Motor imagery (MI) and action observation (AO) are considered effective tools to improve performance in athletes. This systematic review aims to investigate the existing literature on the effects of MI, AO, and the combined use of both methods on sport performance in healthy athletes. This study was conducted following the PRISMA guideline statement. Electronic databases were originally searched. The randomized controlled studies that were published (from January 2000 to May 2024) in the PubMed, Web of Science, MEDLINE, Scopus, and Cochrane Library databases were checked. Eligible studies were independently reviewed by 2 reviewers. Quality assessment was made using the PEDro scale and Cochrane Risk-of-Bias Tool for Randomized Trials. Nine studies (a total of 339 participants) were selected for the analysis. Four studies combined MI and AO methods, while five studies implemented MI training alone. Sport performance parameters including speed, reaction time, sport-specific performance, strength, power performance, and maximum oxygen consumption were evaluated through studies. Eight studies reported significant improvements in various performance parameters, while a study applying one session of MI reported no change in oxygen consumption. The findings indicate that MI, AO, and their combined use may offer significant benefits for sports performance parameters such as speed, reaction time, and strength. While the combination of MI and AO shows promising potential, further research is needed to establish its efficacy. However, no conclusive evidence currently identifies the optimal protocol for maximizing their effectiveness in enhancing sports performance.
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