Oculomotor Exercises and Balance in Athletes

Improvements in Static Balance Following an Oculomotor Exercise Program in Athletes

The goal of this interventional study is to evaluate the effects of a six-week eye-movement exercise program on balance in athletes aged 15 to 30 years participating in basketball, football, and boxing. The main question it aims to answer whether performing daily exercises based on a standardized protocol improves balance and functional interaction among the oculomotor, vestibular, and proprioceptive systems.

Participants will perform six different exercises daily for 10 minutes over six weeks. During the first four weeks, exercises are performed on both legs, while in the last two weeks, exercises are performed on the dominant leg on a 10 mm rubber mat to increase vestibular challenge and stimulate functional integration among the sensory systems.

Balance will be assessed using the Leonardo system and the Stork test (s), focusing on single-leg stance on the dominant leg with eyes open during the last two weeks of training. Reaction time will also be evaluated as a secondary outcome to provide additional insight into sensorimotor performance.

All participants provided informed consent, and for those under 18 years of age, parental consent was obtained. The study was approved by the Ethics Committee of the University of Sports of Tirana.

Study Overview

• Status: Completed
• Conditions: Reaction Time; Static Postural Balance
• Intervention / Treatment: Other: Oculomotor Exercise Protocol; Other: Usual Training

Detailed Description

Babetween the visual and vestibular systems, together with proprioceptive feedback, enable the central nervous system to regulate muscle tone and maintain the center of mass within the baselance is a critical component for motor control and body stability in both daily activities and sports performance. Maintaining balance requires coordination of the vestibular, proprioceptive, and visual systems, as well as the integration of motor responses. The visual system plays a central role in perceiving body position, spatial orientation, and environmental cues, providing essential information for postural control and adaptation to movement. Interactions of support. Visual training can enhance these interactions, improving optic flow and the accuracy of information sent to vestibular and somatosensory systems, ultimately supporting postural stability.

This study focused on training the visual-vestibular system through a standardized oculomotor exercise protocol designed to stimulate functional integration across sensory systems. The protocol includes six exercises targeting eye stretching, smooth pursuit, gaze stabilization, spatial localization, saccades, and vergence/convergence. Exercises are performed in progressive postural conditions, initially with both legs and later on the dominant leg using a 10 mm rubber mat to increase vestibular challenge and promote sensorimotor adaptation. All sessions are supervised individually in a distraction-free environment to ensure consistency, progression, and adherence.

Balance performance is assessed using complementary instrumented and clinical measures to provide sensitive and reliable evaluation. Postural stability is recorded under eyes open and eyes closed conditions using the Leonardo Mechanograph, capturing detailed metrics such as ellipse area (cm²) and sway velocity (mm/s) of the center of pressure trajectory, and the Stork test (s). Standardized procedures, including familiarization trials and controlled environmental conditions, are applied to minimize variability and potential bias.

In addition to balance outcomes, reaction time is evaluated as a secondary indicator of sensorimotor processing, reflecting the efficiency of visuomotor integration following oculomotor training.

The intervention is implemented with rigorous monitoring to ensure compliance and accurate delivery of the exercises, while participants continue their usual sports training. This approach allows for the assessment of functional improvements in postural control and sensorimotor performance resulting from targeted oculomotor training, extending previous findings in clinical populations to healthy athletes in basketball, football, and boxing.

• Study Type: Interventional
• Enrollment (Actual): 139
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Albania
  • Tirana
    • Tirana, Tirana, Albania, 1001
      • Sports University of Tirana

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 15-30 years
• Be engaged in the relevant sports disciplines for a minimum of 12 months, a time considered sufficient for a sports specialization.
• Healthy subjects without cardiorespiratory, psychological, vestibular, or oncological pathologies, as verified by self-declaration (Questionnaire, which is available as supplementary material) and their health booklet.
• Training in the relevant disciplines 5x/week.
• Having a visual acuity of 20/20 after testing, with or without glasses/contact lenses.

