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Article

Beyond the Screen: Do Esports Participants Really Have More Physical Health Problems?

by
Di Tang
1,
Kim-wai Raymond Sum
1,*,
Ruisi Ma
1,2 and
Wai-keung Ho
1
1
The Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
2
School of Physical Education, Jinan University, Guangzhou 510632, China
*
Author to whom correspondence should be addressed.
Sustainability 2023, 15(23), 16391; https://doi.org/10.3390/su152316391
Submission received: 9 August 2023 / Revised: 10 October 2023 / Accepted: 2 November 2023 / Published: 28 November 2023
(This article belongs to the Special Issue Studies of Physical Fitness Improvement and Healthy Lifestyle from a Sustainable Science Sports Perspective)
Browse Figure
Versions Notes

Abstract

:
This cross-sectional study aimed to explore the association between esports participation and physical health and examine the difference in physical health problems between esports participants and non-esports participants. A total of 1549 young adults participated in this investigation. A total of 633 participants were categorized as esports participants, and they were involved in six types of esports games: shooting games, multiplayer online battle arena games, strategy card games, sports games, real-time strategy games, and fighting games. An online survey was conducted to gather data on their demographic information, gaming behavior, traditional sports behavior, and physical health problems. The results demonstrated that esports players reported significantly higher participation in traditional sports compared to non-esports players. No significant differences were found in sleep duration or the selected physical health issues between the two groups. Overall, the findings suggest that esports participation was not associated with negative physical health in this sample of young adults. Furthermore, this study found that players who conscientiously took intermittent breaks and maintained a standardized sitting posture during gameplay had a lower likelihood of reporting neck and back pain. These findings have important implications for challenging conventional negative perceptions of esports and promoting a more objective understanding and appreciation of esports and the sustainable development of esports players. Future research is necessary to explore potential causal relationships between esports participation and health outcomes and to develop a healthier esports practice modality from a sports science perspective.

1. Introduction

Since 2010, the esports industry has experienced unprecedented growth, with a massive increase in gamers and spectators [1,2]. Moreover, an increasing number of academics and researchers are beginning to explore esports from an academic perspective, and the number of published papers related to esports has significantly increased since 2020 [3]. Nevertheless, there is still no widely accepted definition of esports in esports research [1,4,5,6,7,8,9,10]. However, most academics agree that although esports originates from computer games or video games, it cannot be fully equated with video games or electronic games in general [11,12,13,14,15,16]. Currently, two of the most cited esports definitions are from Hamari and Sjöblom and Wagner: “a form of sports where electronic systems facilitate the primary aspects of the sport; the input of players and teams, as well as the output of esports, are mediated by human–computer interfaces” and “an area of sports activities in which people develop and train mental and physical abilities in the use of information and communication technologies” [10]. Additionally, esports is commonly regarded as competitive video gaming in many studies.
Academia has debated the relationship between esports and health since the rise of esports. Numerous studies have undertaken an analysis of the health status of esports players or video gamers, focusing on various aspects such as body composition, dietary habits, participation in physical exercise, musculoskeletal pain, and sleep patterns. These investigations aim to gain insights into the overall well-being and health implications associated with engagement in esports or video gaming [11,17,18,19,20,21]. In 2019, the World Health Organization (WHO) officially classified gaming disorder as a mental illness [22], which is likely to reignite discussions on the relationship between esports and health. From 2011 to 2019, many studies have suggested that video games and esports are associated with negative health outcomes, and a systematic review in 2022 found that esports are linked to unhealthy lifestyles and behaviors among young people [23]. However, some past studies on esports and health-related issues had limitations and encountered problems.

1.1. Theoretical Limitations in Existing Literature

Some existing studies on esports and health-related issues do not clearly distinguish between esports and general computer or video games when defining esports or selecting participants for the study. They also fail to provide clear criteria for classifying esports participants [23,24,25,26,27,28]. For instance, a recent systematic review of the effects of esports and video gaming on young people found that esports and online competitive gaming are associated with unhealthy lifestyles [23]. However, only 1 of the 36 included articles selected esports players for the study, and studies on regular video gaming and screen time behaviors (such as watching TV) were also included. Moreover, over half of the included studies did not provide specific information on the game types played by the participants [23]. Additionally, studies on Massively Multiplayer Online Role-Playing Games (MMORPGs) were also included in the esports studies [23,26], even though MMORPGs are not traditionally or widely accepted as an esports category. It is still unclear whether the results of these studies can be generalized to the esports population.
Furthermore, some previous studies on the relationship between esports and health have only selected professional esports athletes or high-level esports players as participants [20,29,30,31], which also reflects a contradiction when defining esports; some scholars argued that only professional esports could be called esports [32,33,34] while others accepted non-professional esports, semi-professional esports, or recreational esports [35,36,37]. However, whether esports should be limited to professional esports or not still requires further theoretical evidence. Additionally, while some academics are skeptical about the official classification of esports as a sport [38,39,40,41,42], most scholars accept that esports can be considered a sport or has the potential to become one in the future [10,35,43,44]. From an industry perspective, many countries have already classified esports as an official sport, including the US, China, Brazil, Bulgaria, Italy, Korea, and Russia [45]. In the case of traditional sports, it is possible to classify sports as professional sports, mass sports, school sports, and so on, depending on the purpose, level of activity, and participants. Referring to the theoretical division of sports and in the absence of more theoretical evidence that proves esports can only be limited to the professional level, this study acknowledges the existence of non-professional esports. In professional esports, the training methods, lifestyle, and risks of physical and mental injury that a professional esports athlete endures are completely different from those of normal esports players. The high intensity of training and pressure from professional competitions is not something that all esports participants need to endure [20]. Additional empirical evidence is required to assess the generalizability of the study’s findings regarding the health of professional esports athletes to the broader population of esports participants. Moreover, there is currently a lack of research on non-professional esports players.

