Demographics and Health Behavior of Video Game and eSports Players in Germany: The eSports Study 2019

Comparing health risks and musculoskeletal issues between professional and casual mobile esports players: a cross-sectional descriptive study in Jakarta

Mobile gaming poses significant health risks, such as musculoskeletal (MSK) and eye problems, as players maintain the same posture for long periods. The objective of the current study is to describe the prevalence and assess the association of musculoskeletal and eye problems among professional gamers (PG) and casual gamers (CG) with their physical activity level and physical fitness. A total of 94 mobile-gaming athletes (43 PG, 51 CG) were prospectively recruited in this study. Descriptive analysis was performed for BMIs, fatigue scores, musculoskeletal problems profile, and eye problems profile. The associations between physical activity level, BMI, grip strength, flexibility, and MSK injury were tested with a Chi-square test. A total of 65.96% of the players experienced MSK complaints, with the shoulder (26.2%), neck (25.4%), and hand (21.3%) being the top three affected regions. This study also found ocular issues among the players, with eye fatigue (n = 50) as the most frequent complaint. Differential outcomes were observed between the PG and CG groups regarding physical activity (p = 0.001) and flexibility (p = 0.02). Conversely, no statistically significant variances were detected between the PG and CG concerning musculoskeletal (MSK) disorder indicators (p = 1.000), body mass index (BMI) (p = 0.132), body fat (BF) percentage (p = 0.317), grip strength (p = 0.006 for the right side, p = 0.116 for the left side), or waist circumference (p = 0.680). Furthermore, a significant association was observed between physical activity and BMI (p = 0.029). Study results showed that two-thirds of players experienced MSK injury, with the most common complaints being neck, shoulder, hand, and wrist pain. All participants reported at least one eye problem, with the majority reporting multiple complaints. There were significant differences observed in physical activity and flexibility between the PG and CG groups; however, no correlation was found between musculoskeletal injury incidence and the players' physical fitness variables. This lack of correlation may be attributed to the relatively short career span of gamers.

Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis

BACKGROUND

This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations.

OBJECTIVE

The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality.

METHODS

Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis software (version 3.0) was used to perform the meta-analysis. Statistical methods such as funnel plots were used to assess the presence of asymmetry and a p-curve test to test the p-hacking problem, which can indicate publication bias.

RESULTS

Following a thorough screening process, the study involved 55 papers (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into "general use" and "problematic use." The meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality (P<.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k=20). Problematic use was associated with a significant increase in sleep problems (P≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k=36). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r=0.33 (95% CI 0.27-0.40), which was the highest among the general group. The effect of problematic internet use and sleep problems was r=0.51 (95% CI 0.43-0.59), which was the highest among the problematic groups. There were significant differences among these subgroups (general: Qbetween=14.46, P=.001; problematic: Qbetween=27.37, P<.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between Eastern and Western culture was significant (Qbetween=6.69; P=.01). All funnel plots and p-curve analyses showed no evidence of publication and selection bias.

CONCLUSIONS

Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, which is notably more significant in Eastern cultures.

Physical Activity and Self-Determination towards Exercise among Esports Athletes

BACKGROUND

Esports is competitive video gaming, performed within teams or individually, across multiple genres. Players are required to be sedentary for extended periods and require a high-level of cognitive skills for successful competitive performance. There are conflicting findings within the physical activity research in the esports industry. The aim of this research is to explore self-reported physical activity through accelerometer-assessed physical activity, to gain a better insight into the physical activity behaviours of international e'athletes.

METHOD

Participants (n = 796) across multiple popular esports games, holding any in-game rank, competing at any level, were recruited. The survey consisted of demographic details, esports experience, the International Physical Activity Questionnaire-Long Form (IPAQ-LF), and Behavioural Regulations towards Exercise Questionnaire (BREQ-3). Within a convenience sample, local intervarsity e'athletes (n = 18) were recruited to wear a wrist-worn accelerometer to measure physical activity for 7-days and then complete the survey. Results from the accelerometers were compared to the survey results to explore physical activity reporting within this population.

RESULTS

When comparing IPAQ-LF to accelerometer data, players significantly over-report moderate-to-vigorous physical activity and weekly MET-min- 1 (p = .018, r = .63 and p ≤ .001, r = .92). The BREQ-3 showed that e'athletes categorised as high physical activity displayed significantly higher levels of intrinsic motivation, when compared to players categorised as low and moderate physical activity.

CONCLUSIONS

E'athletes significantly over report physical activity time when measured through the IPAQ-LF, suggesting previous surveys may overestimate physical activity and further research is needed. Given the exponential growth of the industry and the level of physical inactivity, esports may contribute to global physical inactivity levels.

Physical symptoms among professional gamers within eSports, a survey study

BACKGROUND

There is a need to establish the prevalence of self-reported physical symptoms such as pain in professional gamers (PGs) and to analyse whether there are correlations between lifestyle factors and self-reported physical symptoms. The purpose of this study was to analyse the prevalence of self-reported physical symptoms including eye-related problems in PGs. A further aim was to analyse the association between physical symptoms and lifestyle factors such as sleep time, play time and physical activity.

METHODS

This study was designed as a cross-sectional study with data based on an electronic survey, created specifically for this study, through discussion and screening of established validated questionnaires for physical symptoms in musculoskeletal conditions: the Karolinska Sleep Questionnaire and the Nordic Musculoskeletal Questionnaire. The survey comprised age and years of experience as a PG as descriptive variables, as well as questions on sleep, play time, physical activity and physical symptoms for the purpose of analysis. The directors of 10 professional gaming corporations were contacted by email with a link to the study-specific survey to distribute to all employees.

RESULTS

A total of 40 answers to the electronic survey were retrieved from 40 PGs, of which 62.5% (n = 25) had experienced at least one physical symptom in the three months prior to answering the survey. There was a significant association between playing time and physical symptoms (OR = 8.0; 95% CI 1.4-44.6, p = 0.018), where playing for more than 35 h a week was positively associated with eight times higher odds of experiencing physical symptoms.

