Investigation of the Immediate Effect of IASTM on Some Parameters in E-Sports Players

Investigation of the Immediate Effect of Instrument-Assisted Soft Tissue Mobilization on Hand Reaction Time, Neck Pain and Cervical Joint Position Sense in University Student E-Sports Players: A Single-Blind Randomized Controlled Pilot Study

Due to the nature of competitive sports, frequent and regular training by e-sports players to increase their performance provides e-athletes with success in the field, but it also increases the time spent in front of the screen. It is known that e-athletes train for an average of 5.5 to 10 hours per day. Therefore, sedentary behavior that develops due to screens is an issue that e-athletes should be careful about. While reasons such as disrupted sleep patterns, increased stress levels and mood changes experienced in the game following increased screen time negatively affect cardiovascular and metabolic health, the fact that e-sports do not require any physical effort also negatively affects the e-sports player's muscular activation. Due to the reasons mentioned, e-sports can cause chronic diseases in the long term. The process from the presence of a stimulus to the execution of the action that will occur following the stimulus is called reaction time. Reaction time can also be described as the value taken when a stimulus exceeds the threshold value, when movement is released or at the beginning of the explosive response. Reaction time consists of stages. The process, which starts with the transmission of the sensory stimulus through the receptors, establishes a perceptual link with the motor response and decides to produce a reactive response, and ends with the process of producing a movement that requires muscular force in the perceptual process. In studies conducted on e-sports players, the most common complaints resulting from long training periods are vision problems and eye fatigue, followed by pain experienced especially in the back, neck and wrist areas. E-sports players perform with poor posture compared to traditional athletes. Games played on mobile phones, especially computer-based games, cause changes in the structure of the spine, pain complaints, movement limitations, and loss of stability and balance. It is argued that the main reason for the pain experienced by approximately half of the players is the anterior displacement of the head due to the prolonged static position spent in front of the screen after a certain number of minutes and the pains brought about by muscle strength imbalances. To our knowledge, there is no study in the literature that investigates the immediate effect of a myofascial release technique applied to university student e-sports players on hand reaction time, neck pain and cervical joint position sense parameters. The aim of this study is to investigate the instantaneous effect of a myofascial release technique, the Graston Technique, on hand reaction time, neck pain and cervical joint position sense in university student e-sports players. Our study is valuable in this respect.

''Electronic sports'' or ''E-sports'' are defined as video games played in a virtual environment in an organized and competitive manner with a specific goal in line with individuals or teams. Although the first steps towards introducing e-sports to the public were taken in the 1970s, it continued to attract attention with the popularity of arcade games in the 1980s. It has also been emphasized that the early 1980s were important years in the history of arcade games. While the first period of e-sports consisted of the times of arcade games, the second period was the period when the use of computers and the internet increased instead of arcade games. It has continued to progress with the variety of games and the variety of internet network technology depending on the developments. E-sports continues to increase its popularity by gaining momentum worldwide with players consisting mainly of the younger population following the development of technology.

Due to the nature of competitive sports, frequent and regular training by e-sports players to increase their performance provides e-sports players with success in the field, but it also increases the time spent in front of the screen. It is known that e-sports players train for an average of 5.5 to 10 hours per day. Therefore, sedentary behavior that develops due to screens is an issue that e-sports players should be careful about. While reasons such as disrupted sleep patterns, increased stress levels and mood changes experienced in the game following increased screen time negatively affect cardiovascular and metabolic health, the fact that e-sports do not require any physical effort also negatively affects the e-sports player's muscular activation. Due to the reasons mentioned, e-sports can cause chronic diseases in the long term.

It is stated that the average career years of a typical professional e-sports players are quite short due to the absolute effort he gives to be the best and to continue in the field. It is expected that this performance of the player, who is expected to make quick and accurate decisions in the moves against the complex visual stimuli presented in the game and the opposing team, will decrease after the age of approximately 24.

