Professional esports players engage in prolonged training sessions and experience high physical and mental stress due to intensive competition schedules. These demands can lead to increased fatigue, decreased performance, and health problems. This randomized controlled trial aims to investigate whether adding a structured neuromuscular exercise program to routine esports training reduces fatigue and stress biomarkers and improves performance-related outcomes in professional esports players.
Esports players often perform long hours of training that require sustained physical and cognitive effort, which may result in musculoskeletal problems, mental fatigue, and elevated stress levels. Most studies in the esports field rely on subjective evaluations and include non-professional populations. Objective assessment of fatigue and stress biomarkers in professional esports athletes is still lacking. This prospective randomized controlled trial will include 24 professional esports players aged 18-35 who train at least 35 hours per week with their teams. Participants will be randomly assigned to either a neuromuscular training group or a control group. The intervention group will complete an 8-week neuromuscular exercise program three times per week in addition to their regular esports training routine. The control group will receive structured physical activity counseling based on ACSM 5A principles. Primary outcomes include serum levels of cortisol, testosterone, testosterone/cortisol ratio, C-reactive protein (CRP), creatine kinase (CK), vitamin B12, and iron measured under standardized fasting conditions. Secondary outcomes include muscle strength (myometry), sleep quality (Pittsburgh Sleep Quality Index), physical activity level (IPAQ-SF), quality of life (SF-12), visual and auditory reaction time tests, lactate measures (Lactate Scout), and mood states (POMS). Outcomes will be assessed at baseline and after the 8-week intervention period. The findings of this study are expected to provide evidence-based recommendations for integrating neuromuscular conditioning into professional esports training to enhance physical health, reduce fatigue and stress, and improve overall performance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
24
A progressive neuromuscular exercise program including dynamic warm-up, aerobic exercises, functional strengthening of lower and upper extremity muscles, core stabilization training, and reaction drills performed 3 times per week for 8 weeks. Duration and repetitions increase biweekly according to a structured progression protocol.
Structured physical activity counseling based on ACSM 5A principles (Assess, Advise, Agree, Assist, Arrange) delivered weekly for 8 weeks to promote sustainable physical activity behaviors and reduce sedentary time during esports training routines.
İstanbul University Cerrahpaşa
Istanbul, Turkey (Türkiye)
Serum cortisol level - Stress Biomarkers
Serum cortisol level will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks
Testosterone level - Stress Biomarkers
Testosterone level will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks
C-Reactive Protein Level (CRP) - Fatigue Biomarkers
Serum CRP levels will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks
Creatine Kinase (CK) Level - Fatigue Biomarkers
Creatine kinase levels will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks.
Vitamin B12 Level - Fatigue Biomarkers
Serum vitamin B12 levels will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks.
Iron Level - Fatigue Biomarkers
Serum iron levels will be analyzed under fasting conditions using standardized laboratory protocols.
Time frame: Baseline and 8 weeks.
Muscle Strength
Hand, forearm, shoulder, and back muscle strength will be assessed using a handheld myometer; mean of three trials recorded in kilograms.
Time frame: Baseline and 8 weeks
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Sleep Quality
Assessment of subjective sleep quality, sleep duration, sleep disturbances, and overall sleep efficiency with Pittsburgh Sleep Quality Index. The Pittsburgh Sleep Quality Index (PSQI) consists of 19 items that generate seven component scores, each ranging from 0 to 3, yielding a global score between 0 and 21, with higher scores indicating poorer sleep quality; a total score greater than 5 reflects clinically significant sleep disturbance.
Time frame: Baseline and 8 weeks
Physical Activity Level
Self-reported physical activity levels converted to MET-minutes per week. (IPAQ-Short Form). The International Physical Activity Questionnaire-Short Form (IPAQ-SF) provides total physical activity expressed in Metabolic Equivalent of Task (MET)-minutes/week, and scores are categorized as follows: \<600 MET-minutes/week indicates low activity, 600-3000 MET-minutes/week indicates moderate activity, and \>3000 MET-minutes/week indicates high physical activity level.
Time frame: Baseline and 8 weeks
Reaction Time
Average visual reaction time over 5 trials recorded in milliseconds. Average response latency to an auditory stimulus over 5 trials.
Time frame: Baseline and 8 weeks
Blood Lactate Concentration
Capillary blood lactate measured to assess metabolic response to neuromuscular training.
Time frame: Baseline and 8 weeks
Mood State
Assessment of tension, depression, anger, fatigue, and vigor subscales with Profile of Mood States (POMS). The Profile of Mood States (POMS) assesses mood across multiple dimensions and yields a Total Mood Disturbance (TMD) score by summing negative mood subscales and subtracting the vigor score; higher TMD scores indicate greater mood disturbance, whereas lower scores reflect better overall mood.
Time frame: Baseline and 8 weeks