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Fulltext Understanding mental fatigue and its detection: a comparative analysis of assessments and tools

Kunasegaran K, Ismail AMH, Ramasamy S, Gnanou JV, Caszo BA, Chen PL

PeerJ, 2023;11:e15744.
PMID: 37637168 DOI: 10.7717/peerj.15744

Mental fatigue has shown to be one of the root causes of decreased productivity and overall cognitive performance, by decreasing an individual's ability to inhibit responses, process information and concentrate. The effects of mental fatigue have led to occupational errors and motorway accidents. Early detection of mental fatigue can prevent the escalation of symptoms that may lead to chronic fatigue syndrome and other disorders. To date, in clinical settings, the assessment of mental fatigue and stress is done through self-reported questionnaires. The validity of these questionnaires is questionable, as they are highly subjective measurement tools and are not immune to response biases. This review examines the wider presence of mental fatigue in the general population and critically compares its various detection techniques (i.e., self-reporting questionnaires, heart rate variability, salivary cortisol levels, electroencephalogram, and saccadic eye movements). The ability of these detection tools to assess inhibition responses (which are sensitive enough to be manifested in a fatigue state) is specifically evaluated for a reliable marker in identifying mentally fatigued individuals. In laboratory settings, antisaccade tasks have been long used to assess inhibitory control and this technique can potentially serve as the most promising assessment tool to objectively detect mental fatigue. However, more studies need to be conducted in the future to validate and correlate this assessment with other existing measures of mental fatigue detection. This review is intended for, but not limited to, mental health professionals, digital health scientists, vision researchers, and behavioral scientists.

Matched MeSH terms: Mental Fatigue/diagnosis
Fulltext The measurement of mental fatigue following an overnight on-call duty among doctors using electroencephalogram

Su AT, Xavier G, Kuan JW

PLoS One, 2023;18(7):e0287999.
PMID: 37406016 DOI: 10.1371/journal.pone.0287999

This study aimed to measure the spectral power differences in the brain rhythms among a group of hospital doctors before and after an overnight on-call duty. Thirty-two healthy doctors who performed regular on-call duty in a tertiary hospital in Sarawak, Malaysia were voluntarily recruited into this study. All participants were interviewed to collect relevant background information, followed by a self-administered questionnaire using Chalder Fatigue Scale and electroencephalogram test before and after an overnight on-call duty. The average overnight sleep duration during the on-call period was 2.2 hours (p<0.001, significantly shorter than usual sleep duration) among the participants. The mean (SD) Chalder Fatigue Scale score of the participants were 10.8 (5.3) before on-call and 18.4 (6.6) after on-call (p-value < 0.001). The theta rhythm showed significant increase in spectral power globally after an overnight on-call duty, especially when measured at eye closure. In contrast, the alpha and beta rhythms showed reduction in spectral power, significantly at temporal region, at eye closure, following an overnight on-call duty. These effects are more statistically significant when we derived the respective relative theta, alpha, and beta values. The finding of this study could be useful for development of electroencephalogram screening tool to detect mental fatigue.

Matched MeSH terms: Mental Fatigue/diagnosis
Fulltext Does mental fatigue affect skilled performance in athletes? A systematic review

Sun H, Soh KG, Roslan S, Wazir MRWN, Soh KL

PLoS One, 2021;16(10):e0258307.
PMID: 34648555 DOI: 10.1371/journal.pone.0258307

BACKGROUND: Mental fatigue is a psychobiological state induced by a prolonged duration of demanding cognitive tasks. The effects of mental fatigue on physical performance have been well investigated in the literature. However, the effect of mental fatigue on skilled performance in sports remains unclear.
OBJECTIVE: This study aimed to report a comprehensive systematic review investigating the carryover effects of mental fatigue on skilled performance among athletes.
METHODS: A thorough search was conducted on PubMed, Web of Science, EBSCOhost (CENTRAL, SPORTDicus), and Scopus to select relevant literature, as well as on Google Scholar and sources of reference for grey literature. The selected literatures are centred on a mental fatigue protocol in which cognitive tasks are performed prior to athletic tasks. Only studies that used an experimental design to test two conditions, namely mental fatigue and non-mental fatigue, were selected.
RESULTS: Eleven articles were chosen based on the selection criteria. Mental fatigue affects skilled performance in three sports: soccer, basketball, and table tennis. A decline in skilled performance (decreased accuracy, increased performing time etc) is relevant to impaired executive functions. Seven studies focus on offensive skills, whereas only two studies are associated with defensive skills.
CONCLUSION: Mental fatigue has a negative effect on various sports skills of high-level athletes, including their technical and decision-making skills; however, the impact is greater on offensive skills than that of defensive skills in terms of the role of athletes. Impaired executive functions may be responsible for the negative effects of mental fatigue on skilled performance.

