Thinking About Elite Performance: The Experience and Impact of Mental Fatigue in Elite Sport Coaching.

PURPOSE: Mental fatigue causes decreases in aspects of athletes' performance. Elite coaches commonly undertake cognitively demanding tasks and are seemingly at similar risk of subsequent performance impairment. However, elite sport coaches' experiences of mental fatigue, alongside other markers of psychobiological stress, have yet to be quantified. METHODS: Three elite coaching and performance staff (2 women and 1 man) provided 100-mm visual analog scale ratings of mental fatigue, physical fatigue, readiness to perform, and salivary samples for later cortisol (sCort) and alpha-amylase (sAA) analysis. Data were obtained on the same morning each week across a 16-week preseason. Data were subset by individual coach for descriptive and repeated-measures correlational analyses. RESULTS: Fluctuating mental fatigue was observed over the 16 weeks (min-max; coach 1 = 25-86 AU; coach 2 = 0-51 AU; and coach 3 = 15 - 76 AU). Elevated levels of mental fatigue were reported at multiple time points, with individual variability observed. sCort (in nanomoles per liter), sAA (in micromoles per liter), and sAA:sCort indicated that coaches experienced psychophysiological stress (min-max; coach 1 sCort = 8.42-17.31, sAA = 52.40-113.06, sAA:sCort = 3.20-12.80; coach 2 sCort = 4.20-9.70, sAA = 158.80-307.20, sAA:sCort = 21.10-61.70; and coach 3 sCort = 6.81-19.66, sAA = 86.55-495.85, sAA:sCort = 4.90-35.50). A significant inverse relationship between mental fatigue and readiness to perform (r = -.44 [-.64 to -.17], P = .002) was identified. CONCLUSIONS: Elite sport coaches report elevated instances of mental fatigue during a preseason training period. Those involved in elite sports should act to understand the presence and potential subsequent impacts of staff mental fatigue and consider management or mitigation strategies. Optimization of the cognitive performance of coaches and performance staff presents as a potential source of competitive advantage.

Efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus: A randomized SHAM-controlled trial.

AIMS: To determine the efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus (T2D), and any persistent benefits 7 weeks following treatment. METHODS: 50 participants with T2D were randomly assigned to either 1) 20x45-minute ECP sessions over 7 weeks (ECP45), 2) 20x30-minute ECP sessions over 7 weeks (ECP30) or 3) SHAM control. Outcomes were assessed at baseline, after 7 weeks of the intervention and 7 weeks after the interventions finished. Efficacy was determined from changes in HbA1c. RESULTS: After 7 weeks, there were significant between-group differences, with ECP45 lowering HbA1c compared to SHAM (mean [95% CI] -0.7 [-0.1 to -1.3] %; -7 [-1 to -15] mmol/mol). Within group changes were; ECP45 (mean ± SD -0.8 ± 0.8%; -8 ± 8 mmol/mol), ECP30 (-0.2 ± 0.5%; -2 ± 6 mmol/mol) and SHAM (-0.1 ± 0.9%; -1 ± 10 mmol/mol). HbA1c in the ECP45 group remained lower 7 weeks after completing the intervention; ECP45 (7.0 ± 1.1%; 53 ± 26 mmol/mol), ECP30 (7.7 ± 1.4%; 60 ± 16 mmol/mol) and SHAM (7.7 ± 1.0%; 60 ± 10 mmol/mol). CONCLUSIONS: In people with T2D, ECP45 for 7 weeks improved glycemic control when compared to ECP30 and a SHAM control group.

The Effectiveness of Online Mental Health First Aid Training in Community Rugby: A Mixed-Methods Approach.

Mental Health First Aid (MHFA) training exists to improve supportive behaviours towards peers, increase mental health literacy, and reduce stigma. Community sport clubs have potential to successfully deliver mental health programs. This study investigated the effectiveness of online MHFA training undertaken by members of the rugby community and evaluated the feasibility and usefulness of the online delivery mode and users' engagement with it. A mixed-methods approach was used to provide depth of understanding through qualitative analysis, combined with quantitative outcomes. Online surveys examining participants' knowledge and perceptions were administered pre- and post-MHFA training. Significant improvements (p < 0.05) across all assessed domains were observed post- compared to pre-MHFA training. A large effect size was identified in relation to advice giving and sign and symptom identification. A moderate effect size pre- to post-improvement was identified for users' perceptions of therapy's effectiveness, the ability of people with severe mental health conditions to recover, and benefit of a healthcare professional. Participants endorsed the MHFA program to improve mental health literacy, advance non-technical skills, and improve confidence. MHFA training can increase the awareness and knowledge of mental health issues in key individuals in community sport clubs and enable them to aid people with mental health concerns. Online MHFA training is associated with improved mental health literacy and may be a suitable and economically sustainable model for community sport.

