Healthy AdolescentsXR-CogBreatheNCT07869446
Extended Reality Cognitive and Breathing Training With Eye Tracking for Attention and Stress Regulation in Adolescent Basketball Players
A study testing Cognitive XR and Breathing XR in people with Healthy Adolescents, run by Riga Stradins University at 2 sites in Latvia.
Trial summary
This study examines whether virtual reality (VR) technology can serve as a supplementary training tool for adolescent basketball players. Two types of 6-week VR training were tested alongside regular basketball practice: one targeting attention and decision-making (cognitive training), and one targeting breathing… Read more about this study
- Who is it for?
- Ages 14 to 17 yearsHealthy volunteers can take part
- Conditions the study is for
- Healthy Adolescents
- What is being tested?
- Cognitive XR and Breathing XR
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 81 participants
- Where
- 2 sitesLatvia
- Study dates
- 7 Nov 2025to 22 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 14 to 17 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Adolescent basketball players aged 14-17 years
- Organized basketball training for at least 5 years
- Training at least 3 times per week
Who cannot join
- Serious musculoskeletal injury or acute medical condition affecting sports performance in the previous month
- Severe orthopedic, neurological, cardiovascular, or other medical disorders
- Use of prescription medications affecting the central nervous system (e.g., psychotropic medication)
- Symptoms of visually induced motion sickness (VIMS): nausea, dizziness, headache, or disorientation before or during participation
Trial locations and contacts
2 sites in 1 country.
Latvia2 sites
Jūrmala Sport School Basketball Arena
Jūrmala
Ventspils Basketball Arena
Ventspils
About this study
Official title: Extended Reality Cognitive and Breathing Training With Eye Tracking for Attention and Stress Regulation in Adolescent Basketball Players: A Feasibility Randomized Controlled Trial
This study examines whether virtual reality (VR) technology can serve as a supplementary training tool for adolescent basketball players. Two types of 6-week VR training were tested alongside regular basketball practice: one targeting attention and decision-making (cognitive training), and one targeting breathing patterns (slow diaphragmatic breathing). A third group continued regular training without any VR component.
Participants were basketball players aged 14-17 who trained at least three times per week. Before and after the 6-week period, all participants completed assessments measuring resting heart rate, heart rate variability, breathing function (CO₂ tolerance, breathing pattern), reactive stress tolerance, selective and sustained attention, and pre-competition anxiety.
The primary aim was to evaluate feasibility - whether participants were willing to join and complete the sessions, whether the procedures worked as intended in a real training environment, and whether the study design is suitable for a larger future trial. The study was not designed to confirm effectiveness.
Read the detailed description
This feasibility randomised controlled trial (RCT) was conducted to evaluate the practicality and acceptability of integrating standalone virtual reality (VR) technology into regular basketball training for adolescent athletes. The study was designed to inform the design and sample size of a future full-scale RCT, and was not powered to confirm intervention effectiveness.
The study used a three-arm parallel-group design. Participants were randomly assigned to one of two experimental extended reality (XR) intervention groups (Cognitive XR or Breathing XR) or to a control group. Randomisation was performed at the individual level. The intervention period lasted six weeks, with two sessions per week for both experimental groups. Control participants continued their regular basketball training without any additional intervention.
All study activities were conducted at participants' existing basketball training venues in Latvia (Ventspils Basketball Arena and Jūrmala Sport School Basketball Arena). Interventions were delivered using the HTC VIVE Focus Vision standalone head-mounted display, requiring no external equipment or PC connection.
Assessments were conducted at two time points: at baseline (before the intervention period) and post-intervention (within one week of the final session). The assessment battery included resting heart rate and heart rate variability (Polar H10 chest strap with KubiosHRV), CO₂ Tolerance Test (CO₂TT), breathing pattern (Hi-Lo test), reactive stress tolerance (Vienna Test System - Determination Test), d2-R Test of Attention (Revised), and pre-competition anxiety test Competitive State Anxiety Inventory-2 Revised (the Latvian-adapted version CSAI-2R-LV).