CONCLUSION

There is a high prevalence of physical symptoms, such as headache and eye symptoms, in professional eSports gamers. There was an association between playing more than 35 h per week with the prevalence of physical symptoms.

Dietary Habits and Gaming Behaviors of Portuguese and Brazilian Esports Players

As the esports industry grows, marketing campaigns for fast food, soft drinks, alcoholic and energy drinks, and dietary supplements at related events intensify. Portuguese and Brazilian esports players' dietary patterns remain unexplored. This study aimed to characterize the dietary and gaming habits of esports players. We applied an anonymous, open online survey to a convenience sample of esports players that included the PREDIMED and the Internet Gaming Disorder Scale. The survey was shared through email and social media platforms, including Facebook, Twitter, Instagram, Discord, WhatsApp, and Twitch. The sample (n = 579) was predominantly male (91.4%), averaged 26.1 (SD = 7.0) years, and 25.9 (SD = 5.5) kg/m2. Most reported a weak (53.7%) adherence to the Mediterranean diet. Almost a third (32.3%) consumed dietary supplements. Our sample presented a low adhesion to the Mediterranean dietary pattern, low consumption of fruit and vegetables, and high consumption of fast food, red and processed meat, soft drinks, and dietary supplements, including caffeine-based supplements. Dietary supplement consumption was related to a higher adhesion to the Mediterranean diet, and a higher level of professionalization and internet gaming disorder correlated with a lower adhesion. In conclusion, we infer that Portuguese and Brazilian esports players follow an unbalanced diet.

Challenging the Portrait of the Unhealthy Gamer-The Fitness and Health Status of Esports Players and Their Peers: Comparative Cross-Sectional Study

BACKGROUND

Esports players are often referred to as sedentary athletes, as gaming requires prolonged sedentary screen exposure. As sedentary behavior and physical inactivity are major causes of noncommunicable diseases and premature death, esports players may be at an increased risk for health implications. Prior research has established esports players as having higher levels of body fat and lower levels of lean body mass versus age-matched controls, suggesting the need to assess further health and fitness outcomes of this demographic. However, while research interest is undoubtedly increasing, the majority of studies has focused on subjective self-report data and has lacked relevant objective health and fitness measurements.

OBJECTIVE

This study aimed to assess the health and fitness status of a group of competitive esports players in relation to an age- and sex-matched comparison group.

METHODS

In total, 51 competitive esports players (mean 23, SD 3 years, 2 female) and 51 nonesports players (mean 24, SD 3 years, 2 female) were enrolled in this cross-sectional laboratory study. The esports players and the nonesports players completed a questionnaire assessing demographic data and self-reported physical activity levels. Furthermore, physical parameters including BMI, waist-to-height ratio, body fat percentage, systolic blood pressure, diastolic blood pressure, pulse wave velocity, maximal grip strength, and maximal oxygen consumption were assessed.

RESULTS

There were no significant differences in BMI (t100=1.54; P=.13; d=0.30), waist-to-height ratio (t100=1.44; P=.16; d=0.28), body fat percentage (t100=-0.48; P=.63; d=-0.09), systolic blood pressure (t100=-0.06; P=.93; d=-0.01), diastolic blood pressure (t100=0.37; P=.71; d=0.07), pulse wave velocity (t93=-2.08; P=.15; d=-0.43), maximal grip strength (t100=-.08; P=.94; d=-0.02), maximal oxygen consumption (t100=-0.11; P=.92; d=-0.02), and physical activity (PA) levels (t86=2.17; P=.08; d=0.46) between the groups.

CONCLUSIONS

While the health narrative directed toward esports players has been mainly negative, this laboratory-based study indicated that esports players are not less healthy or fit compared to their peers. However, it seems that esports players are very heterogeneous and seem to span across the whole range of the fitness and health spectrum. Thus, the generalized statements of the esports athlete as an obese and unhealthy individual may need to be reconsidered.

Perspectives of eFootball Players and Staff Members Regarding the Effects of Esports on Health: A Qualitative Study

BACKGROUND

Recently, esports have been argued to impact esports players' health, particularly for those competing at higher levels. Esports are a relatively new phenomenon, and an inside perspective regarding esports players' needs and experiences is essential to promote adequate health support for this population. Thus, in this qualitative study, we explored the perspectives of elite esports players and staff members regarding the effects of esports participation on health. Ten semi-structured interviews were performed with members of the Portuguese FIFA (i.e. FIFA EA Sports^®) eFootball National team (i.e. five elite electronic football players, one world-class electronic football player, two national team coaches, and two members of the esports department). Data analysis was undertaken following the principles of thematic analysis.

RESULTS

We identified four major superordinate themes: health definition (1), factors of esports that impact mental (2) and mental health (3), and strategies to improve esports players' health (4). Esports-related factors such as gaming, competition, and performance were said to impact mental health, while equipment, facilities, and esports-related sitting time affect physical health. To minimise those risks, four main strategies were suggested: optimising and scheduling esports training, improving lifestyle habits with an emphasis on physical health, enhancing facilities and equipment, and improving health support, particularly with a mental health professional.

CONCLUSION

Esports players and staff members are concerned and aware of esports' mental and physical demands. Understanding what esports players need and perceive about their health, complemented with the view of staff members, and their proposed strategies for health promotion might help define and prioritise healthcare needs, which could help players and the broad esports community.

Nutrition, lifestyle, and cognitive performance in esport athletes

Introduction

Electronic sports, termed esports, is a growing athletic activity in which high levels of attention and cognitive performance are required. With its increasing popularity and competitiveness, interest in strategies to improve performance have emerged. Improving esports athlete performance, namely cognitive endurance, and resilience, may lie in nutritional or lifestyle factors. The Nutrition, Vision, and Cognition in Sport Studies (IONSport) investigated nutritional and behavioral factors that can influence cognition via 3-dimensional multiple objects tracking test (3DMOT) via Neurotracker X (NTx) software. The purpose of this study was to characterize the lifestyle of high level esports athletes with detailed nutrition, sleep, and physical activity assessments, and their association to gaming related cognitive performance.

