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

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Abstract

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.

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Acknowledgements

We would like to thank the Luxemburg Institute of Research in Orthopedics, Sport Medicine and Science (LIROMS) and the Strategic Research Program Exercise and the Brain in Health & Disease: The Added Value of Human-Centered Robotics (SRP17) for their valuable contribution to this work.

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Authors and Affiliations

  1. Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

    Matthias Proost, Jelle Habay, Jonas De Wachter, Kevin De Pauw, Romain Meeusen, Bart Roelands & Jeroen Van Cutsem

  2. BruBotics, Vrije Universiteit Brussel, Brussels, Belgium

    Kevin De Pauw & Romain Meeusen

  3. Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia

    Ben Rattray

  4. Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia

    Ben Rattray

  5. Vital Signs and Performance Monitoring Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium

    Jeroen Van Cutsem

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Correspondence to Jeroen Van Cutsem.

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No sources of funding were used to assist in the preparation of this manuscript.

Conflict of interest

Matthias Proost, Jelle Habay, Jonas De Wachter, Kevin De Pauw, Ben Rattray, Romain Meeusen, Bart Roelands and Jeroen Van Cutsem have no conflicts of interest relevant to the content of this review.

Compliance with ethical standards

Matthias Proost, Jelle Habay, Jonas De Wachter, Kevin De Pauw, Ben Rattray, Romain Meeusen, Bart Roelands and Jeroen Van Cutsem declare that the systematic review complies with all ethical standards.

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The authors declare that all data supporting the findings of this study are available within the manuscript.

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Authorship contribution

The design of the search strategy was performed by MP, and subsequently revised by JH, JDW, BaRo and JVC. Screening on title and abstract was done by MP and JH, while full-text screening was conducted by four authors, i.e., MP, JH, BaRo and JVC. Data analysis was first conducted by MP and JH and was later revised and updated by MP. RoB assessment was performed by MP who also designed the RoB figures. MP wrote the first draft of the manuscript which was later altered by JH, JDW, KDP, BeRa, RM, BaRo and JVC. All authors read, revised and approved the final manuscript.

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Proost, M., Habay, J., De Wachter, J. et al. How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms. Sports Med 52, 2129–2158 (2022). https://doi.org/10.1007/s40279-022-01678-z

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