Mental Fatigue Might Be Not So Bad for Exercise Performance After All: A Systematic Review and Bias-Sensitive Meta-Analysis

Fatigue management: a systematic review of objective measurement techniques for cognitive fatigue

BACKGROUND

Cognitive fatigue is a complex psychobiological state whereby task performance cannot be maintained. Return-to-work protocols typically rely on self-report measures, therefore the current systematic review aimed to identify "real-time" measures of objective cognitive fatigue to inform return-to-work protocols.

METHODS

Studies were included if participants were at least 18 years old, assessed "real-time" objective cognitive fatigue that could be used outside of the lab (neuroimaging measures were, therefore, excluded), used an induction task that was separate to the measurement, were adequately powered, compared objective cognitive fatigue at baseline and post-induction, and included a cognitive fatigue induction task that was at least 30 minutes long.Nine electronic databases were searched until 31 December 2022 (MEDLINE; PsychArticle; PubMED, ProQuest; ProQuest for gray literature; Google Scholar; The Cochrane Library; The Health Technology Assessment Database; and Web of Science), with alerts set up on Google Scholar to notify of new relevant research since this date (reviewed until December 2023). The checklist for quasi-experimental studies (Joanna Briggs Institute, 2014) was used to assess the risk of bias. Whilst a meta-analysis was planned, the data were unsuitable so only a narrative synthesis was conducted.

RESULTS

Fifty-seven studies were included, which were conducted within a variety of settings including naturalistic work scenarios, driving, aviation, and artificial computer-based tasks.Whilst the review found a range of potential measurements, there were inconsistencies in findings across studies highlighting the need for more research into the reliable measurement of objective cognitive fatigue in natural settings.

DISCUSSION

The findings suggest that eye- and body-related measures may be sensitive measures of objective cognitive fatigue. However, comparisons across measurement types should be cautiously interpreted because eye-related and cognitive measures were far more common. The review highlighted the need for more consistent and transparent reporting across the field to advance our understanding of cognitive fatigue.

Mental Fatigue in Sport-From Impaired Performance to Increased Injury Risk

The literature describing the effects of mental fatigue (MF) has grown tremendously. This is accompanied by identification of a host of performance-determining parameters affected by MF. MF results from prolonged cognitive effort and predominantly affects physical, technical, tactical, and perceptual-cognitive dimensions of sport, while physiological parameters (eg, heart rate, lactate) and physical aspects of maximal and supramaximal efforts are predominantly unaffected. The aim of this paper was to provide an overview of the parameters described in the literature as influenced by MF. By identifying the different parameters, we not only see how they affect the performance of athletes but also raise concerns about the potentially increased injury risk due to MF. Preliminary evidence suggests that subsequent disturbances in balance, motor skills, and decision-making processes could potentially increase the vulnerability to injury. An abundance of lab-based studies looked into the effects of MF on performance; however, many questions remain about the mechanisms of origin and neurophysiological causes of MF, and only small steps have been taken to translate this knowledge into practice. Thus, there is a need for more research into the underlying mechanisms of MF and the role of the brain, as well as more applied research with a high ecological validity that also takes into account the potential increased risk of injury due to MF.

The interplay of brain neurotransmission and mental fatigue: A research protocol

INTRODUCTION

Mental fatigue (MF) significantly affects both cognitive and physical performance. However, the precise mechanisms, particularly concerning neurotransmission, require further investigation. An implication of the role of dopamine (DA) and noradrenaline (NA) is stated, but empirical evidence for this theory still needs to be provided. To address this gap, we aim to investigate the role of brain neurotransmission in elucidating if, and how prolonged cognitive activity induces MF and its subsequent impact on cognitive performance.

