The Influence of Motor Competence on Broader Aspects of Health: A Systematic Review of the Longitudinal Associations Between Motor Competence and Cognitive and Social-Emotional Outcomes
Authors: Hill Phillip J. , Mcnarry Melitta A. , Mackintosh Kelly A. , Murray Maeve Aine , Pesce Caterina , Valentini Nadia C. , Getchell Nancy , Tomporowski Phillip D. , Robinson Leah E. , Barnett Lisa M. 
Published: November 2023

Abstract
Background
Motor competence has important developmental associations with aspects of physical health, but there has been no synthesis of longitudinal associations with cognitive and social-emotional health.

Objectives
The first aim was to present a conceptual model that positions motor competence as a mediator between physical activity and cognitive and social-emotional outcomes. The second aim was to synthesize the association of motor competence and cognitive and social-emotional development using longitudinal observational and experimental evidence, in particular to (i) identify the role of task, individual, and environmental characteristics in moderating the association between motor and cognitive and social-emotional outcomes and (ii) synthesize the strength of evidence pertaining to domain-specific relationships.

Methods
This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. Five electronic databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were systematically searched. Following study screening and risk-of-bias assessment by two authors, 49 eligible studies were identified for inclusion and grouped by study design. Evidence for domain-specific paths between motor competence and cognitive and social-emotional outcomes was synthesized by calculating the significant analyses in the hypothesized direction, divided by the total number of analyses for that path. These percentages were then collated for each domain outcome. This collated influence was classified as either no association (0–33%), written as ‘0’, or indeterminate/inconsistent (34–59%), written as ‘?’ If there were fewer than three studies in the domain, the strength of evidence was classified as insufficient (I).

Results
Of the 49 studies, 35% were able to satisfy six or more of the seven risk-of-bias criteria. Longitudinal observational evidence about domain-specific and global associations of motor competence and cognitive and social-emotional development is indeterminate. The included studies also did not provide evidence for a consistent moderating role of age and sex. Some preliminary experimental evidence does support the role of motor competence in moderating the influence of cognitively enriched physical activity on cognitive outcomes, especially working memory and social-emotional skills. However, too few studies were appropriately designed to acknowledge the moderating role of contextual mechanisms.

Conclusions
Between-study heterogeneity means it was not possible to identify definitive domain- and construct-specific relationships between motor competence and cognitive and social-emotional outcomes. To further develop our understanding, it is important that researchers acknowledge the complexity of these relationships within rigorous study designs.