1.2. Methodological Limitations in Existing Literature

A systematic review published in 2022 on the impact of esports and video gaming on lifestyle behaviors revealed that most of the included studies did not compare the results of esports players with those of non-esports or non-gaming players [23]. Another scoping review published in 2022 examined the relationship between esports and health. Among the included studies, only six had a control group of non-esports participants, and their sample sizes were no larger than 104 [11].
Besides, in light of the current state of research on esports and physical and mental health, it is imperative to conduct longitudinal studies and studies with larger sample sizes to comprehensively explore the association between health and esports, as well as the effects of esports [11,23]. In Pereira’s scoping review of the association between esports and health, it was found that out of the 33 studies examined, only 7 had a sample size larger than 200, while 14 studies had a sample size smaller than 50 [11].
Hong Kong’s progression in the field of esports has comparatively lagged behind that of other Asian countries and regions [46]. The presence of the negative health implications associated with esports has adversely influenced its societal perception, resulting in developmental challenges and a range of attitudes toward its advancement in Hong Kong [47]. Previous studies conducted on esports development in Hong Kong have underscored the importance of fostering a positive public image for esports to establish it as a mainstream sport, particularly within the FinTech community [47,48]. However, these studies have not solely relied on empirical data and have lacked a robust theoretical foundation to comprehensively elucidate the perspectives and attitudes of Hong Kong teenagers toward esports development and participation [47].
Considering the research gap and issues above, this study is designed as a cross-sectional study to explore whether there are significant differences in physical health between esports players and non-esports players among young adults, and aims to examine whether the negative physical health problems associated with esports mentioned in the existing literature also occur more frequently in multilevel esports participants compared to non-esports participants. Additionally, this study will collect detailed information on esports game participation (e.g., genres) to strictly distinguish esports players from general video gamers. While some current esports studies lack a clear and strict distinction in the discussion of their findings [28,38,39,40,41,42], most scholars assert that esports cannot be regarded as a general video game, and not all video games can be seen as esports [13,14,15]. Additionally, the study recruited players of varying skill levels and included recreational players. We classified esports participants with their gaming genres to discuss whether there are differences in playing habits (playing posture, the use of digital equipment, etc.) and health among esports players of different genres. Moreover, we want to learn whether the results of this study (strictly limited to the general esports population) are consistent with previous studies on video gamers and professional esports athletes and to provide more evidence for future discussion and research on esports and health, and possibly investigate the factors affecting the health of esports participants.

2. Methodology

2.1. Research Objective

This study was designed as a cross-sectional study, aiming to investigate whether there were statistical differences in physical health between esports players and non-esports players. Furthermore, this study was also to explore whether there are differences in gaming habits and health in players of different game genres. Additionally, the study sought to determine whether the negative health issues linked to esports that were reported in prior research were more prevalent in esports players who participated in multiple levels of competition, compared to in the results of non-esports players and professional esports athletes.

2.2. Participants

A total of 1549 responses were selected for the final data analysis (incomplete responses were excluded). According to the age range of the primary esports population in Hong Kong, young adults aged 18 to 29 living in Hong Kong were considered as the target population for this study [47]. To better compare the health differences between the esports and non-esports populations, the age range of participants in the non-esports group was also set from 18 to 29 years old to avoid potential confounding factors related to age. Since some esports games are under the regulation of the Chinese Online Game Fatigue System, an age limit of 18 was considered. Under the regulation (2007), minors have very few opportunities to participate in esports.
For the selection criteria of the esports population, we primarily included players who actively participate in mainstream esports game types and have engaged in the game within the past six months [47,49]. Although there is currently no widely accepted and universally recognized comprehensive definition of esports [1,4,5,6,7,8,9,10], it is generally acknowledged that esports, in a broad sense, must involve competitive electronic gaming [50,51,52]. The selection of these six game genres also took into consideration the types of esports events included in the 2023 Asian Games, which aligns with the current esports landscape in Asia. These six categories of competitive games are traditionally recognized as widely accepted esports genres. At this stage, recognition from esports communities is an important criterion for determining whether an activity can be considered esports [53]. A total of 633 participants (18.8 ± 1.5) were classified as esports players who played competitive video games such as shooting games (CSGO, PUBG, Overwatch, etc.), multiplayer online battle arena (MOBA) games (Arena of Valor, Honor of King, League of Legends, DotA 2, etc.), strategy card games (Hearthstone, etc.), sports games (FIFA, NBA 2K Series, etc.), real-time strategy (RTS) games (Warcraft, StarCraft, etc.) or fighting games (Street Fighter, Naraka Bladepoint, etc.). General video gamers, such as role-playing gamers and leisure game players, were identified as general video gamers instead of esports players, and a total of 393 participants were categorized as general video gamers. In total, 916 participants were classified as non-esports players (18.6 ± 1.5) (including participants who did not play video games and those playing general video games). If participants are unsure of the type of game they were involved in, they could also select another option to enter the name of the games, and they were classified by the researcher based on their feedback. The additional demographic information of participants is shown in the tables below (Table 1). To avoid misunderstanding the different types of participants, Figure 1 shows the classification and the corresponding number of individuals in each category.

2.3. Data Collection and Measurement

The data collection started in January 2022. An online survey was employed to collect data from participants, and a QR code for the questionnaire was distributed in Hong Kong via university student emails and offline student activities. In collaboration with the physical education unit in the university, we provided interested students with QR codes for the questionnaire to be scanned and completed after their physical education classes. Furthermore, we submitted applications to the university’s mass mail system to send emails to personal mailboxes. This system facilitated the delivery of research-related invitations and recruitment links as email entries to students, alumni, and faculty members, enabling them to independently decide whether to participate in the research based on their interest. Additionally, the survey link and code were made available on websites, specifically on our university research team web page and a research association website, allowing interested individuals to scan the code and participate in the survey.
The data on the physical health problems of different categories of participants were also collected by means of an online questionnaire designed by the team. The whole questionnaire is divided into four sections: personal information (gender, age, education, etc.), gaming behavior (type of games, frequency of game, gaming habits, ranking in the game), sports behavior (type of sports, frequency, etc.), physical health problems (visual impairment, myopia, or dry eye, hearing impairment or hearing loss, palm or finger pain or strain, wrist pain or strain, neck pain or strain, upper back pain or strain, lower back pain or strain, malnutrition, sleep duration). We selected several health issues reported to be related to esports or video gaming behaviors based on previous relevant studies [21,31,54,55]. The participants were presented with a checklist comprising of symptoms and health issues. They were then asked to indicate whether they had encountered any of the mentioned health problems. The textual version of the online questionnaire has been provided in Supplementary Materials.

