Effects of Combining Occupationally Relevant Physical and Cognitive Tasks. A Systematic Review.

OBJECTIVES: Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review investigated to which extent combinations (concurrent or alternating) of occupationally relevant physical and cognitive tasks influence responses reflecting biomechanical exposure, stress, fatigue, performance, and well-being. METHODS: We searched Scopus, Pubmed, Cinahl, and Psychinfo for controlled experiments investigating the effects of combinations of occupationally relevant physical and cognitive tasks in participants aged 18 to 70. In total, we identified 12 447 records. We added recent papers that had cited these studies (n = 573) to arrive at a total of 13 020 publications. After screening for relevance, 61 studies remained, of which 57 were classified to be of medium or high quality. Of the 57 studies, 51 addressed concurrent tasks, 5 alternating tasks, and 1 both concurrent and alternating tasks. RESULTS: Most studies of concurrent physical and cognitive tasks reported negative effects, if numerically small, on indicators of biomechanical exposure, fatigue, and performance, compared to a physical task alone. Results were mixed for stress indicators, and well-being was too little studied to justify any conclusions. Effects depended on the tasks, including their intensity and complexity. Alternating physical and cognitive tasks did not appear to influence outcomes much, compared to having passive breaks in-between physical tasks. CONCLUSIONS: The reviewed evidence indicated that concurrent physical and cognitive work tasks have negative, yet small effects on biomechanical indicators, fatigue and performance, compared to performing the physical task alone, but only if the physical task is intense, and the cognitive task is complex. Alternating between physical and cognitive tasks may have similar effects as breaking up physical tasks by passive breaks, but studies were few. Future studies should address ecologically valid combinations of physical and cognitive tasks, in particular in controlled field studies devoted to the long-term effects of combined work.

Fatigue, Stress, and Performance during Alternating Physical and Cognitive Tasks-Effects of the Temporal Pattern of Alternations.

In occupational life, performing cognitive work tasks in between fatiguing physical work tasks may allow recovery and reduce stress without losing productive working time. The temporal pattern of such alternations is likely a determinant of the recovery effect, influencing both stress and fatigue; the difficulty of the cognitive task (CT) would also be a likely determinant. The aim of this study was to determine to what extent the temporal pattern of alternations between a repetitive physical task and a CT of different difficulties influenced perceived fatigability, performance fatigability, stress-related outcomes, and performance. Fifteen women performed four work sessions comprising 110 min of repeated bouts of a repetitive physical task (pipetting), alternating with a CT (n-back). Sessions differed in bout cycle time (short: 7 + 3 min versus long: 14 + 6 min) and CT difficulty (CTdiff; easy versus difficult). Fatigue was assessed from recordings of maximal voluntary contraction force in shoulder elevations and handgrip pre- and post-work, electromyography (EMG) from the right trapezius and right forearm extensors during work, and repeated self-ratings of fatigue and pain throughout the session. Stress was assessed using electrocardiography (heart rate variability), salivary alpha-amylase, and self-reports. Perceived fatigue increased significantly over time for all protocols and more in long-cycle than short-cycle conditions. EMG activity did not increase markedly over time in any condition. Neither objective nor subjective indicators suggested that stress increased over time, regardless of the temporal pattern. Pipetting performance remained stable in all conditions. Cognitive performance, measured by the proportions of correct positive and false positive answers, differed between CTdiff levels but remained stable over time, with no significant difference between temporal patterns. In summary, temporal patterns of alternating tasks influenced fatigue to some extent but had no obvious influence on stress indicators or performance. Thus, designing job rotation with alternating physical and cognitive work should consider the temporal patterns of alternations to minimize fatigue.

Stress-Related Responses to Alternations between Repetitive Physical Work and Cognitive Tasks of Different Difficulties.

Alternating between physical and cognitive tasks has been proposed as an alternative in job rotation, allowing workers to recover from the physical work while still being productive. However, effects of such alternations on stress have not been investigated. This controlled experiment aimed at determining the extent to which stress-related responses develop during alternating physical and cognitive work, and to determine the extent to which cognitive task (CT) difficulty influences these responses. Fifteen women performed three sessions of 10 consecutive work bouts each including a seven-minute repetitive physical task (pipetting) and a three-minute CT (n-back) at one of three difficulty levels. Stress was assessed in terms of changes in heart rate variability, blood pressure, salivary alpha-amylase, salivary cortisol, perceived stress, and cognitive performance. The work session did not result in any marked stress response, and CT difficulty did not significantly influence stress, apart from alpha-amylase being higher at the easiest CT (F = 5.34, p = 0.02). Thus, according to our results, alternating between repetitive physical tasks and cognitive tasks may be a feasible alternative to classic job rotation between physical tasks only, even if the cognitive task is quite difficult. Future studies should address possible effects of the temporal pattern of alternations, and combine even other occupationally relevant tasks, preferably for extended periods of time.

Alternations between physical and cognitive tasks in repetitive work - effect of cognitive task difficulty on fatigue development in women.

In a context of job rotation, this study determined the extent to which the difficulty of a cognitive task (CT) interspersed between bouts of repetitive, low-intensity work (pipetting) influences recovery from fatigue. Fifteen participants performed three experimental sessions, each comprising 10 repeats of a 7 min + 3 min combination of pipetting and CT. The CT was easy, moderate or hard. Surface electromyography (EMG amplitude of the forearm extensor and trapezius muscles) and self-reports was used to assess fatigability. Perceived fatigue and trapezius EMG amplitude increased during sessions. CT difficulty influenced fatigue development only little, besides forearm extensor EMG increasing more in CT3 than in CT1 and CT2. During CT bouts, fatigability recovered, and to a similar extent irrespective of CT. Thus, CT difficulty influenced recovery of perceived as well as performance fatigability to a minor extent, and may not be a critical issue in job rotation comprising alternating physical and cognitive tasks. Practitioner summary: Alternations between physical and cognitive tasks may be an attractive option for job rotation. In this study on women, we show that the difficulty of the cognitive task influences recovery from fatigue only little and we conclude that cognitive difficulty, within reasonable limits, may be a minor issue in job rotation.

Variation at work: alternations between physically and mentally demanding tasks in blue-collar occupations.

The aims of this questionnaire study were to describe the occurrence and desired number of alternations between mental and physical tasks in industrial and non-industrial blue-collar work, and determine to which extent selected personal and occupational factors influence these conditions. On average, the 122 participating workers (55 females) reported to have close to four alternations per day between mental and physical tasks, and to desire more alternations than they actually had. They also expressed a general preference for performing a physical task after a mental task and vice versa. In univariate regression models, the desired change in task alternations was significantly associated with gender, age, occupation, years with current work tasks and perceived job control, while occupation was the only significant determinant in a multiple regression model including all factors. Our results suggest that alternations between productive physical and mental tasks could be a viable option in future job rotation. Practitioner Summary: We addressed attitudes among blue-collar workers to alternations between physically and mentally demanding tasks. More alternations were desired than those occurring in the job, and workers preferred performing a physical task after a mental and vice versa. Alternating physical and mental tasks could, thus, be a viable option in job rotation.