The process from the presence of a stimulus to the execution of the action that will occur following the stimulus is called reaction time. Reaction time can also be described as the value taken when a stimulus exceeds the threshold value, when movement is released or at the beginning of the explosive response. Reaction time consists of stages. The process, which starts with the transmission of the sensory stimulus through the receptors, establishes a perceptual link with the motor response and decides to produce a reactive response, and ends with the process of producing a movement that requires muscular force in the perceptual process. Stimuli can be visual, auditory or tactile stimuli. In a study, the reaction time was found to be approximately 190 ms (0.19 sec) for light stimuli and approximately 160 ms (0.16 sec) for sound stimuli. When different studies were examined, the reaction time to visual stimuli was found to be 0.15 s, to auditory stimuli 0.12 - 0.27 s, and to tactile stimuli 0.09 - 0.27 s.

In studies conducted on e-sports players, the most common complaints resulting from long training periods are vision problems and eye fatigue, followed by pain experienced especially in the back, neck and wrist areas. E-sports players perform with poor posture compared to traditional athletes. Games played on mobile phones, especially computer-based games, cause changes in the structure of the spine, pain complaints, movement limitations, and loss of stability and balance. It is argued that the main reason for the pain experienced by approximately half of the players is the anterior displacement of the head due to the prolonged static position spent in front of the screen after a certain number of minutes and the pains brought about by muscle strength imbalances. Professional e-sports players perform up to 400 fine motor movements per minute with minor muscle groups. Clicking/pressing movements originating from controllers used repeatedly for long hours do not remain localized with the fingers and can cause pain or injuries in the hand-wrist, elbow, shoulder and cervical region. Neck pain in particular becomes chronic over time. This is because e-sports players train for long hours and compete in competitions in a bad posture where the head is in an anterior tilt position. There are studies in the literature showing that cervical joint position sense is adversely affected in chronic neck pain.

Since the proprioceptive system provides important informational inputs to the central nervous system for motor planning, a decrease in proprioception may lead to postural changes by causing changes in the control of movement, accuracy and timing of motor commands. Proprioception is necessary for well-adapted sensorimotor control. It plays a role in feedback and feedforward sensorimotor control and muscle stiffness regulation, which are particularly important for movement acuity, joint stability, coordination and balance. Cervical proprioception is uniquely important for head-eye coordination and movement control. Proprioception may be impaired in musculoskeletal disorders due to pain, effusion, trauma and fatigue. There is a strong relationship between cervical disability and neck pain. Among functional changes, active range of motion is an important physical variable for activities of daily living and helps to stabilize and orient the head. In patients with neck pain, it has been proven that the cervical joint range of motion decreases, which may be related to the degree of pain and cervical functionality. In a study, it was shown that the Graston Technique applied to the thoracolumbar fascia increased the range of motion and improved the lumbar joint position sense.

In recent years, the examination and treatment of myofascial pathologies have become an indispensable element of the human neuro-musculoskeletal pathology rehabilitation program. On this basis, many soft tissue techniques and myofascial treatment methods have been developed for a more holistic evaluation and treatment of the human body. Instrument-Assisted Soft Tissue Mobilization (IASTM) is a new range of tools that allow clinicians to efficiently find and treat individuals diagnosed with soft tissue dysfunction. ADYSM is a procedure that has its own indications and limitations, and is rapidly gaining popularity due to its effectiveness and efficiency. Foam Roller, kinesio taping, dry needling, Percussive Massage Technique and Graston Technique applications are some of the IASTM techniques.

One of the most commonly used soft tissue techniques is the Graston Technique, which is a manual therapy approach that uses special instruments to perform static and dynamic soft tissue manipulation, aiming to treat soft tissue limitations and increase tissue flexibility, joint range of motion, and patient functionality. The Graston Technique is a soft tissue mobilization technique performed manually with the help of instruments made of stainless steel. With the Graston Technique, adhesions and limitations in the fascia are eliminated. In this application, the body's self-healing mechanism is used. The tissue healing process is initiated with consciously created microtraumas.

To our knowledge, there is no study in the literature that investigates the immediate effect of a myofascial release technique applied to university student e-sports players on hand reaction time, neck pain and cervical joint position sense parameters. The aim of this study is to investigate the instantaneous effect of a myofascial release technique, the Graston Technique, on hand reaction time, neck pain and cervical joint position sense in university student e-sports players. Our study is valuable in this respect.

Inclusion Criteria:

• being a university student
• exercise in front of a screen for at least 3 hours a day
• become a licensed e-sports player
• volunteering to participate in the study

Exclusion Criteria:

• having had upper extremity surgery
• having visual impairment that may affect the research results
• having a neurological problem
• having an orthopedic problem causing neck pain