Effects of Psychological Interventions to Enhance Athletic Performance: A Systematic Review and Meta-Analysis

BACKGROUND

Psychological interventions are commonly applied in sports to help athletes enhance their performance, but the effect psychological interventions have on actual performance is unclear despite decades of research.

OBJECTIVE

We conducted a systematic review with meta-analyses to investigate the effects of a wide range of psychological interventions on performance in competitive athletes.

METHODS

A study protocol was preregistered in PROSPERO, and a literary search was performed in the MEDLINE, PsycINFO, Web of Science, and SPORTDiscus databases. Psychological intervention studies were eligible by using a group design and a quantitative performance outcome with athletes competing at a regional or university level or higher. Included studies were assessed regarding intervention characteristics, research methodology, and risk of bias. A multi-level meta-analysis framework with cluster robust variance estimation was used to quantitatively synthesize the results.

RESULTS

A total of 111 studies met the inclusion criteria, and 25 of these studies (37 effects) could be synthesized into five meta-analyses in which there were similarities in the type of psychological intervention, comparator, and experimental design. Meta-analyses I (multimodal psychological skills training vs control), II (mindfulness- and acceptance-based approaches vs control), and III (imagery vs control) consisted of parallel-group studies, and random-effects models were used to calculate the standardized mean difference. Meta-analyses IV (attentional focus strategies, external vs internal) and V (regulatory focus performance instructions, prevention vs promotion) consisted of counterbalanced crossover design studies, and random-effects models were used to calculate the standardized mean change using change score standardization. Significant results were found in three of the meta-analyses (I, II, and III). Psychological skills training (g = 0.83, 95% confidence interval 0.21-1.45), mindfulness- and acceptance-based approaches (g = 0.67, 95% confidence interval 0.01-1.32), and imagery (g = 0.75, 95% confidence interval 0.14-1.36) outperformed controls with moderate effects. However, when non-randomized trials and subjective performance outcomes were removed in sensitivity analyses, the overall estimates of the effect size were no longer significant in any of the syntheses.

CONCLUSIONS

The significant moderate effects for psychological skills training, mindfulness- and acceptance-based approaches, and imagery are not stable, and further trials with robust research methodology, such as randomized controlled trials, are requested for all types of psychological interventions aiming to enhance performance in athletes. Moreover, improved reporting standards and the provision of datasets in open science repositories are important to consider in future trials in sport psychology.

CLINICAL TRIAL REGISTRATION

PROSPERO CRD42017056677.

Cognition in soccer and futsal: evidence of validity of a 4-instrument protocol to assess executive functioning among women athletes

Evidence suggests that success in sports, especially soccer and futsal are linked to higher levels of executive functioning. Still, the literature does not present a homogeneous set of instruments to measure executive functions, which leads to large variability in results. In this paper, we assembled four already recognised measures to propose a valid 4-instrument protocol to assess executive functions among soccer and futsal athletes. We conducted two studies to validate the proposed protocol. We addressed known-groups validity and latent structure in Study 1 for data collected on 105 female soccer and futsal athletes from elite and lower-division clubs. Findings pointed to partial validity of the protocol - with working memory and inhibition showing the best results. For Study 2, we used performance data from 51 elite female soccer players collected throughout a season of the first division league to assess predictive validity. Our protocol was able to partially replicate previous findings and added new insights on how working memory, processing speed and higher-level executive functions might play different roles for goalscoring and assist-making skills. Specifically, study 1 did not find a significant difference between elite and lower-division athletes in higher-order executive functions as in previous studies, but it did find on visual working memory and inhibitory control which weights towards higher demands of core executive functions. On the other hand, study 2 yielded significant results for processing speed and visual working memory to predict assists among elite soccer players, but not inhibitory control as previous findings suggested. Regardless, the proposed 4-instrument protocol showed adequate criterion and structural validity in both studies.

Bilateral transfer of motor performance as a function of motor imagery training: a systematic review and meta-analysis

Objective

The objective of this review was to evaluate the efficacy of mental imagery training (MIT) in promoting bilateral transfer (BT) of motor performance for healthy subjects.

Data sources

We searched 6 online-databases (Jul-Dec 2022) using terms: "mental practice," "motor imagery training," "motor imagery practice," "mental training," "movement imagery," "cognitive training," "bilateral transfer," "interlimb transfer," "cross education," "motor learning," "strength," "force" and "motor performance."

Study selection and data extraction

We selected randomized-controlled studies that examined the effect of MIT on BT. Two reviewers independently determined if each study met the inclusion criteria for the review. Disagreements were resolved through discussion and, if necessary, by a third reviewer. A total of 9 articles out of 728 initially identified studies were chosen for the meta-analysis.

Data synthesis

The meta-analysis included 14 studies for the comparison between MIT and no-exercise control (CTR) and 15 studies for the comparison between MIT and physical training (PT).

Results

MIT showed significant benefit in inducing BT compared to CTR (ES = 0.78, 95% CI = 0.57-0.98). The effect of MIT on BT was similar to that of PT (ES = -0.02, 95% CI = -0.15-0.17). Subgroup analyses showed that internal MIT (IMIT) was more effective (ES = 2.17, 95% CI = 1.57-2.76) than external MIT (EMIT) (ES = 0.95, 95% CI = 0.74-1.17), and mixed-task (ES = 1.68, 95% CI = 1.26-2.11) was more effective than mirror-task (ES = 0.46, 95% CI = 0.14-0.78) and normal-task (ES = 0.56, 95% CI = 0.23-0.90). No significant difference was found between transfer from dominant limb (DL) to non-dominant limb (NDL) (ES = 0.67, 95% CI = 0.37-0.97) and NDL to DL (ES = 0.87, 95% CI = 0.59-1.15).

