Neuromuscular Training in Professional Esports Players
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Neuromuscular Training, Physical Activity Counseling.
- Who it may be relevant to
- Registry conditions: Esports, Esports Players. Basic parameters: 18 years — 35 years · Male.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effectiveness of Neuromuscular Training Added to Routine Practice on Fatigue and Stress Biomarkers in Professional Esports Players: A Randomized Controlled Trial
Overview
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.
Detailed description
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.
Interventions
- Behavioral Neuromuscular Training
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. - Behavioral Physical Activity Counseling
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.
Primary outcome measures
- Serum cortisol level - Stress Biomarkers [Time frame: Baseline and 8 weeks]
- Testosterone level - Stress Biomarkers [Time frame: Baseline and 8 weeks]
- C-Reactive Protein Level (CRP) - Fatigue Biomarkers [Time frame: Baseline and 8 weeks]
- Creatine Kinase (CK) Level - Fatigue Biomarkers [Time frame: Baseline and 8 weeks.]
- Vitamin B12 Level - Fatigue Biomarkers [Time frame: Baseline and 8 weeks.]
- Iron Level - Fatigue Biomarkers [Time frame: Baseline and 8 weeks.]
Secondary outcome measures (6)
- Muscle Strength [Time frame: Baseline and 8 weeks]
- Sleep Quality [Time frame: Baseline and 8 weeks]
- Physical Activity Level [Time frame: Baseline and 8 weeks]
- Reaction Time [Time frame: Baseline and 8 weeks]
- Blood Lactate Concentration [Time frame: Baseline and 8 weeks]
- Mood State [Time frame: Baseline and 8 weeks]
Eligibility criteria
Inclusion criteria
- Age between 18-35 years
- Currently competing as a contracted professional esports player
- Playing one of the following games at a professional level:
League of Legends, Counter Strike 2, Overwatch, Valorant, Apex Legends, DOTA2, Rocket League, PUBG
- Participating in ≥35 hours/week of training with their team
- Voluntary agreement to participate and sign informed consent
Exclusion criteria
- History or presence of medical conditions affecting safety or performance: metabolic, cardiovascular, renal, neurological, or respiratory disorders
- Playing esports only at amateur or beginner level
- Answering "Yes" to any item in the Physical Activity Readiness Questionnaire (PAR-Q)
Removal Criteria:
- Participating in <35 hours/week esports training during the study
- Missing ≥2 neuromuscular training sessions (intervention group)
- Leaving their professional esports organization (roster removal, retirement, etc.)
- Any illness or injury preventing continuation of esports participation
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
Turkey (Türkiye) · 1 center
- İstanbul University Cerrahpaşa — Istanbul
Publications
- Ambrozy T, Rydzik L, Obminski Z, Blach W, Serafin N, Blach B, Jaszczur-Nowicki J, Ozimek M. The Effect of High-Intensity Interval Training Periods on Morning Serum Testosterone and Cortisol Levels and Physical Fitness in Men Aged 35-40 Years. J Clin Med. 2021 May 15;10(10):2143. doi: 10.3390/jcm10102143. PMID 34063524
- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, Tokgozoglu L. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 Aug;111(1):278-84. doi: 10.2466/06.08.PMS.111.4.278-284. PMID 21058606
- Andre TL, Walsh SM, ValladAo S, Cox D. Physiological and Perceptual Response to a Live Collegiate Esports Tournament. Int J Exerc Sci. 2020 Sep 1;13(6):1418-1429. doi: 10.70252/KNEB6696. eCollection 2020. PMID 33042382
- Nagorsky E, Wiemeyer J. The structure of performance and training in esports. PLoS One. 2020 Aug 25;15(8):e0237584. doi: 10.1371/journal.pone.0237584. eCollection 2020. PMID 32841263
- Bonnar D, Castine B, Kakoschke N, Sharp G. Sleep and performance in Eathletes: for the win! Sleep Health. 2019 Dec;5(6):647-650. doi: 10.1016/j.sleh.2019.06.007. Epub 2019 Jul 15. PMID 31320292
- Emara AK, Ng MK, Cruickshank JA, Kampert MW, Piuzzi NS, Schaffer JL, King D. Gamer's Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports. Curr Sports Med Rep. 2020 Dec;19(12):537-545. doi: 10.1249/JSR.0000000000000787. PMID 33306517
- DiFrancisco-Donoghue J, Balentine J, Schmidt G, Zwibel H. Managing the health of the eSport athlete: an integrated health management model. BMJ Open Sport Exerc Med. 2019 Jan 10;5(1):e000467. doi: 10.1136/bmjsem-2018-000467. eCollection 2019. PMID 30792883
- Jenny, S. E., Manning, R. D., Keiper, M. C., & Olrich, T. W. (2017). Virtual (ly) athletes: where eSports fit within the definition of "Sport". Quest, 69(1), 1-18.
Identifiers
NCT: NCT07325396 · E-SPORT-NME-2025-01