Mental fatigue increases across a 16-week pre-season in elite female athletes.

OBJECTIVES: To examine potential changes in mental and physical fatigue across an elite netball pre-season training phase and relationships between mental fatigue, physical fatigue, salivary cortisol (sCort) and alpha-amylase (sAA). DESIGN: Observational with repeated measures. METHODS: Across a 16-week pre-season, 10 elite female netballers (25.3 ±â€¯3.7y) rated their physical fatigue, mental fatigue and readiness to perform on 100-mm visual analogue scales, and provided salivary samples for sCort and sAA analyses. RESULTS: Linear mixed model analyses revealed elevated (p < 0.05) ratings of mental fatigue for weeks 12, 14 and 15 v 1; 12, 14 and 15 v 4 and 14 v 7. Higher (p < 0.05) ratings of physical fatigue were reported on weeks 6, 10, 11 and 12-16 compared to week 4; and 10 and 13 compared to week 7. Moderate and large ES differences were found between multiple weeks. Mental and physical fatigue demonstrated a shared variance of 14.3% (r = 0.38, p < 0.001) and an inverse relationship was observed between mental fatigue and readiness to perform (r = -0.50; p < 0.001). Changes in sCort nor sAA were not related to changes in mental or physical fatigue. CONCLUSIONS: Mental fatigue fluctuated across the 16-week pre-season phase with elevated ratings observed in the later weeks. Whilst value remains in identifying subjective tools to assess mental fatigue; salivary biomarkers do not appear to be a suitable objective indicator of mental fatigue in the applied sporting environment. Practitioners should work to identify and manage mental fatigue with the same level of importance given to the periodisation of physical fatigue.

How do elite female team sport athletes experience mental fatigue? Comparison between international competition, training and preparation camps.

Mental fatigue has been shown to negatively influence physical, technical and tactical aspects of sporting performance. However, mental fatigue is not routinely monitored or managed in elite sport and it is not clear whether mental fatigue occurs and/or changes across the varied contextual demands experienced by elite athletes in training, preparation and competition. This study explored self-report measures of mental fatigue across eight training camps and six competition periods (two benchmark tournaments and four international test series) with international netballers (n = 22, 25.9 ± 2.7 years) during the 2018-2019 representative period. Mental fatigue was higher during training camps (p < 0.001; 3.20 [3.12, 3.27]) and preparation camps (p < 0.05; 3.27 [3.19, 3.34]) compared to the competition periods (3.49 [3.44, 3.55]). Significant within-group differences were also identified between individual preparation camps and competition subsets. Higher mental fatigue was reported during the preparation camp for international test series 2 comparative to the preparation camp for benchmark tournament 1 (p = 0.047). For individual competitions; greater mental fatigue was found during the international test series 3 competition in comparison to both the benchmark tournament 1 (p <0.001) and international test series 1 (p = 0.020) competition periods. International representative netballers experience differing levels of mental fatigue across training and preparation camps and competition periods. Practitioners should be aware that athletes report instances of elevated mental fatigue across camps, and competition. Mental fatigue is not limited to competition and thus is recommended to be monitored during periods of training and preparation for competition. HighlightsInternational representative netballers experience differing levels of mental fatigue across camp and competition environments.Mental fatigue was higher during training camps and preparation camps compared to the competition periods.Mental fatigue is not limited to competition so is recommended to be monitored during periods of training and preparation for competition.

Mental Fatigue Over 2 Elite Netball Seasons: A Case for Mental Fatigue to be Included in Athlete Self-Report Measures.

PURPOSE: Mental fatigue is emerging as an important consideration for elite sporting performance, yet it is rarely monitored. The present study assessed changes in mental fatigue in professional team-sport athletes across 2 seasons and examined the relationship between mental fatigue and other athlete self-report measures of well-being. METHODS: Elite netballers contracted to all teams competing in Australia's premier professional netball competition during the 2018 and 2019 seasons (N = 154) participated. Using 5-point Likert scales, mental fatigue, fatigue (physical), tiredness, sleep quality, stress, mood, and motivation were assessed daily across 2 seasons composed of 14 round and finals series. RESULTS: The ratings of mental fatigue significantly changed during both seasons. In 2018, lower ratings of mental fatigue were reported in round 1 versus 3, 4, 6, 8, and 14; round 7 versus 6; and round 6 versus 10 (P < .05). In 2019, lower ratings of mental fatigue were identified for round 1 versus 3, 9, 10 to 14, and semifinal; round 2 versus 10 to 13; and 5 versus 10 to 12 (P < .05). Ordinal regression revealed significant differences between mental fatigue and physical fatigue (P < .001), tiredness (P < .001), stress (P < .001), mood (P < .001), and motivation (P < .05). CONCLUSIONS: The present study found mental fatigue to significantly fluctuate across a season in elite netballers. Moreover, perceived mental fatigue differed from physical fatigue, tiredness, stress, mood, and motivation. The data impress the need for mental fatigue to be included as an independent measure of athlete well-being. Monitoring of mental fatigue can allow practitioners to implement strategies to manage its influence on performance.