Research staff supervised the pre-intervention assessment phase and the first two intervention sessions in person. From week two onward, participants accessed sessions independently using individual password-protected profiles on the headset. A midpoint visit was conducted at week three. A minimum adherence threshold of four completed sessions was required for inclusion in the primary analysis, with regularity criteria also applied.
The study was approved by the Riga Stradiņš University Ethics Committee (original approval: 2-PĒK-4/610/2024; additional approvals covering extended details: 2-PĒK-4/814/2025 and 2-PĒK-4/1205/2025). An Open Science Framework (OSF) project page describing the study was created prior to enrollment (osf.io/8sx3r).
- Conditions
- Healthy Adolescents
- Being tested
- Cognitive XR, Breathing XR
- Keywords
- Adolescent athletes, Attention, Basketball, Breathing Biofeedback, Extended Reality, Stress Regulation, Eye Tracking
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cognitive XRBehavioural
Participants complete two 10-minute sessions weekly for 6 weeks (maximum 12 sessions; 120 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display with binocular eye tracking. While dribbling a real basketball, participants follow a moving virtual basketball with their gaze, avoid virtual obstacles, and respond to spatial and auditory cues within predefined court boundaries. Attention time is recorded when a valid gaze signal intersects the active target under the required spatial conditions. Difficulty progresses through target speed, obstacle number and movement, target switching, movement zones, whistle-controlled tasks, jumping obstacles, and spatialized sounds. A fixed pre-programmed level sequence is individually paced according to an on-target-time criterion. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently.
Breathing XRBehavioural
Participants complete two 7-minute sessions weekly for 6 weeks (maximum 12 sessions; 84 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display. Seated within an approximately 1 × 1 m area, participants perform slow diaphragmatic breathing while completing a gaze-controlled virtual basketball-tracking task. Breathing pace progresses from 7 breaths/min in minute 1, to 6.5 breaths/min in minute 2, and 6 breaths/min during minutes 3-7, using a 40:60 inhalation-to-exhalation ratio. A handheld controller placed horizontally on the upper abdomen detects abdominal movement to estimate breathing phase and adherence. Accurate breathing increases virtual-player responsiveness and speed, whereas departures from the prescribed pattern reduce performance. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently.
| Study group | Role | What they receive |
|---|---|---|
| Cognitive XR Training | Experimental | Participants receive a 6-week XR cognitive and visuomotor training program in addition to their usual basketball training. They complete two 10-minute sessions per week, for a maximum of 12 sessions and 120 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue. Receives: Behavioral: Cognitive XR |
| Breathing XR Training | Experimental | Participants receive a 6-week XR breathing and gaze-control training program in addition to their usual basketball training. They complete two 7-minute sessions per week, for a maximum of 12 sessions and 84 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue. Receives: Behavioral: Breathing XR |
| Usual Basketball Training Control (No intervention) | No intervention | Participants continue their usual basketball training routine at their respective clubs. They complete baseline and post-intervention assessments on the same schedule as the intervention groups but receive no study-provided XR cognitive, visuomotor, or breathing training during the 6-week study period. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Recruitment rate
Proportion of eligible athletes who provide consent and are enrolled in the study. Reported as the number enrolled divided by the number eligible.
Measured: During recruitment, up to 6 weeks
Randomization completion rate
Proportion of enrolled participants who are successfully allocated to one of the study arms. Reported as the number randomized divided by the number enrolled.
Measured: At baseline, before intervention initiation
Retention rate
Proportion of enrolled participants who complete the post-intervention assessment. Reported as the number completing follow-up divided by the number enrolled.
Measured: Baseline through 6-week post-intervention assessment
Intervention adherence
Attendance among participants allocated to either XR intervention arm. Reported as the number of intervention sessions completed out of 12 scheduled sessions, expressed as a percentage.
Measured: During the 6-week intervention period
Intervention acceptability
Post-intervention acceptability assessed using a study-specific 4-item questionnaire measuring task interest, mixed-reality excitement, motivation to perform tasks, and willingness to continue. Items are rated from 1 (completely disagree) to 5 (completely agree). Total score range: 4 (minimum) to 20 (maximum). Higher scores indicate greater acceptability. Report item scores and/or mean total score.
