Neuromuscular, Cardiovascular, and Cognitive Fatigue in Motor Learning: A Systematic Review

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Abstract

Background

Fatigue is multifactorial and task-dependent, arising from the interplay between performance and perceived fatigability. Fatigue-related changes in sensorimotor control and neural activity may alter skill acquisition and retention.

Objective

To synthesize behavioral and neurophysiological evidence on how cognitive, cardiovascular, and neuromuscular fatigue influence motor-skill acquisition, consolidation/retention, and transfer.

Methods

A systematic search was conducted within PubMed, Web of Science, and Embase. Thirty-four studies (39 experiments) met inclusion criteria (fatigue effects on motor learning in non-disabled participants). Data were extracted on fatigue protocol, learning taxonomy, learning stage (acquisition vs. retention/transfer), interval, and neurophysiology. Methodological quality was appraised with a tailored Downs & Black checklist.

Results

During acquisition, 64% of experiments reported impairments under fatigue, particularly for visuomotor precision and fine force control; 10% found facilitation (often after cardiovascular exertion or high cognitive load); 15% were neutral; 10% inconclusive. Retention was tested in a fresh state and in a fatigue state in 34 experiments and 6 experiments, respectively. Results during retention tests were relatively variable, depending on fatigue protocols. Neurophysiological measures were scarce (EEG/TMS in only four studies), and very few studies considered the effects of personal factors such as age or sex.

Conclusions

Fatigue does not uniformly impair motor learning. Neuromuscular fatigue typically hampers acquisition and sometimes retention, while cardiovascular exertion can transiently prime plasticity and enhance consolidation. Evidence for cognitive fatigue is limited and inconsistent. Future work should use longer retention windows, state-matched testing, and integrated neurophysiology to clarify mechanisms and guide training under fatigue.

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