Methods

103 male and 16 elite female esports athletes aged 16 to 35 years old completed surveys, food records, and cognitive testing sessions over 10 days. Participants were instructed to maintain their normal dietary and lifestyle habits.

Results

There were positive significant associations between average NTx scores and the following nutrients: magnesium, phosphorous, potassium, sodium, zinc, selenium, thiamin, niacin, vitamins B6 and B12, folate, cholesterol, saturated, polyunsaturated, and monounsaturated fats, omega-6 and omega-3 fatty acids, and choline. Majority of participants did not meet recommended dietary allowances (RDAs) for these micronutrients nor the recommended intakes for dairy, fruit, and vegetables. There was a significant (p = 0.003) positive (r = 0.272) association between total vegetable intake and average NTx score. There was a significant negative association (p = 0.015) with our final sustain session, which measured cognitive resilience, and the Stanford Sleepiness Scale score. Repeated measures analysis was done with these groups over the 18 core NTx sessions. There were significant (p = 0.018) differences between the two groups with those who consumed the recommended amount of protein or more performing significantly better on NTx over the 18 sessions than those that did not consume enough protein. Those who consumed the recommended intakes for riboflavin, phosphorous, vitamin B12, and selenium performed significantly better over the 18 core NTx sessions than those that did not meet the recommended amounts.

Discussion

The need for a nutrition intervention that is rich in protein, vitamins, and minerals is warranted in this population.

Dietary behavior of video game players and esports players in Germany: a cross-sectional study

BACKGROUND

Video gaming and competitive gaming (esports) are gaining more and more recognition in society as well as in research. Increasingly, health-related topics are the focus of research on video game and esports players. Although video gaming is often associated with energy drinks and fast food, no studies have yet examined the players' dietary behavior. Therefore, the aim of this cross-sectional study is to investigate the dietary behavior and additional health-related data of video game players and esports players in Germany.

METHODS

Between July and October 2020, 817 participants (87.1% male; 24.2 ± 6.9 years), divided into video game players and esports players, were surveyed via an online questionnaire about their dietary, health, and gaming behaviors. Descriptive statistics were performed on all questions. To investigate statistically significant differences between video game players and esports players, the Mann-Whitney-U-Test and Kruskall-Wallis-Test were used. Partial Spearman correlations were used to examine possible associations between dietary behavior, health status, well-being, and video game playing time.

RESULTS

Water was the primary source of fluid intake for the players (10.9 ± 7.0 l/week). The average weekly consumption of energy drinks was 0.4 ± 0.9 L. Energy drinks (rho = 0.14; p < 0.01) as well as soft drinks (rho = 0.14; p < 0.01) are positively correlated with the video game playing time. Participants ate 7.5 ± 10.4 servings of fast food per month, which has a positive association with video game playing time (rho = 0.13; p < 0.01). In contrast, vegetables (1.7 ± 1.6 servings/day) and fruits (0.9 ± 1.0 servings/day) are eaten almost daily.

CONCLUSION

In this survey, the dietary behavior of video game players and esports players is similar to that of the German general population. Nevertheless, there is a need for improvement. Especially energy drinks, which are already documented to have adverse health effects, should be limited. In addition, the consumption of fast food and meat should also be reduced, and healthier foods such as fruits and vegetables should be increased instead. Early education and support regarding the associated risks with unhealthy foods is important within the target group.

The role of the body in electronic sport: a scoping review

The popularity of competitive computer and videogaming, also known as electronic sport (esport), has been rising rapidly during the past decades. Because of many parallels with traditional sports, like competitiveness, skill requirements, degree of professionalization, or the way it is portrayed in the media, esport has been adopted as part of the sport canon in many countries. Still, critics argue that playing computer games lacks the physicality commonly seen in traditional sports. A significant part of the competition is mediated through digital platforms and the spotlight shifts from the players’ appearance and actions to their digital avatars. This paper takes on this issue by exploring existing evidence about the role of the body in esport via a scoping review approach. According to the findings of 47 studies, the body’s role in esport is akin to that in traditional sport, including specific motoric requirements or biometric responses. Beyond that, the body can be seen as a link between the digital and physical worlds. Players embody digital avatars in the form of esport-specific movements, transfer of norms and ideals, and identification with the in-game characters. Future research can use this review as a basis for scientific approaches to individual phenomena regarding corporeality in esport and inter-corporeality.

The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

Esports Players Are Less Extroverted and Conscientious than Athletes

The worldwide status of esports as a sporting phenomenon has been developed in the past decade. However, as the esports industry has grown, it has remained an understudied scientific field. Esports is often contrasted with traditional sports regarding various aspects, including lack of physical activity and the online nature of social interactions. However, little is known whether individuals competing in esports-esports players-differ from individuals competing in traditional sports-athletes. To address this question, we examined the personality characteristics of both types of performers. We collected cross-sectional data on esports players' (n = 416) and athletes' (n = 452) personalities and performance characteristics. We found that esports players were less extroverted and conscientious than athletes. Furthermore, greater sports and esports experience was positively related to being more extroverted. Our findings contribute to the literature by documenting the preferences for competitive activities based on individuals' personality characteristics. We suggest that esports (rather than sports) might be a more suitable form of competition for less extroverted and conscientious individuals.