2.4. Statistical Analysis

Statistical analysis was conducted on IBM SPSS Statistics 26. Data normality was tested using a Kolmogorov–Smirnov (KS) test. A chi-square test, Mann–Whitney U test, and Kruskal-Walls H test were conducted to analyze the data from different groups of subjects. A significant difference is considered to exist in different groups when the p-value was less than 0.05. The chi-square test is employed to assess the independence between two or more categorical variables. In this study, it was primarily employed to compare categorical variables such as skeletal muscle pain, traditional sports participation, gaming posture, and intermittent breaks between esports and non-esports populations, as well as players in different gaming categories. When conducting multiple chi-square tests simultaneously or performing multiple comparisons, the Bonferroni correction was applied. The Bonferroni correction is a statistical adjustment method used to address the issue of multiple comparisons in hypothesis testing [56]. The Mann–Whitney U test is utilized to examine differences in non-normally distributed variables between two groups. Within this study, it was applied to assess variables such as sleep duration and gaming time between the esports and non-esports populations. The Kruskal–Wallis H test is utilized to examine differences among three or more non-normally distributed data. In this study, it was used to compare sleep duration and gaming time variables among different genres of esports players.

2.5. Research Ethics

This study was approved by the Survey and Behavioral Research Ethics Committee of The Chinese University of Hong Kong (January 2022). All methods were performed in accordance with the relevant guidelines and regulations. All the participants signed an informed consent form before participating in the study.

3. Results

A total of 1549 participants took part in this investigation, with an average age of 18.7. Among them, there were 632 males and 917 females. Furthermore, among the participants, 633 were esports players, while 916 were non-esports participants. In total, 1063 have a habit of playing video games (esports included).
Regarding the gaming time of all kinds of video gamers, the majority (873 players) reported a daily gaming time of less than 3 h. More specifically, 260 players reported playing for less than 1 h per day, 395 players reported playing for 1 to 2 h per day, and 218 players reported playing for 2 to 3 h per day. On the other hand, 153 players reported a daily gaming time exceeding 3 h.
Within the esports player group, there were six categories: shooting games (147 individuals), MOBA games (321 individuals), strategy card games (60 individuals), sports games (59 individuals), RTS games (21 individuals), and fighting games (25 individuals). Among all the participants engaged in traditional sports, a total of 32 types were identified, including baseball, bowling, squash, jogging, cycling, frisbee, basketball, volleyball, etc.

3.1. Esports and Non-Esports Participants

As shown in Table 1 and Table 2, no significant differences were observed in selected physical health issues between esports and non-esports participants in this study. Since the data on sleep duration and sports frequency were not normally distributed, a Mann–Whitney U test was used to compare this type of data between the two groups. Moreover, no significant difference in sleep duration was found between these two groups. Moreover, it was found that participation in traditional sports was significantly higher among esports participants (66%) than non-esports participants (49.2%) (p < 0.001). However, between the sports players in these two groups, no statistical difference was observed in their sports frequency (see Table 2).

3.2. Esports Players in Different Genres

In the comparison of six different genres of esports players, the p-values were adjusted using the Bonferroni correction. A p-value below 0.008 indicates a significant difference between the corresponding two groups. According to the findings presented in Table 3, players of sports games (93.2%) and fighting games (80%) have a significantly higher proportion of reported engagement in sports activities compared to players of other genres. No statistically significant differences were found in the selected physical health issues among these various types of esports players.
Interestingly, among the participants, 43.5% of shooting game players consciously adopt a more standardized sitting position during gameplay, while only 21.7% of strategy card game players do so. This discrepancy shows a statistically significant difference. Moreover, after conducting the Kruskal–Wallis H test, no significant difference was observed in sleep duration among all participants (p = 0.98, Z = 0.716). Additionally, no significant difference was found in sports frequency between players of different game genres (p = 0.81, Z = 2.304).

3.3. Standardized Sitting Position and Intermittent Breaks

Taking into consideration the substantial differences in symptoms and gaming habits exhibited by different participants, we further investigated the association between specific gaming habits, namely sitting position and intermittent breaks, and health issues. This investigation aimed to contribute to future research on the health of esports or video game players. Our findings indicated a noteworthy disparity in wrist, upper back, and lower back pain or strain between players who adopt a standardized sitting position during gameplay and those who do not. Among players who do not adhere to a standardized sitting position, a higher proportion reported experiencing upper and lower back pain or strain (refer to Table 4), while no significant differences were observed in other symptom categories. Moreover, players who do not take intermittent breaks exhibited a higher proportion of neck pain or strain compared to those who do (refer to Table 4), demonstrating a significant difference. However, no statistically significant disparities in other health issues were observed between these two groups.

