The Impact of Sibling Presence on Motor Competence and Physical Fitness: A Systematic Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Eligibility Criteria
2.3. Study Selection
2.4. Data Extraction
2.5. Quality Appraisal
3. Results
3.1. Study Selection Results
3.2. Design and Samples
3.3. Interventions Characteristics
3.4. Main Outcomes
3.4.1. Does Having Older Siblings Affect Motor Competence?
3.4.2. Does Having Older Siblings Affect Physical Fitness?
3.4.3. Does Having Siblings Affect Motor Competence?
3.4.4. Does Having Siblings Affect Physical Fitness?
3.5. Quality Appraisal Results
4. Discussion
4.1. Limitations
4.2. Implications for Practice
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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| Database | Search Strategy |
|---|---|
| Web of Science | TI = ((“sibling*” OR “brother*” OR “sister*” OR “twin*”) AND (“psychomotor performance” OR “motor activity” OR “motor competence” OR “motor proficiency” OR “motor ability” OR “motor performance” OR “movement competence” OR “gross motor competence” OR “fundamental movement skills” OR “motor skills” OR “physical fitness”)) |
| Scopus | TITLE-ABS-KEY ((“sibling*” OR “brother*” OR “sister*” OR “twin*”) AND (“psychomotor performance” OR “motor activity” OR “motor competence” OR “motor proficiency” OR “motor ability” OR “motor performance” OR “movement competence” OR “gross motor competence” OR “fundamental movement skills” OR “motor skills” OR “physical fitness”)) |
| SportDiscus | (“sibling*” OR “brother*” OR “sister*” OR “twin*”) AND (“psychomotor performance” OR “motor activity” OR “motor competence” OR “motor proficiency” OR “motor ability” OR “motor performance” OR “movement competence” OR “gross motor competence” OR “fundamental movement skills” OR “motor skills” OR “physical fitness”) |
| MEDLINE/PubMed | (“sibling*”[Title] OR “brother*”[Title] OR “sister*”[Title] OR “twin*”[Title]) AND (“psychomotor performance”[Title] OR “motor activity”[Title] OR “motor competence”[Title] OR “motor proficiency”[Title] OR “motor ability”[Title] OR “motor performance”[Title] OR “movement competence”[Title] OR “gross motor competence”[Title] OR “fundamental movement skills”[Title] OR “motor skills”[Title] OR “physical fitness”[Title]) |
| Fist Author (Year) | Sample | Objective | Measure | Results |
|---|---|---|---|---|
| Cheng et al. (2025) [30] | Participants (n, sex): 6200 (NR) Age (mean ± SD): 2–6 years With/without siblings (n, sex, age): Children with 1 sibling (n = 2648, NR, NR) Children with 2 siblings (n = 317, NR, NR) Children with 3 siblings (n = 35, NR, NR) Children without sibling (n = 3200, NR, NR) | To explore the impact of different family background on children’s physical activity. | Outcomes: FMS
Measurement tool: Self-reported questionnaire fulfilled by primary caregivers. | Performance on the FMS scale of children in families with siblings was better than that of children in families with only one child.
|
| Chiva-Bartoll & Estevan (2019) [31] | Participants (n, sex): 55 (23F; 22M) Age (mean ± SD): 8.51 ± 0.31 years With/without siblings (n, sex, age): Children with older siblings or siblings of the same age (n = 37, NR, NR) Children without older or same-age siblings (n = 18, NR, NR) | To analyze the relationship between having or not having older siblings and the level of motor coordination. | Outcome: Motor Coordination. Measurement tool: GRAMI-2:
| For the total sample, it was observed that participants with older siblings or siblings of the same age had a higher level of coordination than those without (t = 4.73; p = 0.01). Children with siblings had a higher level of motor coordination than children without siblings (GRAMI-2 total score: 53.97 ± 3.67; vs. 47.91 ± 3.80; p = 0.002). Girls with siblings had a higher level of motor coordination than girls without siblings (GRAMI-2 total score: 49.44 ± 4.33 vs. 41.59 ± 5.55; p = 0.017). |
| Cruise & O’Reilly. (2014) [32] | Participants (n, sex): 10,748 last born infants, NR Age: 9 months With/without siblings (n, sex, age): Children with 1 sibling (n = 3584, NR, NR) Children with 2 or more siblings (n= 2589, NR, NR) Children without sibling (n = 4571, NR, NR) | To examine the influence of parents, siblings, and aspects of non-parental care on infant development. | Outcomes: Gross Motor Function. Fine Motor Function. Measurement tool: Self-reported questionnaire fulfilled by primary caregivers:
| The presence of one or more older siblings in the household increased the risk of failure in gross motor function:
|
| González-Devesa et al. (2024) [33] | Participants (n, sex): 579 (271F; 308M) Age (range; mean ± SD): 7–18; 12.17 ± 2.91 years With/without siblings (n, sex, age): Children with 1 sibling (n = 265, NR, NR) Children with 2 siblings (n = 161, NR, NR) Children with 3 or more sibling (n = 32, NR, NR) Children without sibling (n = 121, NR, NR) | To confirm whether the 2D:4D digit ratio and having siblings are independent factors that affect motor development, as assessed through agility both in children and adolescents. | Outcomes: Agility. Measurement tool: Field-based test: 10 × 5 shuttle run test from EUROFIT battery. | No association was found between 10 × 5 m shuttle run test and number of siblings (Rho = −0.074; p = 0.076). |
| González-Devesa et al. (2025) [34] | Participants (n, sex): 432 (NR) Age (range; mean ± SD): 6–11; 8.81 ± 1.8 years 12–16; 13.52 ± 1.22 years With/without siblings (n, sex, age): Children with older siblings or siblings of the same age (n = 149, NR, NR) Children without older or same-age siblings (n = 283, NR, NR) | To investigate the influence of relative age and the effects of the presence of siblings on the motor competence of children and adolescents. | Outcomes: Motor competence. Measurement tool: CAMSA | The presence of siblings did not have a statistically significant effect on CAMSA performance (p = 0.697; β = −0.019). |
| Hayashida & Nakatsuka (2013) [35] | Participants (n, sex): 318, NR Age: 4 months With/without siblings (n, sex, age): Babies with siblings < 4 years (n = 108, NR, NR) Babies with siblings ≥ 5 years (n = 35, NR, NR) Babies without siblings (n = 141, NR, NR) | To assess correlations between various factors and the physical development of 4-month-old infants. | Outcomes:
Measurement tool: Self-reported questionnaire fulfilled by parents:
| Babies with siblings < 4 years old had lower scores in KIDS-A compared to those without siblings (10.0 [5–14] vs. 11.0 [6–14]; p < 0.001). No differences were found in KIDS-A scores when babies with siblings ≥ 5 years and babies without siblings were compared (11.0 [7–14] vs. 11.0 [6–14]; p > 0.05). Babies with siblings aged ≥5 years had higher scores in KIDS-A compared to babies with siblings < 4 years old (11.0 [7–14] vs. 10.0 [5–14]; p < 0.05). No intergroup differences were found in KIDS-A in any of the groups (none = 10.0 [2–13]; <4 years = 10.0 [4–13]; ≥5 years = 10.0 [6–13]; p = 0.656). |
| Jia et al. (2022) [36] | Participants (n, sex): 91,619 (44320F; 47299M) Age (mean ± SD): 10.4 ± 0.7 With/without siblings (n, sex, age): Children with siblings (n = 62,988, NR, NR) Only children (n = 28,631, NR, NR)
Only children (n = 25,556)
Only children (n = 25,198) | To analyze whether the status of “only child” affects school performance (including physical health). | Outcome: Physical fitness. Measurement tool: Field-based tests:
| Children with siblings achieved significantly better 50 m sprint times compared to only children (p < 0.001). No significant differences in cardiorespiratory fitness were observed between only children and those with siblings (p > 0.05). |
| Krombholz (2006) [37] | Participants (n, sex): 1194 (556F; 638M) Age interval: 43–84 months | To analyze the relationship of three dimensions of physical performance with age, sex, birth order, participation in sport activities, and socioeconomic status and with cognitive performance in preschool children. | Outcomes: Motor Coordination. Measurement tool: Field-based tests:
Outcome: Physical fitness. Measurement tool: Field-based tests:
Outcome: Manual dexterity. Measurement tool: Field-based test:
| Children with older siblings obtained significantly better values than only children in the following:
|
| Krombholz (2023) [38] | Participants (n, sex): 3200 (1568F; 1578M; 54 no gender information) Age interval: 10–14 months With/without siblings (n, sex, age): Children with older siblings (n = 960, NR, NR) Children without older siblings (n = 2240, NR, NR) | To assess the motor development of children without siblings compared to children who had an older sibling in the first two years of life. | Outcome: Motor development. Measurement tool: Self-reported questionnaire fulfilled by parents on the mastering of 18 motor skills:
| Children without older siblings mastered earlier than children with older siblings the following gross motor skills: Bring hands together earlier (72 ± 32 vs. 67 ± 32; p: 0.01). Children without older siblings mastered earlier than children with older siblings the following manual skills:
|
| Lopes & Monteiro (2021) [39] | Participants (n, sex): 181 (84F; 97M) Age ± SD: 6.10 ± 0.47 years | To assess the effect of somatic and selected socio-cultural factors on motor competence of five to six-year-old children. | Outcomes: Motor competence. Measurement tools: Field-based tests: Tennis ball throw for distance. Speed run 15 m. Standing long jump. | No significant association between having or not having siblings and motor competence was observed. |
| Rebelo et al. (2020) [40] | Participants (n, sex): 405 (206F; 199M) Groups of age (n, age ± SD): From 12 to 23 months (n = 107, age = 18.79 ± 3.73) From 24 to 35 months (n = 153, age = 28.07 ± 3.35) From 36 to 48 months (n = 145, age = 39.31 ± 3.56) With/without siblings (n, sex age ± SD): Children with siblings (n = 199, NR, age = 30.61 ± 8.78) Children without siblings (n = 208, NR, age = 30.70 ± 8.67) | To verify whether the presence of siblings influenced the motor skills development of children in the first 48 months of life. | Outcomes: Motor skill development. Measurement tool: PDMS-2: Postural skills, locomotion skills, object manipulation skills, fine manipulation skills, visuo-motor integration skills. Motor quotients (global motricity and fine motricity). | Group of age from 12 to 23 months: Children with siblings showed higher levels than children without siblings in the following:
Children with siblings showed higher levels than children without siblings in the following:
Children with siblings showed higher levels than children without siblings in the following:
|
| Rodrigues et al. (2020) [41] | Participants (n, sex): 540 (270F; 270M) Age interval: 7–15 years With/without siblings (n, sex, age): Children with siblings (n = 399, 202F; 197M, NR) Children without siblings (n = 141, 70F; 71M, NR) Age groups with sibling vs. only child:
| To examine if being an only child is associated with negative differences on somatic growth and physical fitness compared to being a child with siblings. | Outcomes: Physical fitness. Measurement tools: Field-based tests:
| Children with siblings had better values than only child in the following:
|
| Rodrigues et al. (2021) [42] | Participants (n, sex): 161 (74F; 87M) Age interval: 3–6 years With/without siblings (n, sex, age ± SD): Children with siblings (n = 125, 54F; 71M, age = 4.7 ± 0.79) Children without siblings (n = 34, 19F; 15M, age = 4.6 ± 0.70) | To evaluate the effect of siblings on the three dimensions of motor competence (stability, locomotor and manipulative). | Outcomes: Motor competence. Measurement tool: MCA:
| Children with siblings show a higher percentile average for total MCA and all subscales, nevertheless not statistically significant. No statistically significant differences in the MCA total classification were observed, indicating that a higher percentage of children with siblings placed in the higher proficiency group (37% vs. 18%) and a lower percentage in the average proficiency group (30% vs. 50%). The strength of the association was low (Cramer’s V = 0.20). No other statistically significant differences were observed for all other MCA subscales. |
| Sáez-Sánchez et al. (2021) [43] | Participants (n, sex): 215 (101F; 114M) Age interval (mean ± SD): 3–6 years (3.98 ± 0.82) Groups of age: From 3 years to 3 years and 11 moths (n = 70) From 4 years to 4 years and 11 moths (n = 83) > 5 years (n = 62) With/without siblings (n, sex, age):
| To ascertain whether there are relations of dependency between psychomotor performance in early childhood education and the number of siblings. | Outcomes: Pyschomotor Performance. Measurement tool: Checklist of Psychomotor Activities
| Having siblings had a significant impact both on physical (U = 3795.5; p < 0.01; d = 0.53) and perceptual (U = 4085.5; p < 0.01; d = 0.43) motor aspects. |
| Šerbetar et al. (2021) [44] | Participants (n, sex): 108 (67F; 41M) Age interval (mean ± SD): 9–10 years (9.45 ± 0.50) With/without siblings (n, sex, age):
