Counteracting mental fatigue for athletes: a systematic review of the interventions.

The deleterious effects of mental fatigue (MF) on athletes have been carefully studied in various sports, such as soccer, badminton, and swimming. Even though many researchers have sought ways to ameliorate the negative impact of MF, there is still a lack of studies that review the interventions used to counteract MF among athletes. This review aims to report the current evidence exploring the effects of interventions on MF and sport-specific performance, including sport-specific motor performance and perceptual-cognitive skills. Web of Science, Scopus, PubMed, and SPORTDicus (EBSCOhost) were combed through to find relevant publications. Additionally, the references and Google Scholar were searched for any grey literature. For the current review, we included only randomized controlled trials that involved athletes, a primary task to induce MF, interventions to counter MF with comparable protocols, and the outcomes of sport-specific motor performance and perceptual-cognitive skill. The selection criteria resulted in the inclusion of 10 articles. The manipulations of autonomous self-control exertion, person-fit, nature exposure, mindfulness, and transactional direct current stimulation showed that positive interventions counteract MF and improve sport-specific performance in different domains, including strength, speed, skill, stamina, and perceptual-cognitive skills. The selected interventions could significantly counteract MF and improve subsequent sport-specific performance. Moreover, self-regulation and attention resources showed the importance of the potential mechanisms behind the relevant interventions.

Regular short-duration breaks do not prevent mental fatigue and decline in cognitive efficiency in healthy young men during an office-like simulated mental working day: An EEG study.

Employees in Europe work on average 7.2 h per day. Prolonged periods of uninterrupted cognitive activity during the working day can cause changes in motivation, mental fatigue, and deterioration in cognitive function. In this exploratory study, we aimed to determine the effectiveness of taking 10-min breaks for light exercise every 50 min in preventing these negative effects during a simulated 7-h office-like computer work. Eighteen healthy young adult men (aged 26 ± 3 years) who did not work in an office participated. The effects of 7 h of office-like work with 10-min breaks every 50 min on central nervous system activity, cognitive function, mood, and motivation were investigated and compared with those measured on a control day without work. Our study found that engaging in 7 h of mental work similar to that found in an office environment, with 10-min breaks every 50 min, can negatively impact cognitive efficiency, suppress brain neural network activity, and cause mental fatigue. These effects do not fully recover after a 4.5-h rest. Additionally, taking short breaks during the workday does not prevent mental exhaustion or impairments in cognitive function. These findings should be considered when discussing strategies to prevent mental exhaustion caused by mental work.

Quantitative and qualitative workload assessment in steep terrain forest operations: fostering a safer work environment through yarder automation.

Many forestry roles have changed from being manual tasks with a high physical workload to being a machine operator task with a high mental workload. Automation can support a decrease in mental fatigue by removing tasks that are repetitive and monotonous for the operators. Cable yarding presents an ideal opportunity for early adoption of automation technology; specifically the carriage movement along a defined corridor. A Valentini V-850 cable yarder was used in an Italian harvesting setting, in order to gauge the ergonomic benefit of carriage control automation. The study showed that automating yarder carriage movements improved the ergonomic situation of the workers directly involved in the related primary tasks. However, the caveat is that improving one work task may negatively affect the other work tasks, and therefore introducing automation to a worksite must be done after considering all impacts on the whole system. Practitioner summary: Automation decreased the winch operator's mental workload while improving overall productivity. At the same time, the mental and physiological workload of the operator tasked with bucking were slightly increased. Ideally, winch automation should be coupled with bucking mechanisation to balance the intervention and boost both operator well-being and productivity.

Quick coherence technique facilitating commercial pilots' psychophysiological resilience to the impact of COVID-19.

