Ratings Of Fatigue Research Articles

Fatiga mental y p´ádel: estado de la cuestión

Padel is attracting increased research interest. Although the focus has been on the physical and technical-tactical demands of the game, recently more attention is being paid to its mental demands and, more specifically, the importance of mental fatigue. This literature review provides an overview of mental fatigue in padel. First, we consider the mentally fatiguing nature of padel. Padel players must make complex decisions under high-time pressure, maintain self-confidence, and communicate with their partners in an emotionally charged context. With these cognitive demands, it is not surprising that padel matches and tournaments are mentally fatiguing. Second, we review evidence confirming that mental fatigue is detrimental for padel players’ performance, in agreement with findings observed in other sports. Third, we evaluate strategies to tackle mental fatigue and its effects on padel performance. Until now, the only proven long-term countermeasure is Brain Endurance Training. Finally, we make a series of recommendations for coaches and players to deal with mental fatigue, that focus on the quantification and modulation of mental fatigue among padel players. We strongly recommend i. to include subjective ratings of mental fatigue (i.e., VAS scale) before and after training and competitive matches, ii. to reduce the cognitive load of training before competitions by, for example, use positive feedback or habitual training exercises, and iii. to use Brain Endurance Training during non-competitive moments of the season.

Managing the challenge of fatigue for pilots operating ultra-long range flights

IntroductionUltra-long range (ULR) flights are defined as exceeding regulatory limits: normally 16 h flight time. They pose challenges due to long duty periods that could result in extended wakefulness and sleep loss, increasing the risk of fatigue. This study describes the mitigations used to manage fatigue in these operations. Two data collection phases were conducted on the Auckland-Chicago ULR route: when the route commenced (Study 1) and when the flight crew complement was altered (Study 2). Seasonal differences were also investigated.MethodsStudy 1 involved 72 crew who completed diaries and wore an actigraph to record sleep pre-departure, throughout the trip, and on return. In-flight, fatigue, sleepiness and workload were reported, and reaction time performance was measured. Study 2 involved 75 crew and data collection in the northern summer and northern winter. Crew completed diaries throughout the trip.ResultsStudy 1 data found crew sleep longer than usual in the 24 h pre trip and post flights. On the shorter outbound flight in-flight sleep averaged 3.3 h and on the longer inbound flight, 3.3–3.8 h, with most crew taking 3 breaks. Ratings of sleepiness and fatigue increased, and reaction time performance declined across flights, with greater decrements on longer inbound flights. Pilots did not fully adjust their sleep patterns to local time during the layover and no seasonal differences were found. Comparisons between Study 1 and 2 showed no difference in ratings of fatigue and sleepiness or in-flight sleep duration with an altered crew complement. There was a trend for Captains to report greater workload and less in-flight sleep in Study 2.DiscussionMitigations that allow for preparation and recovery are well utilized by crew. In-flight sleep is relatively short and ways of increasing the amount of sleep obtained should be considered. The incomplete adaptation of sleep during the layover has implications for rest break strategies on the return flight. The altered crew complement did not result in higher levels of fatigue or sleepiness or less in-flight sleep on average, although findings suggest a need to understand the effects of changing the crew complement on workload and in-flight sleep for Captains.

Fatigue recovery and connected factors following paediatric concussion

ObjectiveUsing a biopsychosocial framework and the three-factor fatigue model, we aimed to (1) plot recovery of fatigue over the 3 months following paediatric concussion and (2) explore factors associated with...

The Effects of Reading Speed on Acoustic Voice Parameters and Self-reported Vocal Fatigue in Students.

