{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:35:41Z","timestamp":1792092941835,"version":"4.4.0"},"reference-count":58,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,18]],"date-time":"2023-06-18T00:00:00Z","timestamp":1687046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Visual input significantly affects kinesthesis skills and, hence, visually impaired individuals show less developed sensorimotor control, especially in an unfamiliar outdoor environment. Regular blind baseball practice can counteract such a deficit but, given the complex kinetic chain model required, a targeted workout proposal is needed to improve the main athletic gesture performance. On these premises, we investigated, for the first time, the running and pitching performance of a competitive Italian blind baseball team through quantitative tools and parameters such as Libra Easytech sensorized proprioceptive board, goniometric active range of motion, chronometric speed, and pitching linear length. Moreover, the perceived physical exertion was assessed by the Borg CR10 scale. Consequently, an adapted athletic training protocol was designed and tested on the field during the competitive season, with the aim to strengthen sport specific-gesture coordination and efficacy as well as to prevent injuries. Quantitative assessments showed an improvement in ankle stability index, bilateral upper limb and hip mobility, reactive agility, running braking phase control during second base approaching, and auditory target-related pitching accuracy along with a decrease in perceived physical exertion. This protocol might therefore represent an effective and easily reproducible training and evaluation approach to tailor management of visually impaired baseball players, and safely improve their athletic performance under the supervision of an adapted exercise specialist.<\/jats:p>","DOI":"10.3390\/ijerph20126166","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T02:29:19Z","timestamp":1687141759000},"page":"6166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Reactive Agility and Pitching Performance Improvement in Visually Impaired Competitive Italian Baseball Players: An Innovative Training and Evaluation Proposal"],"prefix":"10.3390","volume":"20","author":[{"given":"Giuditta","family":"Carretti","sequence":"first","affiliation":[{"name":"Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Bianco","sequence":"additional","affiliation":[{"name":"Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1487-6463","authenticated-orcid":false,"given":"Eleonora","family":"Sgambati","sequence":"additional","affiliation":[{"name":"Department of Biosciences and Territory, University of Molise, 86090 Pesche, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-8480","authenticated-orcid":false,"given":"Mirko","family":"Manetti","sequence":"additional","affiliation":[{"name":"Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-0414","authenticated-orcid":false,"given":"Mirca","family":"Marini","sequence":"additional","affiliation":[{"name":"Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e888","DOI":"10.1016\/S2214-109X(17)30293-0","article-title":"Magnitude, Temporal Trends, and Projections of the Global Prevalence of Blindness and Distance and near Vision Impairment: A Systematic Review and Meta-Analysis","volume":"5","author":"Bourne","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.47447\/tjsm.0690","article-title":"Exercise Programming for Individuals with Vision Loss","volume":"57","author":"Esatbeyoglu","year":"2022","journal-title":"Turk. J. Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.29359\/BJHPA.12.3.02","article-title":"Effect of Core Stability Training on Postural Control, Risk of Falling, and Function of the Blind: A Randomized Controlled Trial","volume":"12","author":"Ardakani","year":"2020","journal-title":"Balt. J. Health Phys. Act."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.3389\/fpsyg.2016.01960","article-title":"Auditory Spatial Perception without Vision","volume":"7","author":"Voss","year":"2016","journal-title":"Front. Psychol."},{"key":"ref_5","first-page":"1","article-title":"Balance in the Blind: A Systematic Review","volume":"11","author":"Daneshmandi","year":"2021","journal-title":"Phys. Treat.-Specif. Phys. Ther. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Carretti, G., Mirandola, D., Sgambati, E., Manetti, M., and Marini, M. (2022). Survey on Psychological Well-Being and Quality of Life in Visually Impaired Individuals: Dancesport vs. Other Sound Input-Based Sports. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19084438"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"974560","DOI":"10.1100\/2012\/974560","article-title":"Effects of Visual Deprivation on Gait Dynamic Stability","volume":"2012","author":"Iosa","year":"2012","journal-title":"Sci. World J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.gaitpost.2009.05.017","article-title":"Visual Deprivation Leads to Gait Adaptations That Are Age- and Context-Specific: II. Kinematic Parameters","volume":"30","author":"Hallemans","year":"2009","journal-title":"Gait Posture"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2577","DOI":"10.1016\/j.ridd.2014.05.030","article-title":"Determinants of Gross Motor Skill Performance in Children with Visual Impairments","volume":"35","author":"Haibach","year":"2014","journal-title":"Res. Dev. Disabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.neubiorev.2019.12.031","article-title":"Spatial Metric in Blindness: Behavioural and Cortical Processing","volume":"109","author":"Gori","year":"2020","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"699312","DOI":"10.3389\/fnhum.2021.699312","article-title":"Early Blindness Limits the Head-Trunk Coordination Development for Horizontal Reorientation","volume":"15","author":"Esposito","year":"2021","journal-title":"Front. Hum. Neurosci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6051","DOI":"10.1523\/JNEUROSCI.4544-14.2015","article-title":"Trade-off in the Sound Localization Abilities of Early Blind Individuals between the Horizontal and Vertical Planes","volume":"35","author":"Voss","year":"2015","journal-title":"J. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s00221-021-06235-0","article-title":"Partial Visual Loss Disrupts the Relationship between Judged Room Size and Sound Source Distance","volume":"240","author":"Kolarik","year":"2022","journal-title":"Exp. Brain. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5507\/euj.2011.001","article-title":"The Effect of a Physical Training Programme on Flexibility of Upper Body and Trunk in Visually Impaired and Deaf-Blind Persons","volume":"4","author":"Surakka","year":"2011","journal-title":"Eur. J. Adapt. Phys. Act."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.jbiomech.2014.11.030","article-title":"Effects of Vision and Lumbar Posture on Trunk Neuromuscular Control","volume":"48","author":"Maaswinkel","year":"2015","journal-title":"J. Biomech."},{"key":"ref_16","first-page":"93","article-title":"Investigating the Relationship Between Lower Limb Flexibility with Motor Function and Risk of Falling in Visually Impaired Individuals","volume":"11","author":"Khani","year":"2021","journal-title":"Phys. Treat.-Specif. Phys. Ther. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5002","DOI":"10.2174\/1381612826666200518110241","article-title":"Correlates of Physical Activity of Children and Adolescents with Visual Impairments: A Systematic Review","volume":"26","author":"Li","year":"2020","journal-title":"Curr. Pharm. Des."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s00221-021-06038-3","article-title":"Balance, Gait, and Navigation Performance Are Related to Physical Exercise in Blind and Visually Impaired Children and Adolescents","volume":"239","author":"Rogge","year":"2021","journal-title":"Exp. Brain Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1038\/nn.4658","article-title":"Our Sense of Direction: Progress, Controversies and Challenges","volume":"20","author":"Cullen","year":"2017","journal-title":"Nat. Neurosci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.neuropsychologia.2017.02.004","article-title":"Vestibular Contributions to High-Level Sensorimotor Functions","volume":"105","author":"Medendorp","year":"2017","journal-title":"Neuropsychologia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4341","DOI":"10.1152\/jn.01321.2006","article-title":"Vestibular Perception and Navigation in the Congenitally Blind","volume":"97","author":"Seemungal","year":"2007","journal-title":"J. Neurophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"327","DOI":"10.5334\/pb-50-3-4-327","article-title":"Developing Spatial Knowledge in the Absence of Vision: Allocentric and Egocentric Representations Generated by Blind People When Supported by Auditory Cues","volume":"50","author":"Corazzini","year":"2010","journal-title":"Psychol. Belg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.neubiorev.2012.01.008","article-title":"The Role of Visual Experience for the Neural Basis of Spatial Cognition","volume":"36","author":"Pasqualotto","year":"2012","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.18240\/ijo.2021.07.15","article-title":"Effect of Vision Loss on Plasticity of the Head and Neck Proprioception","volume":"14","author":"Jiang","year":"2021","journal-title":"Int. J. Ophthalmol."