This study investigates the effect of quick coherence technique (QCT) on commercial pilots' resilience to the unprecedented impact of a pandemic. Eighteen commercial pilots voluntarily participated in a 2-day training course on QCT followed by 2 months of self-regulated QCT practicing during controlled rest in the flight deck and day-to day life. There are subjective and objective assessments to evaluate the effects of QCT on commercial pilots' psychophysiological resilience. Results demonstrated that QCT training can significantly increase pilots' psychophysiological resilience thereby improving their mental/physical health, cognitive functions, emotional stability and wellness on both subjective (PSS & AWSA) and objective measures (coherence scores). Moreover, pilots who continued practicing self-regulated QCT gained the maximum benefits. Current research has identified great potential to enhance pilots' mental/physical health via QCT training. Operators can develop peer support programs for pilots to increase resilience and maintain mental and physical health using the QCT technique. Practitioner summary: QCT breathing has been proven to increase commercial pilots' resilience by moderating psychophysiological coherence, strengthening mental/physical capacity and sustaining positive emotions to deal with the challenges both on the flight deck and in everyday life.HIGHLIGHTSPilots have suffered from the impact of the Covid-19 pandemic across many factors including social, economic, mental, physical, emotional, and operational issuesBiofeedback training can increase commercial pilots' resilience by moderating psychophysiological coherence, strengthening mental and physical capacitySelf-regulated practicing QCT to form a habitual behaviour is required to sustain the maximum benefits either in the flight or day-to-day lifeQCT is an effective intervention for aviation authorities and airline operators to develop peer support programs to increase pilots' fatigue resilience.

Effects of Five Amino Acids (Serine, Alanine, Glutamate, Aspartate, and Tyrosine) on Mental Health in Healthy Office Workers: A Randomized, Double-Blind, Placebo-Controlled Exploratory Trial.

BACKGROUND: The importance of maintaining good mental health with overall well-being has recently drawn attention from various spheres of academics and the working population. Amino acid intake has been reported to reduce depression symptoms and other mental health problems. However, the effectiveness of amino acid intake (i.e., single or combined) remains unknown. In this study, we assessed a combination of five amino acids (serine, alanine, glutamate, aspartate, and tyrosine; SAGAT) reported to regulate mental health. METHODS: A randomized, double-blind, placebo-controlled exploratory trial was conducted. Participants, aged between 20 and 65 years with fatigue sensation, were randomized to receive either SAGAT or the placebo and ingested them for four weeks. A transient mental work was loaded at day 0 and after four weeks of intervention. As the primary outcomes, the fatigue sensation was assessed. The mood status, cognitive function, work efficiency, and blood marker were also measured as secondary outcomes. RESULTS: The number of participants analyzed for the efficacy evaluation were 20 in SAGAT and 22 in the placebo. There were no significant differences in the primary outcomes. However, as the secondary outcomes, the SAGAT group showed a significant improvement in motivation and cognitive function in the recovery period after mental work loaded in a four-week intervention compared to the placebo. CONCLUSION: The current findings suggest that SAGAT contributes to maintaining proper motivation and cognitive function. CLINICAL TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trial Registry (ID: UMIN 000041221).

Effect of Indoor Forest Bathing on Reducing Feelings of Fatigue Using Cerebral Activity as an Indicator.

We created an indoor forest bathing environment in a sunlight-type environmentally controlled chamber and both physiological and psychological measurements were conducted for the evaluation of mental fatigue reduction. At first, a working memory load experiment was performed among 10 participants in a space without plants to identify an indicator correlating with feelings of fatigue, using the cerebral activity of the prefrontal cortex. Then, the indicator was used to evaluate whether a 20-min exposure to an indoor forest bathing environment reduced the level of the feeling of fatigue. The working memory load experiment demonstrated that, when mental fatigue increased, the amount of oxygenated hemoglobin (oxy-Hb) in the right prefrontal cortex and the right-left difference in oxy-Hb (ΔRL oxy-Hb) in the prefrontal cortex increased. These were proposed as indicators of mental fatigue. In the indoor forest bathing experiment, staying in an indoor green space showed that the subjective values of feeling of fatigue decreased and ΔRL oxy-Hb decreased. Since these results demonstrated an opposite effect to the increase in ΔRL oxy-Hb related to the feeling of fatigue, it was inferred that the decrease in ΔRL oxy-Hb reflected the fatigue reduction in the indoor forest bathing environment.

How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms.

