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The Mediating Role of Mental Fatigue Awareness in the Relationship Between Perceived Stress and Psychological Well-Being Among Combat Athletes

Last registered on November 17, 2025

Pre-Trial

Trial Information

General Information

Title
Effects of Wrestling Training on Psychological Well-Being, Anxiety, and Resilience in Adolescent Boys
RCT ID
AEARCTR-0017218
Initial registration date
November 11, 2025

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
November 17, 2025, 7:13 AM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
ev

Other Primary Investigator(s)

Additional Trial Information

Status
Completed
Start date
2025-09-05
End date
2025-10-26
Secondary IDs
the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025)
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Introduction
Adolescence is a pivotal stage of human development characterized by rapid physical growth and marked psychosocial transitions. During this period, individuals often experience heightened sensitivity to anxiety, stress, and emotional insta-bility [1,2]. Regular physical activity has been consistently shown to mitigate these risks by enhancing mood, promoting resilience, and improving self-regulation [3–5]. Furthermore, engagement in exercise supports self-esteem, facilitates stress management, and encourages social interaction, which together contribute to long-term mental well-being [6,7].
Wrestling is a demanding sport that combines endurance, agility, and self-control. It has been suggested that introducing the sport at an early age promotes not only physical conditioning but also psychological discipline [8]. Beyond its physical intensity, wrestling emphasizes mental focus and emotional balance, as success often depends on psychological control over one’s opponent [9]. This unique combination of physical and cognitive challenge positions wrestling as a potential tool for improving self-discipline, confidence, and stress tolerance. Research on combat sports generally supports these benefits, indicating lower levels of cognitive and somatic anxiety and higher self-esteem among participants [10,11]. Likewise, in-creases in sport experience are often linked to improved self-regulation and overall psychological resilience [12].
Evidence from longitudinal and systematic studies shows that sustained physical activity during adolescence is asso-ciated with reduced symptoms of anxiety and depression and with greater psychological well-being [7,13]. Psychosocial factors such as self-esteem, resilience, and social support appear to mediate these positive effects, reinforcing the notion that physical activity can serve as an effective mental-health intervention. Within this context, combat sports may foster not only physical development but also emotional control, self-efficacy, and adaptive adjustment [11].
Despite these promising associations, the psychological effects of wrestling training have received limited empirical attention, as most existing research focuses on physiological or performance outcomes. Given that adolescence is a period of increased psychological vulnerability, examining potential protective influences is particularly valuable. Therefore, this study aimed to investigate how structured wrestling training influences psychological well-being, anxiety, and resilience in adolescent boys. We hypothesized that participants engaged in regular wrestling training would exhibit higher well-being, lower anxiety, and greater psychological resilience compared with those in a control group.
Materials and Methods
Study design and Participants
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Experimental design
This study employed a randomized pretest–posttest control group design. Both groups underwent baseline assessments before the intervention and post-tests after six weeks. The Wrestling Group participated in a structured wrestling training program, while the Control Group maintained their usual daily routines without additional exercise. Participants visited the laboratory on three separate occasions. During the first visit, they were informed about the training protocol and completed familiarization procedures. The second visit (one week later) included baseline testing. The third visit occurred after the six-week intervention, during which all post-training assessments were conducted. All measurements were carried out under identical environmental conditions (temperature 22–24°C, relative humidity 45–55%) and supervised by the same research team to ensure consistency. The experimental flow is presented in Figure 1.


















