Background: Hamstring injuries are among the most prevalent musculoskeletal injuries in athletes, particularly in sports involving high-speed running. The Nordic Hamstring Exercise (NHE) is an evidence-based intervention shown to reduce injury risk; however, its widespread adoption is limited by poor adherence, often due to discomfort, monotony, and perceived exertion. Purpose: To investigate whether integrating Virtual Reality (VR) into NHE protocols can enhance athlete motivation, adherence, neuromuscular control, and reduce hamstring reinjury rates. Methods: A randomized controlled trial (RCT) will be conducted with 40–60 male athletes (ages 20–40) with no prior hamstring or lower limb injuries. Participants will be randomly assigned to a standard NHE control group or a VR-enhanced NHE intervention group featuring audiovisual and gamified feedback. The intervention will span 8–12 weeks, with follow-ups at 6 and 12 months. Primary outcomes include isokinetic eccentric hamstring strength, electromyographic (EMG) activity, adherence rates, motivation scores (via validated questionnaires), and reinjury incidence. Data will be analyzed using ANOVA for group comparisons and regression modeling for predictive relationships; qualitative feedback will undergo thematic analysis. Expected Results: It is hypothesized that the VR-NHE group will demonstrate significantly greater eccentric strength gains, enhanced neuromuscular control, higher adherence and motivation scores, and a lower reinjury rate compared to the control group. Conclusion: This study proposes a novel VR-integrated NHE protocol to address adherence and engagement challenges in injury prevention. If successful, this approach could offer a more effective and sustainable strategy for hamstring injury prevention and rehabilitation in athletic populations

Dr. Zaina Tariq is a dedicated healthcare professional currently serving in the Physical Therapy Department at Nagoya University Hospital (NUH), Japan. Based in Nagoya, Aichi, she has built her career around advancing patient care and rehabilitation through evidence-based physical therapy practices. Dr. Tariq’s work focuses on improving functional recovery, promoting mobility, and enhancing the overall quality of life for her patients. With a passion for clinical excellence and research-driven approaches, she contributes to innovative therapeutic interventions and collaborative healthcare delivery. Her professional journey reflects a strong commitment to patient-centered care, interdisciplinary collaboration, and continuous learning. Through her expertise and dedication, Dr. Zaina Tariq plays an integral role in the advancement of physical therapy services within the Japanese healthcare system and beyond