Author(s): PELECKIS, G., SEMJONOVA, G., PLEINICA, S., SURINA, S., TANG, J., DUTE, A., PROMBERGA, E., LIEPA, A., Institution: RIGA STRADINS UNIVERSITY, Country: LATVIA, Abstract-ID: 1612

Introduction
Adolescent athletes demonstrate an elevated sport dropout rate (1), which may be partly associated with increased psychological stress during periods of rapid neurobiological development and growth (2). Effective stress regulation and cognitive control are therefore essential during this developmental stage. Although research on breathing-based interventions in adolescent sport settings remains limited, existing evidence suggests that structured breathing techniques may improve stress regulation and cognitive performance in youth (3). However, traditional breathing exercises without engaging stimuli may limit adherence among adolescents. The aim of this study is to develop and test a Mixed Reality game with an integrated breathing technique, cognitive task, and an eye-tracking system for adolescent basketball players for independent use.

Methods
Adolescent basketball players who have been playing for at least five years twice a week were included in this pilot study. A seven minute Mixed Reality game with an integrated slow-paced breathing (nasal diaphragmatic breathing with a frequency of six breaths per minute (6bpm) and the inhalation:exhalation ratio of 4:6) and eye-tracking was developed and introduced to a group of 14 adolescent basketball players. The 3 week intervention took place in the Autumn of 2025, with the players using the VR headset twice a week before the training. Heart rate variability (HRV), Vienna test system Determination Test (DT), Co2 tolerance test (Co2TT), Hi-Lo breathing pattern test, and the Revised version of the Competitive State Anxiety Inventory-2 (CSAI-2R) were used before and after the intervention to determine any change in the stress, breathing pattern, or reaction time parameters.

Results
The final number of participants that concluded the pre- and post intervention was 13 (12 to 18 years old) with the average attendance of 4/6. The Co2TT (p=0.011, mean difference=-3.77s, Cohen's d=-0.83), DT median reaction time (p<.001, mean difference=-0.068s, Cohen's d=-2.34), and DT Reactive Stress Tolerance (p=0.001, mean difference=+29.0, 95% CI [0.44, 1.86], Cohen's d=1.16) showed statistically significant improvement after the intervention. HRV, CSAI-2R, and Hi-Lo tests didn’t show statistically significant results, indicating that either the group was too small, the intervention too short, or the intervention simply lacks in the expected impact.

Conclusions
Although the stress management and cognitive skills statistically improved after the intervention, a full randomized controlled trial with a control group is necessary to determine the exact effect of the intervention.

References
1. Emmonds et. al., 2024 (doi: 10.1080/02701367.2022.2148623)
2. Romeo et. al., 2013 (doi: 10.1177/0963721413475445)
3. Dziembowska et. al., 2016 (doi: 10.1007/s10484-015-9319-4)