4. Discussion

This study aimed to explore the association between esports and physical health problems and compare the health-related issues between esports participants and non-esports individuals. Based on the methodology of previous health-related esports studies and the research gaps and limitations shown in their findings, this study has further adapted the research design to enable a more accurate exploration of the relationship between esports and health. Firstly, this study strictly limited the recruiting criteria for esports participants and included all levels of esports players as esports participants. Secondly, this study also recruited non-esports players with a similar background (age, education, occupation) as a control group to compare the outcomes, rather than using the health data from the overall population in order to reduce possible health-related confounding factors, which compensated for the lack of a control group in previous relevant studies [23]. Thirdly, based on the limitation of the previous study in sample size [11], we recruited 1549 subjects to participate in this study.
After a series of adjustments to the study design, overall, the result of this study shows a difference from previous studies on esports or video games and health [21,23,57,58]. The result of this study showed that, compared to non-esports participants, esports players do not exhibit a negative health status for the selected physical health issues, and they are even more physically active than non-esports participants. Among all the sports participants, there was no significant difference in their sports frequency between esports and non-esports players. In addition, esports participants of sports games show the highest sports participation rate (93.2%), while real-time strategy gamers show the lowest rate (38.1%). The simultaneous engagement in esports and traditional sports may be attributed to the high similarity between sports games and traditional sports. Esports also exhibit a high level of competitiveness, similar to traditional sports. In the data collected from the participants in our study related to traditional sports, we observed that many of them engaged in competitive activities such as baseball, basketball, volleyball, bowling, and others. These activities demonstrated several similarities to esports, including teamwork, competition, skill development, and strategic thinking. As a result, this may trigger common interest from this group of players. Additionally, research has proposed that playing games and exercising share similar motivations to some extent [59], and gamification has been found to potentially motivate people to exercise [60]. Previous studies have also suggested that the higher the level of esports players, the more physically active and health-conscious they are [20,61,62]. Additionally, the results of this study reaffirm that prolonged sedentary behavior does not necessarily imply a lack of physical activity. Whether or not a person engages in sedentary behavior cannot directly reflect the extent of their participation in physical activities, nor can it fully represent their overall physical health. It is important to consider additional factors and associations in this regard [63,64,65,66,67,68,69].
In terms of sleep duration, there was no significant difference between esports players and non-esports players. Although musculoskeletal problems were reported among esports athletes in previous studies, as in traditional sports or even common jobs [55,70], the sample size of these studies was relatively small, and they did not distinguish the esports practice level or even professional esports athletes. These physical injuries might result from long-term training or competition at a high level or professional level [71,72]. However, in the results of this study, there was no significant difference observed in the prevalence of the selected musculoskeletal problems (fingers, wrist, upper back, lower back) between esports and non-esports participants. Moreover, no significant difference was found in vision, hearing, or malnutrition problems. However, looking at the gaming habits of esports participants and general video gamers, esports players show a higher level of reliance on headsets or earphones, and they wear them for a longer period compared to general video gamers, which might, to some extent, reflect the demands on the responsiveness and discrimination ability to sound of esports players. And compared to video gamers, more esports participants suffer from hearing problems (4.3%). This finding might provide some clues for future research on the construction of the model of esports skills or performance and the hearing health of esports athletes.
Based on the findings of this study, it is recommended that future research in the field of esports should pay greater attention to the characteristics of the target populations and their corresponding esports modalities. Considering the lack of a widely accepted definition of esports, it is crucial for esports researchers to concentrate on and provide a detailed explication of these factors in order to facilitate meaningful discussions and enhance the comprehension of their research outcomes. Moreover, it is noteworthy that the majority of the existing studies investigating the relationship between esports and health have primarily utilized cross-sectional designs. Therefore, there is an urgent need for future research to employ longitudinal studies or rigorous methodologies to further explore the impact of esports participation on health outcomes. These comprehensive investigations will contribute to a deeper understanding of the effects of esports engagement on individual well-being and will enhance both the credibility and reliability of the existing research findings [11,23].
Furthermore, the comparison of esports players across different genres revealed noteworthy disparities in their gaming habits. Specifically, variations were identified in their preferences regarding seating positions, with some players opting for standardized positions while others prioritized healthier alternatives. Additionally, the practice of taking intermittent breaks during gameplay varied among participants. Notably, shooting gamers demonstrated a heightened emphasis on maintaining proper posture during their gaming sessions. Upon further investigation, it was observed that individuals who consciously adopted the correct sitting postures exhibited a significantly reduced likelihood of experiencing upper and lower back pain or strain. Similarly, those who incorporated intermittent rest periods into their prolonged gaming sessions demonstrated a significantly decreased likelihood of suffering from neck pain and strain. These findings underscore the importance of ergonomic factors in esports, as they contribute to the overall well-being of players. Moreover, a recent study highlighted the benefits associated with breaking up extended periods of sitting, extending beyond mere health implications. Specifically, such breaks were found to enhance players’ performance during prolonged gaming sessions. The implications of these findings suggest that managing sitting time effectively not only promotes acute and chronic health benefits but also positively impacts gameplay performance [73]. The findings of this study also suggested the possibility and significance of exploring a healthier practice in the realm of esports. Such an endeavor would not only have a positive impact on the physical well-being of esports players but also contribute to the development of a more rational and scientifically informed professional esports training model comparable to that observed in traditional sports. Enhancing the physical literacy of esports athletes and cultivating their understanding of health-related factors may play a crucial role both in optimizing their performance and fostering their personal growth.

5. Limitations

Firstly, due to limitations in capacity and resources, this article only focuses on the discussion of the health issues related to esports that are commonly addressed in the majority of the literature. The psychological aspects mentioned in previous studies and physiological health issues not covered in this article were not explored. Many variables in our study are based on self-reporting, which may introduce some potential bias. Further research is needed to delve into these unaddressed areas in order to provide a more comprehensive understanding of the relationship between esports and health. More objective measurement should be considered in future research. This will contribute to a more complete and objective perception of esports among the general public.
Secondly, this study is only a preliminary exploration of the association between esports and health, and longitudinal studies and more rigorous experimental data are still needed to test the findings in the future. And future research could consider including more relevant confounding variables in data analysis to provide a more comprehensive understanding of the relationships.
Thirdly, due to incomplete questionnaire responses from 18 participants, they were not included in the final data analysis.

6. Conclusions

Overall, this study did not find any association between esports participation and negative physical health. On the contrary, esports players demonstrated a more positive level of traditional sports participation compared to non-esports participants. It is important to note that sedentary behavior should not be automatically considered as physical inactivity. This observation also suggests that the health concerns associated with esports, as reported in the existing literature, might primarily apply to professional players and should not be generalized to the wider esports community.
In various esports genres, there are differences in sports participation and gaming habits, but no significant difference was found in physical health problems. Players who consciously maintain a standardized sitting position or take intermittent breaks during extended gaming sessions are less likely to experience back and neck pain. The shooting genre stands out with the highest proportion of players paying attention to their posture while playing. This study emphasizes the potential of exploring a healthier and scientifically grounded approach to esports practice, highlighting the need for serious consideration of esports.
Despite the methodological limitations inherent in this cross-sectional study, it was unable to establish conclusive evidence regarding the specific effects of esports on human health. However, the findings of this study will contribute to updating the public’s understanding of esports and esports players (such as challenging the conventional perception of the negative health effects associated with esports players). Additionally, these findings will provide a more objective understanding of the health status of esports players.

Future Work

  • Further research is needed to explore the long-term effects of esports on both professional and non-professional players. Such research would contribute to a more comprehensive understanding of the potential health risks associated with engaging in esports.
  • Developing an esports practice that considers factors like game duration, posture, nutrition, diets, technology, and devices could be a viable solution. However, further research is needed to better understand the impact of these factors on the health and performance of esports players.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/su152316391/s1.

Author Contributions

D.T.: methodology, data collection, formal analysis, writing—original draft, writing—review and editing, and visualization; K.-w.R.S.: writing—review and editing, supervision, and management and coordination responsibility for the research activity planning and execution; R.M.: data analysis; W.-k.H.: data collection. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was approved by the Survey and Behavioral Research Ethics Committee of The Chinese University of Hong Kong (No. SBRE-21-0432; January 2022). All methods were performed in accordance with the relevant guidelines and regulations.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The authors affirm that all data supporting the findings of this study are available within the article. The complete dataset will be provided upon request.

Conflicts of Interest

The authors declare no conflict of interest.