Conclusion

This review concludes that MIT can serve as a valuable alternative or supplement to PT in facilitating BT effects. Notably, IMIT is preferable to EMIT, and interventions incorporating tasks that have access to both intrinsic and extrinsic coordinates (mixed-task) are preferred over those that involve only one of the two coordinates (mirror-task or normal-task). These findings have implications for rehabilitation of patients such as stroke survivors.

Reciprocal facilitation between mental and visuomotor rotations

Humans exhibit remarkably complex cognitive abilities and adaptive behavior in daily life. Cognitive operation in the "mental workspace," such as mentally rotating a piece of luggage to fit into fixed trunk space, helps us maintain and manipulate information on a moment-to-moment basis. Skill acquisition in the "sensorimotor workspace," such as learning a new mapping between the magnitude of new vehicle movement and wheel turn, allows us to adjust our behavior to changing environmental or internal demands to maintain appropriate motor performance. While this cognitive and sensorimotor synergy is at the root of adaptive behavior in the real world, their interplay has been understudied due to a divide-and-conquer approach. We evaluated whether a separate domain-specific or common domain-general operation drives mental and sensorimotor rotational transformations. We observed that participants improved the efficiency of mental rotation speed after the visuomotor rotation training, and their learning rate for visuomotor adaptation also improved after their mental rotation training. Such bidirectional transfer between two widely different tasks highlights the remarkable reciprocal plasticity and demonstrates a common transformation mechanism between two intertwined workspaces. Our findings urge the necessity of an explicitly integrated approach to enhance our understanding of the dynamic interdependence between cognitive and sensorimotor mechanisms.

Elderly may benefit more from motor imagery training in gaining muscle strength than young adults: A systematic review and meta-analysis

Objective

The current review was aimed to determine the effectiveness of mental imagery training (MIT) on the enhancement of maximum voluntary muscle contraction (MVC) force for healthy young and old adults.

Data sources

Six electronic databases were searched from July 2021 to March 2022. Search terms included: "motor imagery training," "motor imagery practice," "mental practice," "mental training," "movement imagery," "cognitive training," "strength," "force," "muscle strength," "performance," "enhancement," "improvement," "development," and "healthy adults."

Study selection and data extraction

Randomized controlled trials of MIT in enhancing muscle strength with healthy adults were selected. The decision on whether a study met the inclusion criteria of the review was made by two reviewers independently. Any disagreements between the two reviewers were first resolved by discussion between the two reviewers. If consensus could not be reached, then it would be arbitrated by a third reviewer.

Data synthesis

Twenty-five studies including both internal MIT and external MIT were included in meta-analysis for determining the efficacy of MIT on enhancing muscle strength and 22 internal MIT were used for subgroup analysis for examining dose-response relationship of MIT on MVC.

Results

MIT demonstrated significant benefit on enhancing muscle strength when compared with no exercise, Effect Size (ES), 1.10, 95% confidence interval (CI), 0.89-1.30, favoring MIT, but was inferior to physical training (PT), ES, 0.38, 95% CI, 0.15-0.62, favoring PT. Subgroup analysis demonstrated that MIT was more effective for older adults (ES, 2.17, 95% CI, 1.57-2.76) than young adults (ES, 0.95, 95% CI, 0.74-1.17), p = 0.0002, and for small finger muscles (ES, 1.64, 95% CI, 1.06-2.22) than large upper extremity muscles (ES, 0.86, 95% CI, 0.56-1.16), p = 0.02. No significant difference was found in the comparison of small finger muscles and large lower extremity muscles, p = 0.19 although the ES of the former (ES, 1.64, 95% CI, 1.06-2.22) was greater than that of the later (ES, 1.20, 95%, 0.88-1.52).

Conclusion

This review demonstrates that MIT has better estimated effects on enhancing MVC force compared to no exercise, but is inferior to PT. The combination of MIT and PT is equivalent to PT alone in enhancing muscle strength. The subgroup group analysis further suggests that older adults and small finger muscles may benefit more from MIT than young adults and larger muscles.

Sport psychology and performance meta-analyses: A systematic review of the literature

Sport psychology as an academic pursuit is nearly two centuries old. An enduring goal since inception has been to understand how psychological techniques can improve athletic performance. Although much evidence exists in the form of meta-analytic reviews related to sport psychology and performance, a systematic review of these meta-analyses is absent from the literature. We aimed to synthesize the extant literature to gain insights into the overall impact of sport psychology on athletic performance. Guided by the PRISMA statement for systematic reviews, we reviewed relevant articles identified via the EBSCOhost interface. Thirty meta-analyses published between 1983 and 2021 met the inclusion criteria, covering 16 distinct sport psychology constructs. Overall, sport psychology interventions/variables hypothesized to enhance performance (e.g., cohesion, confidence, mindfulness) were shown to have a moderate beneficial effect (d = 0.51), whereas variables hypothesized to be detrimental to performance (e.g., cognitive anxiety, depression, ego climate) had a small negative effect (d = -0.21). The quality rating of meta-analyses did not significantly moderate the magnitude of observed effects, nor did the research design (i.e., intervention vs. correlation) of the primary studies included in the meta-analyses. Our review strengthens the evidence base for sport psychology techniques and may be of great practical value to practitioners. We provide recommendations for future research in the area.

SIM: The Surgery Imagery Mindset and Preparing for Surgery

Discussed under various terms such as mental skills, mental rehearsal, cognitive training, and non-technical skills, psychological performance skills are gaining greater acceptance for their contributions to excellence in surgical performance. Mental imagery, specifically performance-enhancing mental imagery for surgeons, has received the greatest attention in the surgical literature. As part of the surgeon's imagery mindset (SIM), this form of mental rehearsal contributes to optimal surgical performance for both developing and practicing surgeons. We discuss the nature of SIM and describe 5 basic guidelines for maximizing the application of performance-enhancing mental imagery in surgical contexts.

