Physical exercise and esports performance: an updated systematic review and study-level meta-analysis

Physical exercise and esports performance: an updated systematic review and study-level meta-analysis. Download PDF Abstract Physical exercise has been proposed as a means of supporting esports-relevant cognition and gaming performance, but the evidence is heterogeneous and frequently reports multiple correlated outcomes. We updated a systematic review of controlled interventions and reconstructed the meta-analysis with the study as the independent unit.

The original searches covered PubMed, Scopus and PsycINFO through May 2026; supplementary searching on 3 August 2026 identified additional controlled evidence, and the database/citation searches were rerun during revision through 4 September 2026, with no further eligible studies identified. Twelve controlled study clusters (660 enrolled or randomized; 608 reported analysed) were included. Nine evaluated exercise-only interventions; five estimable exercise-only studies (184 enrolled; 182 analysed) contributed 18 outcomes to quantitative synthesis after within-study aggregation (assumed between-outcome correlation rho = 0.50), whereas four exercise-only studies were synthesized narratively because compatible sampling variances or effect metrics were unavailable.

The primary interpretive focus was placed on outcome domains: cognitive/psychomotor outcomes yielded Hedges’ g = 0.465 (95% CI 0.073–0.856; k = 4), whereas gaming-specific outcomes were imprecise (g = 0.574, 95% CI − 0.002 to 1.150; k = 3). An exploratory cross-domain omnibus composite yielded g = 0.512 (95% CI 0.214–0.810; k = 5). Because only five of nine exercise-only studies were statistically convertible, this pooled signal may be affected by availability bias and does not summarize the complete eligible exercise evidence.

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