Extended Reality Cognitive and Breathing Training With Eye Tracking for Attention and Stress Regulation in Adolescent Basketball Players

NCT07869446 | Completed

• 2 other identifiers: 2-PĒK-4/1205/2025-Feasibility5.2.1.1.i.0/2/24/I/CFLA/005
• Study Type: interventional
• Target: 81
• Locations: 1 country
• Sites: 2

Brief Summary

This study examines whether virtual reality (VR) technology can serve as a supplementary training tool for adolescent basketball players. Two types of 6-week VR training were tested alongside regular basketball practice: one targeting attention and decision-making (cognitive training), and one targeting breathing patterns (slow diaphragmatic breathing). A third group continued regular training without any VR component. Participants were basketball players aged 14-17 who trained at least three times per week. Before and after the 6-week period, all participants completed assessments measuring resting heart rate, heart rate variability, breathing function (CO₂ tolerance, breathing pattern), reactive stress tolerance, selective and sustained attention, and pre-competition anxiety. The primary aim was to evaluate feasibility - whether participants were willing to join and complete the sessions, whether the procedures worked as intended in a real training environment, and whether the study design is suitable for a larger future trial. The study was not designed to confirm effectiveness.

Conditions

Healthy Adolescents

Keywords

Adolescent athletes; Attention; Basketball; Breathing Biofeedback; Extended Reality; Stress Regulation; Eye Tracking

Outcome Measures

Primary Outcomes (5)

• Recruitment rate

  Proportion of eligible athletes who provide consent and are enrolled in the study. Reported as the number enrolled divided by the number eligible.

  During recruitment, up to 6 weeks

• Randomization completion rate

  Proportion of enrolled participants who are successfully allocated to one of the study arms. Reported as the number randomized divided by the number enrolled.

  At baseline, before intervention initiation

• Retention rate

  Proportion of enrolled participants who complete the post-intervention assessment. Reported as the number completing follow-up divided by the number enrolled.

  Baseline through 6-week post-intervention assessment

• Intervention adherence

  Attendance among participants allocated to either XR intervention arm. Reported as the number of intervention sessions completed out of 12 scheduled sessions, expressed as a percentage.

  During the 6-week intervention period

• Intervention acceptability

  Post-intervention acceptability assessed using a study-specific 4-item questionnaire measuring task interest, mixed-reality excitement, motivation to perform tasks, and willingness to continue. Items are rated from 1 (completely disagree) to 5 (completely agree). Total score range: 4 (minimum) to 20 (maximum). Higher scores indicate greater acceptability. Report item scores and/or mean total score.

  At 6 weeks (post-intervention)

Secondary Outcomes (17)

• Selective attention - concentration performance level (d2-R SUMKL)

  Baseline and 6 weeks

• Sustained attention and processing speed - total correctly processed items (d2-R SUMBZO)

  Baseline and 6 weeks

• Omission errors - failures to mark target stimuli (d2-R SUMAF)

  Baseline and 6 weeks

• Commission errors - false responses (d2-R SUMVF)

  Baseline and 6 weeks

• Change from Baseline to 6 Weeks in Functional Breathing Pattern Proportion

  Baseline and 6 weeks

Study Arms (3)

Cognitive XR Training

EXPERIMENTAL

Participants receive a 6-week XR cognitive and visuomotor training program in addition to their usual basketball training. They complete two 10-minute sessions per week, for a maximum of 12 sessions and 120 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue.

Behavioral: Cognitive XR

Breathing XR Training

EXPERIMENTAL

Participants receive a 6-week XR breathing and gaze-control training program in addition to their usual basketball training. They complete two 7-minute sessions per week, for a maximum of 12 sessions and 84 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue.

Behavioral: Breathing XR

Usual Basketball Training Control (No intervention)

NO INTERVENTION

Participants continue their usual basketball training routine at their respective clubs. They complete baseline and post-intervention assessments on the same schedule as the intervention groups but receive no study-provided XR cognitive, visuomotor, or breathing training during the 6-week study period.

Interventions

Cognitive XR BEHAVIORAL

Participants complete two 10-minute sessions weekly for 6 weeks (maximum 12 sessions; 120 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display with binocular eye tracking. While dribbling a real basketball, participants follow a moving virtual basketball with their gaze, avoid virtual obstacles, and respond to spatial and auditory cues within predefined court boundaries. Attention time is recorded when a valid gaze signal intersects the active target under the required spatial conditions. Difficulty progresses through target speed, obstacle number and movement, target switching, movement zones, whistle-controlled tasks, jumping obstacles, and spatialized sounds. A fixed pre-programmed level sequence is individually paced according to an on-target-time criterion. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently.

Cognitive XR Training

Breathing XR BEHAVIORAL

Participants complete two 7-minute sessions weekly for 6 weeks (maximum 12 sessions; 84 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display. Seated within an approximately 1 × 1 m area, participants perform slow diaphragmatic breathing while completing a gaze-controlled virtual basketball-tracking task. Breathing pace progresses from 7 breaths/min in minute 1, to 6.5 breaths/min in minute 2, and 6 breaths/min during minutes 3-7, using a 40:60 inhalation-to-exhalation ratio. A handheld controller placed horizontally on the upper abdomen detects abdominal movement to estimate breathing phase and adherence. Accurate breathing increases virtual-player responsiveness and speed, whereas departures from the prescribed pattern reduce performance. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently.

Breathing XR Training

Eligibility Criteria

• Age: 14 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Adolescent basketball players aged 14-17 years
• Organized basketball training for at least 5 years
• Training at least 3 times per week

You may not qualify if:

• Serious musculoskeletal injury or acute medical condition affecting sports performance in the previous month
• Severe orthopedic, neurological, cardiovascular, or other medical disorders
• Use of prescription medications affecting the central nervous system (e.g., psychotropic medication)
• Symptoms of visually induced motion sickness (VIMS): nausea, dizziness, headache, or disorientation before or during participation

Sponsors & Collaborators

• Riga Stradins University: lead
• European Union: collaborator

Study Sites (2)

Jūrmala Sport School Basketball Arena

Jūrmala, Latvia

Location

Ventspils Basketball Arena

Ventspils, Latvia

Location

Study Officials

• Agris Liepa, PhD

  Riga Stradins University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant Intern; Junior Researcher (PhD Student)

Study Record Dates

• First Submitted: September 30, 2026
• First Posted: October 9, 2026
• Study Start: November 7, 2025
• Primary Completion: December 22, 2025
• Study Completion: December 22, 2025
• Last Updated: October 9, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share

Locations

LA (2)