.R. | Striking with a baseball bat | During each training session on 5 consecutive days (Monday to Friday) | Timing accuracy [ms] measured as discrepancy between arrival of light stimulus at a certain location and striking the string: Bassin Anticipation Timer | Participants using PP + MIT were significantly more accurate on the striking task than participants in the PP group | Dropouts: N.R. Flow chart: No RoB rating: SC |
Quinton [88] | 2014 | UK | RCT (matched by age), R.N.R. | N.R. | 2 | Total: 36 (F = 2, M = 34) EG: 18 CG: 18 | Total: 9.72 ± 2.05 EG: N.R: CG: N.R. | Futsal player | Gymnasium | Dribbling and passing soccer task | Pretest Posttest | Players’ ball control and decision-making skills: Dribbling and passing soccer task MI ability: MIQ-C | MIT produced no significant improvements in imagery ability or motor task performance, Significant correlation at post-test for the MIT group between age and external visual and kinesthetic imagery ability | Dropouts: N.R. Flow chart: No RoB rating: SC |
Screws [89] | 1997 | USA | RCT, R. N.R. | N.R. | 6 | Total: 30 (N.R.) EG: 10 (5 peg board; 5 pursuit rotor) PP: 10 (5 + 5) CG: 10 (5 + 5) | Total: 12.5 ± N.R. | Children with MMD | Rural School in Alabama | Cognitive-oriented task (peg board) + Skill on motoric-oriented task (pursuit rotor) | Pretest Posttest | Cognitive-oriented task: Correctly placed pegs on peg board Motoric-oriented task: Time on target for the pursuit rotor task | MIT enhanced motor performance of children with MMD on both the peg board test and the pursuit rotor task | Dropouts: N.R. Flow chart: No RoB rating: SC |
Seif-Barghi [90] | 2012 | IR | RCT R. N.R. | Coaches | 2 | Total: 88 Males; U16:17; U19:18 EG: U16 = 9, U19 = 9 CG: U16 = 8, U19 = 9 | Total: 18.99 ± 4.24 U16: EG 15.04 ± 0.94, CG 14.93 ± 0.63; U19: EG 17.72 ± 1.16, CG 17.31 ± 1.46 | Soccer players affiliated with professional soccer clubs taking part in the national championship leagues in four age categories including U16, U19, U21 and over 21 | Soccer field; educational classes in their clubs in a private room | Soccer pass performance | Pretest Posttest | Successful passing performance: Rate index after dividing by total passing counts throughout the minutes of playing presented as percentile | Players in the MIT group could observe an increase in the successful pass rate compared to CG. | Dropouts: 19 Flow chart: Yes RoB rating: SC |
Simonsmeier [91] | 2017 | GER | RCT, R. by software before BL assessment | Judges | 2 | Total: 56 Females MIT first: Low Expertise: 22 High Expertise: 9 MIT last: Low Expertise: 12 High Expertise: 13 | Total: 9.63 ± 2.43 | Gymnasts participating in their sport between 1 and 14 years between 3.5 and 25.5 h/week | Regular training session | The cast to handstand on bars | T1: prior to first training phase T2: between two training phases T3: after second training phase | The cast to handstand on bars performance: Coding system Mental representation: SDA-M Imagery ability: SIAQ | MIT had positive effects on performance only for the high-expertise athletes in MIT last condition | Dropouts: 2 Flow chart: No RoB rating: SC |
Surburg [92] | 1995 | USA | RCT, R. N.R. | N.R. | 4 | Total: 40 (F = 22, M = 18) | Total: 15.65 ± 6.65 | Forty students with mild mental retardation (20 students from Indiana, 20 students from Ohio) | High school pupils | An under-hand baseball throwing task | N.R. | Successful execution of an underhand throwing task with the non-dominant arm | Two types of cognitive demands did not affect imagery MIT did improve motor performance of students with mild mental retardation | Dropouts: N.R. Flow chart: No RoB rating: SC |