Vocal loading tasks (VLTs) help researchers gather acoustic measurements and understand how a healthy speaker adjusts their voice in response to challenges. There is a dearth of evidence measuring the impact of speaking rate in VLTs on acoustic voice parameters and vocal fatigue. In the present study, the relationships between acoustic voice parameters and self-reported vocal fatigue were examined through an experimental VLT. 38 students completed a 45-minute VLT which involved the recording of three randomized reading tasks. The tasks varied by the speed in which the words were presented (slow, medium, fast) on a computer monitor. Vocal fatigue ratings were measured subjectively using a Borg scale and negative adaptations to vocal loading were measured objectively using Sound Pressure Level (SPL, in dBA), fundamental frequency (fo, in semitones), and phonation time (Dt %). Analysis indicated that vocal fatigue increases with time, and the slope of this relationship is affected by the speaking rate. SPL and fo increased with speaking rate and the standard deviation of SPL and fo decreased with speaking rate. On average, the male participants' phonation time values were 7.8% lower than the female participants. The rate of increase of vocal fatigue with time during the experiment was higher in the fast speaking style compared to the slow and medium ones. The results provide support that the novel VLT altered multiple vocal parameters to induce measurable changes in vocal fatigue.

Managing cabin crew fatigue during ultra-long range operations

IntroductionUltra-long range (ULR) flights have the potential to increase fatigue-related risk for cabin crew, if the extended flight times are associated with extended wakefulness, sleep loss and higher levels of crew fatigue. ULR flights may also require longer opportunities for recovery sleep. This study evaluates the utilization of fatigue risk mitigations for cabin crew operating the Auckland – Chicago ULR route with a two-day layover.Methods65 cabin crew (45 women; aged 20–59 years) wore an actigraph and completed a sleep/duty diary for 3 local nights prior to, throughout, and for 3 local nights after a ULR trip. Crewmembers rated their fatigue (Samn-Perelli Crew Status Check), sleepiness (Karolinska Sleepiness Scale), and workload (OW; NASA-TLX) at key times during each flight. Jet lag was rated each day at home and during layover.ResultsFatigue and sleepiness were highest at top-of-descent and after landing and were higher on the inbound flight than on the outbound flight. For every hour of additional sleep in-flight, top-of-descent fatigue ratings decreased by 0.24 points and top-of-descent sleepiness ratings decreased by 0.38, whereas top-of-descent fatigue and sleepiness ratings increased by 0.24 points with every 10-point increase in OW ratings. Crew slept more in the 24-hours prior to the outbound (M = 8.5 h) and inbound flights (M = 9.1 h) compared to pre-trip baseline days (M = 8.2 h). Post-trip, crew slept more during the first day (M = 9.9 h) compared to baseline, with 95% taking a daytime nap. Jet lag ratings decreased daily on return home but were still higher on the fourth day than on the day of the outbound flight.DiscussionCabin crew prepare for ULR flights by obtaining more sleep prior to departure. However, large individual differences in sleep and declining jet lag ratings across pre-trip days suggest that some crewmembers may still be recovering from a previous trip. Further refinement of in-flight sleep strategies and workload mitigations could be considered for managing fatigue risk at top-of-descent. Findings also highlight the importance of a protected period of post-trip rest to facilitate cabin crews' recovery from the effects of sleep restriction and circadian disruption associated with this ULR trip.

Positive imagery in depressive suicidal patients: A randomized controlled trial of the effect of viewing loved ones’ photos on mood states and suicidal ideation

According to research, it has been suggested that individuals who are affected by depression could potentially engage in the creation and experience emotional advantages relating to positive events directed towards the past or future, with the condition that they are provided with suitable mental imagery techniques. The main aim of this study was to assess the impact of utilizing positive imagery, specifically through the utilization of photographs featuring loved ones, on mood states and suicidal ideation among individuals diagnosed with depression and exhibiting suicidal tendencies. This randomized, double-blind, controlled crossover trial was conducted among 78 hospitalized depressive patients at three psychiatric services between April and August 2019. The patients participated in four individual picture-viewing sessions on four consecutive days. The four categories of pictures were included: loved ones, neutral faces of strangers, natural landscapes, and optical illusions. Directly prior to and immediately following the observation of the visual stimuli (photographs), the Brunel Mood Scale (BRUMS) and the Beck Scale for Suicide Ideation (BSSI) were completed by the patients. Repeated measures ANOVAs conducted in this study revealed a significant main effect of time on ratings of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). Additionally, statistically significant interactions were identified between picture category and time in relation to the variables of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). The analysis did not reveal a significant main effect of time on ratings of anger, confusion, and suicidal ideation (P values > 0.05). Likewise, the interaction between picture category and time did not yield significant results for the variables of anger, confusion, and suicidal ideation (P values > 0.05). The positive imagery procedure using the presentation of loved ones’ photos showed beneficial effects on the mood states of depressed patients. The findings of this study suggest that incorporating a greater emphasis on positive imagery within the context of clinical depression may offer potential advantages. This highlights the potential for novel opportunities in the treatment of depression. Trial registrationThe study has been registered in the Iranian Registry of Clinical Trials (registration number: IRCT20180808040744N1; first registration date: December 22, 2018; website: https://en.irct.ir/trial/33186).

