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.

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.

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

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.