Measured: At 6 weeks (post-intervention)
Secondary outcomes (17)
Selective attention - concentration performance level (d2-R SUMKL)
Selective attention was assessed using the d2-R Test of Attention (d2-R). The SUMKL score represents total concentration performance level across all 14 test rows, calculated as the number of correctly cancelled target items minus total errors (higher scores indicate better selective attention). Block-specific indices B1KL-B4KL, reflecting concentration performance in rows 1-4 respectively, were also analyzed. Scores are calculated according to standardized d2-R scoring procedures.
Measured: Baseline and 6 weeks
Sustained attention and processing speed - total correctly processed items (d2-R SUMBZO)
Sustained attention and processing speed were assessed using the d2-R Test of Attention (d2-R). The SUMBZO score represents the total number of correctly processed items across all 14 test rows, reflecting the speed and quantity of attentional processing sustained over the full test duration (higher scores indicate better performance). Block-specific indices B1BZO-B4BZO, reflecting correctly processed items in rows 1-4 respectively, were also analyzed. Scores are calculated according to standardized d2-R scoring procedures.
Measured: Baseline and 6 weeks
Omission errors - failures to mark target stimuli (d2-R SUMAF)
Omission errors were assessed using the d2-R Test of Attention (d2-R). The SUMAF score represents the total number of omission errors (failures) across all 14 test rows - instances where a target stimulus (a letter "d" with exactly two dashes) was not marked within the allotted time. Block-specific index B2AF, reflecting omission errors in row 2, was also analyzed. Lower scores indicate better performance. Scores are calculated according to standardized d2-R scoring procedures.
Measured: Baseline and 6 weeks
Commission errors - false responses (d2-R SUMVF)
Commission errors (false responses) were assessed using the d2-R Test of Attention (d2-R). The SUMVF score represents the total number of false responses - non-target stimuli that were incorrectly cancelled - across all 14 test rows. Lower scores indicate better performance (fewer false responses). Scores are calculated according to standardized d2-R scoring procedures.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Functional Breathing Pattern Proportion
Assessment of resting breathing pattern evaluated using the Hi-Lo Breathing Assessment (Hi-Lo). Participants are classified categorically as exhibiting a "Functional" (predominantly abdominal/diaphragmatic) or "Dysfunctional" (predominantly thoracic/apical) breathing pattern.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Carbon Dioxide Tolerance Test (CO2TT) Exhalation Duration
Exhalation duration in seconds measured using the CO₂ Tolerance Test during seated nasal breathing after a full inhalation. More prolonged exhale signals better CO₂ Tolerance.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Cognitive State Anxiety Subscale Score
Cognitive state anxiety measured using the 5-item Cognitive Anxiety subscale of the Revised Competitive State Anxiety Inventory-2 (CSAI-2R). Items are rated on a 4-point Likert scale (1 = Not at all to 4 = Very much so). Higher scores indicate greater cognitive state anxiety. Subscale score is obtained by summing, dividing by number of items, and multiplying by 10. Score range is 10 to 40 for each subscale.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Somatic State Anxiety Subscale Score
Somatic state anxiety measured using the 7-item Somatic Anxiety subscale of the CSAI-2R. Items are rated on a 4-point Likert scale (1 = Not at all to 4 = Very much so). Higher scores indicate greater physical/somatic anxiety symptoms. Subscale score is obtained by summing, dividing by number of items, and multiplying by 10. Score range is 10 to 40 for each subscale.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Self-Confidence Subscale Score
Sport self-confidence measured using the 5-item Self-Confidence subscale of the CSAI-2R. Items are rated on a 4-point Likert scale (1 = Not at all to 4 = Very much so). Higher scores indicate greater competitive self-confidence. Subscale score is obtained by summing, dividing by number of items, and multiplying by 10. Score range is 10 to 40 for each subscale.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate
Resting heart rate recorded in beats per minute (bpm) using a Polar H10 chest strap during a 3-minute supine morning recording, averaged across three consecutive days. Measured via Kubios HRV software. Lower heart rate reflects enhanced cardiovascular resting status.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability RMSSD