Matched MeSH terms: Mental Fatigue/psychology*
Fulltext Effects of mental fatigue on technical performance in soccer players: A systematic review with a meta-analysis

Sun H, Soh KG, Mohammadi A, Wang X, Bin Z, Zhao Z

Front Public Health, 2022;10:922630.
PMID: 35937235 DOI: 10.3389/fpubh.2022.922630

BACKGROUND: Mental fatigue largely influences technical performance in soccer, including offensive and defensive skills. However, these effects on technical performance among the soccer players have not yet been aggregated to be assessed systematically.
OBJECTIVE: The purpose of the review was to evaluate the impact of mental fatigue on soccer players' overall technical skills.
METHODS: Drawing on Web of Science, PubMed, Scopus, and EBSCOhost (CENTRAL and SPORTDicus), an in-depth search was conducted. PICOS established the eligibility criteria to select the studies as follows: (i) population-healthy soccer players; (ii) intervention-involving any mental-fatigue-prompted protocol; (iii) comparison-control conditions (active or passive without inducing mental fatigue); (iv) outcomes-technical performance (offensive and defensive skill); and (v) study design-randomized controlled trials.
RESULTS: A total of eight studies were qualified for inclusion in the systematic literature review. Overall, the results indicate that mental fatigue had significant effects on technical skills, including offensive and defensive skills. Specifically, there were significant effects on errors (ES = 0.977; p < 0.001), number of tackles (ES = -0.739; p = 0.005), and the percentage of successful tackles (ES = -0.628; p = 0.022), while there were no significant effects on the number of passes (ES = 0.240; p = 0.328), the percentage of accurate passing (ES = -0.008; p = 0.985), and the number of successful passes (ES = -0.322; p = 0.217).
CONCLUSION: Overall, a significant effect of mental fatigue on the technical performance (e.g., tackles and errors) of soccer players was detected, while no significant effects on passing skills were detected. Future studies may consider investigating technical performance together with other important results (e.g., decision-making skills or internal load).
SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2022-2-0008/, Inplasy protocol 202220008.

Matched MeSH terms: Mental Fatigue
Development of statistical models for predicting muscle and mental activities during repetitive precision tasks

Zadry HR, Dawal SZ, Taha Z

Int J Occup Saf Ergon, 2016 Sep;22(3):374-83.
PMID: 27053140 DOI: 10.1080/10803548.2016.1150094

This study was conducted to develop muscle and mental activities on repetitive precision tasks. A laboratory experiment was used to address the objectives. Surface electromyography was used to measure muscle activities from eight upper limb muscles, while electroencephalography recorded mental activities from six channels. Fourteen university students participated in the study. The results show that muscle and mental activities increase for all tasks, indicating the occurrence of muscle and mental fatigue. A linear relationship between muscle activity, mental activity and time was found while subjects were performing the task. Thus, models were developed using those variables. The models were found valid after validation using other students' and workers' data. Findings from this study can contribute as a reference for future studies investigating muscle and mental activity and can be applied in industry as guidelines to manage muscle and mental fatigue, especially to manage job schedules and rotation.

Matched MeSH terms: Mental Fatigue/physiopathology
Fulltext Development and validation of Work-Related Activities during Non-Work Time Scale (WANTS) for doctors

Mohd Fauzi MF, Mohd Yusoff H, Mat Saruan NA, Muhamad Robat R

PLoS One, 2020;15(11):e0241577.
PMID: 33206663 DOI: 10.1371/journal.pone.0241577

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.

Matched MeSH terms: Mental Fatigue/prevention & control*
Adjuvant endocrine therapy side-effects among postmenopausal breast cancer patients in Malaysia

Choo SB, Saifulbahri A, Zullkifli SN, Fadzil ML, Redzuan AM, Abdullah N, et al.

Climacteric, 2019 04;22(2):175-181.
PMID: 30556740 DOI: 10.1080/13697137.2018.1540563

OBJECTIVE: This study was conducted to determine the prevalence and severity of menopausal symptoms and their associated risk factors among postmenopausal breast cancer patients receiving adjuvant endocrine therapy.
METHODS: Postmenopausal breast cancer patients on endocrine therapy were recruited at three hospitals in Malaysia. Presence and severity of menopausal symptoms were determined using the Menopause Rating Scale. Sociodemographic and clinical data were collected from medical records.
RESULTS: A total of 192 patients participated in this study. Commonly reported symptoms were musculoskeletal pain (59.9%), physical and mental exhaustion (59.4%), and hot flushes (41.1%). Multivariate analyses indicated that increasing number of years after menopause until the start of endocrine therapy was significantly associated with less likelihood of reporting menopausal symptoms and musculoskeletal pain. Patients with primary or secondary education levels reported significantly less menopausal urogenital symptoms compared to patients with a tertiary education level. Patients using aromatase inhibitors were twice as likely to experience musculoskeletal pain compared to patients using tamoxifen (odds ratio, 2.18; 95% confidence interval, 1.06-4.50; p

Matched MeSH terms: Mental Fatigue/epidemiology