METHODS

This study (registration number: G095422N) will adopt a randomized cross-over design with sixteen healthy participants aged 18-35 years. The sessions include a familiarization, two experimental (DA: 20mg Methylphenidate; NA: 8mg Reboxetine) conditions, and one placebo (lactose tablet: 10mg) condition. A 60-minute individualized Stroop task will be used to investigate whether, and how the onset of MF changes under the influence of reuptake inhibitors. Attention and response inhibition will be assessed before and after the MF-inducing task using a Go/NoGo task. The integration of physiological (electroencephalography, heart rate), behavioral (attention, response inhibition), and subjective indicators (scales and questionnaires) will be used to detect the underlying mechanisms holistically. Data analysis will involve linear mixed models with significance at p<0.05.

DISCUSSION

The integration of diverse techniques and analyses offers a comprehensive perspective on the onset and impact of MF, introducing a novel approach. Future research plans involve extending this protocol to explore the connection between brain neurotransmission and physical fatigue. This protocol will further advance our understanding of the complex interplay between the brain and fatigue.

A novel protocol to induce mental fatigue

Mental fatigue is a commonplace human experience which is the focus of a growing body of research. Whilst researchers in numerous disciplines have attempted to uncover the origins, nature, and effects of mental fatigue, the literature is marked by many contradictory findings. We identified two major methodological problems for mental fatigue research. First, researchers rarely use objective measures of mental fatigue. Instead, they rely heavily on subjective reports as evidence that mental fatigue has been induced in participants. We aimed to develop a task which led to not only a subjective increase in mental fatigue, but a corresponding performance decrement in the mentally fatiguing task as an objective measure. Secondly, current mental fatigue paradigms have low ecological validity - in most prior studies participants have been fatigued with a single repetitive task such as the n-back or Stroop. To move towards a more ecologically valid paradigm, our participants undertook a battery of diverse cognitive tasks designed to challenge different aspects of executive function. The AX-CPT, n-back, mental rotation, and visual search tasks were chosen to challenge response inhibition, working memory, spatial reasoning, and attention. We report results from 45 participants aged 19 to 63 years who completed a two-hour battery comprising four different cognitive tasks. Subjective fatigue ratings and task performance were measured at the beginning and end of the battery. Our novel method resulted in an increase in subjective ratings of fatigue (p < 0.001) and a reduction in task performance (p = 0.008). Future research into mental fatigue may benefit from using this task battery.

Assessing the Evidential Value of Mental Fatigue and Exercise Research

It has often been reported that mental exertion, presumably leading to mental fatigue, can negatively affect exercise performance; however, recent findings have questioned the strength of the effect. To further complicate this issue, an overlooked problem might be the presence of publication bias in studies using underpowered designs, which is known to inflate false positive report probability and effect size estimates. Altogether, the presence of bias is likely to reduce the evidential value of the published literature on this topic, although it is unknown to what extent. The purpose of the current work was to assess the evidential value of studies published to date on the effect of mental exertion on exercise performance by assessing the presence of publication bias and the observed statistical power achieved by these studies. A traditional meta-analysis revealed a Cohen's dz effect size of - 0.54, 95% CI [- 0.68, - 0.40], p < .001. However, when we applied methods for estimating and correcting for publication bias (based on funnel plot asymmetry and observed p-values), we found that the bias-corrected effect size became negligible with most of publication-bias methods and decreased to - 0.36 in the more optimistic of all the scenarios. A robust Bayesian meta-analysis found strong evidence in favor of publication bias, BFpb > 1000, and inconclusive evidence in favor of the effect, adjusted dz = 0.01, 95% CrI [- 0.46, 0.37], BF10 = 0.90. Furthermore, the median observed statistical power assuming the unadjusted meta-analytic effect size (i.e., - 0.54) as the true effect size was 39% (min = 19%, max = 96%), indicating that, on average, these studies only had a 39% chance of observing a significant result if the true effect was Cohen's dz = - 0.54. If the more optimistic adjusted effect size (- 0.36) was assumed as the true effect, the median statistical power was just 20%. We conclude that the current literature is a useful case study for illustrating the dangers of conducting underpowered studies to detect the effect size of interest.