A - 06 Sensitivity of Remote App-Based Assessment of Cognition among Older Adults to Fatigue-Mediated Differences in Cognitive Functioning.

This study assesses the sensitivity of the mobile cognitive app performance platform (mCAPP), a mobile and engaging cognitive assessment tool, to participant reported fatigue. The mCAPP includes three gamified tasks: a memory task ("Concentration"), a stroop-like task ("Brick Drop"), and a digit-symbol coding-like task ("Space Imposters"). For all games, shorter reaction times and fewer guesses indicate better performance. The cohort included 55 participants (72.73% female; age = 71.60 ± 4.48; education = 16.71 ± 2.30; 49.1% white; 49.1% Black/African American, 1.8% Multiracial) without cognitive impairment who are enrolled in the Penn ADRC cohort. Performance was analyzed as a whole and grouped into days of high (7+) and low (0-3) fatigue (range 0-10). The average fatigue rating was 2.61 ± 2.51. Overall, higher reported fatigue was weakly correlated with more time spent (ρ= 0.22) and a higher number of guesses on Concentration (ρ= 0.12; p-values<0.01). There was a significant difference in speed for those with high fatigue (M = 2.825) and low fatigue (M = 2.592; p = 0.018) on Space Imposters, but not on Brick Drop (p = 0.15). On Concentration, those with high fatigue needed a higher number of guesses (M = 5.356) compared to low fatigue (M = 5.095; p = 0.003) and more time was spent on individual guesses for those with high fatigue (M = 17.587) compared to low fatigue (M = 13.357; p < 0.001). The mCAPP can remotely detect differences in cognitive performance in self-reported high and low fatigue states. Future studies will include looking at sleep data to determine objective measures of fatigue-related behavior and in-depth analysis of performance within-subject.

Effects of different cluster-set rest intervals during plyometric-jump training on measures of physical fitness: A randomized trial.

The optimal intra-set rest for cluster sets (CLS) during plyometric-jump training (PJT) to improve physical fitness remains unclear. The objective of this quasi-experimental study was to compare the effects of PJT with traditional (TRS) vs. CLS structures, using different intra-set rests, on the physical fitness of healthy participants. Forty-seven recreationally active young men performed 3-5 sets of 10-12 repetitions of upper- and lower-body PJT exercises twice a week for six weeks using different set configurations: TRS group (no intra-set rest), and the CLS10, CLS20 and CLS30 groups with 10, 20 and 30 s of intra-set rest, respectively, while the total rest period was equated. Pretest-posttest measurements were carried out 48 h before and after the intervention and the rating of fatigue (ROF) was also assessed using a numerical scale (0-10 points) 20 min after the first and last (i.e., 12th) session. There was no significant difference in the mean energy intake between groups (p > 0.05). The repeated measures ANOVA revealed that all groups showed similar improvements (p < 0.05) in body mass, body mass index, fat-free mass, one repetition maximum (dynamic strength) and repetitions to failure (muscular endurance) in back squat and chest press, handgrip strength, standing long jump, 20 m sprint, 9-m shuttle run (change of direction speed), and ROF. Of note, the ROF was lower for the CLS20 and CLS30 groups, independent from the training effect. The physical fitness of recreationally active young men improved after 6 weeks of PJT involving intra-set rest intervals of 0 s, 10 s, 20 s, or 30 s. However, an intra-set rest of 20 s and 30 s seems to induce lower exercise-induced fatigue perception.

