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March 10, 20260 citationsOpen Access

Mirror Visual Feedback Selectively Attenuates Crossover Fatigue in Distal Upper Limb Musculature: A Randomized Controlled Crossover Investigation Comparing Children and Adults

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AOAymen Ben OthmanWDWissem DhahbiMBManel Bessifi

Key Points

  • This investigation aimed to determine how mirror visual feedback influences crossover fatigue during handgrip exertion and whether effects vary by age and muscle group.
  • Conducted a randomized controlled crossover study comparing children and adults.
  • Participants completed unilateral handgrip fatigue tasks under three visual conditions: mirror, occluded, and control.
  • Quantified non-dominant handgrip force before and after interventions using linear mixed-effects models.
  • Under mirror feedback, non-dominant handgrip force remained stable compared to significant fatigue with occluded vision.
  • Mirror feedback led to a +3.38 kg increase in non-dominant force compared to no mirror, indicating effectiveness.
  • No significant differences in the effects of mirror feedback were found between children and adults.

Abstract

This investigation examined whether mirror visual feedback modulates crossover fatigue magnitude during unilateral handgrip exertion and whether efficacy demonstrates age-dependent and muscle-group-specific characteristics. Thirty-three participants stratified by developmental stage (adults: n = 17, 24.64 ± 5.38 years; children: n = 16, 11.87 ± 0.79 years) completed a randomized controlled crossover protocol incorporating three visual feedback conditions: mirror reflection of the exercised limb, occluded vision (no-mirror), and passive rest control. Participants performed unilateral dominant handgrip fatigue induction (20 × 6 s maximal voluntary isometric contractions) while bilateral force production was quantified pre-intervention and post-intervention across handgrip, elbow flexion, and elbow extension domains. Linear mixed-effects models with participant-specific random intercepts and slopes quantified Condition × Time × Limb interactions. In the non-exercised contralateral limb, linear mixed-effects models demonstrated that under the mirror condition, non-dominant handgrip force was maintained at rest-equivalent levels relative to control (+0.02 kg, 95% CI −1.15, +1.17, p = 0.987, dz =+ 0.003), whereas vision occlusion induced significant crossover fatigue (−3.37 kg −4.40, −2.35, p 0.16), providing no evidence of age moderation within the tested developmental range. Mirror visual feedback constitutes an effective countermeasure against crossover fatigue in distal upper limb musculature. The magnitude of mirror-induced attenuation did not differ between children (aged 10–13 years) and adults within our sample, with no statistically detectable age moderation within the tested developmental range; formal equivalence testing was not conducted. Effects demonstrated anatomical selectivity, favoring hand musculature over proximal elbow musculature.

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Cite This Study

Othman et al. (2026) studied this question.

synapsesocial.com/papers/69af951a70916d39fea4c598https://doi.org/10.3390/life16030435
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