Individualized Mental Fatigue Does Not Impact Neuromuscular Function and Exercise Performance

INTRODUCTION

Recent studies have questioned previous empirical evidence that mental fatigue negatively impacts physical performance. The purpose of this study was to investigate the critical role of individual differences in mental fatigue susceptibility by analyzing the neurophysiological and physical responses to an individualized mental fatigue task.

METHODS

In a preregistered ( https://osf.io/xc8nr/ ), randomized, within-participant design experiment, 22 recreational athletes completed a time to failure test at 80% of their peak power output under mental fatigue (individual mental effort) or control (low mental effort). Before and after the cognitive tasks, subjective feeling of mental fatigue, neuromuscular function of the knee extensors, and corticospinal excitability were measured. Sequential Bayesian analysis until it reached strong evidence in favor of the alternative hypothesis (BF 10 > 6) or the null hypothesis (BF 10 < 1/6) were conducted.

RESULTS

The individualized mental effort task resulted in a higher subjective feeling of mental fatigue in the mental fatigue condition (0.50 (95% confidence interval (CI), 0.39-0.62)) arbitrary units compared with control (0.19 (95% CI, 0.06-0.339)) arbitrary unit. However, exercise performance was similar in both conditions (control: 410 (95% CI, 357-463) s vs mental fatigue: 422 (95% CI, 367-477) s, BF 10 = 0.15). Likewise, mental fatigue did not impair knee extensor maximal force-generating capacity (BF 10 = 0.928) and did not change the extent of fatigability or its origin after the cycling exercise.

CONCLUSIONS

There is no evidence that mental fatigue adversely affects neuromuscular function or physical exercise; even if mental fatigue is individualized, computerized tasks seem not to affect physical performance.

Mental fatigue impairs physical performance but not the neural drive to the muscle: a preliminary analysis

Mental fatigue (MF) does not only affect cognitive but also physical performance. This study aimed to explore the effects of MF on muscle endurance, rate of perceived exertion (RPE), and motor units' activity. Ten healthy males participated in a randomised crossover study. The subjects attended two identical experimental sessions separated by 3 days with the only difference of a cognitive task (incongruent Stroop task [ST]) and a control condition (watching a documentary). Perceived MF and motivation were measured for each session at baseline and after each cognitive task. Four contractions at 20% of maximal voluntary contraction (MVIC) were performed at baseline, after each cognitive and after muscle endurance task while measuring motor units by high-density surface electromyography. Muscle endurance until failure at 50% of MVIC was measured after each cognitive task and the RPE was measured right after failure. ST significantly increased MF (p = 0.001) reduced the motivation (p = 0.008) for the subsequent physical task and also impaired physical performance (p = 0.044). However, estimates of common synaptic inputs and motor unit discharge rates as well as RPE were not affected by MF (p > 0.11). In conclusion, MF impairs muscle endurance and motivation for the physical task but not the neural drive to the muscle at any frequency bands. Although it is physiologically possible for mentally fatigued subjects to generate an optimal neuromuscular function, the altered motivation seems to limit physical performance. Preliminarily, our results suggest that the corticospinal pathways are not affected by MF.

Work performance in industry: The impact of mental fatigue and a passive back exoskeleton on work efficiency

Mental fatigue (MF) is likely to occur in the industrial working population. However, the link between MF and industrial work performance has not been investigated, nor how this interacts with a passive lower back exoskeleton used during industrial work. Therefore, to elucidate its potential effect(s), this study investigated the accuracy of work performance and movement duration through a dual task paradigm and compared results between mentally fatigued volunteers and controls, with and without the exoskeleton. No main effects of MF and the exoskeleton were found. However, when mentally fatigued and wearing the exoskeleton, movement duration significantly increased compared to the baseline condition (β_MF:Exo = 0.17, p = .02, ω² = .03), suggesting an important interaction between the exoskeleton and one's psychobiological state. Importantly, presented data indicate a negative effect on production efficiency through increased performance time. Further research into the cognitive aspects of industrial work performance and human-exoskeleton interaction is therefore warranted.