},{"key":"ref_25","first-page":"123","article-title":"Assessment of Balance Recovery Strategies during Manipulation of Somatosensory, Vision, and Vestibular System in Healthy and Blind Women","volume":"6","author":"Salari","year":"2019","journal-title":"JRSR"},{"key":"ref_26","first-page":"179","article-title":"Better Functioning of the Somatosensory System in Postural Control of Blind Athletes Compared to Non-Athletes","volume":"8","author":"Mohammadi","year":"2019","journal-title":"J. Rehab. Med."},{"key":"ref_27","first-page":"227","article-title":"Can Baseball Improve Balance in Blind Subjects?","volume":"51","author":"Marini","year":"2011","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.gaitpost.2018.03.049","article-title":"Gait and Functionality of Individuals with Visual Impairment Who Participate in Sports","volume":"62","author":"Fischer","year":"2018","journal-title":"Gait Posture"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"723","DOI":"10.23736\/S0393-3660.18.03808-1","article-title":"The Effect of a Physical Fitness Program on the Health-Related Physical Fitness Components of Blind Male Students","volume":"178","author":"Cheikh","year":"2019","journal-title":"Gazz. Med. Ital. Arch. Sci. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s11845-020-02285-5","article-title":"Sports Participation and Quality of Life in Individuals with Visual Impairment","volume":"190","author":"Ilhan","year":"2021","journal-title":"Ir. J. Med. Sci."},{"key":"ref_31","first-page":"131","article-title":"As Rela\u00e7\u00f5es Do Jogo e o Desenvolvimento Motor Na Pessoa Com Defici\u00eancia Visual","volume":"27","author":"Winckler","year":"2006","journal-title":"Rev. Bras. Cienc. Esporte Camp."},{"key":"ref_32","first-page":"43","article-title":"Present-Day Sports Activities among the Blind and Persons with Poor Vision in Different Countries of the World","volume":"119","author":"Talmachev","year":"2003","journal-title":"Vestn. Oftalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1007\/s40279-018-0949-6","article-title":"International Paralympic Committee (IPC) and International Blind Sports Federation (IBSA) Joint Position Stand on the Sport-Specific Classification of Athletes with Vision Impairment","volume":"48","author":"Mann","year":"2018","journal-title":"Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Mirandola, D., Monaci, M., Miccinesi, G., Vannuzzi, A., Sgambati, E., Manetti, M., and Marini, M. (2019). Psychological Well-Being and Quality of Life in Visually Impaired Baseball Players: An Italian National Survey. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0218124"},{"key":"ref_35","first-page":"20","article-title":"Orientation and Mobility of the Visually Impaired in a Blind Baseball Training Method","volume":"3","author":"Chen","year":"2012","journal-title":"J. Phys. Educ. Sport Manag."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"10660","DOI":"10.1038\/s41598-019-47162-z","article-title":"Kinematic Profile of Visually Impaired Football Players During Specific Sports Actions","volume":"9","author":"Finocchietti","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_37","first-page":"20556683221122276","article-title":"Blind Sports\u2019 Blind Spot: The Global Epidemiology of Visual Impairment against Participation Trends in Elite Blind Para Sport","volume":"9","author":"Stratton","year":"2022","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_38","unstructured":"(2022, March 16). WMA\u2013The World Medical Association-Declaration of Helsinki. Available online: https:\/\/www.wma.net\/what-we-do\/medical-ethics\/declaration-of-helsinki\/."},{"key":"ref_39","unstructured":"AGENCY, L.W. (2022, March 16). Il Gioco e le Regole\u2013Baseball x Ciechi\u2013AIBXC. Available online: https:\/\/www.aibxc.it\/giocoregole\/."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lopes, T.R., Pereira, H.M., and Silva, B.M. (2022). Perceived Exertion: Revisiting the History and Updating the Neurophysiology and the Practical Applications. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192114439"},{"key":"ref_41","first-page":"144","article-title":"Influence of Long-Lasting Balancing on Unstable Surface on Changes in Balance","volume":"11","author":"Jaworski","year":"2010","journal-title":"Hum. Mov."},{"key":"ref_42","unstructured":"LIBRA\u2013Dispositivo Per Rieducazione Propriocettiva (2022, February 11). Easytech. Available online: https:\/\/easytechitalia.com\/libra\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1123\/ijspp.2021-0237","article-title":"Differences in Strength, Speed, and Power Performance Between Visually Impaired Paralympic and Olympic Sprinters","volume":"17","author":"Freitas","year":"2022","journal-title":"Int. J. Sports Physiol. Perform."