INTRODUCTION: Mental fatigue (MF) is a psychobiological state that impairs cognitive as well as physical performance in different settings. Recently, numerous studies have sought ways to counteract these negative effects of MF. An overview of the explored countermeasures for MF is, however, lacking. OBJECTIVES: The objective of this review is to provide an overview of the different MF countermeasures currently explored in literature. Countermeasures were classified by the timing of application (before, during or after the moment of MF) and type of intervention (behavioural, physiological and psychological). METHODS: The databases of PubMed (MEDLINE), Web of Science and PsycINFO were searched until March 7, 2022. Studies were eligible when MF was induced using a task with a duration of at least 30 min, when they assessed MF markers in at least two out of the three areas wherein MF markers have been defined (i.e., behavioural, subjective and/or [neuro]physiological) and used a placebo or control group for the countermeasure. RESULTS: A total of 33 studies investigated one or more countermeasures against MF. Of these, eight studies assessed a behavioural countermeasure, 22 a physiological one, one a psychological countermeasure and two a combination of a behavioural and psychological countermeasure. The general finding was that a vast majority of the countermeasures induced a positive effect on behavioural (e.g., task or sport performance) and/or subjective MF markers (e.g., visual analogue scale for MF or alertness). No definitive conclusion could be drawn regarding the effect of the employed countermeasures on (neuro)physiological markers of MF as only 19 of the included studies investigated these measures, and within these a large heterogeneity in the evaluated (neuro)physiological markers was present. DISCUSSION: Within the physiological countermeasures it seems that the use of odours during a MF task or caffeine before the MF task are the most promising interventions in combating MF. Promising behavioural (e.g., listening to music) and psychological (e.g., extrinsic motivation) countermeasures of MF have also been reported. The most assumed mechanism through which these countermeasures operate is the dopaminergic system. However, this mechanism remains speculative as (neuro)physiological markers of MF have been scarcely evaluated to date. CONCLUSION: The present systematic review reveals that a wide range of countermeasures have been found to successfully counteract MF on a subjective, (neuro)physiological and/or behavioural level. Of these, caffeine, odours, music and extrinsic motivation are the most evidenced for countering MF. To provide in-detail practical guidelines for the real-life application of MF countermeasures, more research must be performed into the underlying mechanisms and into the optimal dosage and time of application/intake.

Improvements in musculoskeletal symptoms, mental workload and mental fatigue: Effects of a multicomponent ergonomic intervention among call center workers.

BACKGROUND: Call center workers are highly susceptible to work-related musculoskeletal disorders (WRMSDs) as well as mental stress. Nonetheless, there has been a surprising paucity in the body of the research regarding interventions among call center workers. OBJECTIVE: The purpose of this paper is to investigate the effectiveness of a multicomponent ergonomic intervention program on mental workload, mental fatigue and WRMSDs of call center employees. METHOD: A non-randomized interventional study with a single group pretest-posttest design was conducted among 84 call center workers of a private telecommunication company in the city of Tehran, Iran. At the baseline, data regarding WRMSDs prevalence, mental workload and mental fatigue were collected by means of standard Nordic, NASA-TLX and SOFI questionnaires, respectively. Then, subjects participated in a multifaceted intervention program including comprehensive office ergonomic training, work layout improvement, supervised on-site face to face visits, and provision of quality break time encompassing regular exercise program. Follow-up assessment was carried out after 6 months. RESULTS: After the intervention, prevalence of WMSDs in the neck (10%, P = 0.022), lower back (8.4%, P = 0.04), and knees (9.5%, P = 0.02) decreased significantly, while improvements in other body areas remained insignificant. Results also showed a significant decrease in overall score of mental demand (P = 0.000) as well as three of its subscales including performance (P = 0.02), effort (P = 0.001), and frustration (P = 0.025). Additionally, positive effect of the intervention was also observable on overall mental fatigue of call center workers (P = 0.016). As for its subscales, Lack of energy was reported to decrease meaningfully (P = 0.007) while lack of motivation did not change significantly (P = 0.240). CONCLUSION: Although the primary focus of many ergonomic interventions has remained to measure physical outcomes of the work place, our findings show that multicomponent interventions are indeed capable of boosting cognitive aspects of the work as well. The future studies should consider investigating such outcomes.

Effects of mento-physical exercises on mental fatigue of shift work.