Flight Path and Scheduling Effects on Perceived Jet Lag, Fatigue, and Sleep in Footballers Traveling to and From National Teams.

This study examined posttravel perceptual responses of national-team footballers (soccer) following different flight paths, arrival/departure times, and trip contexts. Details of 396 flights from national-team players (N = 68) were obtained and verified via an online flight database. Each player provided ratings of perceptual fatigue, sleep, soreness, stress, and jet lag for 2days before and after each trip. The flight path (continents of departure and arrival), travel context (into vs out of national team), and arrival and departure times were obtained for each trip. Linear mixed models compared the pretravel with posttravel change in perceptual responses based on flight path, context, and schedule. Perceived jet-lag ratings were more responsive to travel variables (R2 = .48) than other perceptual ratings (R2 < .26). Travel from Asia to Europe (P < .05) and Europe to Australia (P < .001) had significantly higher jet-lag ratings than all other paths. Fatigue scores were worst following Asia to Europe (P < .05) and Europe to Australia (P < .05) travel, while sleep scores were worst following Europe to Australiatravel (P < .01). Perceptual responses were poorer following travel from national team to club compared with all other travel contexts (P < .05). Arrival during the daytime (11 AM to 5 PM) resulted in better perceptual responses than early-morning or late-night arrivals (P < .05). Perceived jet-lag ratings are more responsive to travel demands than perceptual wellness scales in national-team football athletes. Poorer perceptual responses may be expected when travel is longer in nature, ends later in the day, or involves travel out of the national team back to club.

The nutritional risk in patients with neuromyelitis optica spectrum disorder.

The effect of nutrition on chronic autoimmune diseases is well known. This study is the first to assess the nutritional status of patients with neuromyelitis optica spectrum disorder (NMOSD) by administering the Mini Nutritional Assessment (MNA), to explore the impacts of nutrition on patients' quality of life and to identify the factors associated with the nutritional status of NMOSD patients. Our study enrolled 70 NMOSD patients and 66 healthy controls. The following data were assessed: demographic information, disease features, and composite evaluations of life status, including nutrition, sleep, anxiety/depression, fatigue, and quality of life. Then, statistical analysis was performed. The MNA score of NMOSD patients was 20.4±3.3, which was significantly lower than that of HCs (23.3±2.5, P=0.002), especially for the dimensions of global evaluation and anthropometric assessment. Nearly 85% of patients were at risk of malnutrition or had definite malnutrition. The total MNA score was positively correlated with the patient's quality of life (P<0.01). Lower MNA scores were correlated with gender (P=0.02), longer disease duration (P<0.001), more severe anxiety (P=0.004), more severe depression (P=0.003), more severe sleep disturbances (P<0.001), and more severe fatigue (P=0.01). Sleep disturbance was revealed to be a significant independent factor for the NMOSD patients' malnutritional risk (P=0.001). These results suggest that the risk of malnutrition is very high in NMOSD patients and that malnutrition is closely related to their quality of life. Malnutrition among NMOSD patients is caused by a combination of various physiological and psychological factors. A multifaceted and personalized intervention is required to improve the prognosis of NMOSD.

Computational mechanisms underlying the dynamics of physical and cognitive fatigue

The willingness to exert effort for reward is essential but comes at the cost of fatigue. Theories suggest fatigue increases after both physical and cognitive exertion, subsequently reducing the motivation to exert effort. Yet a mechanistic understanding of how this happens on a moment-to-moment basis, and whether mechanisms are common to both mental and physical effort, is lacking. In two studies, participants reported momentary (trial-by-trial) ratings of fatigue during an effort-based decision-making task requiring either physical (grip-force) or cognitive (mental arithmetic) effort. Using a novel computational model, we show that fatigue fluctuates from trial-to-trial as a function of exerted effort and predicts subsequent choices. This mechanism was shared across the domains. Selective to the cognitive domain, committing errors also induced momentary increases in feelings of fatigue. These findings provide insight into the computations underlying the influence of effortful exertion on fatigue and motivation, in both physical and cognitive domains.

Assessing Variability in Reporting Severity of the Same Symptom (Fatigue) in the Context of Different Psychiatric Syndromes.