Parasympathetic autonomic activity measured as the Root Mean Square of Successive Differences (RMSSD) between normal heartbeats, expressed in milliseconds (ms). Recorded via a Polar H10 chest strap in a supine position over 3 minutes on three consecutive mornings and processed using Kubios HRV software. Higher RMSSD values indicate greater vagal tone and stress recovery capacity.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability SDNN
Overall heart rate variability measured as the Standard Deviation of Normal-to-Normal RR intervals (SDNN), expressed in milliseconds (ms). Recorded via a Polar H10 chest strap during a 3-minute supine morning trial and calculated using Kubios HRV software. Higher SDNN reflects greater overall autonomic flexibility.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability High-Frequency Power
Spectral parasympathetic activity measured as High-Frequency power (HF: 0.15-0.40 Hz) in absolute units (ms²). Recorded via a Polar H10 chest strap during a 3-minute supine trial and analyzed via Fast Fourier Transform in Kubios HRV software. Higher HF power indicates enhanced respiratory sinus arrhythmia and vagal modulation.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Mean RR Interval
Mean duration between consecutive cardiac inter-beat intervals (RR intervals), expressed in milliseconds (ms). Recorded via a Polar H10 chest strap during a 3-minute supine resting condition and calculated via Kubios HRV software.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Respiratory Rate
Resting breathing frequency derived from electrocardiogram (ECG)-based chest strap (Polar H10) oscillations (ECG-derived respiration) in Kubios HRV software during a 3-minute resting supine trial, expressed in breaths per minute. Lower resting respiratory rates reflect more efficient resting ventilatory patterns.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Determination Test Correct Responses
Reactive stress tolerance performance evaluated via the Vienna Test System Determination Test, Form S1 (a standard adaptive test protocol). Measured as the total count of correct motor responses executed in response to rapid color, acoustic, and spatial stimuli during the adaptive test module. Higher counts indicate superior stress tolerance and response accuracy under pressure.
Measured: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Determination Test Median Reaction Time
Processing speed under stress evaluated via the Vienna Test System Determination Test (Form S1). Measured as the median reaction time in milliseconds (ms) across all correct responses during the stimulus presentation phase. Lower reaction times indicate faster sensorimotor processing.
Measured: Baseline and 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Oct 2026
- Study start7 Nov 2025
- Primary completion22 Dec 2025
- Study completion22 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Healthy AdolescentsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 81 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riga Stradins University
- Sponsor type
- University, hospital or other
- Collaborators
- European Union
- Responsible party
- Principal investigator, Gints Peleckis, Riga Stradins University
- Investigators
- Agris Liepa, PhD, Study director, Riga Stradins University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07869446
- Sponsor's protocol ID
- 2-PĒK-4/1205/2025-Feasibility
- Other IDs
- 5.2.1.1.i.0/2/24/I/CFLA/005
- Acronym
- XR-CogBreathe
- Status last verified
- Oct 2026
- First submitted
- 30 Sep 2026
- Last updated
- 9 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Extended Reality Cognitive and Breathing Training With Eye Tracking for Attention and Stress Regulation in Adolescent Basketball Players: A Feasibility Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07869446
- Acronym / sponsor ID
- XR-CogBreathe / 2-PĒK-4/1205/2025-Feasibility
- Conditions
- Healthy Adolescents
- Keywords
- Adolescent athletes, Attention, Basketball, Breathing Biofeedback, Extended Reality, Stress Regulation, Eye Tracking
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 81 participants (actual)
- Lead sponsor
- Riga Stradins UniversityUniversity, hospital or other
- Collaborators
- European Union
- Study start
- 7 Nov 2025 (actual)
- Primary completion
- 22 Dec 2025 (actual)
- Study completion
- 22 Dec 2025 (actual)
- First posted
- 9 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study examines whether virtual reality (VR) technology can serve as a supplementary training tool for adolescent basketball players. Two types of 6-week VR training were tested alongside regular basketball practice: one targeting attention and decision-making (cognitive training), and one targeting breathing patterns (slow diaphragmatic breathing). A third group continued regular training without any VR component.