The Association Between Test Anxiety, Self-Efficacy, and Mental Images Among University Students: Results From an Online Survey

Background and Objectives: A substantial portion of students report test anxiety, and those reporting low levels of self-efficacy seem to be especially affected. Previous research has indicated the relevance of mental images in the maintenance of anxiety disorders, however, no data are available with respect to test anxiety. In order to close this gap, the present study investigates the association between test anxiety, self-efficacy and mental images. Method: One hundred sixty-three university students completed an online survey. Test anxiety (PAF), general self-efficacy (WIRKALL-r), study-related self-efficacy (WIRK_STUD), intrusiveness of mental images (IFES), spontaneous use of imagery (SUIS) and vividness of imagery (VVIQ) were examined. Results: Test-related mental images were frequently reported among the surveyed students. Test anxiety showed a positive correlation with IFES and a negative correlation with self-efficacy. Mediation analyses showed that about one fifth of the influence of self-efficacy on test anxiety is mediated by IFES. Discussion: The present study gives first indication about an association between test anxiety, self-efficacy and mental images, even though the results are limited with respect to generalizability. Further investigations with respect to the impact of test-related mental images on the self-efficacy/test-anxiety linkage are needed.

Comparative analysis of the autonomic nervous system response during movement representation in healthy individuals and patients with chronic low back pain: a prospective cohort study

OBJECTIVE

The primary objective was to compare the difference in autonomic nervous system (ANS) response between motor imagery (MI) group and action observation (AO) group. Both consisted of two subgroups: the control subgroup (CG), which consisted of asymptomatic individuals, and the patient subgroup (PG), which consisted of patients with chronic low back pain (CLBP). The secondary objective was to assess ANS activity during AO and MI training according to the fear-of-movement levels of the PGs.

METHODS

Sixty participants were randomly assigned. The autonomic outcome measures included skin conductance (SC), respiration rate (RR), and heart rate (HR).

RESULTS

Results showed that intergroup differences in RR were higher in the PG, with a large effect size (p = .007, d = 1.71). Only the PGs showed intragroup differences in SC (p <.05). In terms of ANS activity during the training, there were no statistically significant intergroup differences (p <.05). However, the strongest intragroup differences were among the AO_PG with greater levels of kinesiophobia. For the SC and HR variables, only this condition showed significant differences between baseline and the first and second movements, with a large effect size (p <.001 and p = .002, respectively, and d >.80).

CONCLUSIONS

The results showed that AO and MI training in the PG and CG resulted in similar but not identical ANS activation, with slightly higher activation in the PG. The differences in the PG could be associated with kinesiophobia when visually exposed to low-back movements that could be interpreted as hazardous or unsafe.

Effects of movement representation techniques on motor learning of thumb-opposition tasks

The present work is the first study that assess long run change after motor learning. The study’s main objective was to evaluate the short to medium-term impact of motor imagery (MI) and action observation (AO) on motor learning of a sequence of thumb-opposition tasks of increasing complexity. We randomly assigned 45 participants to an AO, MI, or placebo observation (PO) group. A sequence of 12 thumb-opposition tasks was taught for 3 consecutive days (4 per day). The primary outcome was accuracy. The secondary outcomes were required time and perfect positioning. The outcomes were assessed immediately after the intervention and at 1 week, 1 month and 4 months postintervention. Regarding the primary outcome, AO group had significantly higher accuracy than the MI or PO group until at least 4 months (p < 0.01, d > 0.80). However, in the bimanual positions, AO was not superior to MI at 1 week postintervention. Regarding secondary outcomes, AO group required less time than the MI group to remember and perform the left-hand and both-hand gestures, with a large effect size (p < 0.01, d > 0.80). In terms of percentage of perfect positions, AO group achieved significantly better results than the MI group until at least 4 months after the intervention in the unimanual gestures (p < 0.01, d > 0.80) and up to 1 month postintervention in the bimanual gestures (p = 0.012, d = 1.29). AO training resulted in greater and longer term motor learning than MI and placebo intervention. If the goal is to learn some motor skills for whatever reason (e.g., following surgery or immobilization.), AO training should be considered clinically.

Effects of mental and physical orofacial training on pressure pain sensitivity and tongue strength: A single-blind randomized controlled trial

OBJECTIVES

The main objective of this study was to analyze differences on pain pressure thresholds, tongue strength and perceived effort between various orofacial motor exercise training dosages of mental representation training through motor imagery (MI) and action observation (AO), first in isolation and then in combination with real exercise performance.

METHODS

A single-blind randomized controlled trial was designed. 48 asymptomatic individuals were randomized into two groups: Intensive training group (IG) and Moderate training group (MG). Both groups performed a first session of MI and AO of orofacial exercises training and a second session of actual orofacial exercises combined with mental representation training, but with different dosage in terms of series and repetitions. Pain pressure thresholds (PPTs) in the masseter and temporal muscles and tongue muscle strength were the main variables.

RESULTS

Regarding the PPT, ANOVA revealed significant between-group differences, where MG showed a significantly higher PPT than IG at post-day2, with a medium effect size. Both groups showed with-in group differences between pre and post intervention measures in the first session, but only the IG showed differences in the second. Regarding tongue muscle strength, ANOVA revealed significant within-group differences only in MG between the pre-day and post-day first intervention.

CONCLUSION

The results of the present study suggest that movement representation training performed in isolation may have a positive effect on PPTs and tongue muscle strength. In addition, the combination with the actual execution of the exercises could be considered effective, but it is necessary to take into account the training dosage to avoid fatigue responses.

