Musculoskeletal Pain Among E-sport Athletes

Study Overview
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Brief Summary
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Background: Musculoskeletal (MSK) pain and injuries are common in endurance sports where athletes are required to perform at high intensity for long periods of time. In the short term, MSK pain may significantly impair the athletes' performance, which can lead to unwanted time-off from practice and competitive tournaments. Previous studies found an association between training load, MSK pain and performance. These results indicate that an athlete may experience MSK pain or get injured from both too low and to high training loads. Electronic sports (E-sports), also known as competitive gaming, is defined by Hamari and Sjöblom as a form of sports where the primary aspects of the sport is facilitated by electronic systems; the input of players and teams as well as the output of the E-sports system are mediated by human-computer interference. There are only few data on MSK pain in E-sports, however a small study with 65 participants found that 41% suffered from back or neck pain and more than 1 in 3 had pain related to the wrist. E-sports athletes have to perform for an extended period of time, similar to athletes from traditional endurance sport. As such, MSK pain in E-sports may be associated with training load like it is seen in other sports. Therefore, MSK pain in E-sports could be an unrecognised issue. To provide health professionals with and optimal starting point for managing these issues, there is a need for well-conducted studies on the prevalence of MSK pain among E-sports athletes. In addition, it is highly relevant to investigate if training loads related to E-sports and physical activity levels are different among athletes with MSK pain compared to athletes without MSK pain. Aims: The aims of this questionnaire-based cross-sectional study are to; I) investigate the prevalence of MSK pain in E-sports athletes, II) assess if training loads among athletes with MSK pain are different from athletes without MSK pain, III) investigate if physical activity levels among athletes with MSK pain are different from athletes without MSK pain and IIII) descriptively present data on participant characteristics, sleep patterns, physical activity levels and utilization of health professionals and pain medication in the study population.

Detailed Description
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Data analysis: The prevalence of MSK pain within the study population will be presented in absolute numbers and as percentage values. To investigate if E-sport related training loads differ among athletes with and without MSK pain we will use total E-sport related training load (N hours spend on structured E-sport + N hours spend on unstructured E-sport). An independent sample t-test will be applied for this comparison if data are normally distributed. To assess if physical activity levels are different among athletes with and without MSK pain we will use the responses from the IPAQ short form. For this comparison we will use an independent sample t-test or the Wilcoxon rank-sum test. Participant characteristics, distribution and number of MSK pain sites, utilization of health professionals and pain medicine, physical activity levels, training loads and sleep patterns will be presented descriptively. The data will be presented with means, standard deviations and 95% confidence intervals. Non-parametric data will be presented with absolute numbers and as percentage values, medians and range.

Official Title
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Musculoskeletal Pain Among E-sport Athletes

Conditions
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Musculoskeletal Pain

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 15-35 Engaged in E-sport at an educational institution, a community-based team or a pro-team. Participating in E-sport through a computer-based game. Exclusion Criteria: Not providing written informed consent prior to enrolment.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| E-sport athletes<br>People aged 15-35 who engage in structured E-sport (e.g. community-based, pro team or educational setting). | Other: No intervention<br>* No intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of pain in the body during the previous week. | Participants are asked if they have experienced any pain in their body during the previous week (yes/no). | Baseline - at time of inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary pain site: questionnaire | Participants are asked where in the body they experience their primary pain complaint (list: head, chest, stomach, back, neck, shoulder, upper arm, elbow, forearm, wrist, hand/fingers, hip/groin, thigh, knee, shinbone, ankle, and foot/toes). | Baseline - at time of inclusion | 
| Other pain sites: questionnaire | Participants are asked if they experience pain at additional sites (List: head, chest, stomach, back, neck. Also shoulder, upper arm, elbow, forearm, wrist, hand/fingers, hip/groin, thigh, knee, shinbone, ankle, and foot/toes with the response categories being right, left or both). | Baseline - at time of inclusion | 
| Pain frequency | Responses are presented on a 5-point Likert scale: daily, weekly, several times per week, monthly, rarely | Baseline - at time of inclusion | 
| Pain intensity: numeric pain rating scale | Participants are asked about worst pain during the previous week in relation to their primary pain site. Pain intensity is assessed with a 0 to 10 point numeric pain rating scale (0=no pain; 10= worst possible pain) | Baseline - at time of inclusion | 
| Pain interference | Participants are asked if their pain interference with their participation in E-sport (yes/no). | Baseline - at time of inclusion | 
| Eye fatigue | Participants are asked if they experience eye fatigue related to E-sport (yes/no). | Baseline - at time of inclusion | 
| Training load (structured E-sport) | Participants are asked about the number of hours they spend on structured E-sport where there is a coach present. | Baseline - at time of inclusion | 
| Training load (unstructured E-sport) | Participants are asked about the number of hours they spend on unstructured E-sport without a coach present. | Baseline - at time of inclusion | 
| Physical activity levels | International Physical Activity Questionnaire (IPAQ) short form (7 item questionnaire). This questionnaire assess the number of days per week spent on vigorous and moderate physical activity, walking and sitting. The questionnaire also assess the amount of time per day (hours/minutes) spent on these activities. | Baseline - at time of inclusion | 
| Hours of sleep | Participants are asked about how many hours they sleep on average during a night. | Baseline - at time of inclusion | 
| Trouble falling a sleep | Participants are asked if they have trouble falling a sleep at night (Not at all, some nights, most nights, don't know) | Baseline - at time of inclusion | 
| Waking up several times at night | Participants are asked if they wake up several times at night (Not at all, some nights, most nights, don't know) | Baseline - at time of inclusion | 
| Trouble sleeping through the night | Participants are asked if they have trouble sleeping all through the night (Not at all, some nights, most nights, don't know) | Baseline - at time of inclusion | 
| Tiered in the morning. | Participants are asked if they feel tiered in the morning (Not at all, some mornings, most mornings, don't know) | Baseline - at time of inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Musculoskeletal Pain, Sleep, Training load, E-sport, Physical activity