EsportsNCT07325396
Neuromuscular Training in Professional Esports Players
A study testing Neuromuscular Training and Physical Activity Counseling in people with Esports and Esports Players, run by Yeditepe University at 1 site in Turkey (Türkiye).
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 to 35 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Esports, Esports Players
- What is being tested?
- Neuromuscular Training and Physical Activity Counseling
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 28 Jan 2026to 1 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- Men only
- Healthy volunteers accepted
- Adult
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Ela TARAKCI contact
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
İstanbul University Cerrahpaşa
Istanbul
Doğukan Tongar, dogukan.tongar@yeditepe.edu.tr
About this study
Official title: Effectiveness of Neuromuscular Training Added to Routine Practice on Fatigue and Stress Biomarkers in Professional Esports Players: A Randomized Controlled Trial
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.
Read the 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 ferritin 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.
- Conditions
- Esports, Esports Players
- Being tested
- Neuromuscular Training, Physical Activity Counseling
- Keywords
- esports, professional gamers, neuromuscular training, fatigue, stress, biomarkers
- Medical subject headings
- Fatigue
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Neuromuscular TrainingBehavioural
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.
Physical Activity CounselingBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| Neuromuscular Training | Experimental | Professional esports players will perform a structured neuromuscular training program added to their routine esports practice, 3 sessions per week for 8 weeks. The program includes warm-up, aerobic, strengthening, core stabilization, functional and reaction drills with progressive weekly increases in duration or repetitions. Receives: Behavioral: Neuromuscular Training |
| Physical Activity Counseling | Active comparator | Professional esports players will receive structured physical activity counseling in addition to their routine esports practice. The counseling will follow ACSM 5A principles (Assess, Advise, Agree, Assist, Arrange) to support behavior change and increase physical activity participation weekly for 8 weeks. Receives: Behavioral: Physical Activity Counseling |
What is being measured
The primary outcome is the main question the study is designed to answer.
Serum cortisol level - Stress Biomarkers
Serum cortisol level will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks
Testosterone level - Stress Biomarkers
Testosterone level will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks
C-Reactive Protein Level (CRP) - Fatigue Biomarkers
Serum CRP levels will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks
Creatine Kinase (CK) Level - Fatigue Biomarkers
Creatine kinase levels will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks.
Vitamin B12 Level - Fatigue Biomarkers
Serum vitamin B12 levels will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks.
Ferritin Level - Fatigue Biomarkers
Serum ferritin levels will be analyzed under fasting conditions using standardized laboratory protocols.
Measured: Baseline and 8 weeks.
Secondary outcomes (6)
Muscle Strength
Hand, forearm, shoulder, and back muscle strength will be assessed using a handheld myometer; mean of three trials recorded in kilograms.
Measured: Baseline and 8 weeks
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.
Measured: 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.
Measured: 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.
Measured: Baseline and 8 weeks
Blood Lactate Concentration
Capillary blood lactate measured to assess metabolic response to neuromuscular training.
Measured: Baseline, 4 weeks 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.
Measured: Baseline and 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jan 2026
- Study start28 Jan 2026
- Primary completion1 Dec 2026 (estimated)
- Study completion1 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for EsportsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 24 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Yeditepe University
- Sponsor type
- University, hospital or other
- Collaborators
- Istanbul University - Cerrahpasa
- Responsible party
- Principal investigator, Doğukan Tongar, Yeditepe University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07325396
- Sponsor's protocol ID
- E-SPORT-NME-2025-01
- Status last verified
- Sep 2026
- First submitted
- 24 Nov 2025
- Last updated
- 10 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared due to privacy protection and confidentiality regulations for professional esports players.
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.
PubMed 34063524Saglam 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.
PubMed 21058606Andre 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.
PubMed 33042382Nagorsky 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.
PubMed 32841263Bonnar 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.
PubMed 31320292Emara 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.
PubMed 33306517DiFrancisco-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.
PubMed 30792883Jenny, 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.