Interindividual Variability in Mental Fatigue-Related Impairments in Endurance Performance: A Systematic Review and Multiple Meta-regression

BACKGROUND

The negative effect of mental fatigue (MF) on physical performance has recently been questioned. One reason behind this could lie in the interindividual differences in MF-susceptibility and the individual features influencing them. However, the range of individual differences in mental fatigue-susceptibility is not known, and there is no clear consensus on which individual features could be responsible for these differences.

OBJECTIVE

To give an overview of interindividual differences in the effects of MF on whole-body endurance performance, and individual features influencing this effect.

METHODS

The review was registered on the PROSPERO database (CRD42022293242). PubMed, Web of Science, SPORTDiscus and PsycINFO were searched until the 16th of June 2022 for studies detailing the effect of MF on dynamic maximal whole-body endurance performance. Studies needed to include healthy participants, describe at least one individual feature in participant characteristics, and apply at least one manipulation check. The Cochrane crossover risk of bias tool was used to assess risk of bias. The meta-analysis and regression were conducted in R.

RESULTS

Twenty-eight studies were included, with 23 added to the meta-analysis. Overall risk of bias of the included studies was high, with only three presenting an unclear or low rating. The meta-analysis shows the effect of MF on endurance performance was on average slightly negative (g = - 0.32, [95% CI - 0.46; - 0.18], p < 0.001). The multiple meta-regression showed no significant influences of the included features (i.e. age, sex, body mass index and physical fitness level) on MF-susceptibility.

CONCLUSIONS

The present review confirmed the negative impact of MF on endurance performance. However, no individual features influencing MF-susceptibility were identified. This can partially be explained by the multiple methodological limitations such as underreporting of participant characteristics, lack of standardization across studies, and the restricted inclusion of potentially relevant variables. Future research should include a rigorous description of multiple different individual features (e.g., performance level, diet, etc.) to further elucidate MF mechanisms.

Everything Comes at a Price: Considerations in Modeling Effort-Based Choice

When observing human behavior, one of the key factors determining choice is effort. It is often assumed that people prefer an easier course of action when the alternative yields the same benefits. However, recent research demonstrates that this is not always the case: effort is not always costly and can also add value. A promising avenue to study effort-based choice is to utilize formal decision models that enable quantitative modeling. In this paper, we aim to present an overview of the current approaches to modeling effort-based choice and discuss some considerations that stem from theoretical and practical issues (present and previous) in studies on the role of effort, focusing on the connections and discrepancies between formal models and the findings from the body of empirical research. Considering that effort can, in some circumstances, act as a cost and as a benefit, reconciling these discrepancies is a practical and theoretical challenge that can ultimately lead to better predictions and increased model validity. Our review identifies and discusses these discrepancies providing direction for future empirical research.

The acute effects of mental fatigue on balance performance in healthy young and older adults - A systematic review and meta-analysis

Cognitive resources contribute to balance control. There is evidence that mental fatigue reduces cognitive resources and impairs balance performance, particularly in older adults and when balance tasks are complex, for example when trying to walk or stand while concurrently performing a secondary cognitive task. We conducted a systematic literature search in PubMed (MEDLINE), Web of Science and Google Scholar to identify eligible studies and performed a random effects meta-analysis to quantify the effects of experimentally induced mental fatigue on balance performance in healthy adults. Subgroup analyses were computed for age (healthy young vs. healthy older adults) and balance task complexity (balance tasks with high complexity vs. balance tasks with low complexity) to examine the moderating effects of these factors on fatigue-mediated balance performance. We identified 7 eligible studies with 9 study groups and 206 participants. Analysis revealed that performing a prolonged cognitive task had a small but significant effect (SMDwm = -0.38) on subsequent balance performance in healthy young and older adults. However, age- and task-related differences in balance responses to fatigue could not be confirmed statistically. Overall, aggregation of the available literature indicates that mental fatigue generally reduces balance in healthy adults. However, interactions between cognitive resource reduction, aging and balance task complexity remain elusive.

