Neuroathletic Training Effects on Muscle Strength, Balance, and Cognition

NCT07117357 | Completed DMC

• 1 other identifier: 2025-49
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

Neuroathletic training is an innovative approach aimed at enhancing neurophysiological processes to improve motor control, reflex responses, balance, proprioception, and cognitive functions. While this method has shown promise in athletes, its acute effects on non-athletic individuals remain underexplored. The posterior chain (gluteus maximus, hamstrings, and erector spinae) plays a critical role in postural stability, movement, and injury prevention. Weakness in these muscles, coupled with poor balance and proprioception, may increase injury risk. Additionally, cognitive performance, including attention and reaction time, is vital for functional activities and may be enhanced through neuroathletic interventions. This study seeks to address the gap in understanding the acute effects of neuroathletic training on non-athletic individuals, providing evidence to support its integration into rehabilitation and injury prevention programs.

Conditions

Posterior Chain Muscle Strength; Gluteus Maximus; Hamstrings; Erector Spinae Endurance; Proprioception; Cognitive Performance; Neuroathletic Training

Outcome Measures

Primary Outcomes (8)

• Gluteus Maximus Muscle Strength (Newton)

  Assessed using a digital handheld dynamometer (Lafayette Manual Muscle Tester, Model 01165) during maximal voluntary isometric contraction in prone hip extension. Three trials are conducted, and the highest value is recorded.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Erector Spinae Endurance (Seconds)

  Evaluated using the Biering-Sørensen Test. Participants maintain a horizontal trunk position with the lower body fixed until fatigue. Time is recorded with a stopwatch.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Knee Joint Proprioception (Degrees)

  Measured using an inclinometer to assess knee joint position sense. Angular deviation from 30° knee flexion target is recorded. The mean error across trials is used as the final score.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Dynamic Balance (Percent Reach Distance)

  Assessed with the Y-Balance Test in three directions: anterior, posteromedial, and posterolateral. Reach distances are normalized to limb length and averaged to calculate dynamic balance performance.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Cognitive Performance - Stroop Test Reaction Time

  Assesses selective attention and cognitive interference using the Stroop Color-Word Test. Reaction time is recorded in milliseconds during the incongruent trial phase.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Cognitive Performance - Stroop Test Error Count

  Assesses accuracy during the Stroop Color-Word Test. The number of errors made during the incongruent trials is recorded.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Cognitive Performance - Trail Making Test Completion Time

  Assesses visual attention and task-switching using Trail Making Test Parts A and B. Time to complete each part is recorded in seconds.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

• Cognitive Performance - Trail Making Test Error Count

  Assesses accuracy during Trail Making Test Parts A and B. The number of errors committed during each test part is recorded.

  Baseline, Immediately Post-Intervention, 15 Minutes Post, 30 Minutes Post

Study Arms (2)

Neuroathletic Training

EXPERIMENTAL

Participants will undergo a 20-minute neuroathletic training protocol using the Z-Health® kit, targeting visual, vestibular, and proprioceptive systems. The protocol includes visual reset exercises (eye massage, palming), star chart eye muscle training, saccade training with letter cards, convergence-divergence training, Brock string training, hip and spine extension exercises, saccule activation lunge exercises, slap tap coordination exercises, and pinhole glasses exercises to enhance motor control, balance, and cognitive performance.

Behavioral: Neuroathletic Training Protocol

Standard Warm-Up

ACTIVE COMPARATOR

Participants will perform a 20-minute standard warm-up protocol consisting of 10 minutes of light walking at a moderate pace on flat terrain, followed by 10 minutes of dynamic stretching exercises (10 repetitions each of leg swings, hip flexor stretches, knee hugs, high knees, butt kicks, arm circles, and trunk rotations). This protocol serves as a control to compare against the neuroathletic training intervention.

Behavioral: Standard Warm-Up Protocol

Interventions

Standard Warm-Up Protocol BEHAVIORAL

This 20-minute warm-up consists of two components: 10 minutes of light walking at a moderate pace and 10 minutes of dynamic stretching (leg swings, hip flexor stretches, knee hugs, high knees, butt kicks, arm circles, and trunk rotations). It is intended to mimic standard pre-activity routines and serves as the comparator condition.

Standard Warm-Up

Neuroathletic Training Protocol BEHAVIORAL

This intervention involves a 20-minute neuroathletic training session using the Z-Health® kit. It includes visual reset exercises (eye massage, palming), star chart eye muscle training, saccade training with letter cards, convergence-divergence drills using Brock string, vestibular activation through lunges, spinal and hip extension exercises, slap tap coordination drills, and use of pinhole glasses. The aim is to stimulate sensory pathways and enhance neuromotor readiness acutely.

Also known as: Z-Health®-based neuroathletic training

Neuroathletic Training

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18-30 years.
• No regular physical activity in the past 6 months (IPAQ Short Form: physical activity level \>3000 MET-min/week excluded).
• Body Mass Index (BMI) 18.5-24.9 kg/m².
• No history of lower extremity injury or neurological conditions.
• Ability to perform study tests and exercises.
• Written informed consent.

You may not qualify if:

• Acute injury in the past 6 months.
• Chronic pain or postural deformities.
• Sensory impairments affecting study participation.
• Musculoskeletal, neurological, respiratory, or cardiovascular conditions limiting exercise.
• History of malignancy.

Sponsors & Collaborators

• Ankara Yildirim Beyazıt University: lead

Study Sites (1)

University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation

Ankara, Etlik, 06010, Turkey (Türkiye)

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcomes assessors, responsible for conducting and analyzing measurements (e.g., muscle strength, balance, proprioception, and cognitive tests), will be blinded to the group allocation of participants to minimize bias in data collection and interpretation. Participants, care providers, and investigators will not be blinded due to the nature of the intervention, which requires active participation and specific instructions for neuroathletic training or standard warm-up protocols.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Parallel group design with two arms (experimental and control). Participants are randomly assigned to either the neuroathletic training group or the standard warm-up control group. Each group undergoes a single 20-minute intervention session, with outcomes measured at baseline, immediately post-intervention, 15 minutes post-intervention, and 30 minutes post-intervention. This design allows for direct comparison of the acute effects of neuroathletic training versus a standard warm-up protocol on the specified outcomes.

Study Record Dates

• First Submitted: August 5, 2025
• First Posted: August 12, 2025
• Study Start: April 11, 2025
• Primary Completion: May 13, 2025
• Study Completion: July 15, 2025
• Last Updated: March 10, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)