Objectives. This study aims to investigate whether mento-physical exercises can decrease mental fatigue during shift work. Methods. Research subjects including the control room staff of an urban train system were chosen randomly, for whom mental fatigue was assessed before and after rest breaks for control and experimental groups. A new protocol was applied in the experimental group, including breathing exercises, isometric and isotonic exercises, and progressive relaxation during the inter-shift break. A designed questionnaire and the Stroop test were used to evaluate fatigue and the reaction time, respectively. Results. Pre and post-test results showed that mental, visual and physical fatigue and reaction time decreased by 14.48, 49.22, 26.85 and 8.35% in the control group and 36.42, 48.48, 76.37 and 20.56% in the experimental group, respectively. Conclusions. At the 5% α level, Student's t test showed that mento-physical exercises effectively decreased mental and physical fatigue as well as reaction time in the experimental group compared to the control group.

Can Nurses Self-Assess Fatigue?: Implications for Nurse Leaders.

OBJECTIVE: The aims of this study were to describe nurses' self-perceptions of fatigue and to examine nurses' acceptance of specific fatigue countermeasures. BACKGROUND: The work of nurses places them at a high risk of fatigue. Evidence suggests 75% to 80% of nurses in the United States experience high levels of fatigue. METHODS: This descriptive, cross-sectional correlational study surveyed 279 nurses. RESULTS: Results suggest that almost half of nurses (46%) are not able to accurately self-assess fatigue. Nurses expressed acceptance of several workplace fatigue reduction strategies. CONCLUSIONS: It may be unrealistic to expect nurses to self-assess fatigue levels and make decisions about their ability to safely provide patient care. Reliable methods for assessing fatigue in the workplace are needed. Several strategies exist that may be used to alleviate fatigue, and many were acceptable to nurses. Nurse leaders are well positioned to implement changes that impact the occurrence of nurse fatigue and thereby the quality of patient care.

Comparing Relaxation Versus Mastery Microbreak Activity: A Within-Task Recovery Perspective.

Recovery from work is generally thought to occur outside of the workplace. However, employees may also have the opportunity to recover within the work day via microbreaks during demanding work tasks. Two major strategies for mitigating fatigue include psychological detachment (i.e., mentally disengaging) and replenishing motivational incentives via positive affect. This study examined whether 40-s "microbreaks" improve work recovery and to what extent different microbreak content (mastery vs. relaxation activities) boost performance. Using an experimental study, we randomly assigned individuals to receive a relaxation microbreak (n = 59), a mastery microbreak (n = 68), or no break (n = 72) in the middle of a monotonous work task and assessed work performance. Microbreaks improved task performance and within-task recovery, but only for psychological detachment (not positive affect). Mastery breaks also resulted in more psychological detachment than relaxation breaks, but this increased detachment did not explain performance differences between break types. These results build on existing recovery theories by further demonstrating within-task recovery and provide practical implications for organizations to consider the importance of microbreaks.

Laryngology Quality of Life Questionnaire Associations: Towards Reducing Survey Burden.

OBJECTIVES: Outcomes in laryngology focus primarily on patient reported outcome measures (PROMs). The increasing number of questionnaires may lead to survey fatigue. We sought to determine the relationship between the newest questionnaire, Laryngopharyngeal Universal Measure of Perceived Sensation (LUMP), and other laryngology PROMs. STUDY DESIGN: Cross-sectional study. METHODS: Patients undergoing laryngology multidisciplinary evaluation prospectively completed laryngology questionnaires. Average summed scores between standard laryngology PROMs (ie, VHI-10, RSI, DI, CSI, EAT-10) and LUMP were compared. Expert consensus panel identified the most clinically relevant statements which were then compared to LUMP summed scores, in increasingly additive fashion. RESULTS: Four hundred eighty patients (259 female) were assessed. Average age was 57.1 ± 17.7 years. Intraclass correlation coefficient (ICC) for each PROM in comparison to LUMP ranged from moderate to poor correlation: 0.64 (RSI), 0.55 (EAT-10), 0.50 (DI), 0.48 (CSI), and 0.34 (VHI-10). ICC for combinations of the five most clinically relevant individual items ranged from 0.29-0.53. CONCLUSIONS: Patients with self-reported globus had statistically significantly higher scores across all PROMs. RSI had moderate correlation with LUMP, and the five selected expert consensus items demonstrated weaker correlation. While RSI may serve as a moderately selective clinical proxy for the LUMP questionnaire, LUMP remains a validated tool with increased specificity for quantification of globus which may be especially important in the research setting. There is continued question about the need for multiple laryngologic PROMs to evaluate patient complaints, and survey reduction remains an area of interest to decrease respondent fatigue, optimize patient care, and quantify interventional success. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1561-1565, 2021.