Mental Fatigue-Associated Decrease in Table Tennis Performance: Is There an Electrophysiological Signature?

Mental fatigue (MF) is a psychobiological state negatively impacting both cognitive and physical performance. Although recent research implies that some table tennis (TT) performance outcomes are impaired by MF, open skill sports such as TT require a more detailed overview of MF-related performance decrements. Moreover, research into MF and sport-specific psychomotor performance lacks the inclusion of brain-related measurements to identify MF mechanisms. Eleven experienced TT players participated in this randomized counterbalanced crossover trial. Participants were either required to perform an individualized Stroop task (MF condition) or watch a documentary (control condition). The primary outcomes were reaction time on a sport-specific visuomotor task and EEG activity throughout the trial. The subjective feeling of MF was significantly different between both conditions and confirmed that the MF condition induced the mentally fatigue state of participants (p < 0.001), though no behavioral indicators (i.e., decrease in performance on Stroop and flanker task) of MF. MF worsened reaction time on the visuomotor task, while other secondary measurements remained largely ambiguous. Spectral power (i.e., decreases in upper α band and θ band) was influenced by MF, while ERPs measured during the visuomotor task remained unaltered. The present study confirms that MF negatively impacts table tennis performance, specifically inhibitory stimuli during the visuomotor task. These findings also further augment our understanding of the effects of MF on human performance.

Correction: Mental Fatigue Might be Not So Bad for Exercise Performance After All: A Systematic Review and Bias-Sensitive Meta-Analysis

This article details a correction to: Holgado, D., Sanabria, D., Perales, J. C., & Vadillo, M. A. (2020). Mental Fatigue Might Be Not So Bad for Exercise Performance After All: A Systematic Review and Bias-Sensitive Meta-Analysis. Journal of Cognition, 3(1), 38. DOI: https://doi.org/10.5334/joc.126

Investigating the Effects of Mental Fatigue on Resistance Exercise Performance

Mental fatigue can impart negative effects on subsequent physical performance, although the mechanisms underlying these effects are not well understood. This study examined whether mental fatigue confers negative carryover effects on the performance of a set of biceps curls, while also investigating physiological and psychological mechanisms proposed to explain the predicted effect. A randomized, cross-over design was employed. On visit 1, participants (N = 10) performed a barbell biceps curl one-repetition maximum (1RM) test. On visits 2-3, participants performed 20 biceps curls at 50% of their 1RM, followed by their respective 10 min experimental manipulation (high vs. low cognitive exertion) and then a second set of biceps curls to exhaustion. Ratings of perceived exertion and electromyography of the biceps brachii, triceps brachii, upper trapezius, thoracic erector spinae and lumbar erector spinae were recorded during the physical task. The total number of repetitions completed was similar across the conditions. Results also failed to show between-condition differences for muscle activation and perceptions of exertion. Future research is needed to build an adequate knowledge base to determine whether there is an effect of mental fatigue on dynamic resistance-based task performance and, if so, identify the mechanisms explaining how and why.

Can Rules in Technical-Tactical Decisions Influence on Physical and Mental Load during Soccer Training? A Pilot Study

This study aimed to analyze the effects of rules limitations in pass decisions during soccer tasks on physical and mental load reported by players. Participants were 40 semiprofessional Spanish soccer players (Mage = 22.40, SD = 2.25) from two male teams. Two training sessions with four tasks (same tasks with different score system: two maintaining ball possession games with goalkeepers, and two maintaining ball possession games) in counterbalanced order between teams were completed. To achieve a goal during limitation tasks, a minimum number of players had to participate in the passes before the goal. Internal (perceived effort and heart rate) and external physical load (distances), mental load (validated adaptation of the NASA-TXL) and fatigue (VASfatigue) were quantified. Paired t-test and magnitude-based inference were conducted. The results showed significantly higher mean speeds (p < 0.01), effort perception (p < 0.001), and mental fatigue (very likely positive) during possession games with restrictions. Additionally, performance satisfaction obtained significantly higher values with goalkeepers and pass restrictions (very likely positive). External physical load showed no significant differences between situations. The influence of mental fatigue on internal load and the complexity of the tasks could explain these results. Coaches can use this information to manipulate the training load in ecological conditions.

