Effects of Combining Occupationally Relevant Physical and Cognitive Tasks. A Systematic Review

OBJECTIVES

Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review investigated to which extent combinations (concurrent or alternating) of occupationally relevant physical and cognitive tasks influence responses reflecting biomechanical exposure, stress, fatigue, performance, and well-being.

METHODS

We searched Scopus, Pubmed, Cinahl, and Psychinfo for controlled experiments investigating the effects of combinations of occupationally relevant physical and cognitive tasks in participants aged 18 to 70. In total, we identified 12 447 records. We added recent papers that had cited these studies (n = 573) to arrive at a total of 13 020 publications. After screening for relevance, 61 studies remained, of which 57 were classified to be of medium or high quality. Of the 57 studies, 51 addressed concurrent tasks, 5 alternating tasks, and 1 both concurrent and alternating tasks.

RESULTS

Most studies of concurrent physical and cognitive tasks reported negative effects, if numerically small, on indicators of biomechanical exposure, fatigue, and performance, compared to a physical task alone. Results were mixed for stress indicators, and well-being was too little studied to justify any conclusions. Effects depended on the tasks, including their intensity and complexity. Alternating physical and cognitive tasks did not appear to influence outcomes much, compared to having passive breaks in-between physical tasks.

CONCLUSIONS

The reviewed evidence indicated that concurrent physical and cognitive work tasks have negative, yet small effects on biomechanical indicators, fatigue and performance, compared to performing the physical task alone, but only if the physical task is intense, and the cognitive task is complex. Alternating between physical and cognitive tasks may have similar effects as breaking up physical tasks by passive breaks, but studies were few. Future studies should address ecologically valid combinations of physical and cognitive tasks, in particular in controlled field studies devoted to the long-term effects of combined work.

More Effort, Less Fatigue: The Role of Interest in Increasing Effort and Reducing Mental Fatigue

People generally prefer easier over more difficult mental tasks. Using two different adaptations of a demand selection task, we show that interest can influence this effect, such that participants choose options with a higher cognitive workload. Interest was also associated with lower feelings of fatigue. In two studies, participants (N = 63 and N = 158) repeatedly made a choice between completing a difficult or easy math problem. Results show that liking math predicts choosing more difficult (vs. easy) math problems (even after controlling for perceived math skill). Two additional studies used the Academic Diligence Task (Galla et al., 2014), where high school students (N = 447 and N = 884) could toggle between a math task and playing a video game/watching videos. In these studies, we again find that math interest relates to greater proportion of time spent on the math problems. Three of these four studies also examined perceived fatigue, finding that interest relates to lower fatigue. An internal meta-analysis of the four studies finds a small but robust effect of interest on both the willingness to exert greater effort and the experience of less fatigue (despite engaging in more effort).

Managing the tension between caring and charting: Labor and delivery nurses' experiences of the electronic health record

Over a decade following the nationwide push to implement electronic health records (EHRs), the focus has shifted to addressing the cognitive burden associated with their use. Most research and discourse about the EHR's impact on clinicians' cognitive work has focused on physicians rather than on nursing-specific issues. Labor and delivery nurses may encounter unique challenges when using EHRs because they also interact with an electronic fetal monitoring system, continuously managing and synthesizing both maternal and fetal data. This grounded theory study explored labor and delivery nurses' perceptions of the EHR's impact on their cognitive work. Data were individual interviews and participant observations with twenty-one nurses from two labor and delivery units in the western U.S. and were analyzed using dimensional analysis. Nurses managed the tension between caring and charting using various strategies to integrate the EHR into their dynamic, high-acuity, specialty practice environment while using EHRs that were not designed for perinatal patients. Use of the EHR and associated technologies disrupted nurses' ability to locate and synthesize information, maintain an overview of the patient's status, and connect with patients and families. Individual-, group-, and environmental-level factors facilitated or constrained nurses' integration of the EHR. These findings represent critical safety failures requiring comprehensive changes to EHR designs and better processes for responding to end-user experiences. More research is needed to develop EHRs that support the dynamic and relationship-based nature of nurses' work and to align with specialty practice environments.

Effect of Acute Exercise and Cycling Desk on Energy Intake and Appetite Response to Mental Work: The CORTEX Study

BACKGROUND

While mental work has been shown to favor overconsumption, the present study compared the effect of a cognitive task alone, followed by acute exercise, or performed on a cycling desk, on short-term food intake and appetite in adults.

METHODS

A total of 19 normal-weight adults randomly completed: resting session (CON), 30-minute cognitive task (CT), 30-minute cognitive task followed by a 15-minute high-intensity interval exercise bout (CT-EX), and 30-minute cognitive task performed on a cycling desk (CT-CD). Energy expenditure was estimated (heart rate-workload relationship), and energy intake (EI; ad libitum) and appetite (visual analog scales) were assessed.

RESULTS

Energy expenditure was higher in CT-EX (P < .001) compared with the other conditions and in CT-CD compared with CON and CT (P < .01). EI was higher in CON (P < .05) and CT-CD compared with CT (P < .01). Relative EI was higher in CON compared with CT (P < .05) and lower in CT-EX compared with CT, CT-CD, and CON (all Ps < .001). Area under the curve desire to eat was higher in CON compared with CT (P < .05) and CT-EX (P < .01). Area under the curve prospective food consumption was higher in CON compared with CT-EX (P < .01). Overall composite appetite score was not different between conditions.

CONCLUSION

While cycling desks are recommended to break up sedentary time, the induced increase in energy expenditure might not be enough to significantly reduce overall short-term relative EI after mental work.