Nutrition Patterns of Polish Esports Players

The aim of this study was to quantify the dietary patterns (DPs) of Polish esports players aged 18-26 years. Data were obtained via questionnaires that assessed dietary habits and frequency of food consumption. Dietary patterns were derived using Principal Component Analysis (PCA) and Factor Analysis (FA). In total, nine distinct DPs were identified. Eight DPs were considered unhealthy; 'fast food', 'High-processed food, meat and confectionery', 'Sweet', 'Fat-diary products', 'Vegetable-fruit', 'Spices and additives', 'Fats' and 'Cereal'; and only one was deemed healthy. E-athletes presented mostly poor dietary habits, which included: irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, frying of meat dishes and sweetening of hot drinks. Healthy dietary habits included proper hydration during the day and consumption of mainly non-sparkling water. The unbalanced and largely unhealthy dietary habits of esports players raise health concerns for these e-athletes, particularly when combined with a sedentary lifestyle. Future research could assess the nutritional knowledge of this group as it relates to national guidelines, investigate interventions designed to introduce healthier eating options into their lifestyle and examine the relationship between DPs and health or cognitive performance.

Lessons for a digital future from the school of the pandemic: From distance learning to virtual reality

The unexpected onset of the pandemic emergency placed so-called Distance Learning (DL) at the center of the academic world, affecting students and teachers across all formative steps. The DL experience has opened up the way for many queries in terms of research on the front of education, besides showcasing instances of innovation within the schooling institution, both increasingly urgent and no longer deferrable. The collective shock that started in March of 2020 was an opportunity to incentivize a leap in evolution, heavily digital in nature, within the educational system; howbeit, the generation of digital natives were already, prior to the onset of COVID-19, waiting to sense greater openness in the Italian school system toward newer technologies, in addition to less standardized, more innovative, creative and hybrid didactic formulas. In the presented study-a web survey launched in the spring of 2021-a large sample of students were invited to retrace their experience with DL, and express their relating assessments and reviews. Conducting the entirety of the study remotely turned out to be a winning data collection technique given a situation, comparable to the one experienced globally, in which face-to-face meetings had become impossible. Through in-depth analysis of the different contexts-social, cultural, technological, spatial, relational-in which the DL experience took hold, this contribution holds the purpose of illustrating the main DL adaptation profiles of the sample reached, valorizing the perceptual dimension, through the systematic comparison of online and in-person didactics. Analysis of the identified forms of adaptation created an opportunity to reconstruct the image of school that the interviewees held, how much they valued it, the trust they placed therein, the developments they predicted and desired for the institution. Focusing-responsibly, and taking stock of the possible ethical implications-on the future opportunities held by technological progress, in itself boosted by the pandemic, are located within a wider experimentation of VR-equipped classrooms, in a multidisciplinary perspective, offering a concrete solution to the needs of both students and teachers.

Esports players, got muscle? Competitive video game players' physical activity, body fat, bone mineral content, and muscle mass in comparison to matched controls

BACKGROUND

Esports players, like traditional athletes, practice for long hours and, thus, are vulnerable to the negative health effects of prolonged sitting. There is a lack of research on the physical activity and the health ramifications of prolonged sitting by competitive players. The purpose of this study was to investigate activity levels, body mass index (BMI), and body composition in collegiate esports players as compared to age-matched controls.

METHODS

Twenty-four male collegiate esports players and non-esports players between 18 and 25 years of age signed a written consent to participate. Physical activity was examined using daily activity (step count) with a wrist-worn activity tracker. A questionnaire assessing physical activity was also administered. Secondary outcomes included body-fat percentage, lean-body mass, BMI, and bone mineral content measured using dual X-ray absorptiometry.

RESULTS

The step count in the esports players was significantly lower than the age-matched controls (6040.2 ± 3028.6 vs. 12843.8 ± 5661.1; p = 0.004). Esports players exhibited greater body-fat percentage (p = 0.05), less lean body mass (p = 0.003), and less bone mineral content (p = 0.03), despite no difference in BMI between the esports and non-esports players.

CONCLUSION

As compared to non-esports players, collegiate esports players were significantly less active and had a higher body-fat percentage, with lower lean body mass and bone mineral content. The BMIs showed no difference between the 2 groups. Esports athletes displayed significantly less activity and poor body composition, which are all correlated with potential health issues and risk of injury. BMI did not capture this difference and should not be considered as an accurate measure of health in competitive esports players.

Esports for Seniors: Acute Effects of Esports Gaming in the Community on the Emotional State and Heart Rate among Japanese Older Adults

In the last few years, esports have become popular among older individuals. Although participation in esports can become a novel activity for older adults, evidence on their effects is limited to young individuals. This study investigated the effects of esports participation on the emotional and physiological states of older adults. Twenty-five older men and women participating in health promotion activities in community centers (75 ± 8 years old) played a two-player racing game (Gran Turismo Sport, Sony) for 8-10 min. Their heart rates (HRs) were measured while the subjects played the games. The blood pressure (BP) and Profile of Mood States (POMS) were measured before and after gaming. The average HR during games (98 ± 17 bpm) was significantly higher than at pre-gaming (76 ± 11 bpm, p < 0.001). The BP before and after the games did not significantly change. Interestingly, the vigor scores (positive mood affect) in POMS increased after the games (p < 0.05) in females, but not in males. In summary, among older individuals, playing esports games showed a moderate increase in HR, no spike/drop of BP, and positive mood elevation. Our preliminary data suggest the feasibility of participating in esports in a community for older adults and that it could affect mood positively, especially among older women.