Concurrent brain endurance training improves endurance exercise performance.

OBJECTIVES: Mental fatigue impairs endurance exercise. Brain endurance training (BET) - engaging in cognitively fatiguing tasks during exercise - can develop resilience to mental fatigue and improve physical performance over physical training alone. The mechanism for this effect is unknown. This experiment examines if BET enhances performance over physical training and investigates potential underlying physiological mechanisms. DESIGN: A mixed design randomised control trial. METHODS: Pre- and post-testing: 36 participants completed dynamic rhythmic muscular endurance handgrip tasks requiring generation of as much force as possible once a second for 300s, performed under 3 counterbalanced conditions: following 600s of a 2-back memory/attention task (subsequent); while performing a 2-back task (concurrent); and on its own (solo). Cardiac activity, electromyographic forearm activity, pre-frontal cerebral haemodynamics (near infrared spectroscopy), and force were recorded. Training: Participants (randomised to a Control or BET group) completed 24 (6 weeks) submaximal hand contractions sessions. The BET group also completed concurrent cognitive tasks (2-back, Stroop). Measures of motivation, physical and mental exertion and mental fatigue were collected throughout. RESULTS: Endurance performance, across the 3 tasks, improved more following BET (32%) than Control (12%) (p<0.05). The better performance following BET occurred with a higher pre-frontal oxygenation during the post-training physical tasks over time relative to Control (p<0.05). CONCLUSIONS: Concurrent BET improved endurance performance over physical training alone. This was accompanied by a training-induced maintenance of pre-frontal oxygenation, suggestive of reduced mental effort during physical activity.

Development and validation of Work-Related Activities during Non-Work Time Scale (WANTS) for doctors.

Work-related activities during non-work time may influence the intershift recovery of post-work fatigue. Currently there is no valid and reliable scale available to measure the frequency for such activities among doctors. Therefore, this study aims to develop and validate 'Work-Related Activities during Non-Work Time Scale' (WANTS) that measure the frequency of work-related activities during non-work time for doctors. This was a scale development and validation study among doctors involving item generation, content and construct validation, and reliability assessment. 23-item seven-point Likert-type scale was developed through deductive (literature search) and inductive (interview with source population, authors' experiences, and expert opinion) methods. The content-validated scale was pre-tested, and the improved scale was subsequently administered to randomly-selected 460 doctors working at public hospital setting. Response rate was 77.76% (n = 382). Initial exploratory factor analysis (EFA) with principal axis factoring (PAF) using varimax rotation revealed unstable six-factor structure consisting of 17 variables; thus, we tested one- to six-factor model, and found that four-factor model is the most stable. Further analysis with principal component analysis (PCA) with a single component on each factor found that 17-variables four-factor model is stable. These factors were labelled as 'work-related thought', 'work-to-home conversation', 'task spillover' and 'superior-subordinate communication'. It showed good internal consistency with overall alpha value of 0.837. The scale is thus valid and reliable for measuring the frequency of each construct of work-related activities during non-work time among doctors.

Utilizing Green Design as Workplace Innovation to Relieve Service Employee Stress in the Luxury Hotel Sector.

This study is an empirical endeavor to provide a clear comprehension regarding how hotel green design as a workplace innovation contributes to relieving employee stress and emotional fatigue and improves job satisfaction and involvement in the formation of organizational citizenship behavior. A quantitative process was employed to attain the research goal. Our empirical findings demonstrated that a green design as a workplace innovation boosts the stress resilience that leads to the decreased emotional exhaustion and increased job satisfaction. In addition, job satisfaction and job involvement were the crucial drivers of the organizational citizenship behavior among the luxury hotel service employees. Moreover, stress resilience, satisfaction and involvement were significant mediators. Job satisfaction and involvement had the strongest influence on organizational citizenship behavior than other variables. The findings of our research will help hotel proprietors to invent efficient strategies to minimize employee stress and maximize fulfillment at work, which will eventually enhance the organizational citizenship behavior.

