NEUROATHLETIC AND REACTIVE TRAINING IN AMERICAN FOOTBALL PLAYERS

The Effects of Neuroathletic Training and Reactive Training on Physical Performance, Injury Risk, and Reaction Time in American Football Players: A Randomized Controlled Trial

This study aims to compare the effects of neuroathletic training, reactive training, and routine team training in American football players. American football requires not only strength, speed, agility, and balance, but also rapid reaction, decision-making, and appropriate motor responses. Therefore, training approaches targeting the nervous system and reaction skills may contribute to both performance enhancement and injury risk reduction.

Active American football players aged 18-30 are randomly assigned to neuroathletic training, reactive training, or control groups. The intervention groups participate in additional exercise sessions twice a week for four weeks, while the control group continues routine team training only. Assessments are performed before and after the intervention period.

Outcome measures include Y Balance Test, Functional Movement Screen, Reactive Balance Test, core endurance test, and sit-and-reach test. These assessments are used to examine reaction performance, dynamic balance, postural control, movement quality, core endurance, and flexibility. The findings are expected to help identify the most effective training approach for improving performance and reducing injury risk in American football players.

Study Overview

• Status: Completed
• Conditions: Neuroathletic Training; American Football Players; Reactive Training
• Intervention / Treatment: Other: Neuroathletic Training; Other: Reactive Training

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kınıklı
    • Denizli, Kınıklı, Turkey (Türkiye), 20160
      • Pamukkale University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

Aged 18-30 years Holding an active American football license during the study season Competing at the university, semi-professional, or professional level Regular participation in team training (6-10 hours per week) At least one year of continuous competitive American football experience Having a structured training background in American football Free from color blindness Free from attention-related disorders Free from any health condition that could affect neuromuscular, reactive, or sport-specific performance

Exclusion Criteria:

Injury within the previous 3 months resulting in absence from training or competition for more than 2 weeks Upper or lower extremity surgery within the previous 6 months History of neurological, vestibular, or cardiovascular disorders that could interfere with neuroathletic training or performance assessments COVID-19 infection within the previous 6 months

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group
Experimental: Neuroathletic Training Group	Other: Neuroathletic Training; A structured exercise program designed to improve the integration of visual, vestibular, and proprioceptive inputs in order to enhance motor control, balance, reaction ability, coordination, and physical performance. Participants in this group receive neuroathletic exercises in addition to routine team training, twice weekly for 4 weeks, with each session lasting 10-15 minutes.
Experimental: Reactive Training Group	Other: Reactive Training; Participants receive a reactive training program in addition to routine team training. The program includes exercises performed with a light-based system and is designed to improve reaction speed, visual-motor response, dynamic balance, coordination, and decision-making ability. Training is performed twice weekly for 4 weeks, with sessions lasting 10-15 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Movement Screen	The Functional Movement Screen (FMS) consists of seven movement tasks designed to assess the balance between mobility and stability: deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk rotary stability, and trunk stability push-up. The test was administered using a standard test kit, and each movement was scored on a scale from 0 to 3 according to the standard scoring system. In the presence of pain, the relevant movement was recorded as 0 points (Altundağ et al., 2021).	At baseline and immediately after the 4-week intervention
Y Balance Test	Dynamic balance and postural control were assessed using the Y Balance Test. Participants stood on the fixed platform with their non-dominant lower extremity while reaching in the anterior, posteromedial, and posterolateral directions with the contralateral lower extremity. Three trials were performed in each direction, and reach distances were normalized to lower extremity length to calculate the composite score. Lower extremity length was measured as the distance between the anterior superior iliac spine and the medial malleolus (Unver et al., 2020).	At baseline and immediately after the 4-week intervention
Reactive Balance Test	The Reactive Balance Test was used to assess reactive postural control and visuomotor response performance associated with injury risk. This test consisted of the integration of the Y Balance Test setup with an LED-based light system (ReactionX) controlled via a smartphone application. The LED lights were positioned at 80% of the participants' maximum reach distance in each direction during the Y Balance Test. Participants were instructed to maintain balance in the standard starting position and deactivate the randomly illuminated LED lights as quickly as possible. A total of 45 visual stimuli were presented at varying intervals ranging from 0.5 to 2.5 seconds to minimize anticipatory effects. Test outcomes were recorded as visuomotor reaction time (ms) and accuracy (%). The test was performed twice; the first trial was considered a familiarization trial, and the results of the second trial were used for analysis (Tekin et al., 2025).	At baseline and immediately after the 4-week intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Core Endurance Test	Core endurance was assessed using the prone plank test. Participants were instructed to lift their body off the mat in a prone position so that only their elbows and toes remained in contact with the surface. The test was terminated if they were unable to correct a disruption in posture within more than three seconds. The test was performed three times, and the mean duration was used for analysis (Unver et al., 2020).	At baseline and immediately after the 4-week intervention
Sit-and-Reach Test	Flexibility was assessed using the sit-and-reach test. Participants were asked to remove their shoes, sit with their feet placed against the testing box, and reach forward as far as possible without bending their knees. The test was performed twice, and the highest value was recorded in centimeters (Mayorga-Vega et al., 2014).	At baseline and immediately after the 4-week intervention

Collaborators and Investigators

• Sponsor: Ebru Tekin

Study record dates

Study Major Dates

• Study Start (Actual): December 12, 2025
• Primary Completion (Actual): March 1, 2026
• Study Completion (Actual): April 8, 2026

Study Registration Dates

• First Submitted: April 11, 2026
• First Submitted That Met QC Criteria: April 17, 2026
• First Posted (Actual): April 20, 2026

Study Record Updates

• Last Update Posted (Actual): April 20, 2026
• Last Update Submitted That Met QC Criteria: April 17, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2025/24 (Istanbul University-Cerrahpasa)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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