Takazono [93] | 2018 | BRA | RCT, R. N.R. | N.R. | 3 | Total:18 (both gender) PP: 6 PP + MIT: 6 CG: 6 | Total: 9.33 ± 0.49 | Right handed, healthy pupils | N.R. | Holding a plastic block and insert it in the support with the right hand | Pretest: before training Posttest: immediately after PP Retention test: 24 h after training) | Task performance: Movement time in sec reach, transport: commercial digital camera Imagery ability: MIQ-C | PP group achieved a persistent performance gain in the “transport”, but not in the “reaching” task PP + MIT group achieved persistent performance gains in both movement components No significant differences were found for CG | Dropouts: N.R. Flow chart: No RoB rating: SC |
Wilson [94] | 2002 | AUS | RCT, R. blocked to ensure similar numbers of children within 4 percentile ranges of total impairment and similar age | Assessor | 3 | Total: 54 (N.R.) EG:18 PP: 18 NP: 18 | Total: Range 7–12 | Children with motor coordination difficulties | Six schools in Brisbane | Catching and throwing a tennis ball, Striking a softball, Jumping to a target using a two-leg take-off, balancing a ball on a bat while walking, placing objects using formboard | Pretest Posttest | Motor function: Movement Assessment Battery for Children | Imagery training, delivered in a multimedia format, can be equally effective to perceptual-motor training in developing the motor skills of children referred with coordination problems. | Dropouts: N.R. Flow chart: No RoB rating: SC |
First Author | MI Experience, MI Familiarization and MI Manipulation Check | PETTLEP Approach and MI Intervention Description | Control Interventions | MIT Session and Order | Location and Position during MIT | MIT Supervision and MI Instructions | MI Mode, MI Perspective, Eyes | Number of MITS and Intervention Duration | Trials per MITS and Total Trials |
---|---|---|---|---|---|---|---|---|---|
Abraham | MI experience: N.R. MI familiarization: N.R. MI check:
| PETTLEP: yes MITG: Specific components of elevé performance, emphasis on ankle PF and foot movements, biomechanics, equal WBD Progression:
| PP: Upper body exercises with focus on postural awareness, joint mobility and strengthening of neck, shoulders, arm, elbows, wrists. No pelvic, abdominal or lower limbs exercises Progression: From 6. Session use of resistance bands and light balls | Session: N.R., probably group Order: N.R. | Location: Dance studio Position: MITG: Lying down supine on mattress CG: Sitting on a chair in a circle | Supervision: Yes Instructions: Live, detailed, descriptive with changing tones of voice, and using arousing mental images | Mode: Visual then kinesthetic Perspective: N.R. Eyes: Closed or open, according to personal preference | Total: 12 MITS = 2 MITS lasting 20–25 min each per week Duration: 6 weeks | Progressions: (1) Number of mental elevé 30–80, (2) tempo of performance: 20–40 movements per min. and for static elevé 8–14 s, (3) complexity of imagery environment |
Asa | MI experience: N.R. MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG: Kinesthetic imagery of the FOS trained sequence 4-3-2-1 | PP: Physical practice of FOS TS using the trained hand NP: No practice on any of the movement sequences, practiced a non-sequential painting task for the same length of time as PP and MIT | Session: N.R. probably individual Order: MIT only | Location: N.R. Position: Comfortably seated in front of a desk with supported elbows and forearms | Supervision: Yes Instructions: Live | Mode: Emphasized kinesthetic imagery and prevented use of visual imagery Perspective: N.R. Eyes: Closed | Total: 1 MITS lasting app. 25 min Duration: 1 day | MITS: Four blocks of 120 mental trials with rest intervals of 2 min between blocks Total trials: 120 |