Figure 1. Experimental design
The inclusion criteria were as follows: a) Candidates must have at least two years of active football training, b) be between the ages of 10 and 13, c) be in good general health, d) have no known respiratory or cardiovascular conditions, e) provide written informed parental consent. The following criteria were used to determine exclusion from the study: The subject's medical history includes the following: a) A history of lung disease or a current upper respiratory tract infection, b) A history of current injury, c) Medication use that may affect breathing or performance, d)Individuals with FEV1/FVC<70 e) Participation in similar studies within the last six months
Body composition measurement
In the study, body composition (e.g., body fat percentage, muscle mass) was assessed using a Jawon Medical GAIA 359 Plus bioelectrical impedance analyzer (Jawon Medical Co., South Korea), with data managed through the BodyPass software (GAIA 359 Plus version). This device was used to confirm that all participants had comparable baseline body characteristics. Body weight was recorded using the same analyzer, while height (cm) was measured with a portable stadiometer (Seca 213, Seca GmbH & Co. KG, Hamburg, Germany).
Sport Anxiety Scale-2 (SAS-2)
The Sport Anxiety Scale-2 (SAS-2) is a revised instrument originally developed to assess competitive anxiety in athletes. The updated version includes 15 items rated on a four-point Likert scale and provides a multidimensional view of anxiety symptoms related to sport performance [15,16]. The Turkish adaptation and validation study conducted by Akman et al. [15] confirmed its reliability and construct validity for adolescent athletes. The scale measures three distinct aspects of compet-itive anxiety: worry, which refers to outcome-related and self-focused concerns; somatic anxiety, which reflects physio-logical tension and physical manifestations of stress; and concentration disruption, which describes difficulties in main-taining attentional focus during performance. Higher scores on each subdimension indicate more severe anxiety symptoms in that domain, and all items in this study were evaluated using a four-point response format ranging from “not at all” to “very much.”
The WHO-5 Well-Being Index
The WHO-5 Well-Being Index is a brief and effective screening tool for assessing psychological well-being. The applicability study of the Turkish version of the WHO-5 was conducted by Eser et al. [17]. Participants are asked to indicate the extent to which each of the five statements has been true for them over the past 14 days. Items are scored on a scale from 0 (at no time) to 5 (all of the time), resulting in a total raw score ranging from 0 (absence of well-being) to 25 (maximal well-being). A standardized 100-point score can also be calculated by multiplying the raw score by four. The WHO-5 can also be used to monitor individual changes over time, with a score change of 10% or more (increase or decrease) considered clinically significant [18].
The Brief Psychological Resilience Scale (BPRS)
The Brief Psychological Resilience Scale (BPRS) was originally developed by Smith et al. [19] to assess an individual’s ability to recover from stress and maintain emotional balance, and it was later adapted for Turkish samples by Doğan [20]. The instrument consists of six items scored on a five-point Likert scale ranging from “strongly disagree” to “strongly agree,” with three of the items (2, 4, and 6) reverse-coded. After adjustment of these items, total scores may range from 6 to 30, where higher values represent greater psychological resilience. The BPRS offers a practical and time-efficient assessment method with demonstrated reliability and cultural applicability in Turkish populations [20]. In the current study, the internal con-sistency of the BPRS was found to be acceptable, with a Cronbach’s alpha coefficient of 0.79 (Table 2).
Weekly training program
The intervention consisted of a six-week wrestling training program conducted three times per week (Tuesday, Thursday, and Saturday) for 60 minutes per session. Each session incorporated fundamental wrestling components, including basic stances and balance, mobility and entry techniques, contact and defensive fundamentals, strength and agility drills, technical inte-gration, and combined practice sessions (Table 1). Previous literature indicates that a training frequency of at least three sessions per week over a period of six to twelve weeks is critical for achieving meaningful physical and neuromuscular adaptations [21,22]. Therefore, a six-week training period was considered appropriate for the present study. The training protocol was meticul
External Link(s)

Registration Citation

Citation
yılmaz, coşkun. 2025. "Effects of Wrestling Training on Psychological Well-Being, Anxiety, and Resilience in Adolescent Boys." AEA RCT Registry. November 17. https://doi.org/10.1257/rct.17218-1.0
Experimental Details

