Introduction: Esports demand peak cognitive performance from esports athletes (e-athletes), yet their sedentary lifestyle raises concerns.  This pilot study explores the effects of aerobic exercise on executive function, cerebral hemodynamics, and heart rate variability (HRV) during gameplay.

Methods: Six high-ranking male e-athletes (20.8 ± 2.1 years old), ranking in the top 10% of their game, were recruited.  Functional Near-Infrared Spectroscopy measured cerebral hemodynamics, cognitive tests assessed executive function, and electrocardiography measured HRV.  Individualised exercise intensities were set through graded exercise testing, followed by a 10-week treadmill-based cardiovascular training program.

Results: Postintervention, weight, and body mass index remained unchanged (p > .05), but the graded exercise test and heart rate deflection point significantly improved (p < .05). Executive function displayed faster reaction times in the Color Word Stroop Task, and notably more accurate responses in the Parametric Go/No-Go tasks (p < .05), with large effect sizes. Functional Near-Infrared Spectroscopy revealed decreased oxygenated hemoglobin levels during rest, with moderate to large effect sizes, while HRV variables showed significant increases with large effect sizes.

Conclusions: This pilot study introduces a 10-week exercise regimen for e-athletes, suggesting positive impacts on cerebral hemodynamics, executive functions, and HRV, warranting further research.