Effects of Short-Term Mental Imagery and Supplemental Visual Feedback on Muscle Coordination in a Myoelectric Task

Changing muscle coordination patterns is a critical part of motor learning - yet there is a lack of simple, clinically feasible techniques to alter these patterns. Here, we investigated the effects of short-term mental imagery and supplemental visual feedback on muscle coordination using a myoelectric reaching task with complex mapping of arm and hand muscles to cursor position. Forty participants were divided into four groups, and practiced this task over 180 trials. During a short intervention period, the controls rested, the task- and muscle-imagery groups were given specific instructions meant to simplify the task, and the supplemental feedback group was provided extra visual information of muscle-to-cursor mapping. Results showed that there were no changes in task performance between groups. However, we found that in terms of muscle coordination, the supplemental visual feedback group showed the most efficient coordination. Furthermore, across all groups, individuals with greater efficiency and exploration showed better task performance at the end of practice. The results from this pilot study point to a greater need for understanding strategies for changing muscle coordination, which could be applicable in a rehabilitation setting.

Mental practice in isolation improves cervical joint position sense in patients with chronic neck pain: a randomized single-blind placebo trial

Objective

The main objective of this trial was to assess whether action observation (AO) training and motor imagery (MI) produced changes in the cervical joint position sense (CJPS) both at the end of the intervention and 10 min postintervention compared with a placebo intervention in patients with nonspecific chronic neck pain (NSCNP).

Methods

A single-blind placebo clinical trial was designed. A total of 30 patients with NSCNP were randomly assigned to the AO group, MI group or placebo observation (PO) group. CJPS in flexion, extension and rotation movements in both planes were the main variables.

Results

The results obtained in the vertical plane showed that the AO group obtained greater improvements than the PO group in the CJPS in terms of cervical extension movement both at the end of the intervention and 10 min postintervention (p = .001, d = 1.81 and p = .004, d = 1.74, respectively), and also in cervical flexion movement, although only at 10 min after the intervention (p = .035, d = 0.72). In addition, the AO group obtained greater improvements than the MI group in the CJPS only at the end of the intervention in cervical extension movement (p = .041, d = 1.17). Regarding the left rotation cervical movement, both the MI and AO groups were superior to the PO group in both planes at the end of the intervention (p < .05, d > 0.80).

Conclusions

Although both AO and MI could be a useful strategy for CJPS improvement, the AO group showed the strongest results. The therapeutic potential of the application of mental practice in a clinical context in the early stages of rehabilitation of NSCNP should be considered.

Does the duration of motor imagery affect the excitability of spinal anterior horn cells?

PURPOSE

Motor imagery, the process of imagining a physical action, has been shown to facilitate the excitability of spinal anterior horn cells. In the acute phase after a stroke, the excitability of spinal anterior horn cells is significantly reduced, which leads to motor deficits. This loss of movement can be prevented by increasing the excitability of spinal anterior horn cells immediately following an injury. Motor imagery is an effective method for facilitating the excitability of spinal anterior horn cells in patients with impaired movement; however, the optimal duration for motor imagery is unclear.

MATERIALS AND METHODS

To investigate time-dependent changes in spinal anterior horn cell excitability during motor imagery, healthy adult participants were recruited to measure the F-wave, an indicator of anterior horn cell excitability. F-waves were measured from participants at baseline, during motor imagery, and post-motor imagery. During motor imagery, participants imagined isometric thenar muscle activity at 50% maximum voluntary contraction for 5 min. F-waves were measured at 1, 3, and 5 min after beginning motor imagery and analysed for persistence and F/M amplitude ratio.

RESULTS

Persistence and F/M amplitude ratios at 1- and 3-min after motor imagery initiation were significantly greater than at baseline. The persistence and F/M amplitude ratio at 5-min after motor imagery initiation, however, was comparable to baseline levels.

CONCLUSION

Therefore, 1 to 3 min of motor imagery is likely sufficient to facilitate the excitability of spinal anterior horn cells.

Effects of Psychological and Psychosocial Interventions on Sport Performance: A Meta-Analysis

BACKGROUND

Psychologists are increasingly supporting the quest for performance enhancement in sport and there is a need to evaluate the evidence base underpinning their work.

OBJECTIVES

To synthesize the most rigorous available research that has evaluated psychological, social, and psychosocial interventions with sport performers on variables relating to their athletic performance, and to address some of the perplexing issues in the sport psychology intervention literature (e.g., do interventions have a lasting effect on sport performance?).

METHODS

Randomized controlled trials were identified through electronic databases, hand-searching volumes of pertinent journals, scrutinizing reference lists of previous reviews, and contacting experts in the evaluation of interventions in this field. Included studies were required to evaluate the effects of psychological, social, or psychosocial interventions on sport performance in athletes when compared to a no-treatment or placebo-controlled treatment comparison group. A random effects meta-analysis calculating the standardized mean difference (Hedges' g), meta-regressions, and trim and fill analyses were conducted. Data were analyzed at post-test and follow-up (ranging from 1 to 4 weeks after the intervention finished) assessments.

RESULTS

Psychological and psychosocial interventions were shown to enhance sport performance at post-test (k = 35, n = 997, Hedges' g = 0.57, 95 % CI = 0.22-0.92) and follow-up assessments (k = 8, n = 189, Hedges' g = 1.16, 95 % CI = 0.25-2.08); no social interventions were included or evaluated. Larger effects were found for psychosocial interventions and there was some evidence that effects were greatest in coach-delivered interventions and in samples with a greater proportion of male participants.

CONCLUSIONS

Psychological and psychosocial interventions have a moderate positive effect on sport performance, and this effect may last at least a month following the end of the intervention. Future research would benefit from following guidelines for intervention reporting.

