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Jasim A M, Aziz G. Efficacy of Swiss Ball Exercises on Motor Control and Defensive Blocking Handball Players With Hamstring Strain Injury. Iranian Rehabilitation Journal 2025; 23 (4) :431-440
URL: http://irj.uswr.ac.ir/article-1-2547-en.html

Objectives: This study aimed to investigate the efficacy of a Swiss ball rehabilitation program on motor control and defensive blocking performance in handball players with grade I hamstring strain injuries.
Methods: This was a pre-post single-group interventional study. A total of 32 professional and semi-professional handball players from Baghdad Premier League clubs were enrolled, with 21 completing the entire 8-week intervention. The rehabilitation program consisted of six Swiss ball exercises performed four times weekly to enhance hamstring strength, hip joint flexibility, and defensive blocking performance. Statistical analyses were performed using paired t-tests and Cohen’s d effect sizes.
Results: Significant improvements were observed in all outcome measures: Perceived hamstring strength in relaxed (+1.1 units, P=0.013) and tensed (+2.3 units, P=0.001) states, hip joint range of motion (ROM) (+9.3°, P=0.004), and defensive wall block performance (+3.5 blocks/15s, P<0.001). The effect sizes ranged from medium to large; the largest was for defensive blocking (d=2.02). 
Discussion: These findings demonstrate that Swiss ball training effectively enhances neuromuscular control, functional mobility, and sports performance in handball players with hamstring injuries. The limitations of this study are its short-term follow-up and single-group design. Future randomized controlled trials are recommended to compare Swiss ball rehabilitation versus normal treatments and to study long-term consequences.