Abbreviations

CSGOCounter-Strike: Global Offensive
FPSFirst-Person Shooter
MMORPGMassively Multiplayer Online Roleplay Game
MOBAMultiplayer Online Battle Arena
RTSReal-Time Strategy
WCGWorld Cyber Games
WHOWorld Health Organization

References

  1. Block, S.; Haack, F. eSports: A new industry. SHS Web Conf. 2021, 92, 04002. [Google Scholar] [CrossRef]
  2. Hamari, J.; Sjöblom, M. What is eSports and why do people watch it? Internet Res. 2017, 27, 211–232. [Google Scholar] [CrossRef]
  3. Chiu, W.; Fan, T.C.M.; Nam, S.B.; Sun, P.H. Knowledge mapping and sustainable development of esports research: A bibliometric and visualized analysis. Sustainability 2021, 13, 10354. [Google Scholar] [CrossRef]
  4. Parshakov, P.; Coates, D.; Zavertiaeva, M. Is diversity good or bad? Evidence from eSports teams analysis. Appl. Econ. 2018, 50, 5064–5075. [Google Scholar] [CrossRef]
  5. Freeman, G.; Wohn, D.Y. eSports as an emerging research context at CHI: Diverse perspectives on definitions. In Proceedings of the 2017 CHI Conference Extended Abstracts on Human Factors in Computing Systems, Denver, CO, USA, 6–11 May 2017. [Google Scholar]
  6. Pu, H.; Kim, J.; Daprano, C. Can esports substitute traditional sports? The convergence of sports and video gaming during the pandemic and beyond. Societies 2021, 11, 129. [Google Scholar] [CrossRef]
  7. Franke, T. The perception of eSports-mainstream culture, real sport and marketisation. Esports Yearb. 2013, 14, 111–144. [Google Scholar]
  8. Kawabe, K.; Horiuchi, F.; Hosokawa, R.; Nakachi, K.; Soga, J.; Ueno, S.-i. Influence of an Esports Program on Problematic Gaming in Children with Autistic Spectrum Disorder: A Pilot Study. Behav. Sci. 2022, 12, 172. [Google Scholar] [CrossRef]
  9. Bertschy, M.; Mühlbacher, H.; Desbordes, M. Esports extension of a football brand: Stakeholder co-creation in action? Eur. Sport Manag. Q. 2020, 20, 47–68. [Google Scholar] [CrossRef]
  10. Wagner, M.G. On the Scientific Relevance of eSports. In Proceedings of the International Conference on Internet Computing, Las Vegas, NV, USA, 26–29 June 2006; pp. 437–442. [Google Scholar]
  11. Monteiro Pereira, A.; Costa, J.A.; Verhagen, E.; Figueiredo, P.; Brito, J. Associations between esports participation and health: A scoping review. Sports Med. 2022, 52, 2039–2060. [Google Scholar] [CrossRef]
  12. Newzoo. Global Esports & Live Streaming Market Reports. Technical Report. 2022. Available online: https://academyonline.uefa.com/fame/Repository/KissDocument/16005001/3/2/1/8/16005001.pdf (accessed on 1 August 2023).
  13. Jenny, S.E.; Manning, R.D.; Keiper, M.C.; Olrich, T.W. Virtual(ly) Athletes: Where eSports Fit Within the Definition of “Sport”. Quest 2016, 69, 1–18. [Google Scholar] [CrossRef]
  14. Martončik, M. e-Sports: Playing just for fun or playing to satisfy life goals? Comput. Hum. Behav. 2015, 48, 208–211. [Google Scholar] [CrossRef]
  15. Taylor, N. Play to the camera: Video ethnography, spectatorship, and e-sports. Convergence 2016, 22, 115–130. [Google Scholar] [CrossRef]
  16. Seo, Y.; Jung, S.-U. Beyond solitary play in computer games: The social practices of eSports. J. Consum. Cult. 2016, 16, 635–655. [Google Scholar] [CrossRef]
  17. Szot, M.; Karpecka-Galka, E.; Drozdz, R.; Fraczek, B. Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports? Healthcare 2022, 10, 186. [Google Scholar] [CrossRef] [PubMed]
  18. Soffner, M.; Bickmann, P.; Tholl, C.; Froböse, I. Dietary behavior of video game players and esports players in Germany: A cross-sectional study. J. Health Popul. Nutr. 2023, 42, 29. [Google Scholar] [CrossRef] [PubMed]
  19. Goulart, J.B.; Aitken, L.S.; Siddiqui, S.; Cuevas, M.; Cardenas, J.; Beathard, K.M.; Riechman, S.E. Nutrition, lifestyle, and cognitive performance in esport athletes. Front. Nutr. 2023, 10, 1120303. [Google Scholar] [CrossRef] [PubMed]
  20. Kari, T.; Karhulahti, V.-M. Do e-athletes move?: A study on training and physical exercise in elite e-sports. Int. J. Gaming Comput.-Mediat. Simul. 2016, 8, 53–66. [Google Scholar] [CrossRef]
  21. Lindberg, L.; Nielsen, S.B.; Damgaard, M.; Sloth, O.R.; Rathleff, M.S.; Straszek, C.L. Musculoskeletal pain is common in competitive gaming: A cross-sectional study among Danish esports athletes. BMJ Open Sport Exerc. Med. 2020, 6, 000799. [Google Scholar] [CrossRef]
  22. World Health Organization. ICD-11 for Mortality and Morbidity Statistics (2018); World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
  23. Chan, G.; Huo, Y.; Kelly, S.; Leung, J.; Tisdale, C. The impact of eSports and online video gaming on lifestyle behaviours in youth: A systematic review. Comput. Hum. Behav. 2022, 126, 106974. [Google Scholar] [CrossRef]
  24. Rudolf, K.; Bickmann, P.; Froböse, I.; Tholl, C.; Wechsler, K.; Grieben, C. Demographics and health behavior of video game and eSports players in Germany: The eSports study 2019. Int. J. Environ. Res. Public Health 2020, 17, 1870. [Google Scholar] [CrossRef]
  25. KuMari, L.; Sharma, U.; Singh, S. E-Sports, Anxiety, Aggression and Psychological Well-being: A Cross-sectional Study. J. Clin. Diagn. Res. 2022, 16, VC1–VC6. [Google Scholar] [CrossRef]