Mental Health and Social Connectedness During the COVID-19 Pandemic: An Analysis of Sports and E-Sports Players

Recently, the pandemic context in which the world finds itself has inspired studies that sought to evaluate to mental health and the way people are relating to the purpose of understanding and promoting improvements psychological health. The epidemiological and public health literature shows that social connection protects and promotes mental health, being an important clinical tool for reducing anxiety, depression, and stress. Thinking in the broad sense of connection, that is, feeling and perceiving oneself connected with the environment, applied to the context of sport, it is suggested that social connection could be related to the interactions in the practice of sport. Although playing sports can promote mental health, there are few findings on the topic in the context of a pandemic and with physical sports and electronic sports (e-sports) players. In this sense, the present study aims to assess the extent to which social connection and mental health indicators are correlated in a sample of sports and e-sports players. The participants were 401 Brazilian physical sports (N = 199, 49.6%) and e-sports players (N = 202, 50.4%), mostly male (53.1%) and single (59.9%), who filled in the Social Connectedness Scale (SCS), the Depression, Anxiety and Stress Scale (DASS), and demographic questions. The results indicated that social connection was negatively correlated and also predict the anxiety (r = −0.37), depression (r = −0.54), and stress (r = −0.39). When comparing sports and e-sports players, a statistically significant difference was identified in the levels of social connection [t(398) = −3.41; sports_mean (SD) = 4.53 (1.14); e-sports_mean (SD) = 4.14 (1.15)] and depression [t(396) = 2.90; sports_mean (SD) = 1.10 (0.89); e-sports_mean (SD) = 0.85 (0.81)]. These findings can serve as a theoretical basis for the development of intervention programs (e.g., to guide managers regarding the social distancing rules that enable them to keep holding sports practices and events) and promoting discussions that focus on the analysis of aspects promoting psychological health in sports context (physical and e-sports).

Sustaining eSports Industry and Regulatory Focus: Empirical Evidence From Chinese Universities

This study examined the factors that affect the attitude and behavioral intentions toward electronic sports (eSports) among students of higher education institutions based on the technology acceptance model (TAM). The conditional impact of preventive regulatory focus was analyzed in various aspects developed on the regulatory focus theory. These aspects comprised of perceived usefulness, perceived ease of use, and perceived risk on the attitude toward eSports. Accordingly, data were collected from 293 students of higher education institutions in China's Henan Province, presenting a 54.56% response rate. The PLS-SEM analysis was subsequently implemented to confirm the proposed hypotheses. The empirical findings confirmed the significant positive impact of perceived usefulness and perceived ease of use on the attitude toward eSports. However, perceived risk negatively affected the attitude toward eSports. Meanwhile, the findings on the moderating hypotheses found a negligible impact on preventive regulatory focus. This impact was found explicitly on the perceived usefulness-perceived ease of use link with attitude toward eSports. However, the preventive regulatory focus negatively moderated the perceived risk attitude toward eSports. Finally, the implication and limitations were illustrated at the end of the paper.

Health Risks and Musculoskeletal Problems of Elite Mobile Esports Players: a Cross-Sectional Descriptive Study

BACKGROUND

Mobile-gaming athletes sit in the same posture for prolonged periods, contributing to significant health risks. This study investigated the health profiles, fatigue, pain and complaints, and musculoskeletal problems of full-time mobile-gaming athletes.

METHODS

A total of 50 elite mobile-gaming athletes were involved in this study. They were the starting lineup players from all ten professional teams competing in a top-tier multiplayer online battle arena tournament. A survey was conducted to evaluate their fatigue patterns, pain levels, and complaints. A descriptive analysis was conducted to evaluate the athletes' health profiles [body mass index (BMI), fat ratio], fatigue, number of complaints, and musculoskeletal problems. The associations of career duration with BMI, fat ratio, and the total number of confirmed injuries were then determined using Spearman's rank correlation test.

RESULTS

A total of 46% and 44% of the participants felt tired frequently and occasionally, while 34% and 58% experienced eyestrain frequently and occasionally, respectively. More than 30% of the participants reported headache and rhinitis. A longer esports career duration was associated with a reduction in BMI (r = -0.272, p = 0.056). Career duration had no significant association with smoking habits (p = 0.666), alcohol habits (p = 0.655), coffee habits (p = 0.946), rounds of games for which the player could maintain concentration (p = 0.253), ease of eyestrain (p = 0.569), tiredness (p = 0.510), dizziness (p = 0.071), or leg numbness (p = 0.318).

CONCLUSION

The findings of this study stress the significance of esports injuries and indicate preventive measures for both athletes and recreational players.

Both Physical and Virtual: On Immediacy in Esports

This article strives to make novel headway in the debate concerning esports' relationship to sports by focusing on the relationship between esports and physicality. More precisely, the aim of this article is to critically assess the claim that esports fails to be sports because it is never properly “direct” or “immediate” compared to physical sports. To do so, I focus on the account of physicality presented by Jason Holt, who provides a theoretical framework meant to justify the claim that esports is never properly immediate and therefore never sports. I begin by motivating Holt's account of physicality by contrasting it with a more classical way of discussing physicality and sports, namely in terms of physical motor skills. Afterwards, I introduce Holt's account of physicality as immediacy and engage with its assumptions more thoroughly to problematize the claim that esports is fundamentally indirect. Lastly, I argue that the assumption that esports necessarily lacks immediacy is based on a narrow understanding of body and, consequently, of space. In response, I offer a different way of thinking about body and space, focusing on the subjective, bodily engagement of the esports practitioners with their practice, whereby physical space and virtual space can be appreciated as immediately interconnected during performance in a hybrid manner. In providing such an account, the article contributes directly to the broader, growing discussion on the relationship between physicality and virtuality in an increasingly digital world.

Associations Between Esports Participation and Health: A Scoping Review

Esports are a contemporary phenomenon, with millions of people involved. Still, scientific literature on the topic is scarce. Anecdotal reports, mostly based on what is known from videogames practice, have associated esports with unhealthy lifestyles and health-related problems. The present scoping review aimed to provide an overview of findings from studies regarding the health and well-being in adult esports players, while identifying the most studied topics in the field and those still lacking scientific research.The search was conducted in MEDLINE, Scopus, Web of Science, B-on, and ESCBO databases. Studies regarding health consequences of esports practice conducted with adult esports players were included. No exclusion criteria concerning age, sex, esports modality, or esports level were applied, but articles related to other forms of video gaming or gambling were excluded. The search was limited to peer-reviewed articles. Opinion and review articles were excluded.There were 1416 articles retrieved from which 33 met the inclusion criteria. Lifestyle habits, sleep, exercise and physical health (including musculoskeletal health), physiological demands, and mental health were the main topics of investigation. Several gaps in the literature were identified, namely studies on cardiovascular, respiratory, or metabolic health, or consuming-related risks. Also, the lack of homogeneous methodologies and definitions used in esports-related studies was identified.Esports practice has been associated with different health-related symptoms, but more studies using more robust methodologies and appropriate research design are needed. Topics such as cardiovascular health or the use of performance-enhancing drugs are lacking.

