Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 The Effect of Feedforward Self-modeling in Combining Action Observation and Motor Imagery on Self-Efficacy and Learning Basketball Free Throws in Children The Effect of Feedforward Self-modeling in Combining Action Observation and Motor Imagery on Self-Efficacy and Learning Basketball Free Throws in Children 17 38 4893 10.22089/mbj.2025.17692.2203 FA Abdolreza Heidari Department of Motor Behavior and Sport Management, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran Mehdi RafeiBoroujeni Department of Motor Behavior and Sport Management, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 0000-0001-8139-6139 Maryam Nezakatalhosseini Department of Motor Behavior and Sport Management, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 0000-0002-4603-7947 Journal Article 2025 01 23 <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Action observation and motor imagery (AOMI) is a combined motor simulation technique wherein individuals simultaneously observe an action and imagine performing it. This dual engagement has been shown to facilitate motor learning and performance more effectively than either technique alone. Presenting the movement via high-resolution video enhances the clarity of visual information, allowing individuals to allocate cognitive resources more efficiently and synchronize imagined motor sensations with observed actions. This synergy strengthens motor skill acquisition by reinforcing the neural representation of movement. Moreover, utilizing accurate and context-relevant models enables learners to better interpret and internalize movement patterns, promoting improved skill acquisition and retention. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward video self-modeling, a technique displaying oneself performing at a level not yet achieved, represents a promising variation within AOMI interventions. This study aimed to investigate the effect of feedforward self-modeling combined with action observation and motor imagery on self-efficacy and the learning of basketball free throws in children. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Two hundred and ten male students in Shahinshahr, Isfahan were initially assessed using the Children’s Motor Imagery Questionnaire (CMIQ). From this cohort, seventy-two students (mean age: 11.63 ± 1.12 years) were selected through convenience sampling based on CMIQ scores. These participants were randomly assigned to six groups: <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward self-modeling with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward self-modeling with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Non-feedforward self-modeling with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Non-feedforward self-modeling with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Skilled model with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Skilled model with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Written informed consent was obtained from participants and their parents. Prior to intervention, participants completed a self-efficacy questionnaire. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">All participants undertook a 10-hour motor imagery training program. Subsequently, a qualified coach instructed the group on basketball free throws. Scoring criteria for the free throw test were explained, and initial performance was recorded as two blocks of ten free throws. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">For the feedforward and non-feedforward self-modeling groups, basketball free throws were video-recorded. Videos for feedforward groups were edited to display the participants executing throws with enhanced skill quality. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">During the six-week intervention, participants practiced free throws three times per week, completing 40 attempts per session. Feedforward self-modeling groups watched their edited videos and engaged in simultaneous or alternating motor imagery (MI) using the PETTLEP model. Non-feedforward self-modeling groups viewed unedited videos of their actual throws, while skilled model groups observed expert performances, pairing these with PETTLEP-guided MI. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Post-intervention testing was conducted immediately after the final session, with retention and transfer tests administered after one week. Data were analyzed via mixed-model analysis of variance (ANOVA). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results<span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Mean basketball free throw scores for the experimental and control groups are shown in Figure 1 for the pretest, posttest, retention, and transfer tests. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Figure 1 – The mean Basketball free throw score in different tests of the research <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Results Figure 1 illustrates mean basketball free throw scores for each group across pre-test, post-test, retention, and transfer assessments, showing improvements from all modeling conditions. Imagery ability questionnaire analysis revealed no significant group differences in internal imagery (F(5,71) = 0.656, p = 0.658), external imagery (F(5,71) = 1.469, p = 0.212), or kinesthetic<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> imagery (F(5,71) = 1.995, p = 0.091). Following exercise sessions, participants self-reported MI engagement and completed imagery fidelity assessments. Multivariate ANOVA confirmed no significant between-group differences in overall imagery ability. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Mixed-design ANOVA for basketball free throw scores demonstrated significant main effects for time (F(3,198) = 27.83, p = 0.001) and group (F(5,66) = 29, p = 0.001), but no significant group × time interaction (F(15,198) = 2.93, p = 0.14). Post hoc testing indicated superior performance in the feedforward self-modeling simultaneous AOMI (p = 0.001), feedforward alternating AOMI (p = 0.001), skilled model simultaneous AOMI (p = 0.001), and skilled model alternating AOMI (p = 0.001) groups relative to non-feedforward simultaneous and alternating AOMI groups. Additionally, feedforward simultaneous AOMI outperformed skilled model simultaneous AOMI (p = 0.01). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Similarly, mixed-design ANOVA for self-efficacy revealed significant main effects for time (F (2,132) = 10.02, p = 0.001) and group (F(5,66) = 28.09, p = 0.001), with no interaction effect (F (10,132) = 0.65, p = 0.6). Post hoc analyses showed self-efficacy improvements in feedforward simultaneous and alternating AOMI and skilled model simultaneous and alternating AOMI groups compared to non-feedforward groups (all p = 0.001). <span dir="LTR" style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Across all groups, mean basketball free throw scores improved from pre-test to post-test, retention, and transfer phases. Scott et al. (2020) demonstrated that combining action observation and motor imagery enhances movement practice efficacy in children with diverse motor abilities beyond either method alone. This synergy enhances attentional focus and kinematic processing of observed movements, facilitating superior learning outcomes. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Research in observational learning emphasizes the model’s characteristics—including skill similarity to the learner and distinction between self and other—as determinants of performance and motor skill acquisition. Self-modeling videos within an AOMI framework likely bolster performance and self-efficacy by allowing individuals to observe themselves performing successfully beyond their current skill level. This dual engagement creates a unique sensorimotor experience that transcends conventional practice conditions, enabling acquisition of proficient motor skills. <span style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study demonstrates that combining action observation with motor imagery (simultaneously or alternately) significantly enhances motor skill performance and self-efficacy in children. Practitioners, including physical education teachers and coaches, are encouraged to integrate diverse AOMI protocols into training regimens. Moreover, sports coaches can optimize self-modeling interventions by employing advanced video editing techniques. Incorporating feedforward video self-modeling together with AOMI yields greater improvement in basketball free throw performance than strategies relying solely on skilled or non-feedforward self-modeling. Ethical Considerations <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study was conducted with approval from the University of Isfahan Ethics Committee (Code: IR.UI.REC.1403.047). Informed consent was obtained from all participants and their guardians. Confidentiality was rigorously maintained. Authors’ Contributions Mehdi RafeiBoroujeni, Abdalreza Heidary, and Maryam Nezakatalhosaini conceptualized the study. Data collection was performed by Abdalreza Heidary; data analysis was led by Mehdi RafeiBoroujeni. Manuscript drafting was conducted by Abdalreza Heidary and Mehdi RafeiBoroujeni. Review and editing were performed by all three authors. Literature review was carried out collaboratively. Mehdi RafeiBoroujeni supervised and coordinated all research activities. Conflict of Interest <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors declare no conflicts of interest relevant to this study’s research, authorship, or publication. Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors express heartfelt appreciation to all participating children for their commitment, as well as those who provided guidance and support throughout the research process. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Action observation and motor imagery (AOMI) is a combined motor simulation technique wherein individuals simultaneously observe an action and imagine performing it. This dual engagement has been shown to facilitate motor learning and performance more effectively than either technique alone. Presenting the movement via high-resolution video enhances the clarity of visual information, allowing individuals to allocate cognitive resources more efficiently and synchronize imagined motor sensations with observed actions. This synergy strengthens motor skill acquisition by reinforcing the neural representation of movement. Moreover, utilizing accurate and context-relevant models enables learners to better interpret and internalize movement patterns, promoting improved skill acquisition and retention. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward video self-modeling, a technique displaying oneself performing at a level not yet achieved, represents a promising variation within AOMI interventions. This study aimed to investigate the effect of feedforward self-modeling combined with action observation and motor imagery on self-efficacy and the learning of basketball free throws in children. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Two hundred and ten male students in Shahinshahr, Isfahan were initially assessed using the Children’s Motor Imagery Questionnaire (CMIQ). From this cohort, seventy-two students (mean age: 11.63 ± 1.12 years) were selected through convenience sampling based on CMIQ scores. These participants were randomly assigned to six groups: <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward self-modeling with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Feedforward self-modeling with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Non-feedforward self-modeling with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Non-feedforward self-modeling with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Skilled model with simultaneous AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Skilled model with alternating AOMI <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Written informed consent was obtained from participants and their parents. Prior to intervention, participants completed a self-efficacy questionnaire. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">All participants undertook a 10-hour motor imagery training program. Subsequently, a qualified coach instructed the group on basketball free throws. Scoring criteria for the free throw test were explained, and initial performance was recorded as two blocks of ten free throws. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">For the feedforward and non-feedforward self-modeling groups, basketball free throws were video-recorded. Videos for feedforward groups were edited to display the participants executing throws with enhanced skill quality. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">During the six-week intervention, participants practiced free throws three times per week, completing 40 attempts per session. Feedforward self-modeling groups watched their edited videos and engaged in simultaneous or alternating motor imagery (MI) using the PETTLEP model. Non-feedforward self-modeling groups viewed unedited videos of their actual throws, while skilled model groups observed expert performances, pairing these with PETTLEP-guided MI. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Post-intervention testing was conducted immediately after the final session, with retention and transfer tests administered after one week. Data were analyzed via mixed-model analysis of variance (ANOVA). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results<span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Mean basketball free throw scores for the experimental and control groups are shown in Figure 1 for the pretest, posttest, retention, and transfer tests. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Figure 1 – The mean Basketball free throw score in different tests of the research <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Results Figure 1 illustrates mean basketball free throw scores for each group across pre-test, post-test, retention, and transfer assessments, showing improvements from all modeling conditions. Imagery ability questionnaire analysis revealed no significant group differences in internal imagery (F(5,71) = 0.656, p = 0.658), external imagery (F(5,71) = 1.469, p = 0.212), or kinesthetic<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> imagery (F(5,71) = 1.995, p = 0.091). Following exercise sessions, participants self-reported MI engagement and completed imagery fidelity assessments. Multivariate ANOVA confirmed no significant between-group differences in overall imagery ability. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Mixed-design ANOVA for basketball free throw scores demonstrated significant main effects for time (F(3,198) = 27.83, p = 0.001) and group (F(5,66) = 29, p = 0.001), but no significant group × time interaction (F(15,198) = 2.93, p = 0.14). Post hoc testing indicated superior performance in the feedforward self-modeling simultaneous AOMI (p = 0.001), feedforward alternating AOMI (p = 0.001), skilled model simultaneous AOMI (p = 0.001), and skilled model alternating AOMI (p = 0.001) groups relative to non-feedforward simultaneous and alternating AOMI groups. Additionally, feedforward simultaneous AOMI outperformed skilled model simultaneous AOMI (p = 0.01). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Similarly, mixed-design ANOVA for self-efficacy revealed significant main effects for time (F (2,132) = 10.02, p = 0.001) and group (F(5,66) = 28.09, p = 0.001), with no interaction effect (F (10,132) = 0.65, p = 0.6). Post hoc analyses showed self-efficacy improvements in feedforward simultaneous and alternating AOMI and skilled model simultaneous and alternating AOMI groups compared to non-feedforward groups (all p = 0.001). <span dir="LTR" style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Across all groups, mean basketball free throw scores improved from pre-test to post-test, retention, and transfer phases. Scott et al. (2020) demonstrated that combining action observation and motor imagery enhances movement practice efficacy in children with diverse motor abilities beyond either method alone. This synergy enhances attentional focus and kinematic processing of observed movements, facilitating superior learning outcomes. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Research in observational learning emphasizes the model’s characteristics—including skill similarity to the learner and distinction between self and other—as determinants of performance and motor skill acquisition. Self-modeling videos within an AOMI framework likely bolster performance and self-efficacy by allowing individuals to observe themselves performing successfully beyond their current skill level. This dual engagement creates a unique sensorimotor experience that transcends conventional practice conditions, enabling acquisition of proficient motor skills. <span style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study demonstrates that combining action observation with motor imagery (simultaneously or alternately) significantly enhances motor skill performance and self-efficacy in children. Practitioners, including physical education teachers and coaches, are encouraged to integrate diverse AOMI protocols into training regimens. Moreover, sports coaches can optimize self-modeling interventions by employing advanced video editing techniques. Incorporating feedforward video self-modeling together with AOMI yields greater improvement in basketball free throw performance than strategies relying solely on skilled or non-feedforward self-modeling. Ethical Considerations <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study was conducted with approval from the University of Isfahan Ethics Committee (Code: IR.UI.REC.1403.047). Informed consent was obtained from all participants and their guardians. Confidentiality was rigorously maintained. Authors’ Contributions Mehdi RafeiBoroujeni, Abdalreza Heidary, and Maryam Nezakatalhosaini conceptualized the study. Data collection was performed by Abdalreza Heidary; data analysis was led by Mehdi RafeiBoroujeni. Manuscript drafting was conducted by Abdalreza Heidary and Mehdi RafeiBoroujeni. Review and editing were performed by all three authors. Literature review was carried out collaboratively. Mehdi RafeiBoroujeni supervised and coordinated all research activities. Conflict of Interest <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors declare no conflicts of interest relevant to this study’s research, authorship, or publication. Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors express heartfelt appreciation to all participating children for their commitment, as well as those who provided guidance and support throughout the research process.

https://mbj.ssrc.ac.ir/article_4893_68d3743587f71fbaa5062152985aff40.pdf

Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 Psychometrics of the Preschool Physical Literacy Assessment Tool: A New Physical Literacy Tool for Early Childhood Years Psychometrics of the Preschool Physical Literacy Assessment Tool: A New Physical Literacy Tool for Early Childhood Years 39 58 4676 10.22089/mbj.2025.17358.2192 FA Zahra Salman Associate Professor of Motor Behavior, Faculty of Physical Education and Sports Sciences, Allameh Tabataba’i University, Tehran, Iran 0000-0001-7093-7518 Journal Article 2024 10 30 Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Physical literacy is widely recognized as a multidimensional construct encompassing motivation, confidence, physical competence, knowledge, and understanding required for lifelong engagement in physical activity (International Physical Literacy Association, 2019). Despite increasing scholarly interest, most assessment tools focus predominantly on school-aged children, leaving a significant research gap concerning preschool populations. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Early childhood represents a crucial period during which foundational movement experiences shape future attitudes, behaviors, and sustained participation in physical activity. Effective assessment and intervention at this stage are essential to foster the development of lasting physical literacy. The Preschool Physical Literacy Assessment Tool (Pre-PLAy), developed by Cairney et al. (2019), provides a comprehensive framework assessing key domains including movement competence, coordinated movements, motivation, and enjoyment. It leverages observations by early childhood educators during structured activities, free play, and self-care tasks, facilitating the capture of developmental and contextual nuances appropriate for children aged 18 to 48 months. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">This study aimed to translate, culturally adapt, and psychometrically evaluate the Pre-PLAy tool for Iranian preschool children. The objectives focused on establishing content validity, construct validity, and internal consistency reliability, ensuring the instrument's methodological soundness and cultural relevance within Iran. Establishing a valid and reliable tool is vital for researchers, educators, and practitioners to accurately assess and promote physical literacy in this age group. Valid assessment facilitates early identification of developmental delays or deficits in physical literacy components, enabling tailored interventions. Moreover, such a tool supports cross-cultural comparisons, enriching global understanding of physical literacy development during early childhood. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Given the rising prevalence of sedentary lifestyles and childhood obesity globally, this research underscores the critical need for early assessment and intervention to cultivate lifelong healthy behaviors. Ultimately, this study contributes foundational evidence toward culturally sensitive practices in early childhood physical education and health promotion. Materials and Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">A descriptive-applied cross-sectional design was employed involving 330 healthy children aged 18 to 48 months, selected via multistage cluster random sampling from kindergartens in Tehran. Following ethical approval from the national research committee and informed parental consent, preschool educators underwent comprehensive training on instrument administration. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">The adapted tool retained the original 19 items across three domains: fundamental motor skills, coordinated movements, and motivation/enjoyment, translated and culturally adapted for use in Iran. Content and face validity were assessed by eight motor behavior specialists using Content Validity Ratio (CVR) and Content Validity Index (CVI) metrics. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Construct validity was evaluated through confirmatory factor analysis (CFA) performed with SmartPLS software. The analyses examined factor loadings, convergent and discriminant validity, and model fit indices. Internal consistency reliability was determined via Cronbach's alpha and composite reliability coefficients. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">After excluding 25 incomplete responses, analyses were conducted on 305 children, balanced by gender. Educators rated each child during structured play, free play, and self-care using Likert scales adapted per subdomain. Reverse scoring was applied to one item to maintain scale integrity. Scoring protocols and analytic procedures closely mirrored the original study to ensure cross-cultural consistency. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;"> Findings <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">The overall CVR for the Preschool Physical Literacy Assessment Tool was 0.96, and the CVI achieved a perfect score of 1.00, indicating excellent content validity. Face validity was unanimously confirmed by reviewers, reflecting appropriateness and clarity of all items. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">CFA findings corroborated the theoretical three-factor model encompassing motor competence, coordinated movements, and motivation/enjoyment. Consistent with Cairney et al. (2019), Items 17 and 19 exhibited insufficient factor loadings and were consequently removed to optimize model fit and interpretability. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Structural path coefficients revealed motor competence (β = 0.97), coordinated movements (β = 0.70), and motivation/enjoyment (β = 0.60) as statistically significant predictors of overall physical literacy. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Convergent validity was confirmed with average variance extracted (AVE) values exceeding the 0.50 threshold for all constructs. Discriminant validity was established via the Fornell-Larcker criterion, confirming distinctiveness among factors. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Reliability analyses demonstrated strong internal consistency, with Cronbach’s alpha values and composite reliability estimates surpassing 0.70 and 0.80, respectively, indicating robust measurement precision and stability. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">These psychometric properties align closely with previous validations of the Pre-PLAy tool and support its suitability for application in research and practical settings to assess physical literacy in young Iranian children. facilitating early identification and intervention efforts. Figure 1. The magnitude of the effect coefficients of the research model in CFA Conclusion Based on analyses of validity and reliability indices, the Preschool Children’s Physical Literacy Assessment Tool demonstrates acceptable levels of conceptual validity, structural validity, and internal consistency. Consistent with internationally recognized definitions of physical literacy, this instrument proves reliable and practical for assessing physical literacy and its core components in preschool-aged children. The findings endorse its use not only in academic research but also as a valuable tool for educators, motor development specialists, and early childhood program planners, particularly within educational and physical activity contexts. Given Iran’s cultural diversity, it is recommended to further examine and psychometrically validate this tool across varied ethnic, geographic, and cultural populations to verify its generalizability and applicability on a national scale. Moreover, applying this instrument within educational, rehabilitative, and therapeutic interventions for children with special needs presents considerable potential for future research. Such studies could explore how environmental, social, and individual factors influence physical literacy development during early childhood. Article Message This study introduces a valid, culturally adapted physical literacy assessment for Iranian children aged 18 to 48 months, encompassing three primary domains: motor competence, coordinated movements, and motivation/enjoyment. With robust psychometric properties, it offers a practical resource for educators, researchers, and policymakers to design targeted early childhood motor development interventions. Addressing a critical gap in preschool physical literacy monitoring, this tool supports evidence-based decision-making in early education and health promotion. Ethical Considerations Ethical approval was granted in 2023 by the Ethics Committee of the Sport Sciences Research Institute (IR.SSRC.REC.1402.217). Written informed consent was obtained from parents or legal guardians. Participant confidentiality was strictly maintained, and data were reported anonymously. Authors’ Contributions Z.S. was responsible for all research stages and assumed full responsibility for the project from inception to completion. Conflict of Interest The author declares no competing interests. Acknowledgments The author gratefully acknowledges the families of participating children for their invaluable cooperation and trust, without which this research would not have been possible. Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Physical literacy is widely recognized as a multidimensional construct encompassing motivation, confidence, physical competence, knowledge, and understanding required for lifelong engagement in physical activity (International Physical Literacy Association, 2019). Despite increasing scholarly interest, most assessment tools focus predominantly on school-aged children, leaving a significant research gap concerning preschool populations. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Early childhood represents a crucial period during which foundational movement experiences shape future attitudes, behaviors, and sustained participation in physical activity. Effective assessment and intervention at this stage are essential to foster the development of lasting physical literacy. The Preschool Physical Literacy Assessment Tool (Pre-PLAy), developed by Cairney et al. (2019), provides a comprehensive framework assessing key domains including movement competence, coordinated movements, motivation, and enjoyment. It leverages observations by early childhood educators during structured activities, free play, and self-care tasks, facilitating the capture of developmental and contextual nuances appropriate for children aged 18 to 48 months. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">This study aimed to translate, culturally adapt, and psychometrically evaluate the Pre-PLAy tool for Iranian preschool children. The objectives focused on establishing content validity, construct validity, and internal consistency reliability, ensuring the instrument's methodological soundness and cultural relevance within Iran. Establishing a valid and reliable tool is vital for researchers, educators, and practitioners to accurately assess and promote physical literacy in this age group. Valid assessment facilitates early identification of developmental delays or deficits in physical literacy components, enabling tailored interventions. Moreover, such a tool supports cross-cultural comparisons, enriching global understanding of physical literacy development during early childhood. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Given the rising prevalence of sedentary lifestyles and childhood obesity globally, this research underscores the critical need for early assessment and intervention to cultivate lifelong healthy behaviors. Ultimately, this study contributes foundational evidence toward culturally sensitive practices in early childhood physical education and health promotion. Materials and Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">A descriptive-applied cross-sectional design was employed involving 330 healthy children aged 18 to 48 months, selected via multistage cluster random sampling from kindergartens in Tehran. Following ethical approval from the national research committee and informed parental consent, preschool educators underwent comprehensive training on instrument administration. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">The adapted tool retained the original 19 items across three domains: fundamental motor skills, coordinated movements, and motivation/enjoyment, translated and culturally adapted for use in Iran. Content and face validity were assessed by eight motor behavior specialists using Content Validity Ratio (CVR) and Content Validity Index (CVI) metrics. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Construct validity was evaluated through confirmatory factor analysis (CFA) performed with SmartPLS software. The analyses examined factor loadings, convergent and discriminant validity, and model fit indices. Internal consistency reliability was determined via Cronbach's alpha and composite reliability coefficients. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">After excluding 25 incomplete responses, analyses were conducted on 305 children, balanced by gender. Educators rated each child during structured play, free play, and self-care using Likert scales adapted per subdomain. Reverse scoring was applied to one item to maintain scale integrity. Scoring protocols and analytic procedures closely mirrored the original study to ensure cross-cultural consistency. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;"> Findings <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">The overall CVR for the Preschool Physical Literacy Assessment Tool was 0.96, and the CVI achieved a perfect score of 1.00, indicating excellent content validity. Face validity was unanimously confirmed by reviewers, reflecting appropriateness and clarity of all items. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">CFA findings corroborated the theoretical three-factor model encompassing motor competence, coordinated movements, and motivation/enjoyment. Consistent with Cairney et al. (2019), Items 17 and 19 exhibited insufficient factor loadings and were consequently removed to optimize model fit and interpretability. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Structural path coefficients revealed motor competence (β = 0.97), coordinated movements (β = 0.70), and motivation/enjoyment (β = 0.60) as statistically significant predictors of overall physical literacy. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Convergent validity was confirmed with average variance extracted (AVE) values exceeding the 0.50 threshold for all constructs. Discriminant validity was established via the Fornell-Larcker criterion, confirming distinctiveness among factors. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">Reliability analyses demonstrated strong internal consistency, with Cronbach’s alpha values and composite reliability estimates surpassing 0.70 and 0.80, respectively, indicating robust measurement precision and stability. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1;">These psychometric properties align closely with previous validations of the Pre-PLAy tool and support its suitability for application in research and practical settings to assess physical literacy in young Iranian children. facilitating early identification and intervention efforts. Figure 1. The magnitude of the effect coefficients of the research model in CFA Conclusion Based on analyses of validity and reliability indices, the Preschool Children’s Physical Literacy Assessment Tool demonstrates acceptable levels of conceptual validity, structural validity, and internal consistency. Consistent with internationally recognized definitions of physical literacy, this instrument proves reliable and practical for assessing physical literacy and its core components in preschool-aged children. The findings endorse its use not only in academic research but also as a valuable tool for educators, motor development specialists, and early childhood program planners, particularly within educational and physical activity contexts. Given Iran’s cultural diversity, it is recommended to further examine and psychometrically validate this tool across varied ethnic, geographic, and cultural populations to verify its generalizability and applicability on a national scale. Moreover, applying this instrument within educational, rehabilitative, and therapeutic interventions for children with special needs presents considerable potential for future research. Such studies could explore how environmental, social, and individual factors influence physical literacy development during early childhood. Article Message This study introduces a valid, culturally adapted physical literacy assessment for Iranian children aged 18 to 48 months, encompassing three primary domains: motor competence, coordinated movements, and motivation/enjoyment. With robust psychometric properties, it offers a practical resource for educators, researchers, and policymakers to design targeted early childhood motor development interventions. Addressing a critical gap in preschool physical literacy monitoring, this tool supports evidence-based decision-making in early education and health promotion. Ethical Considerations Ethical approval was granted in 2023 by the Ethics Committee of the Sport Sciences Research Institute (IR.SSRC.REC.1402.217). Written informed consent was obtained from parents or legal guardians. Participant confidentiality was strictly maintained, and data were reported anonymously. Authors’ Contributions Z.S. was responsible for all research stages and assumed full responsibility for the project from inception to completion. Conflict of Interest The author declares no competing interests. Acknowledgments The author gratefully acknowledges the families of participating children for their invaluable cooperation and trust, without which this research would not have been possible.

