Effects of Combined Myofascial Release and Structured Eye Exercises on Shooting Accuracy and Neck Pain in Pistol Shooters: A Randomised Pilot Study

<title>Abstract</title> <p>Purpose To evaluate the feasibility of a combined myofascial release (MFR) and structured eye exercise protocol in competitive pistol shooters, and to generate preliminary estimates of treatment effect to inform the design of a future definitive randomised controlled trial. Methods This randomised pilot study enrolled 30 pistol shooters aged 15 to 30 years, equally allocated to an experimental group (n = 15; MFR plus twice-daily eye exercises) or a control group (n = 15; conventional neck isometrics, trapezius stretching, and cervical range-of-motion exercises) for one week. Primary outcomes were feasibility metrics: recruitment rate, retention, protocol adherence, and intervention safety. Secondary exploratory outcomes were bullseye shooting accuracy, Numerical Pain Rating Scale (NPRS), fluorescein tear break-up time (TBUT), visual acuity, and near-point accommodation. Clinical outcomes are reported with 95% confidence intervals; hypothesis testing is not performed as the study is too small for confirmatory conclusions. Results All four pre-specified feasibility criteria were met: recruitment rate 66.7% (≥ 60%), retention 100% (≥ 90%), supervised session adherence 100% (≥ 80%), and no serious adverse events. Exploratory clinical findings showed within-group improvements in the experimental group for bullseye score (mean change + 7.60 points; 95% CI 3.85 to 11.35), NPRS (mean change − 6.00; 95% CI − 6.63 to − 5.37), TBUT right eye (+ 3.60 s; 95% CI − 2.32 to 9.52), and TBUT left eye (+ 6.20 s; 95% CI − 2.40 to 14.80). The between-group difference favoured the experimental group for bullseye score (mean difference + 5.67; 95% CI 1.95 to 9.38) and NPRS (mean difference − 5.60; 95% CI − 6.62 to − 4.58). TBUT between-group differences were inconclusive. Visual acuity and accommodation were unchanged. These findings are exploratory and should not be interpreted as confirmatory evidence of efficacy. Trial registration: CTRI/2026/06/113052. Conclusion This pilot study demonstrated that a combined MFR and eye exercise protocol is feasible and acceptable in competitive pistol shooters. Exploratory clinical findings suggest potential benefits in shooting accuracy and neck pain compared with conventional exercises. These preliminary findings support the design of a larger, adequately powered, prospectively registered randomised controlled trial. Trial Registration The fullscale RCT informed by this pilot is prospectively registered with the Clinical Trials RegistryIndia (CTRI/2026/06/113052).</p>