Physiological and Perceptual Recovery-Stress Responses to an Elite Netball Tournament.

PURPOSE: To investigate and explore the relationships between physiological and perceptual recovery and stress responses to elite netball tournament workloads. METHODS: Nine elite female netballers were observed across a 3-day (T1-3), 4-match tournament. Participants provided salivary samples for cortisol and alpha-amylase analysis, completed the Short Recovery Stress Scale (SRSS), and reported session ratings of perceived exertion. Inertial measurement units and heart-rate monitors determined player load, changes of direction (COD), summated heart-rate zones, and jumps. RESULTS: Analysis revealed 6 significant SRSS time effects: (1) decreased recovery markers of physical performance (P = .042), emotional balance (P = .034), and overall recovery (P = .001) and (2) increased perceptual stress markers of muscular stress (P = .001), negative emotional state (P = .026), and overall stress (P = .010). Salivary cortisol decreased over the tournament (T1-3) before progressively increasing posttournament with greater salivary samples for cortisol on T+2 compared with T3 (P = .014, ES = -1.29; -2.24 to -0.22]) and T+1 (P = .031, ES = -1.54; -2.51 to -0.42). SRSS overall recovery moderately negatively correlated with COD (r = -.41, P = .028) and session ratings of perceived exertion (r = -.40, P = .034). Cumulative workload did not relate to posttournament perceptual or salivary responses. Percentage change in salivary variables related (P < .05) to total player load, total COD, and overall recovery across specific cumulative time periods. CONCLUSIONS: During and after an elite netball tournament, athletes indicated increased perceptual stress and lack of recovery. The SRSS is a valuable tool for recovery-stress monitoring in elite tournament netball. It is recommended that practitioners monitor COD due to its negative influence on perceived overall recovery.

Effects of Nutritional Interventions on Accuracy and Reaction Time with Relevance to Mental Fatigue in Sporting, Military, and Aerospace Populations: A Systematic Review and Meta-Analysis.

Background: Research in sport, military, and aerospace populations has shown that mental fatigue may impair cognitive performance. The effect of nutritional interventions that may mitigate such negative effects has been investigated. This systematic review and meta-analysis aimed to quantify the effects of nutritional interventions on cognitive domains often measured in mental fatigue research. Methods: A systematic search for articles was conducted using key terms relevant to mental fatigue in sport, military, and aerospace populations. Two reviewers screened 11,495 abstracts and 125 full texts. A meta-analysis was conducted whereby effect sizes were calculated using subgroups for nutritional intervention and cognitive domains. Results: Fourteen studies were included in the meta-analysis. The consumption of energy drinks was found to have a small positive effect on reaction time, whilst the use of beta-alanine, carbohydrate, and caffeine had no effect. Carbohydrate and caffeine use had no effect on accuracy. Conclusions: The results of this meta-analysis suggest that consuming energy drinks may improve reaction time. The lack of effect observed for other nutritional interventions is likely due to differences in the type, timing, dosage, and form of administration. More rigorous randomized controlled trials related to the effect of nutrition interventions before, during, and after induced mental fatigue are required.

Effect of External Counterpulsation on Running Performance and Perceived Recovery.

PURPOSE: To determine the efficacy of 20 minutes of external counterpulsation (ECP) on subsequent 1.2-km shuttle run test (1.2SRT) performance and perceived recovery following fatiguing high-intensity exercise. METHODS: After familiarization, 13 recreationally active males (21.4 [1.9] y) participated in 2 experimental trials in a randomized crossover design. At 8:00 AM, participants completed a 1.2SRT, followed by an individualized high-intensity exercise bout and 20 minutes of ECP or supine passive rest (control). At 2:00 PM a second 1.2SRT was completed. Completion time for 1.2SRT (measured in seconds), heart rate, and Borg rating of perceived exertion were compared across conditions. Total quality of recovery and 100-mm visual analogue scale of perceived benefit of recovery were assessed at multiple time points. RESULTS: A significantly smaller decline in PM 1.2SRT completion time compared with AM (baseline) was found for ECP compared with control (P = .008; moderate, very likely beneficial effect size of -0.77 [-1.53 to 0.05]). Total quality of recovery was significantly higher for ECP than control (P < .001), and perceived benefit of recovery was higher following ECP (P < .001, very large, most likely beneficial effect size of 2.08 [1.22 to 2.81]). CONCLUSIONS: Twenty minutes of ECP was found to be an effective recovery modality for within-day, between-bouts exercise, positively influencing subsequent 1.2SRT performance and enhancing perceptual recovery. ECP may be applied as a viable alternative to optimize and accelerate the recovery process, particularly in the event of congested training or competition demands.