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of Neuromuscular Training Added to Routine Practice on Fatigue and Stress Biomarkers in Professional Esports Players: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07325396
- Acronym / sponsor ID
- E-SPORT-NME-2025-01
- Conditions
- Esports, Esports Players
- Keywords
- esports, professional gamers, neuromuscular training, fatigue, stress, biomarkers
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 24 participants (estimated)
- Lead sponsor
- Yeditepe UniversityUniversity, hospital or other
- Collaborators
- Istanbul University - Cerrahpasa
- Study start
- 28 Jan 2026 (actual)
- Primary completion
- 1 Dec 2026 (estimated)
- Study completion
- 1 Dec 2026 (estimated)
- First posted
- 8 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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 ferritin 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 design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Neuromuscular Training | Experimental | Behavioral: Neuromuscular TrainingProfessional esports players will perform a structured neuromuscular training program added to their routine esports practice, 3 sessions per week for 8 weeks. The program includes warm-up, aerobic, strengthening, core stabilization, functional and reaction drills with progressive weekly increases in duration or repetitions. |
| Physical Activity Counseling | Active comparator | Behavioral: Physical Activity CounselingProfessional esports players will receive structured physical activity counseling in addition to their routine esports practice. The counseling will follow ACSM 5A principles (Assess, Advise, Agree, Assist, Arrange) to support behavior change and increase physical activity participation weekly for 8 weeks. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- 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
Key exclusion criteria (8 listed)
- History or presence of medical conditions affecting safety or performance: metabolic, cardiovascular, renal, neurological, or respiratory disorders
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Neuromuscular TrainingA 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. | Behavioural | Neuromuscular Training |
| Physical Activity CounselingStructured 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. | Behavioural | Physical Activity Counseling |
Primary outcome
Serum cortisol level - Stress Biomarkers
Time frame: Baseline and 8 weeks
Serum cortisol level will be analyzed under fasting conditions using standardized laboratory protocols.
Testosterone level - Stress Biomarkers
Time frame: Baseline and 8 weeks
Testosterone level will be analyzed under fasting conditions using standardized laboratory protocols.
C-Reactive Protein Level (CRP) - Fatigue Biomarkers
Time frame: Baseline and 8 weeks
Serum CRP levels will be analyzed under fasting conditions using standardized laboratory protocols.
Creatine Kinase (CK) Level - Fatigue Biomarkers
Time frame: Baseline and 8 weeks.
Creatine kinase levels will be analyzed under fasting conditions using standardized laboratory protocols.
Vitamin B12 Level - Fatigue Biomarkers
Time frame: Baseline and 8 weeks.
Serum vitamin B12 levels will be analyzed under fasting conditions using standardized laboratory protocols.
Ferritin Level - Fatigue Biomarkers
Time frame: Baseline and 8 weeks.
Serum ferritin levels will be analyzed under fasting conditions using standardized laboratory protocols.
6 secondary outcomes
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, 4 weeks and 8 weeks
Mood State
Time frame: Baseline and 8 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2026.
- Background: PubMed 34063524Ambrozy 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.
- Background: PubMed 21058606Saglam 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.
- Background: PubMed 33042382Andre 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.
- Background: PubMed 32841263Nagorsky 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.
- Background: PubMed 31320292Bonnar 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.
- Background: PubMed 33306517Emara 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.
- Background: PubMed 30792883DiFrancisco-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.
- BackgroundJenny, 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.
- Individual participant dataSharing planned: No. Individual participant data will not be shared due to privacy protection and confidentiality regulations for professional esports players.
Related trials for Esports
Not yet recruiting
Can Different Exercise Modalities Improve Esports Performance?
Esports Players
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ela TARAKCI contact
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Neuromuscular Training and Physical Activity Counseling in people with Esports and Esports Players, run by Yeditepe University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Doğukan Tongar, Master of Science (+90 0507 843 10 21, doguka.tongar@yeditepe.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Serum cortisol level - Stress Biomarkers (time frame: Baseline and 8 weeks). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07325396, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2026.