| To determine whether children with an older siblings differ from the children without older siblings in physical fitness and body measures. | Outcomes: Motor fitness. Measurement tool: Presidents Challenge Battery
| Children with older siblings showed higher levels than children without siblings in the following:
|
| Schild et al. (2022) [45] | Participants (n, sex): 778 (378F; 400M) Age (mean ± SD; range): 2.67 ± 1.78 years < 2 years (n = 349) 2–6 years (n = 429) With/without siblings (n, sex, age): With siblings (n = 225, NR, NR) Without siblings (n = 269, NR, NR) | To explore environmental and individual factors that are associated with child development and to investigate whether the strength of these associations differs according to the age of the children. | Outcomes: Body Motor Skills. Hand Motor Skills. Measurement tool: Self-reported questionnaire fulfilled by parents:
| Children with older siblings had better levels than children without siblings in the following:
|
| Zareian et al. (2014) [46] | Participants (n, sex): 94, NR Age interval: 9–11 years | To study the role of birth order and birth weight in the static and dynamic balance of boys aged 9–11 years old. | Outcomes: Motor competence:
Measurement tool: Lincoln Oseretsky Motor Development Scale. | Birth order had a significant influence on static balance (F-stat = 53.231; p = 0.001). Static balance for second children was higher than the first and only children at all levels. |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | Overall Rating | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cheng et al. (2025) [30] | + | + | + | + | - | - | - | - | + | - | + | - | NA | + | Fair |
| González-Devesa et al. (2025) [34] | + | + | - | + | - | - | - | + | + | - | + | - | NA | + | Fair |
| González-Devesa et al. (2024) [33] | + | + | + | + | - | - | - | + | + | - | + | - | NA | - | Fair |
| Krombholz (2023) [38] | + | - | - | - | + | - | - | + | + | - | + | - | NA | - | Poor |
| Schild et al. (2022) [45] | + | + | + | + | + | - | - | - | + | - | + | - | NA | + | Fair |
| Jia et al. (2022) [36] | + | + | + | + | + | - | - | + | + | - | + | - | NA | + | Fair |
| Sáez-Sánchez et al. (2021) [43] | + | + | - | + | - | - | - | + | + | - | + | - | NA | - | Poor |
| Šerbetar et al. (2021) [44] | + | - | + | + | - | - | - | + | - | - | + | - | NA | - | Poor |
| Rodrigues et al. (2021) [42] | + | - | + | + | - | - | - | + | + | - | + | - | NA | - | Poor |
| Lopes & Monteiro (2021) [39] | + | + | + | + | - | - | - | + | + | + | + | - | NA | + | Fair |
| Rodrigues et al. (2020) [41] | + | + | + | - | - | - | - | + | + | + | + | - | NA | - | Fair |
| Rebelo et al. (2020) [40] | + | - | + | + | - | - | - | + | + | - | + | - | NA | - | Poor |
| Chiva-Bartoll & Estevan (2019) [31] | + | - | + | + | - | - | - | - | + | - | + | - | NA | - | Poor |
| Zareian et al. (2014) [46] | + | + | + | + | - | - | - | + | + | - | + | - | NA | - | Fair |
| Hayashida & Nakatsuka (2014) [35] | + | + | + | + | + | - | - | - | + | - | + | - | NA | - | Fair |
| Cruise & O’Reilly (2014) [32] | + | + | + | + | + | - | - | - | + | - | + | - | NA | - | Fair |
| Krombholz (2006) [37] | + | - | + | + | - | - | - | + | + | + | + | - | NA | - | Fair |
| % studies meeting the criterion | 100 | 65 | 82 | 88 | 29 | 0 | 0 | 71 | 94 | 18 | 100 | 0 | NA | 29 |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Blanco-Martínez, N.; González-Devesa, D.; Vila, P.V.; Esmerode-Iglesias, A.; Ayán-Pérez, C. The Impact of Sibling Presence on Motor Competence and Physical Fitness: A Systematic Review. Healthcare 2025, 13, 3142. https://doi.org/10.3390/healthcare13233142
Blanco-Martínez N, González-Devesa D, Vila PV, Esmerode-Iglesias A, Ayán-Pérez C. The Impact of Sibling Presence on Motor Competence and Physical Fitness: A Systematic Review. Healthcare. 2025; 13(23):3142. https://doi.org/10.3390/healthcare13233142
Chicago/Turabian StyleBlanco-Martínez, Nerea, Daniel González-Devesa, Pedro Vicente Vila, Antía Esmerode-Iglesias, and Carlos Ayán-Pérez. 2025. "The Impact of Sibling Presence on Motor Competence and Physical Fitness: A Systematic Review" Healthcare 13, no. 23: 3142. https://doi.org/10.3390/healthcare13233142
APA StyleBlanco-Martínez, N., González-Devesa, D., Vila, P. V., Esmerode-Iglesias, A., & Ayán-Pérez, C. (2025). The Impact of Sibling Presence on Motor Competence and Physical Fitness: A Systematic Review. Healthcare, 13(23), 3142. https://doi.org/10.3390/healthcare13233142

