Validation of the Slovenian Version of Motor Imagery Questionnaire 3 (MIQ-3): Promising Tool in Modern Comprehensive Rehabilitation Practice

Validation of the Slovenian Version of the Movement Imagery Questionnaire for Children (MIQ-C): A Measurement Tool to Assess the Imagery Ability of Motor Tasks in Children

Purpose

The ability to perform motor imagery has been shown to influence individual athletic performance and rehabilitation. Recent evidence supports its potential as a training tool to improve motor skills in children. Although there is a standardized assessment of the imagery abilities in Slovenian-speaking adults, there is currently no validated instrument for use with Slovenian children. Therefore, the aim of the present study was to conduct a linguistic validation study of the movement imagery questionnaire for children (MIQ-C).

Methods

A total of 100 healthy children (mean age 10.3±1.3 years; 50 female) were assessed with a Slovenian version of the MIQ-C at Day 1 and Day 8. Inter-day agreement was examined using intraclass correlation coefficients (ICC). Construct validity and internal consistency were assessed using a Cronbach's alpha coefficient and exploratory - confirmatory factor analysis, respectively.

Results

The test-retest ICC were very high for all three scales examined (ICCKI=0.90; ICCIVI=0.92; ICCEVI=0.90). Excellent internal consistency (up to 0.90) was found for kinaesthetic and both visual imageries. Confirmatory analysis confirmed a three-factorial structure of the MIQ-C.

Conclusions

The Slovenian version of the MIQ-C proved to be highly reliable and valid in assessing children's motor imagery abilities, and as such for use with Slovene-speaking children. Moreover, this standardized instrument can be a helpful tool in training and rehabilitation practice with children aged 7-12 years.

Is cognitive control of perception and action via attentional focus moderated by motor imagery?

Motor imagery (MI) has emerged as an individual factor that may modulate the effects of attentional focus on motor skill performance. In this study, we investigated whether global MI, as well as its components (i.e., kinesthetic MI, internal visual MI, and external visual MI) moderate the effect of attentional focus on performance in a group of ninety-two young adult novice air-pistol shooters (age: M = 21.87, SD = 2.54). After completing the movement imagery questionnaire-3 (MIQ-3), participants were asked to complete a pistol shooting experiment in three different attentional focus conditions: (1) No focus instruction condition (control condition with no verbal instruction) (2) an internal focus instruction condition, and (3) an external focus condition. Shot accuracy, performance time, and aiming trace speed (i.e., stability of hold or weapon stability) were measured as the performance variables. Results revealed that shot accuracy was significantly poorer during internal relative to control focus condition. In addition, performance time was significantly higher during external relative to both control and internal condition. However, neither global MI, nor its subscales, moderated the effects of attentional focus on performance. This study supports the importance of attentional focus for perceptual and motor performance, yet global MI and its modalities/perspectives did not moderate pistol shooting performance. This study suggests that perception and action are cognitively controlled by attentional mechanisms, but not motor imagery. Future research with complementary assessment modalities is warranted to extend the present findings.

Imagery ability assessments: a cross-disciplinary systematic review and quality evaluation of psychometric properties

BACKGROUND

Over the last two centuries, researchers developed several assessments to evaluate the multidimensional construct of imagery. However, no comprehensive systematic review (SR) exists for imagery ability evaluation methods and an in-depth quality evaluation of their psychometric properties.

METHODS

We performed a comprehensive systematic search in six databases in the disciplines of sport, psychology, medicine, education: SPORTDiscus, PsycINFO, Cochrane Library, Scopus, Web of Science, and ERIC. Two reviewers independently identified and screened articles for selection. COSMIN checklist was used to evaluate the methodological quality of the studies. All included assessments were evaluated for quality using criteria for good measurement properties. The evidence synthesis was summarised by using the GRADE approach.

RESULTS

In total, 121 articles reporting 155 studies and describing 65 assessments were included. We categorised assessments based on their construct on: (1) motor imagery (n = 15), (2) mental imagery (n = 48) and (3) mental chronometry (n = 2). Methodological quality of studies was mainly doubtful or inadequate. The psychometric properties of most assessments were insufficient or indeterminate. The best rated assessments with sufficient psychometric properties were MIQ, MIQ-R, MIQ-3, and VMIQ-2 for evaluation of motor imagery ability. Regarding mental imagery evaluation, only SIAQ and VVIQ showed sufficient psychometric properties.

