This study aims to identify injury risk factors using a clinical/functional test battery in university basketball and volleyball athletes, to develop individualized exercise prescriptions for athletes scoring below established cut-off values on each test, and to evaluate the effects of an 8-week intervention program on test parameters.
As a secondary aim, all participants will be monitored prospectively over a 6-month season to assess the incidence of injuries and health problems, and to evaluate the contribution of the individualized program to injury-related health outcomes.
The study consists of four phases: (1) baseline cross-sectional assessment (T0), (2) 8-week individualized exercise intervention for athletes below cut-off thresholds, (3) post-intervention reassessment (T1), and (4) 6-month prospective injury surveillance (T2).
Active member of Acibadem University basketball or volleyball team
Regular training within the past 6 months
Age 18 years or older
Willing to participate and provide written informed consent
Surgical intervention within the past 6 months
Acute musculoskeletal injury within the past 2 weeks (acute sprain/strain/contusion etc.) that would preclude testing
History of vestibular disorder, neurological disease, or systemic condition that may affect balance testing
Uncontrolled cardiovascular disease/hypertension or other medical condition contraindicating exercise
Parallel
Test-Specific Individualized Exercise Program
BehavioralAn 8-week individualized exercise program prescribed based on each athlete's baseline test deficits. Components include: 1. Dynamic balance/proprioception exercises (for YBT-LQ deficit): single-leg balance progressions, 3-direction reach drills, BOSU balance exercises. 2. Plyometric control and symmetry exercises (for Hop Test LSI deficit): single-leg hop-and-stick, lateral hops, eccentric step-up/step-down. 3. Hamstring/posterior chain flexibility exercises (for ASLR deficit): static hamstring stretching with strap, PNF contract-relax, seated hamstring stretch. 4. Scapular stability and upper extremity endurance exercises (for CKCUEST deficit): plank shoulder taps, bear crawl, side plank progressions. 5. Posterior shoulder capsule and rotator cuff exercises (for GIRD deficit): cross-body stretch, sleeper stretch, external rotation with resistance band. Dosage: 3 sessions/week, 20-30 minutes/session. Progressive overload applied. Weekly compliance monitored.
Change in Y-Balance Test Lower Quarter (YBT-LQ) Composite Score
Composite score calculated as \[(Anterior + Posteromedial + Posterolateral) / (3 x Leg Length)\] x 100. Assessed bilaterally. Cut-off: composite score less than 94% or right-left asymmetry greater than 4 cm.
Change in Hop-for-Distance Test Limb Symmetry Index (LSI)
LSI calculated as (Weaker Side / Stronger Side) x 100. Three trials per limb, best distance recorded. Cut-off: LSI less than 90%.
Change in Active Straight Leg Raise (ASLR) Hip Flexion Angle
Hip flexion range of motion measured by goniometry in supine position with knee extended. Two measurements per limb, average recorded. Cut-off: hip flexion less than 70 degrees.
Change in Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) Score
Number of hand touches in 15 seconds from push-up position with hands 91 cm apart. Three trials, best score recorded. Cut-off: males less than 21 touches, females less than 23 touches.
Incidence of Musculoskeletal Injuries and Health Problems
Prospective injury surveillance using IOC 2020 Consensus Statement methodology. Events classified by type (injury/illness), onset (acute/overuse), anatomical region, severity (time-loss: 0, 1-3, 4-7, 8-28, greater than 28 days), and recurrence. Comparison between intervention and observation groups.
Pittsburgh Sleep Quality Index (PSQI) Global Score
Self-report measure of sleep quality over the past month. 19 items, 7 components, global score 0-21. Higher scores indicate poorer sleep quality. Global PSQI greater than 5 indicates clinically significant poor sleep quality.
Borg Rating of Perceived Exertion (RPE)
Perceived exertion level assessed using the Borg RPE Scale (6-20).
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