Professional Esports Players: Motivation and Physical Activity Levels

The professionalisation of esports has increased in recent years, generating the need for further study. Its evolution and continuous development have led the consideration of esports as a profession, increasing the number of players, practice modalities, and hours of play dedicated to this field. The aim of this study was to analyse the relationship between physical activity levels and motivational orientations in an international sample of professional esports players. A cross-sectional and observational study was conducted in European and Latin American countries. The sample was non-probabilistic by convenience, and 260 male professional esports players were recruited. A survey was used that included demographic data, body composition, physical activity (International Physical Activity Questionnaire), and motivation (Sport Motivation Scale). The results show that 92.7% of professional esports players have moderate and high levels of physical activity and that players with low levels of physical activity have positive values in all dimensions of motivation. It is concluded that extrinsic and intrinsic motivation correlates inversely with energy expenditure.

Media Consumption, Stress and Wellbeing of Video Game and eSports Players in Germany: The eSports Study 2020

The popularity of video gaming and eSports is increasing rapidly. However, most research focuses on the economical features and psychological consequences of gaming and only little is known about the health behavior of the players. Therefore, this study is a follow-up of the eSports Study 2019 and further investigates the health and health behavior of video game and eSports players in Germany. This cross-sectional study, conducted between April and September 2019, includes 1038 players (91.2% male; 23.0 ± 5.4 years; body mass index: 24.8 ± 5.0 kg/m²) who provided data regarding their health status, physical activity, sleep, media consumption, stress and wellbeing via a web-based survey. Descriptive statistics were performed on all questions. Linear regressions were used to examine the relation between media consumption, wellbeing and stress. Almost all respondents classified their health status as “good” or better (92.5%). The average sedentary and physical activity time was 7.2 ± 3.5 h/day and 8.8 ± 10.7 h/week, respectively. Respondents slept for 7.5 ± 1.3 h/night on weekdays and for 8.5 ± 1.5 h/night on weekends, but many were “sometimes” or more frequently overtired (53.1%). Daily duration of playing video games (230.4 ± 159.3 min/day) and watching livestreams and videos with (102.6 ± 101.7 min/day) and without gaming content (72.9 ± 88.5 min/day) were much higher than watching regular television (18.9 ± 49.1 min/day) or reading analog media (32.1 ± 53.5 min/day). In terms of stress and wellbeing, most players reported low stress levels (13.8 ± 5.7) and reached a moderate average score of 60.1 ± 16.4 out of 100 points in the WHO-5 Well-Being Index. Linear regressions revealed no relevant significant associations. The results indicate good subjective health and health behavior of the target group. However, the high amounts of screen-based media-consumption, as well as the moderate stress and wellbeing levels show potential for improvement. In addition, the target group consumed high amounts of digital media in reference to gaming, while traditional media consumption was distinctly low. Consequently, media campaigns that address health promotion in this target group should use the platforms of digital media instead.

Basic Psychological Need Satisfaction and Thwarting: A Study with Brazilian Professional Players of League of Legends

Recently, the skill to play games has led to the professionalization of the activity in the form of “eSports” (electronic sports). Despite the popularity of eSports, little is known about its professional players from a psychological perspective. Given the importance of the coach-created environment in the athletes’ motivational processes, this study aimed to investigate the key psychological dimensions of the coach-created climate in 75 Brazilian professional players of League of Legends (LoL) considering the Self-Determination Theory (SDT) and Achievement Goal Theory (AGT). Fourteen hypotheses were tested, of which seven were confirmed. The empowering climate was a predictor of basic psychological-needs satisfaction and indirectly influenced autonomous motivation. The need satisfaction had a significant impact on both autonomous motivation and on lack of motivation, which, in turn, explained 56% of the variance in well-being and the intention to keep playing eSports. The disempowering climate was a predictor of psychological-needs thwarting but had no significant impact on autonomous motivation or lack of motivation. The results obtained support SDT and AGT in the context of eSports and were similar to those conducted with athletes from traditional sports, indicating that the empowering-and-disempowering-coaching-climates conceptualization applies not only to traditional sports athletes but also to professional eSports players.

Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports?

Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.

Sleep in Habitual Adult Video Gamers: A Systematic Review

Video gaming is a popular, globally recognized phenomenon, played recreationally or competitively as esports. Gaming is a typically sedentary nighttime activity; therefore, the potential to impact sleep and health is high. Furthermore, there are limited studies on adult gamers, who represent the majority demographic in esports. This review examines evidence describing sleep in habitual adult gamers to understand the associated risk for cardiometabolic disease or the benefits to gaming performance. Three electronic databases (PubMed, Scopus, ISI Web of Science) were searched for peer-reviewed articles published between January 2000 - April 2020. Twelve studies reporting on sleep in habitual adult gamers were included. A narrative synthesis was employed to report results, owing to high levels of heterogeneity across the included studies. Gamers with higher gaming addiction scores were more likely to have shorter, poorer quality sleep and greater daytime sleepiness and insomnia scores than gamers with lower gaming addiction scores and non-gamers. In addition, high-volume gamers were more likely to have worsened sleep quantity and quality, with delayed sleep timing and increased prevalence of insomnia. Despite limitations in the design of the included studies, excessive gaming is broadly associated with worsened sleep parameters. Noteworthy is the lack of studies investigating cardiometabolic health in gamers. Future work should explore the relative contribution and associated risk that various games, genres, and timing of gaming activities have on sleep, physical and mental health, particularly in vulnerable gaming cohorts engaged with contemporary forms of gaming and esports.