Internal and External Imagery Effects on Tennis Skills Among Novices

The purpose of this study was to determine the effects of internal and external visual imagery perspectives on performance accuracy of open and closed tennis skills (i.e., serve, forehand, and backhand) among novices. Thirty-six young male novices, aged 15–18 years, from a summer tennis program participated. Following initial skill acquisition (12 sessions), baseline assessments of imagery ability and imagery perspective preference were used to assign participants to one of three groups: internal imagery ( n = 12), external imagery ( n = 12), or a no-imagery (mental math exercise) control group ( n = 12). The experimental interventions of 15 minutes of mental imagery (internal or external) or mental math exercises followed by 15 minutes of physical practice were held three times a week for six weeks. The performance accuracy of the groups on the serve, forehand, and backhand strokes was measured at pre- and post-test using videotaping. Results showed significant increases in the performance accuracy of all three tennis strokes in all three groups, but serve accuracy in the internal imagery group and forehand accuracy in the external imagery group showed greater improvements, while backhand accuracy was similarly improved in all three groups. These findings highlight differential efficacy of internal and external visual imagery for performance improvement on complex sport skills in early stage motor learning.

Die deutsche Übersetzung des SIQ und SIAQ zur Erfassung von Vorstellungsgebrauch und Vorstellungskompetenz im Sport

Zusammenfassung. Ziel der vorliegenden Studie war es, eine deutschsprachige Übersetzung des Sport Imagery Questionnaire (SIQ; Hall, Mack, Paivio & Hausenblas, 1998 ) sowie des Sport Imagery Ability Questionnaire (SIAQ, Williams & Cumming, 2011 ) zu erstellen und auf ihre psychometrischen Eigenschaften zu überprüfen. Der SIQ erfasst das Konstrukt Vorstellungsgebrauch, der SIAQ die Vorstellungskompetenz. An der Studie nahmen 404 Athletinnen und Athleten aus über 45 Sportarten im Alter von 14 bis 72 Jahren in Präsenz- und Onlineerhebungen teil. Konfirmatorische Faktorenanalysen der deutschen Übersetzungen des SIQ und SIAQ zeigten akzeptable Fit-Indizes und Reliabilitäten. Messinvarianz-Analysen ergaben skalare Invarianz der Erhebungsmethode. Die deutschen Versionen des SIQ und SIAQ zeigen demnach die gleiche Faktorstruktur wie die Originalfragebögen mit vergleichbaren psychometrischen Eigenschaften. Die Ergebnisse liefern Evidenz, dass der SIQ und SIAQ reliable Maße zur Erfassung von Vorstellungsgebrauch und Vorstellungskompetenz für die Forschung und sportpsychologische Praxis darstellen. Weitere Forschung bezüglich der Weiterentwicklung, Retest-Reliabilität und prädiktiven Validität ist wünschenswert.

The Representation of Motor (Inter)action, States of Action, and Learning: Three Perspectives on Motor Learning by Way of Imagery and Execution

Learning in intelligent systems is a result of direct and indirect interaction with the environment. While humans can learn by way of different states of (inter)action such as the execution or the imagery of an action, their unique potential to induce brain- and mind-related changes in the motor action system is still being debated. The systematic repetition of different states of action (e.g., physical and/or mental practice) and their contribution to the learning of complex motor actions has traditionally been approached by way of performance improvements. More recently, approaches highlighting the role of action representation in the learning of complex motor actions have evolved and may provide additional insight into the learning process. In the present perspective paper, we build on brain-related findings and sketch recent research on learning by way of imagery and execution from a hierarchical, perceptual-cognitive approach to motor control and learning. These findings provide insights into the learning of intelligent systems from a perceptual-cognitive, representation-based perspective and as such add to our current understanding of action representation in memory and its changes with practice. Future research should build bridges between approaches in order to more thoroughly understand functional changes throughout the learning process and to facilitate motor learning, which may have particular importance for cognitive systems research in robotics, rehabilitation, and sports.

E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning-a randomized controlled trial

Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.

Training Mobility Tasks after Stroke with Combined Mental and Physical Practice: A Feasibility Study

This study examines the potential of using mental practice (MP) to promote the learning of 2 mobility tasks in persons with stroke. Twelve patients were trained with MP to increase the loading of the affected limb while standing up from a chair and sitting down. Vertical forces were recorded using force plates under each foot and the chair. Changes in the loading of the affected limb and in task duration, immediately after 1 training session and 24 h later, served as outcomes. After training, the loading of the affected limb had increased {P < 0.001) during standing up (16.2%) and sitting down (17.9%), and the improvement remained significant 24 h later, indicating a learning effect. In contrast, the duration of the performance did not change with training. The results indicate that, in the early stage of learning with MP, changes in limb-loading strategies are a more sensitive measure of performance than is speed.

Understanding the Role of the Self in Prime-to-Behavior Effects: The Active-Self Account

In this article, the authors review research showing the different roles that the self-concept can play in affecting prime-to-behavior effects. As an organizing framework, an Active-Self account of stereotype, trait, and exemplar prime-to-behavior effects is presented. According to this view, such primes can influence people's behavior by creating changes in the active self-concept, either by invoking a biased subset of chronic self-content or by introducing new material into the active self-concept. The authors show how involvement of the active self-concept can increase, decrease, or reverse the effects of primes and describe how individual differences in responsiveness of the self to change and usage of the self in guiding behavior (e.g., self-monitoring) can moderate prime-to-behavior effects. The Active-Self account is proposed as an integrative framework that explains how the self is involved in prime-to-behavior effects and helps predict how changes in the self determine which motivational and behavioral representations will guide behavior.