CONCLUSION

Various assessments exist to evaluate an individual's imagery ability within different dimensions or modalities of imagery in different disciplines. However, the psychometric properties of most assessments are insufficient or indeterminate. Several assessments should be revised and further validated. Moreover, most studies were only evaluated with students. Further cross-disciplinary validation studies are needed including older populations with a larger age range. Our findings allow clinicians, coaches, teachers, and researchers to select a suitable imagery ability assessment for their setting and goals based on information about the focus and quality of the assessments.

SYSTEMATIC REVIEWS REGISTER

PROSPERO CRD42017077004 .

Yoga exercise intervention improves balance control and prevents falls in seniors aged 65+

Introduction

Body balance control represents a key factor preventing falls and subsequent injuries in seniors aged 65+. Intervention based on yoga exercises seem to be effective in improving balance.

Objective

The objective is to analyse and compare changes in static, dynamic, and total balance scores, changes in body composition and social indices as effects of yoga-based intervention.

Methods

A total of 500 participants (234 men aged 74.5 SD±7.74 and 266 women aged 76.9 SD±7.23) were assessed using the Tinetti Balance Assessment Tool, the InBody 230 bioimpedance body composition analyser, and the SF-36 Health Survey, applied to pre and post-testing. The experimental group (n=262; 122 males; 140 females) underwent a four-week yoga-based intervention, 30 minutes daily, while the control group (n=238; 112 males; 126 females) underwent its usual daily programme at senior homes or centres. The ANOVA model, consisting of the Group, Stage, Subject and Group × Stage interaction factors, was used for data evaluation.

Results

Intervention led to improvements in the static, dynamic and total balance scores in the experimental group compared to the control group. The results of SF-36 showed positive changes in the psychosocial aspects of health, such as promoting of calmness and happiness in male seniors and reducing fatigue, nervousness and depression in female seniors. The post-intervention decrease in body fat percentage and increase in muscle mass in seniors is discussed.

Conclusions

The four-week yoga-based intervention had positive effects on the static, dynamic and total balance scores, body composition and social status.

Motor Imagery and Action Observation as Appropriate Strategies for Home-Based Rehabilitation: A Mini-Review Focusing on Improving Physical Function in Orthopedic Patients

Dynamic stability of the knee and weakness of the extensor muscles are considered to be the most important functional limitations after anterior cruciate ligament (ACL) injury, probably due to changes at the central (cortical and corticospinal) level of motor control rather than at the peripheral level. Despite general technological advances, fewer contraindicative surgical procedures, and extensive postoperative rehabilitation, up to 65% of patients fail to return to their preinjury level of sports, and only half were able to return to competitive sport. Later, it becomes clear that current rehabilitation after knee surgery is not sufficient to address the functional limitations after ACL reconstruction even years after surgery. Therefore, new therapeutic tools targeting the central neural system, i.e., the higher centers of motor control, should be investigated and integrated into current rehabilitation practice. To improve motor performance when overt movement cannot be fully performed (e.g., due to pain, impaired motor control, and/or joint immobilization), several techniques have been developed to increase physical and mental activation without the need to perform overt movements. Among the most popular cognitive techniques used to increase physical performance are motor imagery and action observation practices. This review, which examines the available evidence, presents the underlying mechanisms of the efficacy of cognitive interventions and provides guidelines for their use at home.

Validation of the Oxford Knee Score and Lower Extremity Functional Score questionnaires for use in Slovenia

BACKGROUND

With the increasing prevalence of total knee replacement (TKR) due to knee osteoarthritis, the absence of patient-reported outcome measures in Slovenia must be addressed.

QUESTIONS/PURPOSES

(1) We cross-culturally adapted Oxford Knee Score (OKS) and Lower Extremity Functional Scale (LEFS) questionnaires to the Slovenian-speaking community. (2) We evaluated OKS and LEFS psychometric characteristics.

PATIENTS AND METHODS

In the first assessment (Time 1) Slovenian versions of both questionnaires (OKS-Slo and LEFS-Slo), knee pain, timed-up to go (TUG) and sit to stand (STS) tests were completed by 123 subjects (55% females), of which 78 were patients scheduled for TKR and 45 were healthy age-matched controls. The questionnaires were assessed one week apart (Time 2) to investigate the test-retest reliability, with 121 subjects (98.4%) completing second measurements.