  26. Chung, T.; Sum, S.; Chan, M.; Lai, E.; Cheng, N. Will esports result in a higher prevalence of problematic gaming? A review of the global situation. J. Behav. Addict. 2019, 8, 384–394. [Google Scholar] [CrossRef]
  27. Yusoff, N.H.; Yunus, Y.H.M. Male Dominant Sport: The Challenges of Esports Female Athletes. Pertanika J. Soc. Sci. Humanit. 2021, 29, 1415–1429. [Google Scholar] [CrossRef]
  28. García, J.; Murillo, C. Sports video games participation: What can we learn for esports? Sports Bus. Manag. 2020, 10, 169–185. [Google Scholar] [CrossRef]
  29. Smith, M.J.; Birch, P.D.; Bright, D. Identifying stressors and coping strategies of elite esports competitors. Int. J. Gaming Comput.-Mediat. Simul. 2019, 11, 22–39. [Google Scholar] [CrossRef]
  30. Sousa, A.; Ahmad, S.L.; Hassan, T.; Yuen, K.; Douris, P.; Zwibel, H.; DiFrancisco-Donoghue, J. Physiological and cognitive functions following a discrete session of competitive esports gaming. Front. Psychol. 2020, 11, 1030. [Google Scholar] [CrossRef]
  31. Lee, S.; Bonnar, D.; Roane, B.; Gradisar, M.; Jang, E.; Suh, S. 0192 Sleep Characteristics and Mood of Professional Esports Athletes: A Multi-National Study. Sleep 2020, 43, A75–A76. [Google Scholar] [CrossRef]
  32. Ekdahl, D.; Ravn, S. Social bodies in virtual worlds: Intercorporeality in Esports. Phenomenol. Cogn. Sci. 2021, 21, 293–316. [Google Scholar] [CrossRef]
  33. Tang, T. Understanding Esports: An Introduction to the Global Phenomenon. J. Broadcast. Electron. Media 2021, 65, 311–313. [Google Scholar] [CrossRef]
  34. Xenopoulos, P.; Doraiswamy, H.; Silva, C. Valuing Player Actions in Counter-Strike: Global Offensive. In Proceedings of the 8th IEEE International Conference on Big Data, Atlanta, GA, USA, 10–13 December 2020. [Google Scholar]
  35. Jang, W.; Byon, K.K. Antecedents and consequence associated with esports gameplay. Int. J. Sports Mark. Spons. 2019, 21, 1–22. [Google Scholar] [CrossRef]
  36. Zimmer, R.T.; Haupt, S.; Heidenreich, H.; Schmidt, W.F.J. Acute Effects of Esports on the Cardiovascular System and Energy Expenditure in Amateur Esports Players. Front. Sports Act. Living 2022, 4, 824006. [Google Scholar] [CrossRef] [PubMed]
  37. Harris, B.; Igelman, A.A.; Pollock, M. peer-to-peer esports sanctioning organization. Gaming Law Rev. 2020, 24, 614–617. [Google Scholar] [CrossRef]
  38. Scholz, T.; Völkel, L.; Uebach, C. Sportification of esports-A systematization of sport-teams entering the esports ecosystem. Int. J. Esports 2021, 2. Available online: https://www.ijesports.org/article/48/html (accessed on 1 August 2023).
  39. Zhou, W.; Yang Zhou, Z. E-sports Report path and mode: A Case Study on China Youth Online. In Proceedings of the 29th International World Wide Web Conference, Taipei, Taiwan, 20–24 April 2020. [Google Scholar]
  40. Parry, J. E-sports are not sports. Sport Ethics Philos. 2019, 13, 3–18. [Google Scholar] [CrossRef]
  41. Holden, J.T.; Kaburakis, A.; Rodenberg, R. The Future Is Now: Esports Policy Considerations and Potential Litigation. J. Leg. Asp. Sport 2017, 27, 46–78. [Google Scholar] [CrossRef]
  42. Scholz, T.M. eSports is Business: Management in the World of Competitive Gaming; Springer International Publishing: Berlin/Heidelberg, Germany, 2019; pp. 1–155. [Google Scholar]
  43. Kane, D.; Spradley, B.D. Recognizing ESports as a Sport. Sport J. 2017, 19, 1–9. [Google Scholar]
  44. Gawrysiak, J.; Burton, R.; Jenny, S.; Williams, D. Using esports efficiently to enhance and extend brand perceptions—A literature review. Phys. Cult. Sport. Stud. Res. 2020, 86, 1–14. [Google Scholar] [CrossRef]
  45. Weiss, T. Cultural Influences on Hedonic Adoption Behavior: Propositions Regarding the Adoption of Competitive Video and Computer Online Gaming. 2008. Available online: https://aisel.aisnet.org/digit2008/7 (accessed on 1 August 2023).
  46. Chung, P.-K.; Ou, K.-l.; Wong, M.Y.C.; Lau, K.-L.; Leung, K.-M. Investigation of Hong Kong students’ Esports participation intentions using the theory of planned behavior approach: A structural equation model. Hum. Behav. Emerg. Technol. 2022, 2022, 6405085. [Google Scholar] [CrossRef]
  47. Wong, M.Y.C.; Chung, P.K.; Ou, K.L.; Leung, K.M. Perception of Hong Kong Teenagers and Young Adults on Esports Participation: A Qualitative Study Using Theory of Planned Behavior. Front. Psychol. 2021, 12, 650000. [Google Scholar] [CrossRef]
  48. HKSAR OotGCIO. Report on Promotion of E-Sports Development in Hong Kong; Hong Kong Cyberport Management Co., Ltd.: Hong Kong, China, 2018. [Google Scholar]
  49. Francis, J.; Eccles, M.P.; Johnston, M.; Walker, A.; Grimshaw, J.M.; Foy, R.; Kaner, E.F.; Smith, L.; Bonetti, D. Constructing Questionnaires Based on the Theory of Planned Behaviour: A Manual for Health Services Researchers; Centre for Health Services Research, University of Newcastle: Newcastle upon Tyne, UK, 2004. [Google Scholar]
  50. Jonasson, K.; Thiborg, J. Electronic sport and its impact on future sport. Sport Soc. 2010, 13, 287–299. [Google Scholar] [CrossRef]