The societal impact of electronic sport: a scoping review

Competitive computer gaming, known as electronic sport or esport, is growing and professionalizing profoundly during the past years with experts struggling to allocate it in society. This scoping review explores existing evidence and identifies potential societal impact of esport by applying the Mapping Elite Sports Societal Impact Model. Main findings included insights on the motivation of passive and active esport consumption, beneficial socializing, pedagogical or educational aspects, hegemonial clinical pictures in esport, differing popularity regarding demographics and games, and potential interference of the esport economy in traditional sports. The findings implicate a paradigm shift in the world of sport. It can be stated that esport affects society in a positive and a negative way, although the fragmented body of research has only given superficial evidence so far. Future research needs to go into detail regarding the peculiarities and find approaches of isolating the positive aspects, while reducing the negative spin-offs and allow a well-regulated handling of esport on a broad societal level.

Mental health symptoms in electronic football players

Background

The escalated competitive pressure and professionalisation of esports players could predispose them to mental health symptoms. We aimed to develop a model to explore the association between distress and anxiety/depression symptoms and potential associations between adaptive or maladaptive coping strategies, sleeping disturbance, alcohol consumption and eating habits in electronic football players.

Methods

The present exploratory cross-sectional study includes the Distress Screener, General Health Questionnaire, Brief Cope, Sleep Disturbance Domain of the Patient-Reported Outcomes Measurement Information System, Alcohol Use Disorders Identification Test Consumption and a set of questions regarding eating habits. A two-step robust maximum likelihood method of the Structural Equation Modelling approach was used.

Results

Both measurement model (χ²/df=1065.04 (637), p<0.001; Tucker-Lewis Index (TLI)=0.91, Comparative Fit Index (CFI)=0.92, standardised root mean residual (SRMR)=0.07 and root mean square error of approximation (RMSEA)=0.05; 95% CI 0.043 to 0.053) and hypothesised structural model (χ²/df=1131.98 (648); p<0.001; TLI=0.90, CFI=0.91, SRMR=0.07 and RMSEA=0.05; 95% CI 0.054 to 0.06) showed an adequate fit to the data. Stress was positively related with depression and anxiety symptoms. Only anxiety symptoms were linked with coping strategies. Maladaptive coping strategies were related to sleep disturbance, alcohol consumption and poor eating habits, whereas adaptive coping strategies were associated with less sleep disturbance, reduced alcohol consumption and better eating habits.

Conclusion

An integrative approach to help electronic football players when early signs of distress are present might help avoid other mental health symptoms that interfere with players’ well-being and overall health. Additionally, adequate coping strategies to manage anxiety symptoms due to distress may help counteract potential negative consequences for lifestyle habits in electronic football players.

Physical Activity and Health Promotion in Esports and Gaming-Discussing Unique Opportunities for an Unprecedented Cultural Phenomenon

Due to long periods of sedentary behavior, and unhealthy diets gamers and esports players are at risk for numerous chronic diseases and all-cause mortality. Health research has started addressing the public health implications of the esports phenomenon, drawing a bleak picture of this megatrend. However, instead of just highlighting adverse public health implications of this trend, it is recommended to become involved in this phenomenon and positively influence it. Esports has an enormous potential for physical activity and health-promoting efforts, provides a context for broadly disseminating interventions, and offers new ways of gaining access to an often-neglected population. This paper presents: the potential of the esports phenomenon to promote physical activity, health, and well-being in gamers and esports players; the strategic and preventive solutions to ameliorate esports possible adverse health impacts; and the utilization of esports technology (streams, media platforms, exergames, etc.) as an innovative health promotion tool, especially reaching gamers and esports players with attractive and interactive interventions. This is to encourage systematic scientific research so that evidence-based guidelines and intervention strategies involving regular physical activity, healthy diet, and sleep hygiene for esports will be developed. The goal is to promote public health approaches that move toward a better integration of esports and gaming.

Assessment of mental fatigue and stress on electronic sport players with data fusion

Stress and mental fatigue are in existence constantly in daily life, and decrease our productivity while performing our daily routines. The purpose of this study was to analyze the states of stress and mental fatigue using data fusion while e-sport activity. In the study, ten volunteers performed e-sport duty which required both physical and mental effort and skills for 2 min. Volunteers' electroencephalogram (EEG), galvanic skin response (GSR), heart rate variability (HRV), and eye tracking data were obtained before and during game and then were analyzed. In addition, the effects of e-sports were evaluated with visual analogue scale and d2 attention tests. The d2 tests are performed after the game, and the game has a positive effect on attention and concentration. EEG from the frontal region indicates that the game is partly caused by stress and mental fatigue. HRV analysis showed that the sympathetic and vagal activities created by e-sports on people are different. By evaluating HRV and GSR together, it was seen that the emotional processes of the participants were stressed in some and excited in others. Data fusion can serve a variety of purposes such as determining the effect of e-sports activity on the person and the appropriate game type.

To be or not to be (e)sports? That is not the question! Why and how sport and exercise psychology could research esports

Whether esports can be considered a sport is highly debated. The German Olympic Sport Federation (DOSB) and the German Society for Sport Sciences (DVS) recently stated that esports should not be integrated into the canon of sport. Our aim is not to further fuel this debate but rather to argue that to be or not to be sport is not the most important question from a scientific perspective. After summarizing the current discussion on whether esports constitute a sport, this paper discusses why and how sport and exercise psychology (SEP), in particular, could research esports. To exploit research opportunities in esports, such as adapting validated methods and testing existing models, scholars in SEP could examine the aspects arising from its positional stance. We argue that the potential of SEP approaches, models, and methods, positions it well to play an important role in research on esports. The present perspective provides a starting point for a constructive discourse on the development of SEP and the potential for its role in esports research.