Bahmani | MI experience: No experience MI familiarization: N.R. MI check: Open-ended questions | PETTLEP: N.R. Two different MIT groups: MIT internal focus: Participants were asked ‘to focus on the tossing arm’ MIT external focus: Participants were instructed ‘to focus on the ball’ | Session: N.R. Order: PP before MIT | Location: N.R. Position: Standing, 6.1 m away from target | Supervision: N.R. Instructions: N.R. | Mode: N.R. Perspective: Internal and external Eyes: N.R. | Total: 1 MITS Duration: 1 day | MITS: Six blocks à 10 mental tosses Total trials: 60 | |
Battaglia | MI experience: N.R. MI familiarization: N.R. MI check: 10 open-ended questions | PETTLEP: Yes MITG:
| CG: Light core training (abdominal muscle exercises) and active flexibility training + 3 min: 5 PP of each vertical jump | Session: N.R. Order: MIT before PP | Location: N.R., probably gym Position: N.R. | Supervision: N.R. Instructions: N.R. | Mode: Visual Perspective: N.R. Eyes: N.R. | Total: 12 Two MITS per day for 6 days/week Duration: 6 weeks | MITS: Five mental trials of each of the 3 vertical jumps = 15 MI trials Total trials: 180 |
Cabral-Sequeira | MI experience: N.R. MI familiarization: N.R. MI check: Participants signaled initiation and end of trials by tapping their index finger of the resting (less affected) arm on supporting table | PETTLEP: N.R. MITG: Day 1: MIT of aiming task Day 2: PP of aiming task | CG: Day 1: Manipulation of a keyboard of a personal computer with less affected hand to play a game called ‘Tetris’ Day 2: PP of aiming task | Session: N.R. Order: PP before MIT | Location: Laboratory Position: Seating position on a height adjustable chair, hands relaxed and supported on table | Supervision: Yes Instructions: Live | Mode: N.R. Perspective: Internal Eyes: Closed | Total: 1 MITS lasting app. 34 min Duration: 2 days | MITS: Two sets of 5 × 10 mental trials with app. 10 min between sets Total trials: 100 |
de Sousa Fortes | MI experience: Yes MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG:
| CG: Watched videos of advertisements related to sports equipment (e.g., caps, t-shirts, and shorts). No communication allowed during sessions | Session: N.R. probably group Order: PP before MIT | Location: Quiet environment in gym, close to court, Participants wore competition outfits Position: N.R. | Supervision: N.R. Instructions: N.R. | Mode: N.R. Perspective: Internal Eyes: N.R. | Total: 24 Three MITS/wk lasting app. 10 min Duration: 8 weeks | MITS: N.R. Total trials: N.R. |
de Sousa Fortes | MI experience: Yes MI familiarization: N.R. MI check: Participants were asked to provide information about the technique adopted and the magnitude of the perceived emotions Timer to control for MI trials | PETTLEP: N.R. MITG:
| CG: Watching videos about the history of the Olympics | Session: N.R. probably individual Order: PP before MIT | Location: Quiet environment close to the tennis court, participants wore competition outfits Position: N.R. | Supervision: Yes Instructions: N.R: | Mode: N.R. Perspective: Internal Eyes: N.R: | Total: 24 Three MITS/wk lasting app. 10 min Duration: 8 weeks | MITS: N.R. Total trials: N.R. |
Doussoulin | MI experience: N.R. MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG: MIT of the ball throwing while running task | CG1: Modeling condition: Watching a video recording of ball throwing performance while running being performed by an expert CG2: PP of ball throwing performance while running | Session: N.R. Order: PP before MIT | Location: N.R. Position: N.R. | Supervision: N.R. Instructions: N.R. | Mode: N.R. Perspective: N.R. Eyes: N.R. | Total: 6 MITS Duration: N.R. | MITS: Sixty mental trials Total trials: 60 |
Fekih_a | MI experience: Yes MI familiarization: N.R. MI check: Chronometer for each athlete to control the duration of mental trials of the 10 tennis service | PETTLEP: N.R., probably partially MITG:
| CG: PP + watching videos about the history of the Olympic Games | Session: Individual Order: PP before MIT | Location: Quiet environment near the tennis court, participants wore competition outfits Position: N.R. | Supervision: Yes Instructions: N.R. | Mode: N.R. Perspective: Not clear: ‘first person situation’ Eyes: N.R. | Total: 12 Three MITS/wk lasting 10 min = app. 120 min Duration: 4 weeks | MITS: 10 mental trials Total trials: 120 |
Fekih_b | MI experience: N.R. MI familiarization: N.R. MI check: Chronometer for each athlete to control the duration of mental trials of the 10 tennis service | PETTLEP: N.R. MITG:
| CG: PP + watching videos about the history of the Olympic Games | Session: N.R. Order: PP before MIT | Location: Quiet environment near the tennis court, Participants wore competition outfits Position: N.R. | Supervision: Yes Instructions: N.R. | Mode: Visual before kinesthetic Perspective: External before internal Eyes: N.R. | Total: 12 Three MITS/wk lasting 15 min= app. 180 min Duration: 4 weeks | MITS: Ten mental trials Total trials: 120 |
Hemayattalab | MI experience: N.R. MI familiarization: Yes, 1 MI training session including internal kinesthetic imagery MI check: After pretest and before intervention a MIT training session including internal kinesthetic imagery and N.R. | PETTLEP: N.R. Three different MIT groups MITG:
PP followed by MIT: 12 TS PP of basketball free throw + 12 TS MIT basketball free throw MIT followed by PP: 12 TS MIT of basketball free throw + 12 TS PP basketball free throw | Two different control groups: PP: 30× physical practice of basketball free throw for 24 MITS CG: no training at all | Session: N.R. Order: Only MIT or PP in 1 TS | Location: N.R. Position: N.R. | Supervision: N.R. Instructions: N.R. | Mode: Kinesthetic Perspective: Internal Eyes: N.R. | Total: 24 30 min per MITS Duration: N.R. | MITS: 30 Total trials: MIT only: 720 PP followed by MIT: 360 MIT followed by PP: 360 |
Kanthack | MI experience: No pervious MIT experience MI familiarization: N.R. MI check: Three open-ended questions | PETTLEP: N.R. MITG:
| CG: Participants were taken to another room for 4 min | Session: N.R. Order: MIT before PP | Location: Room off the basketball court, less than 20 m from the basket Position: Sitting | Supervision: Yes Instructions: N.R. | Mode: N.R. Perspective: N.R. Eyes: Closed | Total: 1 Duration: 3 min | MITS: N.R. Total trials: N.R. |
Mohammadhasani | MI experience: N.R. MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG:
| PP1: Participants physically practiced the kata skill with systematically increasing contextual interference for five sessions and five attempts each session in groups PP2: Participants practiced the kata skill for five sessions and five attempts each session in groups | Session: N.R. probably group Order: MIT before PP | Location: N.R. Position: Sitting on ground | Supervision: Yes Instructions: Live, acoustic Instructor loudly narrated the movement pattern of the kata skill step by step | Mode: N.R. Perspective: N.R. Eyes: Closed | Total: 5 Duration: N.R. | MITS: 5 Total trials: 25 |
Norouzi | MI experience: N.R. MI familiarization: N.R. MI check: N.R. and 2 open-ended questions | PETTLEP: Yes If participants wished to modify their imagery activity, such modifications were incorporated in subsequent imagery sessions (learning). Two different MIT groups MIT1: Internal PETTLEP + PP MIT2: External PETTLEP + PP | PP: Participants practiced physically only | Session: Group Order: MIT before PP | Location: Football field Position: N.R. | Supervision: Yes, once a week Instructions: Verbal, audio | Mode: N.R. Perspective: N.R. Eyes: N.R. | Total: 12 3 MITS/wk lasting 10 × 2 min = 20 min Duration: 4 weeks | MITS: N.R. Total trials: N.R. |