  51. Cranmer, E.E.; Han, D.-I.D.; van Gisbergen, M.; Jung, T. Esports matrix: Structuring the esports research agenda. Comput. Hum. Behav. 2021, 117, 106671. [Google Scholar] [CrossRef]
  52. Jeong, D.; Youk, S. Refining esports: A quantitative cartography of esports literature. Entertain. Comput. 2023, 47, 100597. [Google Scholar] [CrossRef]
  53. Taylor, T. The rise of massive multiplayer online games, esports, and game live streaming. Am. J. Play 2020, 12, 107–116. [Google Scholar]
  54. Ayenigbara, I.O. Gaming disorder and effects of gaming on health: An overview. J. Addict. Med. Ther. Sci. 2018, 4, 1–3. [Google Scholar] [CrossRef]
  55. Zwibel, H.; DiFrancisco-Donoghue, J.; DeFeo, A.; Yao, S. An osteopathic physician’s approach to the Esports athlete. J. Osteopath. Med. 2019, 119, 756–762. [Google Scholar] [CrossRef]
  56. Bretz, F.; Hothorn, T.; Westfall, P. Multiple Comparisons Using R; CRC Press: Boca Raton, FL, USA, 2016. [Google Scholar]
  57. DiFrancisco-Donoghue, J.; Werner, W.G.; Douris, P.C.; Zwibel, H. Esports players, got muscle? Competitive video game players’ physical activity, body fat, bone mineral content, and muscle mass in comparison to matched controls. J. Sport Health Sci. 2022, 11, 725–730. [Google Scholar] [CrossRef]
  58. Palanichamy, T.; Sharma, M.K.; Sahu, M.; Kanchana, D.M. Influence of Esports on stress: A systematic review. Ind. Psychiatry J. 2020, 29, 191–199. [Google Scholar] [CrossRef]
  59. Osorio, G.; Moffat, D.C.; Sykes, J. Exergaming, exercise, and gaming: Sharing motivations. Games Health Res. Dev. Clin. Appl. 2012, 1, 205–210. [Google Scholar] [CrossRef]
  60. Kari, T.; Piippo, J.; Frank, L.; Makkonen, M.; Moilanen, P. To Gamify or Not to Gamify? Gamification in Exercise Applications and Its Role in Impacting Exercise Motivation. 2016. Available online: https://aisel.aisnet.org/bled2016/20 (accessed on 1 August 2023).
  61. Kelly, S.; Leung, J. The new frontier of esports and gaming: A scoping meta-review of health impacts and research agenda. Front. Sports Act. Living 2021, 3, 640362. [Google Scholar] [CrossRef]
  62. Trotter, M.G.; Coulter, T.J.; Davis, P.A.; Poulus, D.R.; Polman, R. The Association between Esports Participation, Health and Physical Activity Behaviour. Int. J. Environ. Res. Public Health 2020, 17, 7329. [Google Scholar] [CrossRef]
  63. Peterson, N.E.; Sirard, J.R.; Kulbok, P.A.; DeBoer, M.D.; Erickson, J.M. Sedentary behavior and physical activity of young adult university students. Res. Nurs. Health 2018, 41, 30–38. [Google Scholar] [CrossRef] [PubMed]
  64. Van der Ploeg, H.P.; Hillsdon, M. Is sedentary behaviour just physical inactivity by another name? Int. J. Behav. Nutr. Phys. Act. 2017, 14, 142. [Google Scholar] [CrossRef]
  65. Ekelund, U.; Brage, S.; Besson, H.; Sharp, S.; Wareham, N.J. Time spent being sedentary and weight gain in healthy adults: Reverse or bidirectional causality? Am. J. Clin. Nutr. 2008, 88, 612–617. [Google Scholar] [CrossRef] [PubMed]
  66. Ekelund, U.; Brage, S.; Griffin, S.J.; Wareham, N.J. Objectively measured moderate-and vigorous-intensity physical activity but not sedentary time predicts insulin resistance in high-risk individuals. Diabetes Care 2009, 32, 1081–1086. [Google Scholar] [CrossRef] [PubMed]
  67. Herber-Gast, G.-C.M.; Jackson, C.A.; Mishra, G.D.; Brown, W.J. Self-reported sitting time is not associated with incidence of cardiovascular disease in a population-based cohort of mid-aged women. Int. J. Behav. Nutr. Phys. Act. 2013, 10, 55. [Google Scholar] [CrossRef] [PubMed]
  68. Pulsford, R.M.; Stamatakis, E.; Britton, A.R.; Brunner, E.J.; Hillsdon, M. Associations of sitting behaviours with all-cause mortality over a 16-year follow-up: The Whitehall II study. Int. J. Epidemiol. 2015, 44, 1909–1916. [Google Scholar] [CrossRef]
  69. Stamatakis, E.; Pulsford, R.M.; Brunner, E.J.; Britton, A.R.; Bauman, A.E.; Biddle, S.J.; Hillsdon, M. Sitting behaviour is not associated with incident diabetes over 13 years: The Whitehall II cohort study. Br. J. Sports Med. 2017, 51, 818–823. [Google Scholar] [CrossRef]
  70. McGee, C.; Ho, K. Tendinopathies in video gaming and esports. Front. Sports Act. Living 2021, 3, 689371. [Google Scholar] [CrossRef]
  71. Pereira, A.M.; Brito, J.; Figueiredo, P.; Verhagen, E. Virtual sports deserve real sports medical attention. BMJ Open Sport Exerc. Med. 2019, 5, e000606. [Google Scholar] [CrossRef]
  72. Marker, C.; Gnambs, T.; Appel, M. Exploring the myth of the chubby gamer: A meta-analysis on sedentary video gaming and body mass. Soc. Sci. Med. 2022, 301, 112325. [Google Scholar] [CrossRef]
  73. DiFrancisco-Donoghue, J.; Jenny, S.E.; Douris, P.C.; Ahmad, S.; Yuen, K.; Hassan, T.; Gan, H.; Abraham, K.; Sousa, A. Breaking up prolonged sitting with a 6 min walk improves executive function in women and men esports players: A randomised trial. BMJ Open Sport Exerc. Med. 2021, 7, e001118. [Google Scholar] [CrossRef]
Sustainability 15 16391 g001
Figure 1. Classification of participants and their corresponding numbers.
Figure 1. Classification of participants and their corresponding numbers.
Sustainability 15 16391 g001
Table 1. Comparison between esports and non-esports participants.
