Effects of a 12-Week Pickleball Training Program on Cognitive and Motor Skills in Adolescents With Mild Intellectual Disability

This study will be conducted using a quasi-experimental pre-test-post-test control group design to examine the effects of a 12-week pickleball training program on physical and cognitive outcomes in individuals with mild intellectual disability. Participants will be recruited from a special education vocational school and will be aged between 14 and 18 years.

Participants will be assigned to either an experimental group or a control group. The experimental group will participate in a structured pickleball training program for 12 weeks, delivered three times per week. Each session will include two on-court practice sessions and one skill-based training session focusing on fundamental movement and sport-specific skills. Each training session will consist of a 5-minute warm-up, a 40-minute main activity phase, and a 5-minute cool-down period. The control group will continue their regular school-based physical education and daily academic routines without additional intervention.

Outcome assessments will be conducted at four time points: baseline (pre-test), mid-intervention (week 6-7), post-intervention (week 12), and follow-up (4-6 weeks after completion of the intervention). All assessments will be administered by the same research team using standardized protocols to ensure consistency.

Cognitive functions will be evaluated using computer-based tests from the Psychology Experiment Building Language (PEBL) battery. Sustained attention will be assessed using the Mackworth Clock Test, visuospatial working memory using the Corsi Block Test, selective attention and change detection ability using the Change Detection Test, and processing speed and short-term memory using the Digit Span Test.

Motor performance will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) short form. This standardized assessment evaluates fine motor precision, bilateral coordination, balance, agility, and strength-related motor skills.

In addition, handgrip strength will be measured using a handheld dynamometer, and lower extremity muscular endurance will be assessed using the 30-second sit-to-stand test. Balance performance will also be evaluated through the BOT-2 balance subtests.

All intervention sessions will be adapted to the functional abilities of participants to ensure safety and accessibility. Activities will be delivered by a qualified instructor supported by an assistant instructor, with individualized guidance provided as needed.

Data will be analyzed using appropriate statistical methods based on distribution assumptions. A mixed-design repeated measures ANOVA will be used to examine group-by-time interactions. The level of significance will be set at p < .05.

• Pickleball Training Intervention Group (Behavioral): A structured 12-week pickleball training intervention will be implemented for adolescents with mild intellectual disability. The program will be delivered three times per week under the supervision of a qualified physical education specialist and an assistant instructor. Each session will last approximately 45 minutes and will follow a standardized structure consisting of a 5-minute warm-up, 40 minutes of skill-based pickleball training, and a 5-minute cool-down period. The training content will include progressive instruction and practice of fundamental and advanced pickleball skills, including serving, forehand and backhand strokes, volley, dink, lob, smash, drop shot, and basic tactical gameplay. Sessions will be conducted in either an indoor gymnasium or outdoor court depending on weather conditions. The intervention is designed to improve motor proficiency, balance, muscular strength, and cognitive performance in participants with mild intellectual disability.
• Standard Special Education Curriculum (Other): Participants in the control group will continue their standard special education curriculum without participation in any structured physical activity or pickleball-based training throughout the study period.

Primary outcomes

• Sustained Attention [Baseline (Week 0, pre-intervention), Mid-intervention (Week 6-7), Post-intervention (Week 12), Follow-up (4-6 weeks after intervention completion)]: Sustained attention will be assessed using the Mackworth Clock Test. Higher scores indicate better sustained attention performance.
• Visuospatial Working Memory [Baseline (Week 0, pre-intervention), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Visuospatial working memory will be assessed using the Block Test. Higher scores indicate better visuospatial working memory performance.
• Selective Attention [Baseline (Week 0, pre-intervention), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Selective attention will be assessed using the Change Detection Test. Higher scores indicate better selective attention performance.
• Working Memory [Baseline (Week 0, pre-intervention), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Working memory will be assessed using the Digit Span Test. Higher scores indicate better working memory performance.
• Motor Proficiency [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Motor proficiency will be assessed using the BOT-2 Short Form. Higher scores indicate better motor proficiency.
• Balance [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Balance performance will be assessed using the balance subtests of the BOT-2. Higher scores indicate better balance performance.
• Hand Grip Strength [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Hand grip strength will be measured using a hand dynamometer. Higher scores indicate greater grip strength.
• Lower Limb Strength [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Lower limb strength will be assessed using the 30-second sit-to-stand test. Higher repetition scores indicate greater lower limb strength.

Secondary outcomes

• Height [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Height will be measured in centimeters to assess anthropometric characteristics.
• Body Weight [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Body weight will be measured in kilograms to assess anthropometric characteristics.
• Body Mass Index (BMI) [Baseline (Week 0), Mid-intervention (Weeks 6-7), Post-intervention (Week 12), and Follow-up (4-6 weeks after intervention completion)]: Body mass index (BMI) will be calculated using height and body weight measurements and reported in kg/m² to assess anthropometric characteristics.

Sex: All, ages: 14 Years to 18 Years

Inclusion Criteria:

* Having a diagnosis of mild intellectual disability
* Being enrolled in a special education vocational high school
* Being between 14 and 18 years of age
* Having the ability to follow simple verbal instructions
* Having no additional severe or secondary disability
* Having no musculoskeletal condition preventing racket use
* Providing voluntary assent and parental consent

Exclusion Criteria:

* Refusal to participate in the study at any stage
* Irregular school attendance during the intervention period
* Failure to attend pickleball training sessions consistently
* Presence of a chronic medical condition limiting participation
* Participation in racket sports within the last 3 months
* Withdrawal of parental consent during the study

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• Elif Top, Prof.Dr., Principal investigator, Burdur Mehmet Akif Ersoy University, Faculty of Sport Sciences