Porretta | MI experience: N. R. MI familiarization: Explanation until participants understood MIT and MIT for 4 trials MI check: Participants were asked how they actually imaged the task after familiarization and after each practice day | PETTLEP: N.R. MITG:
| PP: Participants were swinging the bat and hitting the string + were solving mathematical problems in between | Session: Individual Order: MIT before PP | Location: N.R. Position: N.R. | Supervision: N.R. Instructions: Live, acoustic | Mode: Visual and kinesthetic Perspective: N.R. Eyes: Closed | Total: 5 Duration: 5 days | MITS: 25 × 4 mental trials Total trials: 100 |
Quinton | MI experience: N.R. MI familiarization: Participants were given a stimulus–response training in the first session to help them be more aware of what they were seeing and feeling during their imagination MI check: N.R. | PETTLEP: Yes, partially Participants were dressed in soccer kit, foot placed on the ball, usual environment (same gymnasium), changing session content MITG:
| CG: PP + participants received sport-specific nutritional advice | Session: N.R. Order: PP before MIT | Location: Gymnasium Position: Standing, foot placed on ball, dressed in soccer kit | Supervision: N.R. Instructions: Live, acoustic | Mode: according to personal preferences Perspective: according to personal preferences Eyes: according to personal preferences | Total: 10 Two MITS/wk Duration: 5 weeks | MITS: N.R. Total trials: N.R. |
Screws | MI experience: N.R. MI familiarization: Imagery training orientation: Investigator discussed meaning of MIT and explained how to use MIT for motor task enhancement Participants were given MIT activities to acquaint them with MIT procedures. MI check: N.R. | PETTLEP: N.R. MITG:
| Two control groups: CG1: Participants physically practiced 20 trials on peg board or pursuit rotor game + made different geometric shapes CG2: no PP or MIT at any time, spent same amount of time with researcher | Session: N. R. Order: N. R. | Location: N. R. Position: N. R. | Supervision: N.R. Instructions: N. R. | Mode: N.R. Perspective: N.R. Eyes: N.R. | Total: 8 Five days/wk until prescribed number of sessions were completed Duration: 8 MITS, total 164 min | MITS: 20 Total trials: 160 |
Seif-Barghi | MI experience: Little experience MI familiarization: Introduction session for defining and explanation of sport imagery, its application in soccer. Participants completed exercises to develop external and internal imagery, real time speeds of images and create images applying all senses. MI check: Feedback sessions at the end of each MITS Weekly interviews instantly before MIT Randomly asked questions about training course | PETTLEP: N.R. MITG:
| CG: N.R. = neutral task group’ + normal training and match activities | Session: N.R probably group Order: N.R. | Location: Quiet room in their football clubs Position: N.R. | Supervision: Yes Instructions: N.R. | Mode: N.R. Perspective: N.R. Eyes: Participants were recommended to start MIT with eyes closed. With increasing experience they could continue with eyes either open or closed | Total: 8 One MITS/wk lasting 10–15 min = 150 min MIT should be used on daily basis Duration: 8 weeks | MITS: N.R. Total trials: N.R. |
Simonsmeier | MI experience: Assessed at BL MI familiarization: Athletes participated in a 20 min workshop, to facilitate understanding of MIT importance for motor learning Brief introduction to imagery script MI check: Four-item questionnaire post intervention, MIT diary for participants and trainers | PETTLEP: Yes MITG:
| CG: normal PP training | Session: N.R. probably individual Order: N.R. | Location: Regular training gym wearing regular clothes Position: N.R. | Supervision: N.R., probably unsupervised Instructions: Pre-recorded audio script | Mode: Visual and kinesthetic Perspective: Internal Eyes: N.R. | Total: 16 Four MITS/wk lasting 5 min = 80 min Duration: 4 weeks | MITS: Three mental trials Total trials: 48 |