Perceptual-Cognitive Changes During Motor Learning: The Influence of Mental and Physical Practice on Mental Representation, Gaze Behavior, and Performance of a Complex Action

Despite the wealth of research on differences between experts and novices with respect to their perceptual-cognitive background (e.g., mental representations, gaze behavior), little is known about the change of these perceptual-cognitive components over the course of motor learning. In the present study, changes in one's mental representation, quiet eye behavior, and outcome performance were examined over the course of skill acquisition as it related to physical and mental practice. Novices (N = 45) were assigned to one of three conditions: physical practice, combined physical plus mental practice, and no practice. Participants in the practice groups trained on a golf putting task over the course of 3 days, either by repeatedly executing the putt, or by both executing and imaging the putt. Findings revealed improvements in putting performance across both practice conditions. Regarding the perceptual-cognitive changes, participants practicing mentally and physically revealed longer quiet eye durations as well as more elaborate representation structures in comparison to the control group, while this was not the case for participants who underwent physical practice only. Thus, in the present study, combined mental and physical practice led to both formation of mental representations in long-term memory and longer quiet eye durations. Interestingly, the length of the quiet eye directly related to the degree of elaborateness of the underlying mental representation, supporting the notion that the quiet eye reflects cognitive processing. This study is the first to show that the quiet eye becomes longer in novices practicing a motor action. Moreover, the findings of the present study suggest that perceptual and cognitive adaptations co-occur over the course of motor learning.

Exploring virtual mental practice in maintenance task training

PURPOSE

- This paper aims to contribute to a general understanding of mental practice by investigating the utility of and participant reaction to a virtual reality maintenance training among underground coal mine first responders.

DESIGN/METHODOLOGY/APPROACH

- Researchers at the National Institute for Occupational Safety and Health's Office of Mine Safety and Health Research (OMSHR) developed software to provide opportunities for mine rescue team members to learn to inspect, assemble and test their closed-circuit breathing apparatus and to practice those skills. In total, 31 mine rescue team members utilized OMSHR's BG 4 Benching Trainer software and provided feedback to the development team. After training, participants completed a brief post-training questionnaire, which included demographics, perceived training climate and general training evaluation items.

FINDINGS

- The results overall indicate a generally positive reaction to and high perceived utility of the BG 4 benching software. In addition, the perceived training climate appears to have an effect on the perceived utility of the mental practice virtual reality game, with benchmen from mines with more positive training climates reporting greater perceived efficacy in the training's ability to prepare trainees for real emergencies.

ORIGINALITY/VALUE

- This paper helps to broaden current applications of mental practice and is one of the few empirical investigations into a non-rehabilitation virtual reality extension of mental practice. This paper also contributes to the growing literature advocating for greater usage of accurate and well-informed mental practice techniques, tools and methodologies, especially for occupational populations with limitations on exposure to hands-on training.

Motor imagery: lessons learned in movement science might be applicable for spaceflight

Before participating in a space mission, astronauts undergo parabolic-flight and underwater training to facilitate their subsequent adaptation to weightlessness. Unfortunately, similar training methods can’t be used to prepare re-adaptation to planetary gravity. Here, we propose a quick, simple and inexpensive approach that could be used to prepare astronauts both for the absence and for the renewed presence of gravity. This approach is based on motor imagery (MI), a process in which actions are produced in working memory without any overt output. Training protocols based on MI have repeatedly been shown to modify brain circuitry and to improve motor performance in healthy young adults, healthy seniors and stroke victims, and are routinely used to optimize performance of elite athletes. We propose to use similar protocols preflight, to prepare for weightlessness, and late inflight, to prepare for landing.

Mental representation and mental practice: experimental investigation on the functional links between motor memory and motor imagery

Recent research on mental representation of complex action has revealed distinct differences in the structure of representational frameworks between experts and novices. More recently, research on the development of mental representation structure has elicited functional changes in novices' representations as a result of practice. However, research investigating if and how mental practice adds to this adaptation process is lacking. In the present study, we examined the influence of mental practice (i.e., motor imagery rehearsal) on both putting performance and the development of one's representation of the golf putt during early skill acquisition. Novice golfers (N = 52) practiced the task of golf putting under one of four different practice conditions: mental, physical, mental-physical combined, and no practice. Participants were tested prior to and after a practice phase, as well as after a three day retention interval. Mental representation structures of the putt were measured, using the structural dimensional analysis of mental representation. This method provides psychometric data on the distances and groupings of basic action concepts in long-term memory. Additionally, putting accuracy and putting consistency were measured using two-dimensional error scores of each putt. Findings revealed significant performance improvements over the course of practice together with functional adaptations in mental representation structure. Interestingly, after three days of practice, the mental representations of participants who incorporated mental practice into their practice regime displayed representation structures that were more similar to a functional structure than did participants who did not incorporate mental practice. The findings of the present study suggest that mental practice promotes the cognitive adaptation process during motor learning, leading to more elaborate representations than physical practice only.

Using the mind as a simulator: a randomized controlled trial of mental training

OBJECTIVES

Laparoscopic simulators have been introduced as safe and effective methods of developing basic skills. Mental training is a novel training method likened to using the mind as a simulator to mentally rehearse the movements of a task or operation. It is widely used by professional athletes and musicians and has been suggested as a technique that could be used by surgical trainees. The purpose of this study was to assess the use of mental training in developing basic laparoscopic skills in novices.

METHODS

Sixty-four medical students without laparoscopic experience were randomized into 4 groups. The first 3 groups were trained to cut a circle on a box trainer. Group 1 received no additional training (BT), Group 2 received additional virtual reality training (BT + VRS), and Group 3 received additional mental training (BT + MT). The fourth group was trained on a virtual reality simulator with additional mental training (box-free). The following 4 assessment criterias: time, accuracy, precision and overall performance were measured on both the box-trainer and virtual simulator.

RESULTS

The mental training group (BT + MT) demonstrated improved laparoscopic skills over both assessments. The improvement in skills in the VRS group (BT + VRS) was limited to VRS assessment and not observed in the box assessment. The fourth group (box-free) had the worst performance on both methods of assessment.