RESULTS

Significant differences were observed between the two groups. Where patients had greater body mass index, they were slower in TUG, weaker in STS, had greater knee pain in both knees and scored lower on both questionnaires. Additionally, correlation analysis showed that OKS-Slo and LEFS-Slo correlated almost perfectly (correlation coefficient [CC] = .968, p < 0.001). Excellent negative correlations were observed with TUG (OKS-Slo/CC = - 0.679, p < 0.001; LEFS-Slo/CC = - 0.692, p < 0.001) and STS (OKS-Slo/CC = 0.790, p < 0.001; LEFS-Slo/CC = 0.815, p < 0.001) tests, while knee pain of affected leg correlated the most (OKS-Slo/CC = - 0.923, p < 0.001; LEFS-Slo/CC = - 0.915, p < 0.001). The Cronbach's alpha coefficient for both the OKS-Slo and LEFS-Slo ranged between 0.87 and 0.99, while the interclass correlation coefficient was excellent; i.e., 0.99. Finally, both questionnaires proved to be unidimensional measures.

CONCLUSION

The Slovenian version of both questionnaires is feasible, valid and reliable for use in clinical studies including the older adult population in Slovenia.

LEVEL OF EVIDENCE

Level III, Diagnostic-case-control study.

Association Between Oral Health-Related and Health-Related Quality of Life

OBJECTIVES

To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population.

METHODS

A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL.

RESULTS

Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit.

CONCLUSIONS

OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.

Specific and general adaptations following motor imagery practice focused on muscle strength in total knee arthroplasty rehabilitation: A randomized controlled trial

BACKGROUND

Motor imagery (MI) has been a widely used strategy in the past two decades to enhance physical capabilities among orthopaedic patients. However, its effectiveness is still questioned, since the demonstrated effects were likely task-dependent, with little evidence of transfer to tasks not specifically trained with MI.

OBJECTIVE

The aim of this study was to investigate whether an MI practice focused on maximal isometric knee extension strength, causes additional specific and general adaptations upon neuromuscular and functional variables when compared to conventional rehabilitation only, in patients submitted to total knee arthroplasty (TKA).

DESIGN

Parallel group randomized controlled clinical trial.

PARTICIPANTS

Thirty-four patients (56% man) submitted to TKA.

PROGRAM

Patients were randomly assigned to an MI practice group (MIp: 15 minutes per day/5 days per week in addition to routine physical therapy) or control group (CON) that performed routine physical therapy alone for four weeks.

OUTCOME MEASURES

The maximal isometric knee extension strength of the operated leg was defined as the primary outcome. Secondary outcomes were spatial and temporal gait parameters, 30-second chair sit-to-stand performance, a self-reported physical function assessed by the Lower Extremity Functional Scale (LEFS) questionnaire, and an MI ability score. All measurements were conducted before and one month after TKA.

RESULTS

Significant differences in treatment effects were observed for the MIp group compared to CON: the MIp showed less strength decrease (ES = 1.15, 95% CI: 0.32, 1.99, p = 0.022); faster self-selected speed under single (ES = 2.12, 95% CI: 1.16, 3.08, p = 0.001) and dual task (ES = 1.59, large, 95% CI: 0.67, 2.50, p = 0.002) conditions; brisk-pace gait speed during single (ES = 1.32, 95% CI: 0.47, 2.17, p = 0.020) and dual task conditions (ES = 1.31, large, 95% CI: 0.38, 2.23, p = 0.013); improved chair sit-to-stand (ES = 1.45, large, 95% CI: 0.58, 2.31, p = 0.004) performance; and a higher score on MI ability questionnaires for kinaesthetic imagery (KI) (ES = 0.55, 95% CI: -0.23, 1.34, p = 0.010) and internal visual imagery (EVI) (ES = 0.99, 95% CI: 0.18, 1.80, p = 0.039) scales, respectively. In addition, only MIp showed unaltered single and double support periods, as well as stride length and cadence during single task self-selected gait condition. Finally, analysis showed that the improved MI ability score achieved at the end of MI training was significantly correlated with the changes in the strength of the operated leg (kinaesthetic imagery: r = 0.741, p = 0.004; and internal visual imagery: r = 0.623, p = 0.023).

CONCLUSIONS

MI training, when added in a corollary to routine physical therapy, led to improvements in both specific and general adaptations that were related to patients' physical capabilities. While future studies must also evaluate the long-term effects, conducting MI training during acute and post-acute rehabilitation phases is advised, especially when the extent and range of physical exercise is limited or made impossible.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03684148.