This study investigates the effectiveness of a six-week reactive neuromuscular training program in enhancing balance and performance in these athletes.
Design
A controlled clinical trialو with a parallel-group design, single-blind, randomized, phase 2, was conducted on 30 patients. G Power software was used for randomization.
Settings and conduct
The Declaration of Helsinki conducted This randomized clinical trial involving 30 male volleyball players in Quchan with a history of ACL reconstruction. Using simple random sampling, participants were randomly assigned to an exercise group (n=15) and a control group (n=15). Single-blinding was applied, with participants unaware of group assignments. Informed consent and medical history were collected before the study.
Participants/Inclusion and exclusion criteria
Inclusion Criteria: Participants aged 18-30 years with at least 12 months post-ACL reconstruction, a minimum of three years of regular volleyball experience (three sessions per week), no persistent lower limb injuries or abnormalities, and no participation in ACL prevention programs.
Exclusion Criteria: Non-compliance, failure to complete the protocol or post-test, sports injuries, pain during training, or missing more than two sessions.
Intervention groups
The intervention group participated in a Reactive Neuromuscular Training program over six weeks. The exercises aimed to improve balance, agility, and proprioception while reducing incorrect movement patterns. A trainer supervised the sessions and was involved in using Thera-bands to challenge stability.
The control group received no intervention and continued daily activities without specific training.
Main outcome variables
Balance, Performance
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20110803007211N6
Registration date:2025-01-15, 1403/10/26
Registration timing:retrospective
Last update:2025-01-15, 1403/10/26
Update count:0
Registration date
2025-01-15, 1403/10/26
Registrant information
Name
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
05714413512
Email address
mseyedahmadi@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2025-01-04, 1403/10/15
Expected recruitment end date
2025-01-14, 1403/10/25
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Effect of Six Weeks Reactive Neuromuscular Training on Balance and Performance in Volleyball Players with Anterior Cruciate Ligament Reconstruction
Public title
The Impact of Neuromuscular Training on Balance and Performance Improvement in Volleyball Players
Purpose
Supportive
Inclusion/Exclusion criteria
Inclusion criteria:
1. Age between 18 and 30 years
2. History of anterior cruciate ligament (ACL) reconstruction at least 12 months prior to the start of the study;
3. Return to unrestricted sports participation without reported limitations;
4. Minimum of three years of regular participation in volleyball;
5. An average of three volleyball training sessions per week;
6. No significant lower limb abnormalities (e.g., hip anteversion, genu valgum, genu varum, tibial torsion, or flat feet);
Exclusion criteria:
(1) Non-compliance with study procedures
(2) Failure to complete the protocol;
(3) Occurrence of a sports injury resulting in absence from training;
(4) Development of pain during training;
(5) Failure to complete the post-test
(6) Missing more than two training sessions.
Age
From 18 years old to 30 years old
Gender
Male
Phase
N/A
Groups that have been masked
Investigator
Outcome assessor
Sample size
Target sample size:
30
Randomization (investigator's opinion)
Randomized
Randomization description
In this study, the randomization process of participants will be conducted using Random Allocation Software 2.0 through the block randomization method to ensure a balanced distribution across the groups. The unit of randomization will be individual. The random sequence generated by the software will be placed in sealed and numbered envelopes, which will be opened sequentially after the initial assessment of participants and confirmation of the inclusion criteria. This method ensures allocation concealment, reducing bias and improving the accuracy of the study results.
Blinding (investigator's opinion)
Single blinded
Blinding description
Considering the nature of the intervention in this study, which involves neuromuscular reactive exercises, blinding participants is not feasible. The specific exercises performed by the experimental group are easily distinguishable by the participants, making it impractical to achieve participant-level blinding. However, to reduce assessment bias, the outcome evaluations will be conducted by independent assessors blinded to group allocation, and the random allocation of participants to groups will be handled by an independent person who is not involved in data collection or intervention delivery.
This ensures that blinding is maintained at the level of outcome assessors and the randomization process, which contributes to reducing bias and improving the validity of the study results. Additionally, this limitation will be clearly stated in the discussion and limitations section of the final manuscript.
Placebo
Not used
Assignment
Single
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics Committee of Sport Sciences Research Institute
Other specified acquired deformities of musculoskeletal system
Primary outcomes
1
Description
Balance
Timepoint
At the beginning of the study (before the start of the intervention) and at the end of the study (6 weeks after the intervention)
Method of measurement
Y-Balance Test: The test measures dynamic balance in three directions (anterior, posteromedial, and posterolateral). The participant pushes a movable platform with their non-dominant foot while standing on the dominant foot. The reach distance, expressed as a percentage of leg length, is averaged over three attempts. The test shows high reliability for both individual directions and total scores.