Objective The objective of this study is to examine the variability in the self-reported fatigue symptom severity in major depressive disorder (MDD) compared to generalized anxiety disorder (GAD). Methods A retrospective chart review was conducted of 100 patients evaluated for fatigue using depression and anxiety questionnaires. The study examined whether ratings of fatigue varied based on whether fatigue was being rated by the patient in the context of MDD vs. when fatigue was being rated by the same patient in the context of GAD. A related-sampleWilcoxon signed-rank test and Mann-Whitney U test were used to compare the median differences between depression and anxiety fatigue scores. The significance level used was 0.05. Results This study found a statistically significant difference in the median difference of the paired depression fatigue and anxiety fatigue scores (depression score - anxiety score) regardless of the order of administration (Wilcoxon signed-rank test statistic = 135.500, p-value =.008, N = 100 paired scores). Conclusion The study's conclusions show that although the symptom of fatigue is listed in the Diagnostic Statistical Manual 5 (DSM-5) criteria for MDD as well as GAD, it may be perceived by patients differently based on the context of the syndrome. This emphasizes the importance of considering the context of symptom reporting in patients with MDD and GAD to improve diagnostic methodologies and treatment strategies.

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.

Investigating the Impact of Visual Input on Voice Production in Virtual Reality

This study explored the independent effects of visual input on voice production using virtual reality. Specifically, its effects on acoustic voice parameters and vocal status ratings, with the hypothesis that larger (a virtual lecture hall and theater compared to an office) and more full virtual rooms (75% of the capacity compared to 45%) would result in changes to the voice parameters and vocal status ratings. Voice production from 30 vocally healthy participants was recorded in six virtual reality conditions. After each condition, the participants provided vocal status ratings. The voice recordings were processed to calculate mean and standard deviation of sound pressure level and fundamental frequency, mean pitch strength, time dose, and cepstral peak prominence smoothed. The effects of the virtual reality conditions on these voice acoustic parameters and the vocal status ratings were analyzed. The full virtual reality rooms resulted in significantly higher vocal fatigue and vocal discomfort ratings. The larger virtual reality rooms were significantly related to increases in mean and the standard deviation of sound pressure level, mean pitch strength, and cepstral peak prominence smoothed. This study demonstrated that visual size and visual fullness input during speech tasks have distinct effects on voice production and self-reported vocal status. Visual size is related to voice acoustic outcomes, while visual fullness is related to self-reported outcomes.

What do women mean by poor sleep? A large population-based sample with polysomnographical indicators, inflammation, fatigue, depression, and anxiety

Survey studies indicate that reports of disturbed sleep are prevalent and may be prospectively linked to several major diseases. However, it is not clear what self-reported disturbed sleep represents, since the link with objective sleep measures (polysomnography; PSG) seems very weak. The purpose of the present study was to try to investigate what combination of variables (PSG, inflammation, fatigue, anxiety, depression) that would characterize those who complain of disturbed sleep. This has never been done before. Participants were 319 women in a population-based sample, who gave ratings of sleep quality, fatigue, depression, and anxiety, then had their sleep recorded at home, and had blood drawn the following morning for analysis of immune parameters. Correlations and hierarchical multivariable regression analyses were applied to the data. For ratings of difficulties initiating sleep, the associations in the final step were ß = .22, (p < .001) for fatigue, ß = 0.22 (p < .001) for anxiety, and ß = 0.17 (p < .01) for sleep latency, with R2 = 0.14. The rating of repeated awakenings was associated with fatigue (ß = 0.35, p < .001) and C-reactive protein (CRP) (ß = 0.12, p < .05), with R2 = 0.19. The rating of early morning awakenings was associated with fatigue (ß = 0.31, p < .001), total sleep time (TST) (ß = −0.20, p < .01), and CRP (ß = 0.15, p < .05), with R2 = 0.17. Interleukin-6 and Tumour Necrosis Factor were not associated with ratings of sleep problems. The results indicate that subjective fatigue, rather than objective sleep variables, is central in the perception of poor sleep, together with CRP.