CONCLUSION

The addition of mental training led to improved laparoscopic skills development. It is a flexible technique and has the potential to challenge VRS as a more cost-effective training method associated with lower capital investment. Given the benefits of mental training with further research, it could be considered for inclusion in training curricula.

Imagery Use of Athletes in Individual and Team Sports That Require Open and Closed Skill

This study compared use of imagery in elite male and female athletes in open and closed and individual or team sports. A total of 151 elite Turkish athletes ages 15 to 29 years old (males' M age = 20.7 yr., SD = 3.3; females' M age = 20.0 yr., SD = 3.5) from open-team sports ( n = 66), open-individual sports ( n = 26), and closed-individual sports ( n = 59) completed the Sport Imagery Questionnaire. A significant multivariate effect of sport type was found. Univariate analyses indicated that male and female athletes in team open-skill sports and individual closed-skill sports used more Motivational General–Mastery imagery than did athletes in individual open-skill sports.

Retroactive interference and mental practice effects on motor performance: a pilot study

This study examined the effect of similar versus dissimilar retroactive interference on the mental practice effects for performing a novel motor skill. Research has shown that mental practice of a motor task can interfere with learning and performance of the task; however, little is known about how different retroactive interference activities affect mental practice effects. 90 volunteers ages 18 to 51 years (M=26.8, SD=9.6) completed a pre-test and post-test of 10 sets of five trials of a throwing task with the non-preferred hand. In the practice phase, participants mentally practiced the throwing task and then mentally practiced a task that was similar, dissimilar, or completed an unrelated reading task. Performance for all groups improved from pre- to post-test; however, there were no differences in increases for the three groups. The findings suggest that mental practice of similar and dissimilar tasks produced no significant interference in performance.

Frequency of Lucid Dreams and Lucid Dream Practice in German Athletes

Mental practice is the cognitive rehearsal of a motor task in the absence of overt physical movement. A different and rather unknown kind of mental rehearsal is practice in lucid dreams. Within lucid dreams, the dreamer is able to control the ongoing dream content and for athletes it is possible to use the dream state to deliberately practice sport skills while physically asleep. In this study, 840 German athletes from various sports were asked about their experience with lucid dreams. About 57% of the athletes stated that they experienced a lucid dream at least once in their lives, 24% are frequent lucid dreamers (having one or more lucid dreams per month), and 9% of the lucid dreamers used this dream state to practice sport skills, and the majority of those athletes had the impression that the rehearsal within the lucid dream improved their performance in wakefulness. The prevalence rate of lucid dreaming in professional athletes is similar as in general population, however the rough estimate of the percentage of lucid dreams compared to all dreams in athletes was found to be nearly twice as high as in general population (14.5% vs. 7.5%). The possibilities of lucid dream practice for professional sports will be discussed.

Mental practice and the retention of motor learning: a pilot study

This study compared the effects of mental practice, physical practice, and no practice on the performance and retention of a novel throwing task. Research supports the effectiveness of mental practice on performance; however, retention of learning has not been adequately investigated. Participants were 152 students ages 18 to 44 years (M = 20.5, SD = 2.9), who completed a pretest, posttest, and five-week delayed retention test of dart throwing with the nonpreferred hand. In the practice phase, participants completed 50 mental practice or physical practice trials of the darts task or 50 trials of a catching task. Results indicated that overall scores increased from pretest to posttest and retention test, and decreased from posttest to retention test, but that these effects did not differ for type of practice. The findings suggest equal learning and retention of learning for novel throwing tasks for control, mental practice, and physical practice conditions; however, further research that considers issues raised is recommended.

Amount of Mental Practice and Performance of a Simple Motor Task

The effects of different amounts of mental practice on the performance of a motor skill were studied. Research supports the effectiveness of mental practice on performance; however, little is known about how much practice is needed and whether there is an optimal amount for these practice effects. Participants, 209 students ages 18 to 44 years ( M = 20.5, SD = 2.9), completed a pre- and posttest of dart throwing with the nonpreferred hand. In the practice phase, participants completed either 25 (Mental Practice 25), 50 (Mental Practice 50), or 100 (Mental Practice 100) trials of the darts task or 50 trials of a catching task (Catching Task). Performance for all groups improved from pre- to posttest. Improvements for the three mental practice groups were greater than for the Catching Task group; however, there were no differences for the three Mental Practice groups. The findings support the positive effect of mental practice over a control condition and suggest that small amounts of mental practice may be sufficient for performance improvements, at least for a simple motor skill.

Beating the bunker: the effect of PETTLEP imagery on golf bunker shot performance

The aim of this study was to compare the effects of physical practice with PETTLEP-based (Physical, Environment, Task, Timing, Learning, Emotion and Perspective; Holmes & Collins, 2001) imagery and PETTLEP + physical practice interventions on golf bunker shot performance. Thirty-two male county- or international-level golfers were assigned to one of four groups; PETTLEP imagery, physical practice, PETTLEP + physical practice, or control. The PETTLEP imagery group imaged 15 bunker shots, their interventions incorporating PETTLEP components, such as physical, environment, and emotion, twice a week. The physical practice group physically performed their 15 bunker shots twice per week; the PETTLEP + physical practice group performed PETTLEP imagery once per week and physical practice once per week. Each group performed their respective tasks for 6 weeks. Pre- and posttests consisted of 15 bunker shots, with points awarded according to the ball proximity to the pin. All groups improved significantly (p < .01) from pre- to posttest, and the PETTLEP + physical practice group improved more (p < .05) than the PETTLEP and physical practice groups. However, there was no significant difference between the physical practice and PETTLEP groups (p > .05). Findings, therefore, support the effectiveness of PETTLEP in enhancing golf performance, especially when combined with physical practice.