Participants were basketball players aged 14-17 who trained at least three times per week. Before and after the 6-week period, all participants completed assessments measuring resting heart rate, heart rate variability, breathing function (CO₂ tolerance, breathing pattern), reactive stress tolerance, selective and sustained attention, and pre-competition anxiety.
The primary aim was to evaluate feasibility - whether participants were willing to join and complete the sessions, whether the procedures worked as intended in a real training environment, and whether the study design is suitable for a larger future trial. The study was not designed to confirm effectiveness.
Detailed description
This feasibility randomised controlled trial (RCT) was conducted to evaluate the practicality and acceptability of integrating standalone virtual reality (VR) technology into regular basketball training for adolescent athletes. The study was designed to inform the design and sample size of a future full-scale RCT, and was not powered to confirm intervention effectiveness.
The study used a three-arm parallel-group design. Participants were randomly assigned to one of two experimental extended reality (XR) intervention groups (Cognitive XR or Breathing XR) or to a control group. Randomisation was performed at the individual level. The intervention period lasted six weeks, with two sessions per week for both experimental groups. Control participants continued their regular basketball training without any additional intervention.
All study activities were conducted at participants' existing basketball training venues in Latvia (Ventspils Basketball Arena and Jūrmala Sport School Basketball Arena). Interventions were delivered using the HTC VIVE Focus Vision standalone head-mounted display, requiring no external equipment or PC connection.
Assessments were conducted at two time points: at baseline (before the intervention period) and post-intervention (within one week of the final session). The assessment battery included resting heart rate and heart rate variability (Polar H10 chest strap with KubiosHRV), CO₂ Tolerance Test (CO₂TT), breathing pattern (Hi-Lo test), reactive stress tolerance (Vienna Test System - Determination Test), d2-R Test of Attention (Revised), and pre-competition anxiety test Competitive State Anxiety Inventory-2 Revised (the Latvian-adapted version CSAI-2R-LV).
Research staff supervised the pre-intervention assessment phase and the first two intervention sessions in person. From week two onward, participants accessed sessions independently using individual password-protected profiles on the headset. A midpoint visit was conducted at week three. A minimum adherence threshold of four completed sessions was required for inclusion in the primary analysis, with regularity criteria also applied.
The study was approved by the Riga Stradiņš University Ethics Committee (original approval: 2-PĒK-4/610/2024; additional approvals covering extended details: 2-PĒK-4/814/2025 and 2-PĒK-4/1205/2025). An Open Science Framework (OSF) project page describing the study was created prior to enrollment (osf.io/8sx3r).
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Cognitive XR Training | Experimental | Behavioral: Cognitive XRParticipants receive a 6-week XR cognitive and visuomotor training program in addition to their usual basketball training. They complete two 10-minute sessions per week, for a maximum of 12 sessions and 120 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue. |
| Breathing XR Training | Experimental | Behavioral: Breathing XRParticipants receive a 6-week XR breathing and gaze-control training program in addition to their usual basketball training. They complete two 7-minute sessions per week, for a maximum of 12 sessions and 84 minutes of total exposure. Sessions are delivered at the participant's usual basketball-training venue. |
| Usual Basketball Training Control (No intervention) | No intervention | –Participants continue their usual basketball training routine at their respective clubs. They complete baseline and post-intervention assessments on the same schedule as the intervention groups but receive no study-provided XR cognitive, visuomotor, or breathing training during the 6-week study period. |
Who may qualify
- Ages
- 14 to 17 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Adolescent basketball players aged 14-17 years
- Organized basketball training for at least 5 years
- Training at least 3 times per week
Key exclusion criteria (4 listed)
- Serious musculoskeletal injury or acute medical condition affecting sports performance in the previous month
- Severe orthopedic, neurological, cardiovascular, or other medical disorders
- Use of prescription medications affecting the central nervous system (e.g., psychotropic medication)