A 4-week endurance training program improves tolerance to mental exertion in untrained individuals.

OBJECTIVES: The aim of this study was to investigate whether 4 weeks of endurance training could improve tolerance to mental exertion in untrained participants. DESIGN: Longitudinal training study. METHODS: Twenty untrained young adults (14 F, 6 M; 27.6±6.2 years) completed a 4-week training protocol in a randomised and counterbalanced order. Baseline and follow-up assessment were conducted over three sessions in the week preceding and following the training period. During session 1, participants completed an incremental maximal ramp test. During sessions 2 and 3 participants completed a 15min cycling time trial preceded by either a mental exertion or control conditions. Following baseline assessments, participants were randomised into a physical training or placebo group that completed the training intervention thrice weekly over four weeks. RESULTS: The physical training resulted in increase in VO2 peak relative to the placebo group (p=0.003). Linear Mixed Models utilising the control condition time trial performance as a covariate found the physical training group increased their time trial distance following the mental exertion condition to a greater extent than the placebo group (p=0.03). RPE during the time trial and perceptual measures of mental exertion did not significantly change between groups (all p>0.10) although interaction effects were observed when considering the RPE-power output relationship during the time trial. CONCLUSIONS: Four weeks of endurance training increased tolerance to mental exertion in untrained participants during a subsequent physical performance, but not during prolonged cognitive performance. This finding suggests that the ability to tolerate mental exertion is trainable in at least some contexts and highlights the far-reaching benefits of endurance training.

Can Creatine Combat the Mental Fatigue-associated Decrease in Visuomotor Skills?

PURPOSE: The importance of the brain in sports was recently confirmed by the negative effect of mental fatigue (MF) on sport-specific psychomotor skills. Creatine supplementation improves strength but can also improve cognitive functioning. To explore the role of creatine in combating MF, we evaluated whether creatine supplementation counteracts the MF-associated impairment in sport-specific psychomotor skills. METHODS: In 23°C, 14 healthy participants (4 females, 10 males; mean ± SD, age = 24 ± 3 yr, mass = 74 ± 13 kg, height = 179 ± 9 cm) performed a 90-min mentally fatiguing task (counterbalanced, crossover, and double-blinded; i.e., Stroop task) in two different conditions: after a 7-d creatine supplementation (CR; 20 g·d) and after a 7-d calcium lactate supplementation (placebo [PLAC]), separated by a 5-wk washout. In both conditions, a 7-min sport-specific visuomotor task, a dynamic handgrip strength endurance task, and a 3-min Flanker task was performed before and after the mentally fatiguing task. Physiological and perceptual responses were measured throughout the protocol. RESULTS: Handgrip strength endurance was higher in CR compared with PLAC (P = 0.022). MF impaired visuomotor response time (+4.4%; P = 0.022) and Flanker accuracy (-5.0%; P = 0.009) in both conditions. Accuracy on the Stroop task was higher in CR compared with PLAC (+4.9%; P = 0.026). Within the perceptual and physiological parameters, only motivation and vigor (P ≤ 0.027) were lower in CR compared with PLAC. CONCLUSION: Creatine supplementation improved physical (strength endurance) and prolonged cognitive (Stroop accuracy) performance, yet it did not combat MF-induced impairments in short sport-specific psychomotor or cognitive (Flanker) performance. These results warrant further investigation in the potential role of creatine in combating the MF-associated decrements in prolonged (e.g., 90-min soccer game) sport performance and suggest a role of brain phosphocreatine in MF.

COVID-19 pandemic response fatigue in Africa: causes, consequences, and counter-measures.

A notable decline in adherence to COVID-19 preventive measures has been observed despite the increasing number of cases following the suspension of lockdown measures. The African governments have positively responded to the COVID-19 pandemic in previous times, however presently the COVID-19 response on the African continent is in a state of fatigue. Therefore, public vigilance on COVID-19 needs to be reinvigorated through behavioral change communication via different channels of disseminating information. In addition, support systems and social protection should be established to address the COVID-19 pandemic fatigue. Also, increased funding should be made available for enhancing the COVID-19 outbreak response.