Non-local Muscle Fatigue Effects on Muscle Strength, Power, and Endurance in Healthy Individuals: A Systematic Review with Meta-analysis

BACKGROUND

The fatigue of a muscle or muscle group can produce global responses to a variety of systems (i.e., cardiovascular, endocrine, and others). There are also reported strength and endurance impairments of non-exercised muscles following the fatigue of another muscle; however, the literature is inconsistent.

OBJECTIVE

To examine whether non-local muscle fatigue (NLMF) occurs following the performance of a fatiguing bout of exercise of a different muscle(s).

DESIGN

Systematic review and meta-analysis.

SEARCH AND INCLUSION

A systematic literature search using a Boolean search strategy was conducted with PubMed, SPORTDiscus, Web of Science, and Google Scholar in April 2020, and was supplemented with additional 'snowballing' searches up to September 2020. To be included in our analysis, studies had to include at least one intentional performance measure (i.e., strength, endurance, or power), which if reduced could be considered evidence of muscle fatigue, and also had to include the implementation of a fatiguing protocol to a location (i.e., limb or limbs) that differed to those for which performance was measured. We excluded studies that measured only mechanistic variables such as electromyographic activity, or spinal/supraspinal excitability. After search and screening, 52 studies were eligible for inclusion including 57 groups of participants (median sample = 11) and a total of 303 participants.

RESULTS

The main multilevel meta-analysis model including all effects sizes (278 across 50 clusters [median = 4, range = 1 to 18 effects per cluster) revealed a trivial point estimate with high precision for the interval estimate [- 0.02 (95% CIs = - 0.14 to 0.09)], yet with substantial heterogeneity (Q₍₂₇₇₎ = 642.3, p < 0.01), I² = 67.4%). Subgroup and meta-regression analyses showed that NLMF effects were not moderated by study design (between vs. within-participant), homologous vs. heterologous effects, upper or lower body effects, participant training status, sex, age, the time of post-fatigue protocol measurement, or the severity of the fatigue protocol. However, there did appear to be an effect of type of outcome measure where both strength [0.11 (95% CIs = 0.01-0.21)] and power outcomes had trivial effects [- 0.01 (95% CIs = - 0.24 to 0.22)], whereas endurance outcomes showed moderate albeit imprecise effects [- 0.54 (95% CIs = - 0.95 to - 0.14)].

CONCLUSIONS

Overall, the findings do not support the existence of a general NLMF effect; however, when examining specific types of performance outcomes, there may be an effect specifically upon endurance-based outcomes (i.e., time to task failure). However, there are relatively fewer studies that have examined endurance effects or mechanisms explaining this possible effect, in addition to fewer studies including women or younger and older participants, and considering causal effects of prior training history through the use of longitudinal intervention study designs. Thus, it seems pertinent that future research on NLMF effects should be redirected towards these still relatively unexplored areas.

A Primer on the Role of Boredom in Self-Controlled Sports and Exercise Behavior

Self-control is critical for successful participation and performance in sports and therefore has attracted considerable research interest. Yet, knowledge about self-control remains surprisingly incomplete and inconsistent. Here, we draw attention to boredom as an experience that likely plays an important role in sports and exercise (e.g., exercise can be perceived as boring but can also be used to alleviate boredom). Specifically, we argue that studying boredom in the context of sports and exercise will also advance our understanding of self-control as a reward-based choice. We demonstrate this by discussing evidence for links between self-control and boredom and by highlighting the role boredom plays for guiding goal-directed behavior. As such, boredom is likely to interact with self-control in affecting sports performance and exercise participation. We close by highlighting several promising routes for integrating self-control and boredom research in the context of sports performance and exercise behavior.