Background Recent evidence suggests that structured physical exercise (PE) may enhance electronic sports (esports) performance by targeting physiological and cognitive mechanisms similar to those known from traditional athletic training. Esports require rapid decision-making, sustained attention, and fine motor abilities—capacities strongly influenced by regular PE. However, research on the effectiveness and practical implementation of acute and chronic PE interventions on esports performance remains fragmented. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searches were conducted across three major databases, supplemented by snowballing and hand-searching. Studies meeting the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) criteria were subsequently included. Results The review synthesized findings from twelve experimental studies investigating acute and chronic PE interventions with e-athletes of different expertises. The interventions included mostly high-intensity interval-training using cycling, walking, treadmill protocols, and exergaming using virtual reality applications, such as Beat Saber. Eight studies analyzed acute effects of PE interventions and typically ranged from 6 to 30 min, while five studies evaluated chronic PE programs and lasted 8-10 weeks with sessions of about 30 min three times per week (one study analyzed both). Across studies, both acute and chronic PE interventions produced beneficial effects on esports-related outcomes. Acute PE consistently improved performance metrics, e.g., executive function, reaction time, aiming accuracy, and elimination rate. Chronic PE interventions demonstrated mixed results: several studies reported gains in executive functions, overall coordination, and grip strength, whereas others found no significant effects on direct esports-related performance measures. Importantly, rest intervals of up to 30 min between exercise and play did not diminish positive effects, underlining the practical feasibility of PE as part of tournament preparation routines. Conclusions Current evidence supports the systematic inclusion of structured PE in esports training. PE might not only promotes health and stress resilience but also improves cognitive and perceptual abilities directly linked to competitive esports and gaming performance. Future research should standardize esports performance measures, investigate the specific mechanisms of transfer between physical and virtual training, and validate long-term interventions to establish evidence-based PE protocols for e-athletes.
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