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.3389\/fpsyg.2017.01932","article-title":"Audio Spatial Representation Around the Body","volume":"8","author":"Campus","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_45","unstructured":"Ferro, A., Graupera, L., and Vera, P. (2016, January 18\u201322). Kinematic and Kinetic Study of Running Technique at Different High Speeds in Blind Paralympic Athletes. Proceedings of the 34 International Conference of Biomechanics in Sport (2016), Tsukuba, Japan. Available online: https:\/\/ojs.ub.uni-konstanz.de\/cpa\/article\/view\/752."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5114\/pq.2020.95771","article-title":"Change in the Biomechanical Characteristics of Running as a Result of an Individual 1-Year Program for Training an Elite Athlete with visual impairment for Paralympic Games","volume":"28","author":"Kozina","year":"2020","journal-title":"Physiother. Quart."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/08952841.2014.928140","article-title":"The Effect of Sensorimotor Training on the Postural Stability of Visually Impaired Women over 50 Years of Age","volume":"27","author":"Salamon","year":"2015","journal-title":"J. Women Aging"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.4085\/1062-6050-52.11.16","article-title":"Proprioceptive Training for the Prevention of Ankle Sprains: An Evidence-Based Review","volume":"52","author":"Rivera","year":"2017","journal-title":"J. Athl. Train."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1007\/s00221-002-1143-4","article-title":"Feedforward Adaptations Are Used to Compensate for a Potential Loss of Balance","volume":"145","author":"Pavol","year":"2002","journal-title":"Exp. Brain. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2165\/00007256-200535010-00004","article-title":"The Impact of Instability Resistance Training on Balance and Stability","volume":"35","author":"Anderson","year":"2005","journal-title":"Sports Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"316","DOI":"10.5435\/00124635-200509000-00005","article-title":"Core Stability and Its Relationship to Lower Extremity Function and Injury","volume":"13","author":"Willson","year":"2005","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1519\/JSC.0000000000002036","article-title":"Quantitative Analysis of Proximal and Distal Kinetic Chain Musculature During Dynamic Exercises","volume":"32","author":"Oliver","year":"2018","journal-title":"J. Strength Cond. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1249\/JSR.0000000000000416","article-title":"Track and Field Throwing Sports: Injuries and Prevention","volume":"16","author":"Meron","year":"2017","journal-title":"Curr. Sports Med. Rep."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"E47","DOI":"10.1055\/a-1854-1007","article-title":"Neuromechanical Integration of Pelvic-Thoracic Rotation among Youth Baseball Throwers","volume":"6","author":"Winters","year":"2022","journal-title":"Sports Med. Int. Open"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s12178-022-09744-9","article-title":"Throwing Injury Prevention Strategies with a Whole Kinetic Chain-Focused Approach","volume":"15","author":"Mayes","year":"2022","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1080\/14763141.2018.1503321","article-title":"Kinematic Sequence Patterns in the Overhead Baseball Pitch","volume":"19","author":"Scarborough","year":"2020","journal-title":"Sports Biomech."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1177\/1941738116686545","article-title":"The Relationship Between Pitching Mechanics and Injury: A Review of Current Concepts","volume":"9","author":"Chalmers","year":"2017","journal-title":"Sports Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e000704","DOI":"10.1136\/bmjsem-2019-000704","article-title":"Individual Factors Associated with Baseball Pitching Performance: Scoping Review","volume":"6","author":"Mercier","year":"2020","journal-title":"BMJ Open Sport Exerc. Med."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/12\/6166\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:55:56Z","timestamp":1760126156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/12\/6166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,18]]},"references-count":58,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["ijerph20126166"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20126166","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,18]]}}}