Surburg | MI experience: N. R. MI familiarization: Preparing subjects MIT with multiple trials of closing the eyes and rehearse task MI check: Questions regarding MIT content post-intervention | PETTLEP: N.R. MITG:
| Two different PP groups were participants practiced an underhand throw with the non-preferred hand: PP1: Low cognitive condition: experimenter stood next to the right side of the target PP2: High cognitive condition: experimenter served as base runner and participant had to toss the ball to the next base | Session: N.R. Order: MIT before PP | Location: N.R. Position: N.R. | Supervision: N. R. Instructions: N.R. | Mode: N. R. Perspective: N.R. Eyes: Closed | Total: N.R. Duration: 1 week | MITS: N.R. Total trials: N.R. |
Takazono | MI experience: N.R. MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG:
| Two different control groups PP: 240 physical trials of the experimental task CG: 180 mental trials of another visual rotation + 60 physical trials of the experimental task | Session: N.R., probably individual Order: MIT before PP | Location: N.R. Position: Seated in a chair in front of a table, starting with the palm of the right hand downwards resting on the starting point | Supervision: N. R., probably yes Instructions: Live, acoustic | Mode: N.R., ‘Imagine this movement, thinking of all the sensations it provides’ Perspective: N.R. Eyes: Closed | Total: 1 Duration: 1 day | MITS: 240 Total trials: 240 |
Wilson | MI experience: N.R. MI familiarization: N.R. MI check: N.R. | PETTLEP: N.R. MITG: Software-based MIT Dynamic stimulus materials were presented in increasing complexity:
| Two different control groups PP: Traditional perceptual-motor training of the experimental task NP: wait-list control | Session: Individual Order: MIT before PP | Location: N.R. Position: N.R., probably sitting in front of a computer screen | Supervision: Yes Instructions: live | Mode: N.R., probably kinesthetic Perspective: External before internal Eyes: N.R. | Total: 5 1 MITS/wk Duration: 5 weeks | MITS: 50 Total trials: N.R., probably 250 |
2.4. Data Analysis
Primary Outcomes
3. Results
3.1. Characteristics of the Included Studies
3.2. Characteristics of Included Motor Imagery Training Interventions
- MIT as individual one-to-one session or group session was reported in four studies only (2 × group session, 2 × one-to-one session),
- A combination of MIT with PP was reported in 16 studies with an equal distribution whether MIT was performed before or after PP,
- Nine studies reported the location of the MIT and eight studies reported the position of the participant during MIT,
- Supervision during MIT session was reported and provided in eleven studies,
- Used instructions to guide the participants in their MIT was stated in ten studies using mainly live and acoustic instructions,
- The MI mode was described in seven studies reporting both visual and kinesthetic modes, which is similar to MI perspective. MI perspectives (internal, external) were described in nine studies. Both MIT session elements, mode and perspective, were used separately or in combination,
- Authors reported in ten studies whether participants had open or closed eyes during MIT,
- Surprisingly, participants were evaluated regarding their MI ability in twelve studies only. Authors used different standardized (MIQ, MIQ-R, MIQ-RS, MIQ-C) or customized MI ability questionnaires or EMG recordings,
- Temporal parameters regarding MIT sessions can be summarized as follows: Number of total MIT sessions varied between one and 24 with an intervention duration between one day and eight weeks. One MIT session took about three to 34 min, while between three and 80 MI trials were performed, summing up to 720 MI trials over one MIT intervention period.