Exclusion Criteria:

• Subjects with vertigo symptoms, with divergent/convergent strabismus
• Subjects with cardiorespiratory, psychological, vestibular, or oncological problems
• Athletes under the age of 15
• Subjects with injury in the last 12 months that required medical attention, concussion, and cognitive deficits

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group (EG)-Oculomotor Exercise Protocol; Participants perform the standardized oculomotor exercise protocol in addition to their usual sports training. Exercises are conducted daily for 10 minutes, 5 days per week, for 6 weeks. During the first four weeks, exercises are performed in a bipedal stance, and during the final two weeks, exercises are progressed to a single-leg stance on the dominant leg using a 10-mm rubber mat to increase vestibular challenge and sensory stimulation. All sessions are individually supervised by a licensed physiotherapist. Interventions: Oculomotor exercise protocol (eye stretching, smooth pursuit, gaze stabilization, spatial localization, saccades, vergence/convergence exercises)	Other: Oculomotor Exercise Protocol; Participants perform a 6-exercise oculomotor training program specifically designed to improve postural balance through the visual-vestibular-proprioceptive systems. Each session lasts 10 minutes, conducted 5 days per week for 6 weeks. Weeks 1-4: Exercises are performed in a bipedal stance to develop basic oculomotor control. Weeks 5-6: Exercises are progressed to a single-leg stance on a 10-mm rubber mat to further challenge the vestibular and proprioceptive systems. Exercises include eye stretching, smooth pursuit, saccades, gaze stabilization, spatial localization, and vergence/convergence exercises. All sessions are supervised individually by a licensed physiotherapist. Participants continue their usual sports training during the study period. This intervention is distinct because it combines multiple oculomotor exercises over several weeks with progressive difficulty to target balance improvements in healthy athletes, unlike; Other Names: Eye Movement Exercises
Active Comparator: Control Group (CG)-Usual Training; Participants continue their usual sports training routine without additional oculomotor exercises. Interventions: None / usual sports training	Other: Usual Training; Participants continue their regular sports practice routine without performing any additional oculomotor exercises. This arm serves as a comparison to evaluate the effects of the oculomotor exercise protocol, isolating the impact of the experimental intervention from routine training.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static balance -Stork test duration	Static balance assessed on the dominant leg with eyes open using Stork test. Duration of maintained position was recorded. Outcome expressed as duration in seconds (s).	Baseline (pre-intervention) and 6 weeks (post-intervention)
Static balance-Center of pressure ellipse area	Static balance assessed on the dominant leg with eyes open using the Leonardo Mechanograph system. Center of pressure ellipse area was recorded. Outcome expressed in (cm²).	Baseline (pre-intervention ) and 6 weeks (post-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static balance-Postural sway velocity	Static balance assessed using Leonardo Mechanograph system. Sway velocity (mm/s) was recorded during single-leg stance on the dominant leg with eyes open. Outcome values expressed in millimeters per second (mm/s).	Baseline( pre-intervention) and 6 weeks (post-intervention)
Reaction time	Reaction time performance was assessed using a Light Trainer system, and reaction time was recorded in milliseconds (ms).	Baseline (pre-intervention) and 6 weeks (post-intervention)

Collaborators and Investigators

• Sponsor: Sport University of Tirana

Study record dates

Study Major Dates

• Study Start (Actual): November 20, 2024
• Primary Completion (Actual): July 10, 2025
• Study Completion (Actual): July 15, 2025

Study Registration Dates

• First Submitted: February 18, 2026
• First Submitted That Met QC Criteria: February 18, 2026
• First Posted (Actual): February 24, 2026

Study Record Updates

• Last Update Posted (Actual): March 3, 2026
• Last Update Submitted That Met QC Criteria: February 26, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: sport; reaction time; vestibular system; static balance; eye exercises; visual system
• Other Study ID Numbers: PROT. 3373/1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared to protect participant privacy. Only aggregate results and findings from the study will be made publicly available through publication.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No