Effects of brain endurance training on cognitive function, physical performance and perceived exertion in healthy adults: a systematic review and three-level meta-analysis.
7 affiliations
- 1College of Physical Education and Health Science, Chongqing Normal University, Chongqing, China.
- 2College of Sports and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
- 3Sports Coaching College, Beijing Sport University, Beijing, China.
- 4College of Physical Education and Health Management, Chongqing University of Education, Chongqing, China.
- 5Department of Physical Education, Tongji University, Shanghai, China.
- 6School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
- 7School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.
Abstract
Background
Mental fatigue impairs cognitive function and physical performance in healthy adults. Brain endurance training (BET) has emerged as a strategy to enhance resistance to mental fatigue and improve both cognitive and physical outcomes; however, its effects have not been comprehensively synthesized.Objective
To systematically assess the effects of BET on cognitive function, physical performance, and perceived exertion in healthy adults.Methods
Searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, and SPORTDiscus on September 9, 2025. Data (mean ± standard deviation and sample size) were extracted, and pooled effects were calculated as Hedges'g using random-effects meta-analysis models. Subgroup and meta-regression analyses were performed to explore potential moderators.Results
Eleven studies (13 trials; n=441 participants) were included. BET significantly improved cognitive function (g = 0.64, 95% CI [0.24, 1.04], P = 0.006) and physical performance (g = 0.48, 95% CI [0.33, 0.62], p<0.001), whereas no statistically significant effect was observed for perceived exertion (g = -0.01, 95% CI [-0.25, 0.23]). Effects on cognitive function and physical performance appeared larger under mental-fatigue than non-fatigued testing conditions. Evidence for other potential moderators was inconclusive, and intervention duration was not significantly associated with any outcome. The certainty of evidence was low for cognitive function and physical performance and moderate for perceived exertion.Conclusion
BET was associated with improvements in cognitive function and physical performance in healthy adults, with effects appearing larger under mental-fatigue testing conditions. BET had no statistically significant effect on perceived exertion. Given the limited number of studies and low certainty of evidence for the primary performance outcomes, these findings should be interpreted cautiously.
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BibTeX
@article{zheng2026effects,
title = {{Effects of brain endurance training on cognitive function, physical performance and perceived exertion in healthy adults: a systematic review and three-level meta-analysis.}},
author = {Xin Zheng and Yu'an Sun and Ziren Zhao and Chao Wang and Zhangyuting Shang and Yixun Xie and Kai Xu and Kaixiang Zhou and Olivier Girard},
journal = {Frontiers in physiology},
year = {2026},
month = oct,
doi = {10.3389/fphys.2026.1923855},
url = {https://europepmc.org/article/MED/42898810},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of brain endurance training on cognitive function, physical performance and perceived exertion in healthy adults: a systematic review and three-level meta-analysis.
AU - Xin Zheng
AU - Yu'an Sun
AU - Ziren Zhao
AU - Chao Wang
AU - Zhangyuting Shang
AU - Yixun Xie
AU - Kai Xu
AU - Kaixiang Zhou
AU - Olivier Girard
PY - 2026
DA - 2026/10/05
JO - Frontiers in physiology
DO - 10.3389/fphys.2026.1923855
UR - https://europepmc.org/article/MED/42898810
AB - Background Mental fatigue impairs cognitive function and physical performance in healthy adults. Brain endurance training (BET) has emerged as a strategy to enhance resistance to mental fatigue and improve both cognitive and physical outcomes; however, its effects have not been comprehensively synthesized.Objective To systematically assess the effects of BET on cognitive function, physical performance, and perceived exertion in healthy adults.Methods Searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, and SPORTDiscus on September 9, 2025. Data (mean ± standard deviation and sample size) were extracted, and pooled effects were calculated as Hedges'g using random-effects meta-analysis models. Subgroup and meta-regression analyses were performed to explore potential moderators.Results Eleven studies (13 trials; n=441 participants) were included. BET significantly improved cognitive function (g = 0.64, 95% CI [0.24, 1.04], P = 0.006) and physical performance (g = 0.48, 95% CI [0.33, 0.62], p<0.001), whereas no statistically significant effect was observed for perceived exertion (g = -0.01, 95% CI [-0.25, 0.23]). Effects on cognitive function and physical performance appeared larger under mental-fatigue than non-fatigued testing conditions. Evidence for other potential moderators was inconclusive, and intervention duration was not significantly associated with any outcome. The certainty of evidence was low for cognitive function and physical performance and moderate for perceived exertion.Conclusion BET was associated with improvements in cognitive function and physical performance in healthy adults, with effects appearing larger under mental-fatigue testing conditions. BET had no statistically significant effect on perceived exertion. Given the limited number of studies and low certainty of evidence for the primary performance outcomes, these findings should be interpreted cautiously.
SN - 1664-042X
ER -