3.3. Risk of Bias
3.4. Primary Outcomes-Effect of Motor Imagery Training Interventions
3.5. GRADE Evidence Profile Table
3.6. Further Analyses
4. Discussion
4.1. Motor Imagery Training Interventions
4.2. Methodology of the Included Studies
4.3. Strengths and Limitations
4.4. Implications for Further Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No. | Query | Results |
---|---|---|
#5 | #1 AND #2 AND #3 NOT [conference abstract]/lim NOT ([animals]/lim NOT [humans]/lim) | 1388 |
#4 | #1 AND #2 AND #3 | 1695 |
#3 | ‘controlled clinical trial’/exp OR crossover*:ti,ab,kw OR ‘cross-over*’:ti,ab,kw OR placebo*:ti,ab,kw OR sham:ti,ab,kw OR (((single OR double) NEAR/2 blind*):ti,ab,kw) OR random*:ti,ab,kw OR allocat*:ti,ab,kw OR factorial*:ti,ab,kw OR assign*:ti,ab,kw OR (((clinical OR controlled) NEAR/2 (trial* OR stud*)):ti,ab,kw) OR trial:ti | 3,145,824 |
#2 | ‘motor imagery’/exp OR ‘motor imagery training’/exp OR ‘imagery’/exp OR ‘imagination’/exp OR (((motor OR locomot* OR mental OR kinesthetic* OR kinaesthetic* OR movement*) NEAR/2 (imag*OR simulation* OR ideation* OR visual*)):ti,ab,kw) OR (((mental* OR cognitive* OR covert*) NEAR/2 (movement* OR rehears* OR imag* OR practic* OR practis* OR training* OR represent*OR stimulation* OR ideation* OR visual*)):ti,ab,kw) OR imagery:ti,ab,kw OR imagining:ti,ab,kw OR imagination*:ti,ab,kw | 64,715 |
#1 | ‘child’/exp OR ‘adolescent’/exp OR ‘pediatrics’/exp OR ‘cerebral palsy’/exp OR ‘developmental coordination disorder’/exp OR child*:ti,ab,kw OR boy:ti,ab,kw OR boys:ti,ab,kw OR girl*:ti,ab,kw OR pediatric*:ti,ab,kw OR paediatric*:ti,ab,kw OR adoles*:ti,ab,kw OR teen*:ti,ab,kw OR ‘preschool*’:ti,ab,kw OR (((cerebral OR brain OR spastic) NEAR/2 (palsy OR paralys* OR pares* OR diplegia)):ti,ab,kw) OR ‘developmental coordination disorder*’:ti,ab,kw OR dcd:ti,ab,kw | 4,523,492 |
Certainty Assessment | No. of Patients | Effect | Quality of Evidence | Importance | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of Studies | Study Design | Risk of Bias | Inconsistency | Indirectness | Imprecision | Other Considerations | MI | Control | Relative (95% CI) | Absolute (95% CI) | ||
Accuracy (Follow-up range 3 to 4 weeks) | ||||||||||||
2 | RCT | serious a | not serious | not serious b | serious c | none | 32 | 34 | - | SMD 1.05 (0.53, 1.57) | ⨁⨁◯◯ LOW | not important |
Ball stroke speed (Follow-up range 3 to 4 weeks) | ||||||||||||
2 | RCT | serious a | not serious | not serious b | serious c | none | 32 | 34 | - | SMD 0.83 (0.33, 1.34) | ⨁⨁◯◯ LOW | not important |
Tennis service performance (Follow-up range 3 to 4 weeks) | ||||||||||||
2 | RCT | serious a | serious d | not serious b | serious c | none | 32 | 34 | - | SMD 1.87 (0.64, 3.10) | ⨁◯◯◯ VERY LOW | not important |
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Behrendt, F.; Zumbrunnen, V.; Brem, L.; Suica, Z.; Gäumann, S.; Ziller, C.; Gerth, U.; Schuster-Amft, C. Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 9467. https://doi.org/10.3390/ijerph18189467
Behrendt F, Zumbrunnen V, Brem L, Suica Z, Gäumann S, Ziller C, Gerth U, Schuster-Amft C. Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021; 18(18):9467. https://doi.org/10.3390/ijerph18189467
Chicago/Turabian StyleBehrendt, Frank, Valerie Zumbrunnen, Lynn Brem, Zorica Suica, Szabina Gäumann, Carina Ziller, Ulrich Gerth, and Corina Schuster-Amft. 2021. "Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 18, no. 18: 9467. https://doi.org/10.3390/ijerph18189467