The psychomotor theory of human mind

This study presents a new theory to explain the neural origins of human mind. This is the psychomotor theory. The author briefly analyzed the historical development of the mind-brain theories. The close relations between psychological and motor systems were subjected to a rather detailed analysis, using psychiatric and neurological examples. The feedback circuits between mind, brain, and body were shown to occur within the mind-brain-body triad, in normal states, and psycho-neural diseases. It was stated that psychiatric signs and symptoms are coupled with motor disturbances; neurological diseases are coupled with psychological disturbances; changes in cortico-spinal motor-system activity may influence mind-brain-body triad, and vice versa. Accordingly, a psychomotor theory was created to explain the psychomotor coupling in health and disease, stating that, not the mind-brain duality or unity, but the mind-brain-body triad as a functional unit may be essential in health and disease, because mind does not end in the brain, but further controls movements, in a reciprocal manner; mental and motor events share the same neural substrate, cortical, and spinal motoneurons; mental events emerging from the motoneuronal system expressed by the human language may be closely coupled with the unity of the mind-brain-body triad. So, the psychomotor theory rejects the mind-brain duality and instead advances the unity of the psychomotor system, which will have important consequences in understanding and improving the human mind, brain, and body in health and disease.

Working memory and mental practice outcomes after stroke

OBJECTIVE

To examine the relationship between working memory and motor improvement obtained after a single training session combining mental and physical practice.

DESIGN

Before-after trial.

SETTING

Laboratory of a university-affiliated research rehabilitation center.

PARTICIPANTS

A sample of 12 patients with stroke and 14 age- and gender-matched healthy subjects.

INTERVENTION

In a single session, patients were trained with combined mental and physical practice to increase the loading on the affected leg while standing up and sitting down.

MAIN OUTCOME MEASURES

Motor improvement as measured by the percentage change in limb loading on the affected limb after training and 24 hours later (follow-up), and the relationship between working memory and percentage motor improvement.

RESULTS

The loading on the affected leg was improved after training (P< .01) and at follow-up (P< .05), and working memory scores at follow-up correlated significantly (P< .004 to P< .007) with the level of improvement. The visuospatial domain yielded the strongest correlation (r= .83), followed by the verbal (r= .62) and kinesthetic (r= .59) domains.

CONCLUSIONS

These results suggest that the outcome (improved limb loading) of mental rehearsal with motor imagery depends on the ability to maintain and manipulate information in working memory.

Influence of mental practice on development of voluntary control of a novel motor acquisition task

The purpose of this investigation was to assess whether mental practice facilitates the development of voluntary control over the recruitment of the abductor hallucis muscle to produce isolated big toe abduction. A sample of convenience of 15 women and 20 men with a mean age of 28.8 yr. (SD=5.7) and healthy feet, who were unable voluntarily to abduct the big toe, were randomly assigned to one of three groups, a mental practice group, a physical practice group, and a group who performed a control movement during practice. Each subject received neuromuscular electrical stimulation to introduce the desired movement prior to each of five practice bouts over a single session lasting 2 hr. Big toe abduction active range of motion and surface electromyographic (EMG) output of the abductor hallucis and extensor digitorum brevis muscles were measured prior to the first practice bout and following each practice bout, yielding seven acquisition trials. Acquisition is defined as an improvement in both active range of motion and in the difference between the integrated EMG of the abductor hallucis and extensor digitorum brevis muscles during successive acquisition trials. Seven members of both the mental and physical practice groups and one member of the control group met the acquisition criteria. Chi-square analysis indicated the group difference was statistically significant, suggesting mental practice was effective for this task.

The effects of imagery perspective as a function of skill level on alpha activity

A strategy being used by athletes to enhance their performance is imagery. In previous research studying imagery, Lang's (1977, 1979) Information-Processing Theory states two types of propositions: stimulus propositions (SP) and response propositions (RP). The beneficial use of imagery scripts emphasizing these propositions may depend on the skill level of the performer. The purpose of this study was to investigate differences in lower (8-10 Hz) and upper (11-13 Hz) alpha activities during imagery emphasizing SP and imagery emphasizing RP as related to the skill level of the subjects. Twenty-two right-handed male subjects were assigned to either an 'expert' (n=11) or a 'novice' (n=11) group. Lower and upper alpha activities from six active sites were recorded during imagery of a golf-putting task. After subsequent fast Fourier transform (FFT) analysis of results, mean lower and upper alpha power values were entered into separate repeated measures mixed model designs. Results revealed significant differences in skill level at the occipital sites in the lower alpha band. Moreover, a significant interaction between imagery perspective and skill level was found in the lower alpha band at the occipital site and in the upper alpha band at the parietal site. Significant differences were found in imagery perspective at the parietal, temporal, and occipital sites in the lower alpha band. In addition, a significant interaction effect, imagery perspective by hemisphere, was found in the upper alpha band at the parietal site. Conclusions are discussed based on the results and future research is suggested.

Potential role of mental practice using motor imagery in neurologic rehabilitation

For many patients with damage to the central nervous system (CNS), execution of motor tasks is very difficult, sometimes impossible, even after early participation in an active rehabilitation program. Several investigators have recently proposed that mental practice could be used by these patients as a therapeutic tool to improve their performance of motor functions, yet very little empirical work addresses this issue directly. This article discusses the rationale for investigating mental practice as a means of promoting motor recovery in patients with a neurologic disorder. We first present evidence supporting the existence of a similarity between executed and imagined actions using data from psychophysical, neurophysiologic, and brain imaging studies. This parallel is then extended to the repetition of movements during physical and mental practice of a motor skill. Finally, a new model is proposed to emphasize the key role of motor imagery as an essential process of mental practice, and also to stimulate additional research on this type of training in the rehabilitation of patients with motor impairments of cerebral origin.