Changes in subjective mental and physical fatigue during netball games in elite development athletes.

OBJECTIVES: To assess the magnitude of changes in, and relationships between, physical and mental fatigue pre-to-post match in elite development netballers. DESIGN: Observational. METHODS: Twelve female netballers (21.3±2.9 years) competing in the Australian Netball League reported perceptual measures of mental and physical fatigue pre- and post-match on 12 separate competition occasions. Minutes played, to allow for calculation of weighted changes (ratings proportional to playing time), positional groups and performance analysis variables were also assessed. RESULTS: Post-match ratings were higher (p<0.01) than pre-match for both mental (pre: 31.02±19.28; post: 44.73±24.47) and physical fatigue (pre: 28.86±15.37; post: 47.21±24.67). The correlation coefficient between change in mental and physical fatigue (r=0.37, p<0.01) revealed a shared variance of 13.9%. Acute changes in mental fatigue were related to minutes played (r=0.32, p<0.01) as was change in physical fatigue (r=0.59, p<0.01). No differences in change in mental fatigue were found between positional groups (p=0.07) though change in physical fatigue was higher for shooters compared to defenders (p<0.05). Performance variables revealed no relationships with mental or physical fatigue, with the exception of turnover number with both post-match weighted physical (r= -0.23, p<0.01) and weighted-change in physical fatigue (r=-0.16, p<0.05). CONCLUSIONS: Mental and physical fatigue were found to increase across netball matches in elite development athletes. Mental fatigue emerged as a largely separate construct to physical fatigue.

What is mental fatigue in elite sport? Perceptions from athletes and staff.

Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity shown to negatively influence physical performance. Variation exists across the literature regarding the manifestations and impact of mental fatigue; with little knowledge of the domain-specific manifestations in elite sport. The difficulties in defining mental fatigue may explain why it is not consistently assessed by coaching or support staff. The aim of this study was therefore to investigate athlete and staff understandings of mental fatigue in elite sport. Nine focus group discussions were conducted involving a total of 32 athletes (n = 17) and staff (n = 15) from elite sporting organisations. Athletes and staff believe mental fatigue negatively impacts sporting performance. Analysis revealed perceived associations between mental fatigue and changes in behaviour including, disengagement, decreased motivation and enthusiasm, increased displays of emotion and withdrawal. Changes in concentration, decreased discipline and attention to detail also emerged as descriptors of mental fatigue. Media engagements, study and work commitments were reported to induce mental fatigue. Repetitive tasks, over-analysis, thinking about the sport in question and environmental instability were further reported perceived causes. Experience and personality emerged as factors contributing to individual susceptibility. Mental fatigue is perceived to not only develop acutely but also build in a cumulative manner in the elite sporting environment. The present findings inform the design of future studies examining MF in elite athletes; they also hold the potential to improve how best to monitor and manage the condition in applied practice.

The application of mental fatigue research to elite team sport performance: New perspectives.

OBJECTIVES: Mental fatigue resulting from prolonged periods of demanding cognitive activity, has been found to impair endurance exercise performance and performance in some sport-specific tasks. The application of such research to the elite sporting environment however is limited. DESIGN & METHODS: This article reviews the literature relevant to mental fatigue and team sporting performance with aim to provide perspectives on the transferability and significance of currently available evidence to the applied elite sporting context. RESULTS: Inconsistent findings in the limited available literature can be attributed to large variations in the participants involved, the nature of the cognitively demanding tasks used to induce mental fatigue and the tests used to assess performance outcomes. Few studies have used trained athletes in combination with performance tests that accurately represent the physiological and technical demands experienced by athletes in competition. While there is growing interest in the acute influence of mental fatigue on exercise performance, a potential cumulative effect of mental fatigue on performance over, for example, a competitive season is an area yet to be investigated. CONCLUSIONS: If it is accepted that mental fatigue impairs the performance of some athletes, then improving the ecological validity of research in the area of mental fatigue and sport will significantly advance our understanding of how to better monitor and manage mental fatigue. At the elite level of competition, where outcomes are determined by very small margins of difference, reducing the impact of mental fatigue on performance has potential to be significant.