Exercise interventions and multidimensional cognitive function in esports players: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: Esports places stringent demands on participants in terms of neural information processing speed, real-time decision-making precision, and cognitive stability. The coexistence of prolonged sedentary training patterns and sustained high-intensity mental workload has rendered the maintenance of cognitive function in esports populations an urgent scientific concern. This study employs systematic review and meta-analysis methods to quantitatively synthesize the effects of exercise interventions on multidimensional cognitive function in esports players, with the aim of providing evidence-based references for the scientific training of esports athletes. METHODS: A systematic search was conducted across PubMed, Embase, Web of Science, Cochrane Library, and Scopus from database inception to May 3, 2026, to identify randomized controlled trials (RCTs) that investigated physical activity interventions among esports players. Two independent researchers completed literature screening and data extraction. The RoB 2.0 tool was used to assess risk of bias, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized using a random-effects model. RESULTS: A total of 5,298 records were identified through database searching, and 10 randomized controlled trials involving 503 participants were ultimately included. Regarding cognitive speed, exercise intervention significantly reduced players' reaction time (SMD = 0.84, 95% CI: 0.50-1.18), with subgroup analysis indicating that VR/exergame interventions yielded a numerically higher effect size (SMD = 1.01) compared to traditional aerobic exercise (SMD = 0.64). Regarding operational accuracy, the intervention effect was robust and highly consistent across conditions (SMD = 0.58, 95% CI: 0.40-0.76, I2 = 0%), remaining stable across both intervention media (traditional 0.53 vs. VR 0.64) and intervention duration (acute 0.57 vs. long-term 0.59). Regarding executive function and memory, the pooled effect size after excluding high-risk studies was SMD = 0.63 (95% CI: 0.36-0.91, I2 = 0%), suggesting a robust promoting effect of exercise intervention on higher-order cognitive function. Sensitivity analyses confirmed that core outcome effects remained significant after removing sources of heterogeneity, and Egger's test indicated no significant publication bias for the accuracy outcome (p = 0.54). CONCLUSION: Current evidence suggests that exercise intervention is a potentially effective approach for improving multidimensional cognitive function in esports players, with positive effects observed across cognitive processing speed, operational precision, and executive function and memory. VR/exergame interventions showed a numerically larger effect size for cognitive processing speed compared with traditional exercise modalities; however, this difference should be interpreted cautiously due to the exploratory nature of subgroup analyses. Future esports training systems may consider incorporating structured exercise interventions into routine training programs, with the aim of maintaining players' cognitive health while exploring feasible pathways for extending career longevity. SYSTEMATIC REVIEW REGISTRATION: www.crd.york.ac.uk/prospero, identifier [CRD420261385557].