Sleep Characteristics and Mood of Professional Esports Athletes: A Multi-National Study

Esports is becoming increasingly professionalized, yet research on performance management is remarkably lacking. The present study aimed to investigate the sleep and mood of professional esports athletes. Participants were 17 professional esports athletes from South Korea (N = 8), Australia (N = 4), and the United States (N = 5) who played first person shooter games (mean age 20 ± 3.5 years, 100% male). All participants wore a wrist-activity monitor for 7–14 days and completed subjective sleep and mood questionnaires. Participants had a median total sleep time of 6.8 h and a sleep efficiency of 86.4% per night. All participants had significantly delayed sleep patterns (median sleep onset 3:43 a.m. and wake time 11:24 a.m.). Participants had a median sleep onset latency of 20.4 min and prolonged wake after sleep onset of 47.9 min. Korean players had significantly higher depression scores compared to the other groups (p < 0.01) and trained longer per day than the Australian or United States teams (13.4 vs. 4.8 vs. 6.1 h, respectively). Depression scores were strongly correlated with number of awakenings, wake after sleep onset, and daily training time (p < 0.05). As the first pilot sleep study in the esports field, this study indicates that esports athletes show delayed sleep patterns and have prolonged wake after sleep onset. These sleep patterns may be associated with mood (depression) and training time. Sleep interventions designed specifically for esports athletes appear warranted.

Video games and their associations with physical health: a scoping review

Objective

The objective of this scoping review is to investigate the possible links between the practice of video games and physical health. It seeks to answer the following question: What are the physical health consequences of playing video games in healthy video game player? and How is it currently investigated?.

Methods

A scoping review was conducted to identify observational and experimental studies pertaining to our research question. Retrieved papers were screened using a two-phase method first involving a selection based on titles and abstracts. Then, potentially relevant studies were read and triaged. The final set of included studies was analysed, and data were subsequently extracted. Observational studies and experimental studies were assessed using the appropriate Cochrane Risk of Bias Tool and data were synthetised according to specific physical health and related health behaviours.

Results

Twelve peer-reviewed articles were retained for further analyses. Results of this scoping review suggest preliminary evidence that time spent gaming is associated with some health outcomes indicators. Our results indicate preliminary evidence that increased gaming time is associated with higher body mass index and lower self-reported general health status. There is insufficient evidence to conclude on a possible association between gaming time and physical activity or sedentary behaviours, sleep or fatigue, musculoskeletal pain or dietary behaviours.

Conclusion

The results of this sopping review suggest an association between increased video game playing time and a deterioration in some physical health indicators but available evidence is scarce, precluding from any strong conclusion.

The Association between Esports Participation, Health and Physical Activity Behaviour

We investigated the association between obesity, self-reported physical activity, cigarette smoking, alcohol consumption, and perceived health in esports players, and the influence of player in-game rank. Data was collected with an online survey with an international participant sample of esports players representing five esports and all skill levels (n = 1772). Esports players were more likely to be categorized as normal weight, or obesity class 2 and 3 and as non-smokers (92%) and non-drinkers (65.1%) compared to international reference data. Esports players met international physical activity guidelines less than global general population. Esports players ranked in the top 10% were more physically active compared to the remaining esports players. As esports player in-game rank increased, so did the amount of time spent playing esports. Although esports players appear generally healthy, a small group was significantly obese and most esports players did not meet physical activity guidelines, indicating potential future health risks.

The eSports conundrum: is the sports sciences community ready to face them? A perspective

The reality of eSports is something much more complex than individual users playing video games. There are several characteristics that eSports have in common with traditional sports: from the spirit of competition to the structural composition of the teams, including the increase in performance with training and practice, up to the injuries and physical and psychological stress of the athlete. The number of scientific papers interested in this reality is still relatively low, although in recent years there has been a significant increase in this regard. Probably the lack of knowledge of the world of eSports by inexperts can represent an initial obstacle in the approach to this environment. Therefore, an all-round analysis of the eSports industry is fundamental: including the figures that characterize them, the different eSports disciplines, the possible physical and mental consequences for athletes. Emphasizing the similarities between electronic and non-electronic sports is essential in order to make people, and the scientific community in particular, understand how they should be considered equal to the "traditional" vision of sports especially in the need for professional medical support. The number of professional and amateur eSports players increase every day as well as the birth of professional organizations and national teams while medical monitoring seems to have fallen behind. In the near future, we hope that the scientific community and in particular the medical disciplines will be able to closely support the world of eSports to guarantee the correct assistance to all professional and non-professional athletes. An increase in the number of scientific work and specific studies will certainly bring benefits in countering physical attrition, reducing the risk of injury, in psychological support to athletes and in the fight against doping reality.

Influence of Esports on stress: A systematic review

Esports is an electronic sport known as competitive video gaming, which has seen tremendous growth over the past few years. Unlike traditional sports such as hockey, baseball, and soccer, Esports is an interconnection of multiple platforms, computing, gaming, and media into a sport event. A systematic review was conducted to collate and review all the research studies concerning Esports from a health perspective and analyze various physical and psychological distress regarding Esports. Relevant published papers were identified through the electronic databases Google Scholar, PubMed, and Research Gate. As a result of the systematic research review, seven articles were identified that investigated three major domains (i) Esports and physical issues, (ii) Esports and psychological distress, and (iii) Esports and addiction. The result indicated that Esports excessive play and its competitive nature lead to physical and psychological problems. Physical issues include eye fatigue, blurry vision, low back pain, tension headache, wrist pain, hand pain, and poor posture while gaming. Psychological issues include depression, anxiety, apathy, uncooperative attitude, tense, sleep disturbances, mental distress, aggressive affect and behaviors, distress in social life, and emotional disturbances. The studies also found that long hours of online gaming was associated with the presence of depression, social phobia, obsession-compulsion, interpersonal sensitivity, hostility, phobic anxiety, paranoid ideation, psychoticism attention-deficit hyperactivity disorder, and gaming addiction. This review draws insight into the problematic side of Esports and suggested that future studies must focus on the interventions to deal with the negative impact of Esports.