Table 1. Comparison between esports and non-esports participants.
EsportsNon-Esportsp (Chi-Square Test)
Age (mean ± SD) 18.8 ± 1.518.6 ± 1.5
SexMale395 (62%)237 (26%)*** <0.001
Female238 (38%)679 (74%)
(Traditional) Sports participationYes418 (66%)451 (49.2%)*** <0.001
No215 (34%)465 (50.8%)
Visual impairment, myopia, or dry eyeYes350 (55.3%)529 (57.8%)0.339
No283 (44.7%)387 (42.2%)
Hearing impairment or hearing lossYes27 (4.3%)32 (3.5%)0.435
No606 (95.7%)884 (96.5%)
Palm or finger pain or strainYes62 (9.8%)87 (9.5%)0.846
No571 (90.2%)892 (90.5%)
Wrist pain or strainYes56 (8.8%)66 (7.2%)0.238
No577 (91.2%)850 (92.8%)
Neck pain or strainYes84 (13.3%)153 (16.7%)0.065
No549 (86.7%)763 (83.3%)
Upper back pain or strainYes63 (10%)120 (13.1%)0.059
No570 (88.9%)796 (86.9%)
Lower back pain or strainYes65 (10.3%)119 (13%)0.103
No568 (89.7%)797 (887%)
MalnutritionYes28 (4.4%)35 (4.3%)0.555
No605 (95.6%)881 (96.2%)
*** p < 0.001.
Table 2. Comparison of sleep duration and sports frequency between esports and non-esports participants.
Table 2. Comparison of sleep duration and sports frequency between esports and non-esports participants.
EsportsNon-EsportsTotal
Sleep Duration
≤5 h42 (6.6%)70 (7.6%)171 (11%)
5.1–6 h98 (15.5%)189 (20.6%)507 (32.7%)
6.1–7 h210 (33.2%)262 (28.6%)472 (30.5%)
7.1 to 8 h211 (33.3%)296 (32.3%)287 (18.5%)
≥8 h72 (11.4%)99 (10.8%)112 (7.2%)
p (Mann–Whitney U test)0.116 (Z = −1.574, p > 0.05)
Sports Frequency
Almost everyday26 (6.2%)23 (5.1%)49 (5.6%)
Three to five times a week90 (21.5%)91 (20.2%)181 (20.8%)
Once a week164 (39.2%)191 (42.4%)355 (40.9%)
Once or twice a month97 (23.2%)99 (22.0%)196 (88%)
Less than once a month41 (9.8%)47 (10.4%)88 (10.1%)
p (Mann–Whitney U test)0.666 (Z = −0.432, p > 0.05)
Table 3. Comparison among esports participants in different game genres.
Table 3. Comparison among esports participants in different game genres.
Shooting GamesMOBA GamesStrategy Card GamesSports GamesReal-Time
Strategy Games		Fighting Games
Age (mean ± SD) 18.8
± 1.7		18.7
± 1.3		18.7
± 1.2		18.9
± 1.3		19.4
± 3.4		18.6
± 0.9
SexMale9618831491813
Female511332910312
(Traditional) Sports participationYes88 a*207 a*40 a*55 b*8 a*20 a, b
No59 a*114 a*20 a*4 b*13 a*5 a, b
Visual impairment, myopia, or dry eyeYes 88 a 174 a 38 a 30 a 12 a 8 a
No 59 a 147 a 22 a 29a 9 a 17 a
Hearing impairment or hearing lossYes 6 a 13 a 3 a 2 a 1 a 2 a
No 141 308 a 57 a 57 a 20 a 23 a
Palm or finger pain or strainYes 13 a 32 a 9 a 4 a 2 a 2 a
No 134 a 289 a 51 a 55 a 19 a 23 a
Wrist pain or strainYes 16 a 25 a 9 a 1 a 3 a 2 a
No 131 a 296 a 51 a 58 a 18 a 23 a
Neck pain or strainYes 17 a 37 a 13 a 6 a 3 a 8 a
No 130 a 284 a 47 a 53 a 18 a 17 a
Upper back pain or strainYes 16 a 28 a 9 a 6 a 2 a 2 a
No 131 a 293 a 51 a 53 a 19 a 23 a
Lower back pain or strainYes 12 a 35 a 9 a 4 a 1 a 4 a
No 135 a 286 a 51 a 55 a 20 a 21 a
MalnutritionYes 6 a 17 a 1 a 1 a 0 a 3 a
No 141 a 304 a 59 a 58 a 21 a 22 a
Standardized or healthy sitting positionYes 64 a * 107 a, b 13 b * 24 a, b 9 a, b 5 a, b
No 83 a * 214 a, b 47 b * 35 a, b 12 a, b 20 a, b
Intermittent breakYes 101 a 185 a 38 a 37 a 15 a 11 a
No 46 a 136 a 22 a 22 a 6 a 14 a
1. Chi-square tests were conducted to analyze multiple pairwise comparisons. 2. “a, b”: The same letter indicates no significant difference between the two groups, while different letters indicate the presence of a difference between the two groups. 3. * Significant difference exists between this group and some other groups.
Table 4. Comparison of health issues between participants taking different sitting positions and taking intermittent breaks and not.
Table 4. Comparison of health issues between participants taking different sitting positions and taking intermittent breaks and not.
StandardizedNon-Standardizedp (Chi-Square Test)
Wrist pain or strainYes 35 (10.9%)46 (6.5%)* 0.015
No285 (89.1%)660 (93.5%)
Upper back pain or strainYes 26 (8.1%)88 (12.5%)* 0.04
No294 (91.9%)618 (87.5%)
Lower back pain or strainYes 22 (6.9%)85 (12%)* 0.012
No298 (93.1%)621 (88%)
Intermittent breaksNo breaks
Neck pain or strainYes77 (12.3%)76 (19%)** 0.003
No549 (87.7%)324 (81%)
* p < 0.05, ** p < 0.01.
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Tang, D.; Sum, K.-w.R.; Ma, R.; Ho, W.-k. Beyond the Screen: Do Esports Participants Really Have More Physical Health Problems? Sustainability 2023, 15, 16391. https://doi.org/10.3390/su152316391

AMA Style

Tang D, Sum K-wR, Ma R, Ho W-k. Beyond the Screen: Do Esports Participants Really Have More Physical Health Problems? Sustainability. 2023; 15(23):16391. https://doi.org/10.3390/su152316391

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Tang, Di, Kim-wai Raymond Sum, Ruisi Ma, and Wai-keung Ho. 2023. "Beyond the Screen: Do Esports Participants Really Have More Physical Health Problems?" Sustainability 15, no. 23: 16391. https://doi.org/10.3390/su152316391

APA Style

Tang, D., Sum, K. -w. R., Ma, R., & Ho, W. -k. (2023). Beyond the Screen: Do Esports Participants Really Have More Physical Health Problems? Sustainability, 15(23), 16391. https://doi.org/10.3390/su152316391

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