https://mbj.ssrc.ac.ir/article_4676_ea6979872125d5acbac6068f186a0359.pdf

Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 The Effect of a Course of Pilates Training with Moderate to High Intensity on Cognitive Function and Anxiety in Women with Anxiety Disorders The Effect of a Course of Pilates Training with Moderate to High Intensity on Cognitive Function and Anxiety in Women with Anxiety Disorders 59 78 4682 10.22089/mbj.2025.18155.2219 FA Mahsa Agagol Tabar Department of Sport Biomechanics and Motor Behavior, University of Mazandaran , Babolsar, Mazandaran, Iran 0009-0006-6524-1325 Mozhgan Memarmoghaddam Department of Sport Biomechanics and Motor Behavior, University of Mazandaran Babolsar, Mazandaran, Iran 0000-0002-8655-1481 Seyyed Mohammad Kazem Vaez Mousavi Faculty of Social and Cultural Sciences, Imam Hossein University, Tehran, Iran 0000-0002-2606-0816 ,Mehdi Pour Asghar Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0001-9751-7492 Journal Article 2025 06 27 <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anxiety disorders are among the most common mental health conditions, presenting significant challenges in both psychological and physical domains throughout a person’s life. They are known to impair cognitive functions such as inhibition, planning, and problem solving, which are crucial for effective daily functioning and information processing. Among the promising interventions for anxiety, Pilates has garnered increasing attention in recent years. Pilates exercises are believed to promote neurogenesis and enhance cognitive functioning by increasing levels of neurotrophins, which support neuronal growth and plasticity. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Despite Pilates’ rising popularity and preliminary evidence suggesting benefits for anxiety and cognitive function across diverse populations, there remains a paucity of studies specifically examining its effects on women diagnosed with anxiety disorders. The present study aims to fill this gap by investigating how an eight-week course of moderate to high intensity Pilates training influences cognitive performance and anxiety symptoms in women affected by anxiety disorders. <span dir="LTR" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The study employed a semi-experimental, applied design. The statistical sample comprised 30 women aged 25 to 40 years residing in Babol<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> city. Participants were randomly assigned to experimental and control groups through voluntary sampling, based on pre-established inclusion criteria. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Instruments <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Beck Anxiety Inventory (BAI), containing 21 items scored from 0 to 63, was used to assess anxiety levels. Its internal consistency reliability (Cronbach’s alpha) has been reported as 0.92. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Tower of London Test (TOL), a computerized assessment consisting of 12 problem-solving tasks with a maximum score of 36, evaluates planning and problem-solving abilities. Its validity has been documented at 0.79. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Go-No-Go Test (computerized) assesses behavioral inhibition by requiring participants to respond to certain stimuli (“go”) and inhibit responses to others (“no-go”). Its reliability stands at 0.87. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Intervention: <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The experimental group participated in Pilates sessions for 8 weeks, 3 times per week, each lasting 60 minutes at moderate to intense exercise intensities. Intensity was regulated by calculating participants’ heart rate reserve (HRR) using the Karvonen formula and maintaining exercise intensity between 55 and 70% of HRR. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Procedure: At baseline, participants completed the BAI, the TOL test, and the Go-No-Go test to establish anxiety and cognitive function parameters. The experimental group then engaged in Pilates training as detailed above, while controls maintained their usual activities without added exercise. After completing the intervention, posttest assessments identical to the baseline tests were conducted. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Statistical Analysis <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data were analyzed using SPSS version 26. Descriptive statistics summarized participant characteristics and baseline values. Multivariate analysis of covariance (MANCOVA) was applied to assess the effect of Pilates on anxiety and cognitive functions, controlling for potential confounders. Additionally, one-way ANOVA tested differences on specific cognitive components. Statistical significance was determined at the alpha level of 0.05. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The results of Table 1 in the analysis of covariance show that Pilates exercises had a significant effect on the anxiety of women with anxiety disorders (p=0.00). The effect size obtained shows that 63% of the changes in anxiety reduction were due to Pilates exercises. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Table1- The results of covariance analysis of the effect of Pilates on anxiety <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Observed power <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Effect size <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">significance <span lang="AR-SA" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">F <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Mean square <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">df <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Sum of squares <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Statistics <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">1.000 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.63 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.000 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">43.58 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">356.40 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">1 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">356. 40 Group <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Table 2 shows that, according to the significance level obtained in the Tower of London test, Pilates exercises had a significant effect on planning and problem solving ((F4,18) =3.38, p=0.031). The effect size shows that 0.42 of the changes made in the experimental group are related to the application of the independent variable. Another result of this study on the Go-No-Go test showed that cognitive inhibition did not change significantly under the influence of Pilates exercises ((F4,20) =2.65, p=0.063). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-bidi-language: AR-SA;"> <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-bidi-language: AR-SA;">Table 2- The results of multivariate covariance analysis of the effect of Pilates on the Tower <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">of London and Go-No Go tests Test Statistics <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">Value <span lang="EN-AU" style="font-size: 10.0pt; line-height: 150%; font-family: 'Book Antiqua',serif; mso-fareast-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-ansi-language: EN-AU;">F significance Effect size Observed power <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Tower of London <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Wilkes Lambda <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.57 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">3.37 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.031 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.429 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.736 <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Go-No-Go <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Wilkes Lambda <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.65 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">2.65 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.06 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.34 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.63 <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The results of the between-group effects of the components of the Tower of London test using one-way analysis of variance show that the exercises performed in this study had the greatest effect on the components of delay time (p=0.002), total time (p=0.006), total score (p=0.032), respectively, and the test time (p=0.052) and number of errors (p=0.067) did not show a significant effect despite the improvement of these components. Also, the study of the between-group effects of the components of the Go-No-Go test showed that only the inhibition component had significant changes (p=0.013) and the presentation error (p=0.118) and omission error (p=0.089) components did not show a significant change despite the improvement in the post-test results. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The findings affirm that an eight-week Pilates training program substantially reduces anxiety and enhances cognitive functions related to planning and problem solving among women diagnosed with anxiety disorders. The key mechanism underlying these effects likely involves the intrinsic coordination of breathing and movement characteristic of Pilates. This integration activates the parasympathetic nervous system while reducing sympathetic nervous overactivity, facilitating relaxation and stress reduction. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anxious individuals have a propensity to be distracted by irrelevant stimuli, with anxiety disproportionately impairing inhibitory control compared to other cognitive domains via diminished attentional mechanisms. This may explain why cognitive inhibitory improvements were less pronounced; longer or more intensive training might be necessary to produce significant gains in this area. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Pilates training positively influences executive functions by decreasing anxiety and increasing attentional capacity. For instance, enhanced performance on the Tower of London test may be attributed to anxiety reduction, allowing participants to allocate cognitive resources more efficiently, resulting in better accuracy and reduced mental effort. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The absence of a statistically significant impact of Pilates on inhibition in this sample aligns with attention control theory, which postulates that interference control improvements lag behind other cognitive domains following anxiety interventions. <span dir="LTR" style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study suggests Pilates can be a valuable non-pharmacological intervention to improve both mental health and cognitive functioning in women with anxiety disorders. Its benefits include anxiety reduction, enhanced planning and problem-solving abilities, and improved behavioral inhibition. These outcomes position Pilates as an effective holistic approach integrating mind-body health. <span dir="RTL" lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Participation was voluntary, with written informed consent obtained from all participants. The study received ethical approval under code IR.UMZ.REC.1403.057<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> from the Ethics Committee of University of Mazandaran<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors’ Contributions <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">First author: Concept development, data collection, and literature review <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Second author: Topic selection, data analysis, article writing, and project management <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Third author: Topic selection, manuscript revision, and project management <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Fourth author: Clinical diagnosis of anxiety in participants, manuscript editing and revision <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare no conflicts of interest related to this research. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors extend their sincere gratitude to all participants for their cooperation and commitment throughout this study. <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anxiety disorders are among the most common mental health conditions, presenting significant challenges in both psychological and physical domains throughout a person’s life. They are known to impair cognitive functions such as inhibition, planning, and problem solving, which are crucial for effective daily functioning and information processing. Among the promising interventions for anxiety, Pilates has garnered increasing attention in recent years. Pilates exercises are believed to promote neurogenesis and enhance cognitive functioning by increasing levels of neurotrophins, which support neuronal growth and plasticity. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Despite Pilates’ rising popularity and preliminary evidence suggesting benefits for anxiety and cognitive function across diverse populations, there remains a paucity of studies specifically examining its effects on women diagnosed with anxiety disorders. The present study aims to fill this gap by investigating how an eight-week course of moderate to high intensity Pilates training influences cognitive performance and anxiety symptoms in women affected by anxiety disorders. <span dir="LTR" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The study employed a semi-experimental, applied design. The statistical sample comprised 30 women aged 25 to 40 years residing in Babol<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> city. Participants were randomly assigned to experimental and control groups through voluntary sampling, based on pre-established inclusion criteria. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Instruments <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Beck Anxiety Inventory (BAI), containing 21 items scored from 0 to 63, was used to assess anxiety levels. Its internal consistency reliability (Cronbach’s alpha) has been reported as 0.92. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Tower of London Test (TOL), a computerized assessment consisting of 12 problem-solving tasks with a maximum score of 36, evaluates planning and problem-solving abilities. Its validity has been documented at 0.79. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The Go-No-Go Test (computerized) assesses behavioral inhibition by requiring participants to respond to certain stimuli (“go”) and inhibit responses to others (“no-go”). Its reliability stands at 0.87. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Intervention: <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The experimental group participated in Pilates sessions for 8 weeks, 3 times per week, each lasting 60 minutes at moderate to intense exercise intensities. Intensity was regulated by calculating participants’ heart rate reserve (HRR) using the Karvonen formula and maintaining exercise intensity between 55 and 70% of HRR. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Procedure: At baseline, participants completed the BAI, the TOL test, and the Go-No-Go test to establish anxiety and cognitive function parameters. The experimental group then engaged in Pilates training as detailed above, while controls maintained their usual activities without added exercise. After completing the intervention, posttest assessments identical to the baseline tests were conducted. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Statistical Analysis <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data were analyzed using SPSS version 26. Descriptive statistics summarized participant characteristics and baseline values. Multivariate analysis of covariance (MANCOVA) was applied to assess the effect of Pilates on anxiety and cognitive functions, controlling for potential confounders. Additionally, one-way ANOVA tested differences on specific cognitive components. Statistical significance was determined at the alpha level of 0.05. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The results of Table 1 in the analysis of covariance show that Pilates exercises had a significant effect on the anxiety of women with anxiety disorders (p=0.00). The effect size obtained shows that 63% of the changes in anxiety reduction were due to Pilates exercises. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Table1- The results of covariance analysis of the effect of Pilates on anxiety <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Observed power <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Effect size <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">significance <span lang="AR-SA" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;"> <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">F <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Mean square <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">df <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Sum of squares <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Statistics <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">1.000 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.63 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.000 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">43.58 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">356.40 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">1 <span style="font-size: 10.0pt; line-height: 115%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">356. 40 Group <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Table 2 shows that, according to the significance level obtained in the Tower of London test, Pilates exercises had a significant effect on planning and problem solving ((F4,18) =3.38, p=0.031). The effect size shows that 0.42 of the changes made in the experimental group are related to the application of the independent variable. Another result of this study on the Go-No-Go test showed that cognitive inhibition did not change significantly under the influence of Pilates exercises ((F4,20) =2.65, p=0.063). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-bidi-language: AR-SA;"> <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; color: black; mso-themecolor: text1; mso-bidi-language: AR-SA;">Table 2- The results of multivariate covariance analysis of the effect of Pilates on the Tower <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">of London and Go-No Go tests Test Statistics <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">Value <span lang="EN-AU" style="font-size: 10.0pt; line-height: 150%; font-family: 'Book Antiqua',serif; mso-fareast-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-ansi-language: EN-AU;">F significance Effect size Observed power <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Tower of London <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Wilkes Lambda <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.57 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">3.37 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.031 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.429 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.736 <span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Go-No-Go <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA;">Wilkes Lambda <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.65 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">2.65 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.06 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.34 <span style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual;">0.63 <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The results of the between-group effects of the components of the Tower of London test using one-way analysis of variance show that the exercises performed in this study had the greatest effect on the components of delay time (p=0.002), total time (p=0.006), total score (p=0.032), respectively, and the test time (p=0.052) and number of errors (p=0.067) did not show a significant effect despite the improvement of these components. Also, the study of the between-group effects of the components of the Go-No-Go test showed that only the inhibition component had significant changes (p=0.013) and the presentation error (p=0.118) and omission error (p=0.089) components did not show a significant change despite the improvement in the post-test results. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The findings affirm that an eight-week Pilates training program substantially reduces anxiety and enhances cognitive functions related to planning and problem solving among women diagnosed with anxiety disorders. The key mechanism underlying these effects likely involves the intrinsic coordination of breathing and movement characteristic of Pilates. This integration activates the parasympathetic nervous system while reducing sympathetic nervous overactivity, facilitating relaxation and stress reduction. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anxious individuals have a propensity to be distracted by irrelevant stimuli, with anxiety disproportionately impairing inhibitory control compared to other cognitive domains via diminished attentional mechanisms. This may explain why cognitive inhibitory improvements were less pronounced; longer or more intensive training might be necessary to produce significant gains in this area. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Pilates training positively influences executive functions by decreasing anxiety and increasing attentional capacity. For instance, enhanced performance on the Tower of London test may be attributed to anxiety reduction, allowing participants to allocate cognitive resources more efficiently, resulting in better accuracy and reduced mental effort. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The absence of a statistically significant impact of Pilates on inhibition in this sample aligns with attention control theory, which postulates that interference control improvements lag behind other cognitive domains following anxiety interventions. <span dir="LTR" style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study suggests Pilates can be a valuable non-pharmacological intervention to improve both mental health and cognitive functioning in women with anxiety disorders. Its benefits include anxiety reduction, enhanced planning and problem-solving abilities, and improved behavioral inhibition. These outcomes position Pilates as an effective holistic approach integrating mind-body health. <span dir="RTL" lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Participation was voluntary, with written informed consent obtained from all participants. The study received ethical approval under code IR.UMZ.REC.1403.057<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> from the Ethics Committee of University of Mazandaran<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors’ Contributions <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">First author: Concept development, data collection, and literature review <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Second author: Topic selection, data analysis, article writing, and project management <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Third author: Topic selection, manuscript revision, and project management <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Fourth author: Clinical diagnosis of anxiety in participants, manuscript editing and revision <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare no conflicts of interest related to this research. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors extend their sincere gratitude to all participants for their cooperation and commitment throughout this study. <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">

https://mbj.ssrc.ac.ir/article_4682_75ebb02f92fc30a8040bbd625af999f1.pdf

Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 The Effect of Active Video Game and Traditional Training on Social Communication of Children with Autism Spectrum Disorder The Effect of Active Video Game and Traditional Training on Social Communication of Children with Autism Spectrum Disorder 79 92 4753 10.22089/mbj.2025.18175.2220 FA Roza Tabeshian . Department of Motor Behavior, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 0000-0003-1373-8517 Shila Safavi Homami . Department of Motor Behavior, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 0000-0001-6317-3804 Ahmadreza Movahedi . Department of Motor Behavior, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran 0000-0002-2313-4752 Journal Article 2025 07 06 <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by impairments in social interaction, communication, and behavioral challenges. These core deficits significantly affect children’s day-to-day functioning as well as their overall quality of life. While numerous interventions have been developed to address communication difficulties in children with ASD, traditional approaches such as Applied Behavior Analysis (ABA) often require sustained, long-term commitment and may fall short in fully engaging children in intrinsically motivating ways. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">In recent years, alternative therapies—particularly physical activity programs—have gained attention as complementary treatments. Emerging evidence indicates that physical exercise can enhance cognitive and emotional outcomes in children, including those diagnosed with ASD. Specifically, physical activity has been linked to improvements in executive functioning, emotional regulation, and social behavior. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">A promising development in this field is the use of active video games, or exergames, which combine physical activity with interactive video gameplay. Exergames provide a platform that simultaneously targets motor and cognitive skills development while sustaining high levels of motivation and engagement. This study was designed to examine the relative effectiveness of exergames compared to traditional physical exercise programs in enhancing social communication skills in children with ASD. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The primary research questions addressed were: Do either intervention types lead to statistically significant reductions in communication disorder severity relative to a control group receiving standard therapy? If so, which intervention yields superior outcomes? Additionally, the study evaluated whether improvements were maintained over time by instituting a 30-day post-intervention follow-up assessment. <span dir="RTL" lang="AR-SA" style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This quasi-experimental study recruited 45 children diagnosed with ASD, aged 8 to 12 years. Participants were selected purposively based on rigorous inclusion and exclusion criteria, specifically excluding those with major health problems or prior experience with active video games. Children were randomly allocated into three groups of 15 each: an active video game (exergame) group, a traditional exercise group, and a no-additional-intervention control group. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The intervention period spanned eight weeks. The traditional exercise group attended structured exercise sessions comprising a 10-minute warm-up, 25 minutes of aerobic and stretching exercises, followed by a 10-minute cool-down. The exergame group followed the same scheduling but replaced the aerobic/stretching component with 25 minutes of active gameplay using the Nintendo Switch Ring Fit Adventure—a platform encouraging full-body movement and interaction. The control group continued with their usual therapy regimen, including ABA, without additional physical exercise. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Social communication was measured using the Gilliam Autism Rating Scale – Second Edition (GARS-2), a validated instrument assessing autism-related behaviors and communication abilities. Assessments were conducted at baseline (pre-test), immediately post-intervention (post-test), and 30 days after intervention completion (follow-up). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Analysis of covariance (ANCOVA), controlling for baseline baseline scores, revealed a significant main effect of group on social communication disorder severity (F (2,41) = 12.22, p < 0.0001, η² = 0.82), demonstrating that intervention type strongly influenced outcomes. Post hoc comparisons indicated that both the exergame and traditional exercise groups scored significantly lower on communication disorder severity post-intervention compared with controls, confirming the positive impact of physical activity interventions. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Notably, the exergame group outperformed the traditional exercise group, with a mean difference of 4.18 points favoring exergames (p = 0.016). The traditional exercise group also showed superior performance relative to controls, with a mean difference of 3.17 points (p = 0.015). This suggests that, while both physical activity modalities benefit social communication in children with ASD, exergames may offer enhanced efficacy. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Follow-up data analysis revealed no significant differences between post-test and 30-day follow-up scores within any group, indicating that the improvements achieved were sustained over time. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The evidence strongly supports active video games as an engaging, effective, and sustainable intervention to enhance social communication in children with ASD. Relative to traditional exercise, exergames produced superior improvements and maintained these effects at one-month follow-up. Given these findings, therapists, healthcare providers, and educators should contemplate incorporating exergame interventions into individualized therapy and educational plans for children with ASD. Such interventions offer a dual advantage of promoting physical health while simultaneously addressing cognitive and social domains aligned with the core challenges of ASD. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Article Message <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This study underscores the potential of physical activity to improve social communication skills in children on the Autism Spectrum, particularly through technology-based, interactive exergames. These interventions capitalize on the natural attraction to video games and hold promise for improving communication and physical engagement, ultimately fostering higher motivation and more meaningful social interactions. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Ethical Considerations <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The study was conducted in compliance with the University of Isfahan Ethics Committee (Code: IR.UI.REC.1402.166). Written informed consent was obtained from all participants or legal guardians prior to enrollment. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Authors' Contributions <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">All authors equally contributed to all phases of the research process. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conflict of Interest <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The authors declare no conflicts of interest. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Acknowledgments <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The authors gratefully acknowledge the invaluable support from all participants and staff who aided in the execution of this study. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by impairments in social interaction, communication, and behavioral challenges. These core deficits significantly affect children’s day-to-day functioning as well as their overall quality of life. While numerous interventions have been developed to address communication difficulties in children with ASD, traditional approaches such as Applied Behavior Analysis (ABA) often require sustained, long-term commitment and may fall short in fully engaging children in intrinsically motivating ways. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">In recent years, alternative therapies—particularly physical activity programs—have gained attention as complementary treatments. Emerging evidence indicates that physical exercise can enhance cognitive and emotional outcomes in children, including those diagnosed with ASD. Specifically, physical activity has been linked to improvements in executive functioning, emotional regulation, and social behavior. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">A promising development in this field is the use of active video games, or exergames, which combine physical activity with interactive video gameplay. Exergames provide a platform that simultaneously targets motor and cognitive skills development while sustaining high levels of motivation and engagement. This study was designed to examine the relative effectiveness of exergames compared to traditional physical exercise programs in enhancing social communication skills in children with ASD. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The primary research questions addressed were: Do either intervention types lead to statistically significant reductions in communication disorder severity relative to a control group receiving standard therapy? If so, which intervention yields superior outcomes? Additionally, the study evaluated whether improvements were maintained over time by instituting a 30-day post-intervention follow-up assessment. <span dir="RTL" lang="AR-SA" style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This quasi-experimental study recruited 45 children diagnosed with ASD, aged 8 to 12 years. Participants were selected purposively based on rigorous inclusion and exclusion criteria, specifically excluding those with major health problems or prior experience with active video games. Children were randomly allocated into three groups of 15 each: an active video game (exergame) group, a traditional exercise group, and a no-additional-intervention control group. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The intervention period spanned eight weeks. The traditional exercise group attended structured exercise sessions comprising a 10-minute warm-up, 25 minutes of aerobic and stretching exercises, followed by a 10-minute cool-down. The exergame group followed the same scheduling but replaced the aerobic/stretching component with 25 minutes of active gameplay using the Nintendo Switch Ring Fit Adventure—a platform encouraging full-body movement and interaction. The control group continued with their usual therapy regimen, including ABA, without additional physical exercise. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Social communication was measured using the Gilliam Autism Rating Scale – Second Edition (GARS-2), a validated instrument assessing autism-related behaviors and communication abilities. Assessments were conducted at baseline (pre-test), immediately post-intervention (post-test), and 30 days after intervention completion (follow-up). <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Analysis of covariance (ANCOVA), controlling for baseline baseline scores, revealed a significant main effect of group on social communication disorder severity (F (2,41) = 12.22, p < 0.0001, η² = 0.82), demonstrating that intervention type strongly influenced outcomes. Post hoc comparisons indicated that both the exergame and traditional exercise groups scored significantly lower on communication disorder severity post-intervention compared with controls, confirming the positive impact of physical activity interventions. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Notably, the exergame group outperformed the traditional exercise group, with a mean difference of 4.18 points favoring exergames (p = 0.016). The traditional exercise group also showed superior performance relative to controls, with a mean difference of 3.17 points (p = 0.015). This suggests that, while both physical activity modalities benefit social communication in children with ASD, exergames may offer enhanced efficacy. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Follow-up data analysis revealed no significant differences between post-test and 30-day follow-up scores within any group, indicating that the improvements achieved were sustained over time. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The evidence strongly supports active video games as an engaging, effective, and sustainable intervention to enhance social communication in children with ASD. Relative to traditional exercise, exergames produced superior improvements and maintained these effects at one-month follow-up. Given these findings, therapists, healthcare providers, and educators should contemplate incorporating exergame interventions into individualized therapy and educational plans for children with ASD. Such interventions offer a dual advantage of promoting physical health while simultaneously addressing cognitive and social domains aligned with the core challenges of ASD. <span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Article Message <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This study underscores the potential of physical activity to improve social communication skills in children on the Autism Spectrum, particularly through technology-based, interactive exergames. These interventions capitalize on the natural attraction to video games and hold promise for improving communication and physical engagement, ultimately fostering higher motivation and more meaningful social interactions. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Ethical Considerations <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The study was conducted in compliance with the University of Isfahan Ethics Committee (Code: IR.UI.REC.1402.166). Written informed consent was obtained from all participants or legal guardians prior to enrollment. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Authors' Contributions <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">All authors equally contributed to all phases of the research process. <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conflict of Interest <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The authors declare no conflicts of interest. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Acknowledgments <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The authors gratefully acknowledge the invaluable support from all participants and staff who aided in the execution of this study. <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> <span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">

https://mbj.ssrc.ac.ir/article_4753_dfc6aa246e88ab3e32caeaaecf433550.pdf

Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 Observation, and Motor Imagery on Accuracy and Functional Degrees of Freedom of Golf Put: The Modulating Effect of Feedback Observation, and Motor Imagery on Accuracy and Functional Degrees of Freedom of Golf Put: The Modulating Effect of Feedback 93 110 4894 10.22089/mbj.2025.16694.2151 FA Davoud Fazeli , Department of Sports Sciences, Faculty of Education and Psychology, Shiraz University, Shiraz, Iran 0000-0001-6716-8156 Fatemeh Jabbari , Department of Sports Sciences, Faculty of Education and Psychology, Shiraz University, Shiraz, Iran Hossein Taghizadeh , Department of Sports Sciences, Faculty of Education and Psychology, Shiraz University, Shiraz, Iran Leila Ghohestani , Department of Sports Sciences, Faculty of Education and Psychology, Shiraz University, Shiraz, Iran Journal Article 2024 04 21 <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Background and Purpose <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Motor learning can occur through various practice modalities such as physical execution, action observation, and motor imagery. According to the simulation theory, these methods engage similar neural mechanisms and activate overlapping brain regions, suggesting a shared basis for skill acquisition. While several neurophysiological and behavioral studies have supported this claim, there is also evidence indicating distinct underlying mechanisms for these methods. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Despite extensive research on movement outcomes, few studies have examined the effects of these practice methods on coordination-related variables such as functional degrees of freedom (fDOF). fDOF reflects the flexibility and synergistic structure of neuromuscular coordination and can be quantified using techniques like principal component analysis. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study investigates whether physical practice, action observation, and motor imagery similarly affect movement accuracy and fDOF during a golf putting task. Exploring these effects may clarify the extent to which these methods share underlying mechanisms and inform the development of optimized training protocols. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This semi-experimental study used a pretest–posttest design with four groups: physical practice, motor imagery, action observation, and control. Forty right-handed male university students (mean age = 25 ± 3.4 years) with normal or corrected-to-normal vision participated. Participants were randomly assigned to groups. The experimental task was golf putting on a 4×9 m artificial green using a standard club and ball. The target was a 4 cm diameter circle fixed to the green. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">After signing consent forms, participants completed a revised Movement Imagery Questionnaire. Seventeen reflective markers were placed bilaterally on key anatomical points. Each participant performed 12 trials aiming at a target 2.44 meters away. Kinematic data were captured with a six-camera SIMI motion analysis system at 200 Hz sample rate. Participants wore tight black clothing to improve marker visibility. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">During acquisition, each group completed 162 practice trials across nine blocks (18 trials per block, 2-minute rest between blocks). The physical practice group performed actual strokes without verbal or visual feedback. The action observation group watched videos of matched physical participants. The motor imagery group imagined each putt while holding the club at the start position and verbally confirmed each trial. The control group did not train but read an article on exercise benefits during the same period. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Twenty-four hours later, all participants completed a retention test identical to the pretest. Putting accuracy was assessed by measuring radial error—the distance between the ball’s edge and the target. Kinematic data were filtered with a 4th-order Butterworth filter (7 Hz cutoff frequency), then standardized (Z-scores). Principal component analysis (PCA) on 54 variables (X, Y, Z coordinates of 18 markers) was used to estimate functional degrees of freedom (fDOF). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">A 4 (Group) × 2 (Test Phase) mixed-design ANOVA was used to analyze both accuracy and kinematic data. All statistical analyses were performed using SPSS version 16, with the significance level set at p < 0.05. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The analysis of participants’ imagery ability (both visual and kinesthetic dimensions) revealed no significant differences between groups, indicating homogeneity in baseline mental imagery skills (all F < 1). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Regarding putting accuracy, results from the 4 (Group) × 2 (Test Phase) mixed ANOVA indicated significant main effects of Group (F(3,36) = 19.78, p <.001, η²p = 0.62), Test Phase (F(1,36) = 102.36, p < 0.001, η²p = 0.74), and their interaction (F(3,36) = 18.57, p < 0.001, η²p = 0.60). Post hoc comparisons showed no significant differences between groups at the pretest phase (p = 0.98), whereas all pairwise comparisons at the posttest were significant (all p < 0.05). In terms of accuracy, performance ranked from best to worst as follows: Physical (M = 20.13), Observation (M = 26.39), Imagery (M = 29.52), and Control (M = 36.23). Significant improvements from pretest to posttest were observed in all groups except the control group (p = 0.81), indicating the effectiveness of all three training methods, particularly physical and observational practice. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">For functional degrees of freedom (fDOF), the ANOVA revealed significant main effects for Group (F(3,36) = 3.03, p = 0.05, η²p = 0.21), Test Phase (F (1,36) = 8.72, p = 0.005, η²p = 0.19), and their interaction (F(3,36) = 5.76, p = 0.003, η²p = 0.32). There were no significant group differences at pretest (p = 0.94), but during the posttest, the physical practice group showed significantly lower fDOF than all other groups (all p < 0.05), and the observation group showed significantly lower fDOF than both the imagery and control groups (all p < 0.05). No significant difference was found between the imagery and control groups (p = 0.08). Mean posttest fDOF values were: Physical = 4.66, Observation = 5.16, Control = 5.72, Imagery = 6.06. Furthermore, significant within-group reductions in fDOF from pretest to posttest were observed in the physical and observation groups (both p < 0.05), but not in the imagery or control groups. These findings suggest that physical and observational training were more effective in enhancing coordination and reducing movement redundancy. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The results demonstrated that while all experimental groups improved in accuracy from pretest to posttest, physical practice yielded the highest performance, followed by action observation and motor imagery. Functional degrees of freedom (fDOF) decreased significantly only in the physical and observation groups, indicating more efficient movement coordination. These findings suggest that the three practice methods may rely on distinct underlying mechanisms. Based on internal model theory (32), motor imagery may lack effective sensory feedback integration, leading to less precise motor tuning. In contrast, action observation allows visual feedback but still lacks proprioceptive engagement, resulting in intermediate effectiveness. Physical practice, combining both feedback modalities, produced the most efficient learning. The results align with models emphasizing error correction and feedback-based adaptation (30,35-37). Future research should manipulate feedback availability directly and include EEG or coordination metrics to further explore neural and behavioral mechanisms. Overall, combining these methods may optimize motor learning depending on task demands. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study highlights the differential effectiveness of physical execution, action observation, and motor imagery in motor learning. While all three methods improved performance, physical practice showed superior outcomes in both accuracy and movement coordination. Action observation ranked second, outperforming motor imagery. Functional degrees of freedom analysis revealed more efficient neuromuscular control in the physical and observational groups. These results suggest that feedback availability and sensory engagement are critical for optimizing internal model updating. The findings support using combined or complementary practice strategies based on task complexity, offering practical implications for motor learning and rehabilitation interventions. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study was reviewed and approved by the Ethics Committee of Shiraz University<span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors’ Contributions <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conceptualization: Davoud Fazeli <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data Collection: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data Analysis: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Manuscript Writing: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Review and Editing: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Responsible for funding: None declared <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Literature Review: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Project Manager: Davoud Fazeli <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Any Other Contributions: None <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare no conflict of interest related to the publication of this article. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors express their sincere gratitude to the participants whose cooperation made this research possible. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Background and Purpose <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Motor learning can occur through various practice modalities such as physical execution, action observation, and motor imagery. According to the simulation theory, these methods engage similar neural mechanisms and activate overlapping brain regions, suggesting a shared basis for skill acquisition. While several neurophysiological and behavioral studies have supported this claim, there is also evidence indicating distinct underlying mechanisms for these methods. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Despite extensive research on movement outcomes, few studies have examined the effects of these practice methods on coordination-related variables such as functional degrees of freedom (fDOF). fDOF reflects the flexibility and synergistic structure of neuromuscular coordination and can be quantified using techniques like principal component analysis. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study investigates whether physical practice, action observation, and motor imagery similarly affect movement accuracy and fDOF during a golf putting task. Exploring these effects may clarify the extent to which these methods share underlying mechanisms and inform the development of optimized training protocols. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This semi-experimental study used a pretest–posttest design with four groups: physical practice, motor imagery, action observation, and control. Forty right-handed male university students (mean age = 25 ± 3.4 years) with normal or corrected-to-normal vision participated. Participants were randomly assigned to groups. The experimental task was golf putting on a 4×9 m artificial green using a standard club and ball. The target was a 4 cm diameter circle fixed to the green. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">After signing consent forms, participants completed a revised Movement Imagery Questionnaire. Seventeen reflective markers were placed bilaterally on key anatomical points. Each participant performed 12 trials aiming at a target 2.44 meters away. Kinematic data were captured with a six-camera SIMI motion analysis system at 200 Hz sample rate. Participants wore tight black clothing to improve marker visibility. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">During acquisition, each group completed 162 practice trials across nine blocks (18 trials per block, 2-minute rest between blocks). The physical practice group performed actual strokes without verbal or visual feedback. The action observation group watched videos of matched physical participants. The motor imagery group imagined each putt while holding the club at the start position and verbally confirmed each trial. The control group did not train but read an article on exercise benefits during the same period. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Twenty-four hours later, all participants completed a retention test identical to the pretest. Putting accuracy was assessed by measuring radial error—the distance between the ball’s edge and the target. Kinematic data were filtered with a 4th-order Butterworth filter (7 Hz cutoff frequency), then standardized (Z-scores). Principal component analysis (PCA) on 54 variables (X, Y, Z coordinates of 18 markers) was used to estimate functional degrees of freedom (fDOF). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">A 4 (Group) × 2 (Test Phase) mixed-design ANOVA was used to analyze both accuracy and kinematic data. All statistical analyses were performed using SPSS version 16, with the significance level set at p < 0.05. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The analysis of participants’ imagery ability (both visual and kinesthetic dimensions) revealed no significant differences between groups, indicating homogeneity in baseline mental imagery skills (all F < 1). <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Regarding putting accuracy, results from the 4 (Group) × 2 (Test Phase) mixed ANOVA indicated significant main effects of Group (F(3,36) = 19.78, p <.001, η²p = 0.62), Test Phase (F(1,36) = 102.36, p < 0.001, η²p = 0.74), and their interaction (F(3,36) = 18.57, p < 0.001, η²p = 0.60). Post hoc comparisons showed no significant differences between groups at the pretest phase (p = 0.98), whereas all pairwise comparisons at the posttest were significant (all p < 0.05). In terms of accuracy, performance ranked from best to worst as follows: Physical (M = 20.13), Observation (M = 26.39), Imagery (M = 29.52), and Control (M = 36.23). Significant improvements from pretest to posttest were observed in all groups except the control group (p = 0.81), indicating the effectiveness of all three training methods, particularly physical and observational practice. <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">For functional degrees of freedom (fDOF), the ANOVA revealed significant main effects for Group (F(3,36) = 3.03, p = 0.05, η²p = 0.21), Test Phase (F (1,36) = 8.72, p = 0.005, η²p = 0.19), and their interaction (F(3,36) = 5.76, p = 0.003, η²p = 0.32). There were no significant group differences at pretest (p = 0.94), but during the posttest, the physical practice group showed significantly lower fDOF than all other groups (all p < 0.05), and the observation group showed significantly lower fDOF than both the imagery and control groups (all p < 0.05). No significant difference was found between the imagery and control groups (p = 0.08). Mean posttest fDOF values were: Physical = 4.66, Observation = 5.16, Control = 5.72, Imagery = 6.06. Furthermore, significant within-group reductions in fDOF from pretest to posttest were observed in the physical and observation groups (both p < 0.05), but not in the imagery or control groups. These findings suggest that physical and observational training were more effective in enhancing coordination and reducing movement redundancy. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The results demonstrated that while all experimental groups improved in accuracy from pretest to posttest, physical practice yielded the highest performance, followed by action observation and motor imagery. Functional degrees of freedom (fDOF) decreased significantly only in the physical and observation groups, indicating more efficient movement coordination. These findings suggest that the three practice methods may rely on distinct underlying mechanisms. Based on internal model theory (32), motor imagery may lack effective sensory feedback integration, leading to less precise motor tuning. In contrast, action observation allows visual feedback but still lacks proprioceptive engagement, resulting in intermediate effectiveness. Physical practice, combining both feedback modalities, produced the most efficient learning. The results align with models emphasizing error correction and feedback-based adaptation (30,35-37). Future research should manipulate feedback availability directly and include EEG or coordination metrics to further explore neural and behavioral mechanisms. Overall, combining these methods may optimize motor learning depending on task demands. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study highlights the differential effectiveness of physical execution, action observation, and motor imagery in motor learning. While all three methods improved performance, physical practice showed superior outcomes in both accuracy and movement coordination. Action observation ranked second, outperforming motor imagery. Functional degrees of freedom analysis revealed more efficient neuromuscular control in the physical and observational groups. These results suggest that feedback availability and sensory engagement are critical for optimizing internal model updating. The findings support using combined or complementary practice strategies based on task complexity, offering practical implications for motor learning and rehabilitation interventions. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study was reviewed and approved by the Ethics Committee of Shiraz University<span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors’ Contributions <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conceptualization: Davoud Fazeli <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data Collection: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Data Analysis: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Manuscript Writing: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Review and Editing: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Responsible for funding: None declared <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Literature Review: Davoud Fazeli, Fatemeh Jabbari, Hossein Taghizadeh, Leila Ghohestani <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Project Manager: Davoud Fazeli <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Any Other Contributions: None <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare no conflict of interest related to the publication of this article. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors express their sincere gratitude to the participants whose cooperation made this research possible.