Subjective valuation of performance feedback is robust to trait cognitive fatigue in multiple sclerosis.

Performance feedback is vital to rehabilitation interventions that treat cognitive impairments from multiple sclerosis (MS). Optimal treatment relies on participants' motivation to learn from feedback throughout these interventions. Cognitive fatigue, a prevalent symptom of MS, is associated with aberrant reward processing, which necessitates research into how fatigue affects perceived reward value of feedback in these individuals. The current study investigated how trait fatigue influences subjective valuation of feedback and subsequent feedback-seeking behavior in people with MS. 33 MS and 32 neurotypical (NT) participants completed a willingness-to-pay associative memory paradigm that assessed feedback valuation via trial-by-trial decisions to either purchase or forego feedback in service of maximizing a performance-contingent monetary reward. Participant ratings of trait fatigue were also collected. Generalized logistic mixed modeling was used to analyze factors that influenced trial-wise feedback purchase decisions and task performance. Despite reporting greater trait fatigue, MS participants purchased comparable amounts of feedback as NT participants. Like NT participants, MS participants were more likely to purchase feedback when they were less confident about response accuracy. MS participants also performed comparably to NT participants, who both particularly benefited from purchase decisions that yielded negative feedback (i.e., indicating a response error). Trait cognitive fatigue may not impact performance feedback valuation in people with MS. Nonetheless, confidence in performance may drive their feedback-seeking behavior and may serve as a target for improving learning throughout cognitive rehabilitation and maximizing treatment success.

Subjective cognition and memory lapses in the daily lives of breast cancer survivors: Examining associations with objective cognitive performance, fatigue, and depressed mood.

Subjective reports of cancer-related cognitive impairment often far exceed that documented using in-person neuropsychological assessment. This study evaluated whether subjective cognition was associated with real-time objective cognitive performance in daily life versus performance on an in-person neuropsychological battery, as well as fatigue and depressed mood. Participants were 47 women (M age=53.3years) who completed adjuvant treatment for early-stage breast cancer 6-36months previously. During an in-person assessment, participants completed a neuropsychological battery and questionnaires on subjective cognition, fatigue, and depressed mood. Over 14days, participants responded to up to 5 prompts that assessed real-time processing speed and memory and self-reported ratings of depressed mood and fatigue. In the evenings, participants rated their subjective cognition that day and reported on memory lapses (e.g., forgetting a word). During the in-person assessment, participants who rated their cognition worse reported worse depressed mood, but did not exhibit poorer objective cognitive performance. Women with worse rated daily subjective cognition reported more daily fatigue but did not demonstrate worse real-time objective cognition. Finally, women who reported memory lapses at the end of the day reported more fatigue and depressed mood, demonstrated better real-time performance on processing speed (p=0.001), and worse in-person processing speed and visuospatial skills (p's≤0.02). Subjective cognition was consistently associated with self-reported fatigue and depressed mood. Specific memory lapses were related to in-person and daily objective cognitive performance. This suggests that incorporating reports of memory lapses may help clinicians identify those with objectively measured cancer-related cognitive impairment.

Eye Movement Desensitization and Reprocessing Therapy in Chronic Fatigue Syndrome: A Single-Case Experiment Testing the Effect on Persistent Negative Evaluation of Fatigue

Background:While cognitive behavioral therapy (CBT) for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) can lead to the normalization of fatigue levels and resumption of activities, a subgroup of patients still evaluates fatigue negatively.Objective:The objective was to investigate whether eye movement desensitization and reprocessing (EMDR) therapy leads to a less negative evaluation of fatigue.Method:This was a randomized single-case experimental study. Five CFS/ME patients (all female, mean age of 35 years), who had completed CBT but still evaluated fatigue negatively, received EMDR therapy. The primary outcome, that is, negative evaluation of fatigue, was assessed daily (three items, e.g., “My fatigue is frustrating”). During EMDR therapy sessions, distress in response to a selected image was measured. Clinical assessments were performed before, directly after, and one month after EMDR therapy.Results:During EMDR therapy sessions, all patients reported high distress related to memories of having CFS/ME. EMDR therapy led to a reduction in this distress. Daily measured negative evaluations of fatigue declined in three patients, albeit not significantly. Three of five patients showed clinically relevant improvement in evaluations of fatigue on clinical pre-/post measures.Conclusion:EMDR therapy can reduce emotional distress associated with fatigue, but it is unclear whether it can change its negative evaluation.