2
Description
Motor Performance (Vertical Jump, Triple Hop, Single-Leg 6-Meter Hop)
Timepoint
At the beginning of the study (before the intervention) and at the end of the study (6 weeks after the intervention)
Method of measurement
Vertical Jump Test: This test evaluates the explosive power of the lower limbs in the vertical direction. The participant jumps three times, and the distance between the zero point and the highest jump is measured. The average of the three attempts is recorded as the final score. Triple Hop Test: This test assesses the power, speed, balance, and coordination of the lower limbs. The participant performs three consecutive hops with the dominant foot, and the distance from the starting line to the point where the heel touches the ground during the third hop is measured. Single-Leg 6-Meter Hop Test: This test evaluates power, speed, and balance with an emphasis on time. The participant covers a 6-meter distance with consecutive hops as fast as possible. The time taken from the starting line to crossing the finish line is recorded, and the best time from three attempts is considered the final result.
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group: The Reactive Neuromuscular Training (RNMT): protocol aimed to improve movement patterns through self-adjustment and minimal verbal feedback. Conducted over six weeks with 18 sessions (three per week, each 60 minutes), it included a 10-minute warm-up, 40 minutes of balance, agility, and proprioception exercises, and perturbation forces using Thera-bands. Intensity was tailored using the Borg Scale (level ≤6) to prevent fatigue, focusing on correcting knee valgus and ensuring proper movement. Exercises involved static and dynamic tasks for stability, agility drills, and proprioceptive activities. The control group maintained daily routines without training, and the protocol emphasized movement quality over cardiovascular endurance.
Category
Rehabilitation
2
Description
Control group: The control group in this study did not receive any intervention and continued with their daily activities.
Research Deputy of Hakim Nizami Higher Education Institute in Quchan
Full name of responsible person
Dr .Nader Naqshbandi
Street address
Sento Qochan-Mashhad Road, In Front of Saipa Agency, Qochan, Khorasan Razavi Province, Iran
City
Quchan
Province
Razavi Khorasan
Postal code
9471787194
Phone
+98 51 4721 1773
Email
N.Naqshbandi@yahoo.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
No
Title of funding source
Research Deputy of Hakim Nizami Institute of Higher Education,
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Hakim Nizami Higher Education Institute in Quchan
Full name of responsible person
Karim Khalaghi
Position
Asistant professor
Latest degree
Ph.D.
Other areas of specialty/work
Sport Medicine
Street address
Sento Qochan-Mashhad Road, In Front of Saipa Agency, Qochan, Khorasan Razavi Province, Iran
City
Quchan
Province
Razavi Khorasan
Postal code
9471787194
Phone
+98 51 4721 1773
Email
karim.khalaghi@yahoo.com
Person responsible for scientific inquiries
Contact
Name of organization / entity
Hakim Nizami Qochan Institute of Higher Education
Full name of responsible person
karim khalaghi
Position
Asistant professor
Latest degree
Ph.D.
Other areas of specialty/work
Sport Medicine
Street address
Sento Qochan-Mashhad Road, In Front of Saipa Agency, Qochan, Khorasan Razavi Province, Iran
City
Quchan
Province
Razavi Khorasan
Postal code
9471787194
Phone
+98 51 4721 1773
Email
karim.khalaghi@yahoo.com
Person responsible for updating data
Contact
Name of organization / entity
Velayat University
Full name of responsible person
Mohammad Seyedahmadi
Position
Asistant professor
Latest degree
Ph.D.
Other areas of specialty/work
Sport Medicine
Street address
Shahid Moradi Highway, Iranshahr, Sistan and Baluchistan, Iran
City
Iranshahr
Province
Sistan-va-Balouchestan
Postal code
9911131311
Phone
0543721252
Email
mseyedahmadi@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
No - There is not a plan to make this available
Statistical Analysis Plan
No - There is not a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
No - There is not a plan to make this available
Analytic Code
No - There is not a plan to make this available
Data Dictionary
No - There is not a plan to make this available
Title and more details about the data/document
Data related to the Effect of Six Weeks of Reactive Neuromuscular Training on Balance and Performance in Volleyball Players with Anterior Cruciate Ligament Reconstruction includes body status information (balance and motor performance) and questionnaire data for 30 participants (15 intervention, 15 control) in Excel or SPSS file formats. The data will be available one week after an official request and compliance with ethical considerations.
When the data will become available and for how long
After the article's publication, upon request from the corresponding author, the data will be sent within one week.
To whom data/document is available
All researchers working in this field of study.
Under which criteria data/document could be used
The data will be generalizable and usable for conducting similar studies on comparable groups.
From where data/document is obtainable
An email should be sent to Mr. Mohammad Seyedahmadi, the corresponding author, at Mseyedahmadi@gmail.com.
What processes are involved for a request to access data/document
After emailing the corresponding author, the requested data will be sent within one week.