https://mbj.ssrc.ac.ir/article_4894_723dadb8c699bf14f74503dbcb6e09c1.pdf

Sport Sciences Research Institute Motor Behavior 2538-273X 17 62 2025 12 22 The Effect of Quiet Eye Training on Fixation of Gaze in Learning Interceptive Task of 10-12-Year-Old Children The Effect of Quiet Eye Training on Fixation of Gaze in Learning Interceptive Task of 10-12-Year-Old Children 111 126 4419 10.22089/mbj.2024.16564.2144 FA Fatemeh Sharafiyan Department of Educational Sciences, Farhangian University, Tehran, Iran. 0000-0003-1584-2705 Mehdi Shahbazi Department of Movement Behavior and Sports Psychology, Tehran Faculty of Sports Sciences. University of Tehran. Tehran. Iran 0000-0002-2148-4150 Shahzad Tahmasebi Boroujeni Department of Behavioral and Cognitive Sports Sciences, Faculty of Sports Sciences and Health, University of Tehran, Tehran, Iran 0000-0002-0875-3993 Journal Article 2024 04 06 <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Athletes continuously use visual information in the performance of sports skills, then this information is processed by the brain and they create the appropriate movement in the form of movement commands. Gaze behavior is necessary to collect accurate vision information and control human movements in sports and life. In the definitions, gaze behavior includes four components: fixation, saccade, tracking, and steady eye. In interceptive skills where the target is constantly moving, the athletes must first fixate on the object, then track it and process its direction, and finally organize their limbs to adapt to it. A variety of visual training can be used in the performance of interceptive tasks, including the quiet eye training proposed by Vickers. Research has confirmed the effectiveness of quiet eye training in children's fundamental skills and targeting and interceptive tasks in children. Considering the necessity of developing specialized skills, including volleyball, and the challenging nature of volleyball training for beginners, this study aims to investigate the effect of quiet eye training on the fixation of gaze in learning volleyball service. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">20 beginner female students (mean age = 10.12) were selected as available samples. First, the participants warmed up with sports movements. Then, they were equipped with an eye-tracking device. A pre-test was taken, which included receiving 20 volleyball serves and sending them to the passer (10 simple and 10 smash serves) in three designated areas of the mini volleyball court (1, 3, 4). During the execution of the service, the gaze of the service receiver on the contact point of the server's hand with the ball was recorded by the eye-tracking device. Also was recorded the number of receptions that were done with the service receiver staring at the passer while receiving the ball. After taking the pre-test, they were randomly replaced into two groups of 10 people (technical and quiet eye training). The skill of receiving a volleyball serve was taught using the video of a skilled person's performance and the coach gave both groups verbal action instructions. Both groups participated in 9 training sessions individually (three sessions a week). In each session, each person performed 5 blocks of 10 receiving and sending volleyball services. The exercises of the technical group included receiving and sending service to the passer from different directions and distances, which were performed as variable exercises by changing the parameters of the distance and direction in different areas. Quiet eye group training was performed based on Vickers' 7 steps of QE training (8): 1- The first step, the gaze behavior information of the skilled sample was defined. 2- In the second step, the subject's gaze behavior was recorded by the eye tracker for 20 service receptions in the pre-test, to provide visual feedback and compare it with the skilled sample. 3- In the third step, the subjects were trained by using the performance video and the gaze behavior of a skilled person to receive volleyball service. 4- In the fourth step, the visual information in the action of the subjects was compared with the visual information in the action of a skilled person and the subjects were asked about the differences. 5- In the fifth step, the subjects were asked which of the features of the gaze behavior they wanted to improve. 6- In the sixth step, the task of receiving a volleyball serve was implemented in the form of variable exercise to lead to an increase in the length of fixation of the gaze. 7- In the seventh step, the service recipient's visual attention was evaluated competitively. 48 hours after the last training session, the first retention test and one month later the second retention test was performed. Data analysis was done with a composite analysis of variance and the Yeoman-Whitney test at a significant level of P ≤ 0.05. <span style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The results of the analysis of variance did not show a significant difference between the two groups in the length of the fixation of the receiver's gaze on the point of contact of the server's hand with the ball in the three test stages (p=0.065). The results of the Mann--Whitney U test did not show a significant difference between the two groups in the number of receptions of the service that was performed with the fixation of the receiver's gaze on the passor in the first (p=0.165) and second retention (p=0.052). It seems that quiet eye training has a significant effect on the learning of the interceptive task compared to technical training and a similar effect on the fixation of children's gaze. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">According to this research, the performance of receiving volleyball service improved significantly in both groups from the pre-test to the first and second retention, which shows the effect of both quiet eye training and technical on learning movement skills. However, the performance of the quiet eye training group was better than the technique training, which shows the greater effect of quiet eye training on motor learning. However, no significant difference was observed in the gaze fixation in both the technical training and quiet eye training groups indicating simultaneous perceptual and cognitive adaptations during motor learning. On the other hand, the inhibition hypothesis explains the longer gaze fixation and the greater effectiveness of quiet eye training in skilled subjects but in the present study participants were beginners. It is concluded that quiet eye training increases the performance and learning of beginners compared to technical training but has the same effect on gaze behavior. <span style="mso-bidi-font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study highlights the potential of perceptual–cognitive training approaches, such as quiet eye exercises, in developing motor learning and attentional control in children's sport education. <span style="font-size: 10.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The ethical approval for this study was obtained from the Sport Sciences Research Institute under the code <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">IR.SSRC.REC.1402.227. <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors' Contributions <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conceptualization: Fatemeh Sharafiyan, Mehdi Shahbazi, Shahzad Tahmasebi Boroujeni Data Collection: Fatemeh Sharafiyan Data Analysis: Fatemeh Sharafiyan, Mehdi Shahbazi Manuscript Writing: Fatemeh Sharafiyan Review and Editing: Mehdi Shahbazi, Shahzad Tahmasebi Boroujeni Project Manager: Mehdi Shahbazi <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare that there are no conflicts of interest concerning the publication of this manuscript. <span style="font-size: 9.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors would like to sincerely thank all the participants in the study for their collaboration. <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Athletes continuously use visual information in the performance of sports skills, then this information is processed by the brain and they create the appropriate movement in the form of movement commands. Gaze behavior is necessary to collect accurate vision information and control human movements in sports and life. In the definitions, gaze behavior includes four components: fixation, saccade, tracking, and steady eye. In interceptive skills where the target is constantly moving, the athletes must first fixate on the object, then track it and process its direction, and finally organize their limbs to adapt to it. A variety of visual training can be used in the performance of interceptive tasks, including the quiet eye training proposed by Vickers. Research has confirmed the effectiveness of quiet eye training in children's fundamental skills and targeting and interceptive tasks in children. Considering the necessity of developing specialized skills, including volleyball, and the challenging nature of volleyball training for beginners, this study aims to investigate the effect of quiet eye training on the fixation of gaze in learning volleyball service. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">20 beginner female students (mean age = 10.12) were selected as available samples. First, the participants warmed up with sports movements. Then, they were equipped with an eye-tracking device. A pre-test was taken, which included receiving 20 volleyball serves and sending them to the passer (10 simple and 10 smash serves) in three designated areas of the mini volleyball court (1, 3, 4). During the execution of the service, the gaze of the service receiver on the contact point of the server's hand with the ball was recorded by the eye-tracking device. Also was recorded the number of receptions that were done with the service receiver staring at the passer while receiving the ball. After taking the pre-test, they were randomly replaced into two groups of 10 people (technical and quiet eye training). The skill of receiving a volleyball serve was taught using the video of a skilled person's performance and the coach gave both groups verbal action instructions. Both groups participated in 9 training sessions individually (three sessions a week). In each session, each person performed 5 blocks of 10 receiving and sending volleyball services. The exercises of the technical group included receiving and sending service to the passer from different directions and distances, which were performed as variable exercises by changing the parameters of the distance and direction in different areas. Quiet eye group training was performed based on Vickers' 7 steps of QE training (8): 1- The first step, the gaze behavior information of the skilled sample was defined. 2- In the second step, the subject's gaze behavior was recorded by the eye tracker for 20 service receptions in the pre-test, to provide visual feedback and compare it with the skilled sample. 3- In the third step, the subjects were trained by using the performance video and the gaze behavior of a skilled person to receive volleyball service. 4- In the fourth step, the visual information in the action of the subjects was compared with the visual information in the action of a skilled person and the subjects were asked about the differences. 5- In the fifth step, the subjects were asked which of the features of the gaze behavior they wanted to improve. 6- In the sixth step, the task of receiving a volleyball serve was implemented in the form of variable exercise to lead to an increase in the length of fixation of the gaze. 7- In the seventh step, the service recipient's visual attention was evaluated competitively. 48 hours after the last training session, the first retention test and one month later the second retention test was performed. Data analysis was done with a composite analysis of variance and the Yeoman-Whitney test at a significant level of P ≤ 0.05. <span style="font-size: 9.0pt; mso-bidi-font-size: 10.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The results of the analysis of variance did not show a significant difference between the two groups in the length of the fixation of the receiver's gaze on the point of contact of the server's hand with the ball in the three test stages (p=0.065). The results of the Mann--Whitney U test did not show a significant difference between the two groups in the number of receptions of the service that was performed with the fixation of the receiver's gaze on the passor in the first (p=0.165) and second retention (p=0.052). It seems that quiet eye training has a significant effect on the learning of the interceptive task compared to technical training and a similar effect on the fixation of children's gaze. <span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conclusion <span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">According to this research, the performance of receiving volleyball service improved significantly in both groups from the pre-test to the first and second retention, which shows the effect of both quiet eye training and technical on learning movement skills. However, the performance of the quiet eye training group was better than the technique training, which shows the greater effect of quiet eye training on motor learning. However, no significant difference was observed in the gaze fixation in both the technical training and quiet eye training groups indicating simultaneous perceptual and cognitive adaptations during motor learning. On the other hand, the inhibition hypothesis explains the longer gaze fixation and the greater effectiveness of quiet eye training in skilled subjects but in the present study participants were beginners. It is concluded that quiet eye training increases the performance and learning of beginners compared to technical training but has the same effect on gaze behavior. <span style="mso-bidi-font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 14.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Article Message <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study highlights the potential of perceptual–cognitive training approaches, such as quiet eye exercises, in developing motor learning and attentional control in children's sport education. <span style="font-size: 10.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Ethical Considerations <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The ethical approval for this study was obtained from the Sport Sciences Research Institute under the code <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">IR.SSRC.REC.1402.227. <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Authors' Contributions <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conceptualization: Fatemeh Sharafiyan, Mehdi Shahbazi, Shahzad Tahmasebi Boroujeni Data Collection: Fatemeh Sharafiyan Data Analysis: Fatemeh Sharafiyan, Mehdi Shahbazi Manuscript Writing: Fatemeh Sharafiyan Review and Editing: Mehdi Shahbazi, Shahzad Tahmasebi Boroujeni Project Manager: Mehdi Shahbazi <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Conflict of Interest <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors declare that there are no conflicts of interest concerning the publication of this manuscript. <span style="font-size: 9.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> <span style="mso-bidi-font-size: 12.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Acknowledgments <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The authors would like to sincerely thank all the participants in the study for their collaboration. <span style="font-size: 11.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">

https://mbj.ssrc.ac.ir/article_4419_65a99bb7a3115fdede20da98b08a370f.pdf