Reliability and Validity of the Japanese Version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ).

brain sciences Article Reliability and Validity of the Japanese Version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ) Hideki Nakano *, Takayuki Kodama, Kazumasa Ukai, Satoru Kawahara, Shiori Horikawa and Shin Murata Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-city, Kyoto 607-8175, Japan; (T.K.); (K.U.); (S.K.); (S.H.); (S.M.); * Correspondence: ; Tel.: +81-75-571-1111



 Received: 28 March 2018; Accepted: 29 April 2018; Published: 2 May 2018 Abstract: In this study, we aimed to (1) translate the English version of the Kinesthetic and Visual Imagery Questionnaire (KVIQ), which assesses motor imagery ability, into Japanese, and (2) investigate the reliability and validity of the Japanese KVIQ. We enrolled 28 healthy adults in this study. We used Cronbach’s alpha coefficients to assess reliability reflected by the internal consistency. Additionally, we assessed validity reflected by the criterion-related validity between the Japanese KVIQ and the Japanese version of the Movement Imagery Questionnaire-Revised (MIQ-R) with Spearman’s rank correlation coefficients. The Cronbach’s alpha coefficients for the KVIQ-20 were 0.88 (Visual) and 0.91 (Kinesthetic), which indicates high reliability. There was a significant positive correlation between the Japanese KVIQ-20 (Total) and the Japanese MIQ-R (Total) (r = 0.86, p < 0.01). Our results suggest that the Japanese KVIQ is an assessment that is a reliable and valid index of motor imagery ability. Keywords: motor imagery; kinesthetic and visual imagery questionnaire; Japanese 1. Introduction Motor imagery is commonly defined as the mental simulation of one’s own performance without any associated overt movement [1]. Previous studies have suggested that motor imagery increases motor skill acquisition [2] and muscle strength [3] in healthy participants. Moreover, it is indicated that motor imagery is an effective rehabilitation tool for patients with various diseases involving the central nervous system or acute injuries requiring orthopedic interventions, including subacute stroke [4–8], chronic stroke [9–11], traumatic brain injury [12], multiple sclerosis [12], shoulder impingement syndrome [13], postsurgical injury of the anterior cruciate ligament [14], postsurgical flexor tendon repair [15], burn injury [16], phantom limb pain [17], complex regional pain syndrome [17,18], and motor coordination problems [19]. Regarding the neural mechanisms, motor imagery appears to activate the fronto-parietal network, as well as subcortical and cerebellar regions, which are also associated with actual motor execution [20]. Typically, motor imagery is subdivided into two different modalities: visual imagery and kinesthetic imagery [21,22]. These modalities have been defined previously by Guillot et al. [21]. Visual imagery requires self-visualization of a movement from a first-person (internal visual imagery) or third-person (external visual imagery) perspective. The first-person perspective corresponds to the representation of a movement as if the individual is conducting the action themselves, suggesting that they would visualize the movement as if they had a camera on their head. In contrast, the third-person perspective corresponds to the representation of movements as if the participant was a spectator and Brain Sci. 2018, 8, 79; doi:10.3390/brainsci8050079 www.mdpi.com/journal/brainsci Brain Sci. 2018, 8, 79 2 of 7 someone (either the individual or another person) performed the action. Kinesthetic imagery requires one to “feel the movement”, and to mentally perceive muscle contractions and stretching. Previous research suggests that healthy subjects can be classified into visual-dominant and kinesthetic-dominant groups [23]. Moreover, motor learning performance appears to be more efficient for visual-dominant individuals when they are instructed to direct their attention externally. In contrast, motor learning performance is more efficient for kinesthetic-dominant individuals when they were instructed to direct their attention internally [23]. Furthermore, a similar phenomenon has also been observed in stroke patients [24]. Such results suggest it is important to evaluate motor imagery ability in individuals to determine the appropriate motor learning strategy. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) [25] is a representative tool to assess motor imagery ability. The KVIQ can be used to assess healthy individuals, as well as those with physical disabilities. It allows easy evaluation of motor imagery ability in a sitting position with single joint motions. Furthermore, the KVIQ assesses both visual and kinesthetic dimensions of motor imagery. The KVIQ is not self-administered, rather it is administered by a trained assessor. It assesses the vividness of each dimension of motor imagery (clarity of the image/intensity of sensation) on a 5-point ordinal scale. There are multiple versions of the KVIQ, including the KVIQ-20, which consists of 20 items (10 items each for visual and kinesthetic subscales), and the short version, KVIQ-10, which is a subset of the KVIQ-20, consisting of 10 items (5 items each for visual and kinesthetic subscales). The KVIQ-20 total score ranges from 20 to 100 (visual and kinesthetic subscale scores each range from 10 to 50). Meanwhile, the KVIQ-10 total score ranges from 10 to 50 (visual and kinesthetic subscale scores each range from 5 to 25). Higher scores indicate greater aptitude in motor imagery. Globally, both the KVIQ-20 and KVIQ-10 are widely used to evaluate motor imagery ability [26–28], and they have already been translated into German [29]. However, the KVIQ has not yet been adopted for Japanese speakers. Developing a Japanese version of the KVIQ is important to promote motor learning strategies focused on motor imagery, and to contribute to treatment for Japanese individuals with physical disabilities. The Movement Imagery Questionnaire-Revised (MIQ-R) [30] is a questionnaire to assess motor imagery ability that was developed as a short version of the Movement Imagery Questionnaire (MIQ) [31]. The MIQ consists of 18 items (9 items each for visual and kinesthetic subscales), and the short version, the MIQ-R, consists of 8 items (4 items each for visual and kinesthetic subscales). The MIQ-R total score ranges from 8 to 56 (visual and kinesthetic subscales score each range from 4 to 28). The two main differences between the KVIQ and MIQ/MIQ-R are the mode of administration and the selection of movements to be imagined [29]. Whereas the MIQ/MIQ-R is self-administered and focuses on complex high-level body movements, the KVIQ requires an examiner to be present to give instructions, perform example movements, and complete the scoring sheet. Moreover, the KVIQ focuses on simple, one joint axis movements of the upper and lower limbs, head, and trunk in a sitting posi (...truncated)