Interventions

Intervention(s)
This study employed a randomized pretest–posttest control group design. Both groups underwent baseline assessments before the intervention and post-tests after six weeks. The Wrestling Group participated in a structured wrestling training program, while the Control Group maintained their usual daily routines without additional exercise. Participants visited the laboratory on three separate occasions. During the first visit, they were informed about the training protocol and completed familiarization procedures. The second visit (one week later) included baseline testing. The third visit occurred after the six-week intervention, during which all post-training assessments were conducted. All measurements were carried out under identical environmental conditions (temperature 22–24°C, relative humidity 45–55%) and supervised by the same research team to ensure consistency.
Weekly training program
The intervention consisted of a six-week wrestling training program conducted three times per week (Tuesday, Thursday, and Saturday) for 60 minutes per session. Each session incorporated fundamental wrestling components, including basic stances and balance, mobility and entry techniques, contact and defensive fundamentals, strength and agility drills, technical inte-gration, and combined practice sessions (Table 1). Previous literature indicates that a training frequency of at least three sessions per week over a period of six to twelve weeks is critical for achieving meaningful physical and neuromuscular adaptations [21,22]. Therefore, a six-week training period was considered appropriate for the present study. The training protocol was meticulously structured into three progressive phases under the guidance of three certified wrestling experts. Each session began with a 15-minute warm-up phase, which included a five-minute low-intensity run followed by a 10-minute agility and coordination circuit consisting of side steps, crossover steps, two-foot jumps, single-leg hops, squat jumps, high knees, lunges, cut kicks, and backward steps (one- and two-step). This was followed by a five-minute dynamic stretching routine targeting major muscle groups to enhance flexibility and prevent muscle stiffness. The remaining 40 minutes were dedicated to the main training phase, which focused on wrestling-specific drills integrating basic stances, mobility, contact and defensive techniques, as well as strength and agility exercises combined with technical applications to improve overall performance. All sessions were supervised to ensure the proper execution of exercises and progression throughout the training period [23]. There has been no risk of trauma/injury throughout all wrestling training sessions. All participants in the wrestling training group demonstrated full adherence to the intervention protocol. Each of the 20 par-ticipants attended all 18 scheduled training sessions (3 sessions per week for 6 weeks), resulting in an adherence rate of 100%. No participant dropped out or missed any session. Similarly, the control group completed all pre- and post-test as-sessments with no attrition.
Table 1. Descriptive characteristics of the participants
1 Week Basic stances and balance (Wrestling stance (low, medium, high); Movement techniques (forward, backward, lateral); Balance exercises; Mobilization and flexibility drills
2 Week Mobility and basic entries (Opportunity-seeking drills; Single-leg takedown (penetration step); Double-leg takedown; Medicine ball exercises for power development; Basic falling and standing-up techniques)
3 Week Contact and defensive fundamentals (Hand contact drills (grappling games); Defensive stance and counter techniques; Balance disruption exercises (push-pull drills); Short-distance sprints and resistance band applications
4 Week Strength, agility, and technical integration (Resistance-based entries (with bands or a sparring partner); Technical repetitions (single- and double-leg takedowns); Agility ladder and cone drills; Core strengthening exercises (e.g., planks, leg raises); Partner-based technical applications
5 Week Combined trainings (Each set of combined movements was repeated 3 times for 4 minutes. A 1-minute rest was given between each set).
6 Week Combined trainings (Each set of combined movements was repeated 3 times for 4 minutes. A 1-minute rest was given between each set).
Intervention (Hidden)
Intervention Start Date
2025-09-07
Intervention End Date
2025-10-19

Primary Outcomes

Primary Outcomes (end points)
Psychological Resilience
Primary Outcomes (explanation)
The sample size calculation was based on this variable:
“Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable.” Therefore, the main objective of the study was to examine the effect of wrestling training on psychological resilience in adolescent boys.

Secondary Outcomes

Secondary Outcomes (end points)
Psychological Well-Being and Sport Anxiety
Secondary Outcomes (explanation)
Assessed using the WHO-5 Well-Being Index. Assessed using the Sport Anxiety Scale-2 (SAS-2).

Experimental Design

Experimental Design
This study employed a randomized pretest–posttest control group design. Both groups underwent baseline assessments before the intervention and post-tests after six weeks. The Wrestling Group participated in a structured wrestling training program, while the Control Group maintained their usual daily routines without additional exercise. Participants visited the laboratory on three separate occasions. During the first visit, they were informed about the training protocol and completed familiarization procedures. The second visit (one week later) included baseline testing. The third visit occurred after the six-week intervention, during which all post-training assessments were conducted. All measurements were carried out under identical environmental conditions (temperature 22–24°C, relative humidity 45–55%) and supervised by the same research team to ensure consistency
Experimental Design Details
Randomization Method
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Randomization Unit
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Sample size: planned number of observations
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Sample size (or number of clusters) by treatment arms
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Thirty healthy male adolescents voluntarily participated in this randomized controlled study. Participants were ran-domly assigned to a Wrestling Group (WG; n = 15) or a Control Group (CG; n = 15) using an online randomization tool (www.randomizer.org). The required sample size was determined using the G*Power program (version 3.1.9.2; Düsseldorf, Germany). Power analysis indicated that a minimum of 12 participants per group would be sufficient to detect significant effects (effect size = 0.80; actual power = 0.89), taking psychological resilience as the primary outcome variable [14]. To account for possible dropouts, the sample size was increased by 25%, resulting in 15 participants per group (n = 30). Inclu-sion criteria required that participants (a) were between 12–15 years of age, (b) had no previous experience in wrestling or organized combat sports, and (c) had not engaged in regular physical training (> 60 minutes per week) during the previous six months. Exclusion criteria included any musculoskeletal injury, chronic illness, or psychological disorder that could inter-fere with participation. All participants and their parents were fully informed about the study’s purpose and procedures, and written informed consent was obtained from the parents or legal guardians. The study protocol was approved by the Ethics Committee of Gümüşhane University (Approval No: 2025/6, June 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
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Is the intervention completed?
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Data Collection Complete
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