KMAN Publication Inc. International Journal of Sport Studies for Health 2588-5782 In Press 2026 07 10 Combined Cognitive-Motor Training Improves Agility, Decision-Making, and Match Performance in Competitive Tennis Players: A Randomized Controlled Trial Combined Cognitive-Motor Training Improves Agility, Decision-Making, and Match Performance in Competitive Tennis Players: A Randomized Controlled Trial EN Journal Article Objectives: Modern tennis performance requires the integration of perceptual-cognitive and movement-related abilities because of the dynamic and unpredictable nature of competitive match play. Although combined cognitive-motor training (CCMT) has received increasing attention in open-skill sports, evidence regarding its effectiveness in competitive tennis remains limited. This study aimed to investigate the effects of CCMT on reactive agility, tennis-specific decision-making, and match performance in competitive tennis players. Methods: This assessor-blinded randomized controlled trial used a parallel-group pretest–posttest design. Forty competitive tennis players aged 16–22 years were randomly assigned to an experimental group (n = 20) or a control group (n = 20). After two non-intervention-related withdrawals in the control group, the final per-protocol analysis included 38 participants. The experimental group completed an eight-week CCMT program integrated into their regular training schedule, whereas the control group continued regular tennis training only. Reactive agility, tennis-specific decision-making, and match performance were assessed before and after the intervention. Data were analyzed using a linear mixed model, with statistical significance set at p < 0.05. Results: The experimental group showed a significantly greater reduction in reactive agility completion time than the control group (F = 18.72, p < 0.001). Significant group × time interaction effects were also found for decision-making accuracy (F = 16.94, p < 0.001) and decision-making response time (F = 14.27, p < 0.001), indicating greater increases in decision-making accuracy and greater reductions in response time in the experimental group. In addition, the experimental group demonstrated greater improvements in match-performance outcomes, including increased winners (F = 11.83, p = 0.002), reduced unforced errors (F = 13.26, p = 0.001), increased rally success percentage (F = 15.11, p < 0.001), increased point-winning efficiency (F = 13.02, p = 0.001), and improved tactical efficiency index (F = 12.48, p = 0.001). No serious adverse events or intervention-related injuries were reported during the intervention period. Conclusion: Combined cognitive-motor training was more effective than regular tennis training alone in improving reactive agility, tennis-specific decision-making, and competitive match performance in competitive tennis players. These findings suggest that integrating cognitive challenges into representative sport-specific movement tasks may be an effective strategy for enhancing perceptual-cognitive and movement-related performance capacities in competitive tennis. Future studies should examine the long-term retention of these effects and clarify the mechanisms underlying cognitive-motor adaptation in sport-specific training environments.