Are Short Duration Naps Better than Long Duration Naps for Mitigating Sleep Inertia? Brief Report of a Randomized Crossover Trial of Simulated Night Shift Work

Objective We sought to test the effects of different duration naps on post-nap cognitive performance during simulated night shifts. Methods We used a randomized laboratory-based crossover trial design with simulated 12-hr night shifts and each participant completing three conditions of 72 hrs each (Clinicaltrials.gov; registration # NCT04469803). The three conditions tested included no-nap, a 30-min nap opportunity, and a 2-hr nap opportunity. Naps occurred at 02:00 hrs. Cognitive performance was assessed with the Brief 3-min Psychomotor Vigilance Test (PVT-B). Four PVT-B measures include: reaction time (RT in milliseconds (ms)), lapses (RT > 355 ms), false starts (reactions before stimulus or RT <100 ms), and speed (1,000/RT). The PVT-B was performed at the start of the simulated night shift (19:00), end of shift (07:00), pre-nap (02:00), and at 0 mins, 10 mins, 20 mins, and 30 mins following the 30-min and 2-hr nap conditions. Simultaneously, participants reported subjective ratings of fatigue and other constructs. Results Twenty-eight (15 female), mostly certified emergency medical technicians or paramedics, consented to participate. For all three conditions, looking within condition, PVT-B lapse performance at the end of the 12-hr simulated night shift (at 07:00) was poorer compared to shift start (p < 0.05). Performance on PVT-B speed, RT, and false starts were poorer at shift end than shift start for the no-nap and 30-min nap conditions (p < 0.05), but not for the 2-hr nap condition (p > 0.05). Compared to pre-nap measures, performance on the PVT-B assessed at 0 mins post-nap showed significant performance declines for lapses and speed for both the 30-min and 2-hr nap conditions (p < 0.05), but not at 10, 20, or 30 mins post-nap. After waking from the 2-hr on-shift nap opportunity (at 0 mins), participants rated sleepiness, difficulty with concentration, and alertness poorer than pre-nap (p < 0.05). Participants in the 30-min nap condition rated alertness poorer immediately after the nap (at 0 mins) compared to pre-nap (p < 0.05) Conclusions While sleep inertia was detectable immediately following short 30-min and long 2-hr nap opportunities during simulated night shift work, deficits in cognitive performance and subjective ratings quickly dissipated and were not detectable at 10–30 mins post-nap.

The Impact of Lower Extremity Fatigue on Lower Quadrant Dysfunction and Health Profile in Hairdressers.

Fatigue is also an important occupational condition for hairdressers.The purpose of this study was to determine the lower extremity fatigue and related factors in hairdressers.Lower Extremity Fatigue was assessed with 2 questions containing a 5-point Likert scale. Numerical fatigue rating scale was used to assess general fatigue level, visual analogue scale was used to assess occupational satisfaction, Nottingham Health Profile (NHP) was used to assess health profile, and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess lower quadrant pain profile.In the assessment of lower extremity pain, statistically significant difference was found between Fatigue and Non-fatigue groups in waist (p:0.018), right knee (p:0.020), left knee (p:0.019) and right lower leg (p:0.023) parameters. In the lower extremity Weighted Scores, there were significant differences between the fatigue and non-fatigue groups in waist (p:0.0001), right upper leg (p:0.018), left upper leg (p:0.009), right knee (p:0.0001) left knee (p:0.0001), right lower leg (p:0.001) and left lower leg (p:0.002). The difference in the Energy, Pain and Physical Mobility sub-dimensions of the Nottingham Health Profile of the hairdressers in 'Fatigue Group' was at a significant level.In conclusion, the rate of lower extremity fatigue found in hairdressers in the present study was quite high and lower extremity fatigue was associated with lower extremity pain and health profile.