- Symptoms of visually induced motion sickness (VIMS): nausea, dizziness, headache, or disorientation before or during participation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cognitive XRParticipants complete two 10-minute sessions weekly for 6 weeks (maximum 12 sessions; 120 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display with binocular eye tracking. While dribbling a real basketball, participants follow a moving virtual basketball with their gaze, avoid virtual obstacles, and respond to spatial and auditory cues within predefined court boundaries. Attention time is recorded when a valid gaze signal intersects the active target under the required spatial conditions. Difficulty progresses through target speed, obstacle number and movement, target switching, movement zones, whistle-controlled tasks, jumping obstacles, and spatialized sounds. A fixed pre-programmed level sequence is individually paced according to an on-target-time criterion. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently. | Behavioural | Cognitive XR Training |
| Breathing XRParticipants complete two 7-minute sessions weekly for 6 weeks (maximum 12 sessions; 84 minutes total exposure) using an HTC VIVE Focus Vision standalone head-mounted display. Seated within an approximately 1 × 1 m area, participants perform slow diaphragmatic breathing while completing a gaze-controlled virtual basketball-tracking task. Breathing pace progresses from 7 breaths/min in minute 1, to 6.5 breaths/min in minute 2, and 6 breaths/min during minutes 3-7, using a 40:60 inhalation-to-exhalation ratio. A handheld controller placed horizontally on the upper abdomen detects abdominal movement to estimate breathing phase and adherence. Accurate breathing increases virtual-player responsiveness and speed, whereas departures from the prescribed pattern reduce performance. Research staff supervise baseline testing and the first two sessions; from week 2, participants use password-protected individual profiles independently. | Behavioural | Breathing XR Training |
Primary outcome
Recruitment rate
Time frame: During recruitment, up to 6 weeks
Proportion of eligible athletes who provide consent and are enrolled in the study. Reported as the number enrolled divided by the number eligible.
Randomization completion rate
Time frame: At baseline, before intervention initiation
Proportion of enrolled participants who are successfully allocated to one of the study arms. Reported as the number randomized divided by the number enrolled.
Retention rate
Time frame: Baseline through 6-week post-intervention assessment
Proportion of enrolled participants who complete the post-intervention assessment. Reported as the number completing follow-up divided by the number enrolled.
Intervention adherence
Time frame: During the 6-week intervention period
Attendance among participants allocated to either XR intervention arm. Reported as the number of intervention sessions completed out of 12 scheduled sessions, expressed as a percentage.
Intervention acceptability
Time frame: At 6 weeks (post-intervention)
Post-intervention acceptability assessed using a study-specific 4-item questionnaire measuring task interest, mixed-reality excitement, motivation to perform tasks, and willingness to continue. Items are rated from 1 (completely disagree) to 5 (completely agree). Total score range: 4 (minimum) to 20 (maximum). Higher scores indicate greater acceptability. Report item scores and/or mean total score.
17 secondary outcomes
Selective attention - concentration performance level (d2-R SUMKL)
Time frame: Baseline and 6 weeks
Sustained attention and processing speed - total correctly processed items (d2-R SUMBZO)
Time frame: Baseline and 6 weeks
Omission errors - failures to mark target stimuli (d2-R SUMAF)
Time frame: Baseline and 6 weeks
Commission errors - false responses (d2-R SUMVF)
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Functional Breathing Pattern Proportion
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Carbon Dioxide Tolerance Test (CO2TT) Exhalation Duration
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Cognitive State Anxiety Subscale Score
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Somatic State Anxiety Subscale Score
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in CSAI-2R Self-Confidence Subscale Score
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability RMSSD
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability SDNN
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Heart Rate Variability High-Frequency Power
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Mean RR Interval
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Resting Respiratory Rate
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Determination Test Correct Responses
Time frame: Baseline and 6 weeks
Change from Baseline to 6 Weeks in Determination Test Median Reaction Time
Time frame: Baseline and 6 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Oct 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Agris Liepa, PhD study director
Riga Stradins University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Cognitive XR and Breathing XR in people with Healthy Adolescents, run by Riga Stradins University at 2 sites in Latvia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Latvia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Recruitment rate (time frame: During recruitment, up to 6 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Oct 2026; AzTrials last refreshed its copy on 30 Oct 2026.