{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:52:44Z","timestamp":1791211964135,"version":"4.1.0"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically assess the effects of BET on cognitive function, physical performance, and perceived exertion in healthy adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, and SPORTDiscus on September 9, 2025. Data (mean \u00b1 standard deviation and sample size) were extracted, and pooled effects were calculated as Hedges\u2019g using random-effects meta-analysis models. Subgroup and meta-regression analyses were performed to explore potential moderators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies (13 trials; n=441 participants) were included. BET significantly improved cognitive function (g = 0.64, 95% CI [0.24, 1.04], P\u00a0=\u00a00.006) and physical performance (g = 0.48, 95% CI [0.33, 0.62], p&amp;lt;0.001), whereas no statistically significant effect was observed for perceived exertion (g = \u22120.01, 95% CI [\u22120.25, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1923855","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:57:30Z","timestamp":1791208650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"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"],"prefix":"10.3389","volume":"17","author":[{"given":"Xin","family":"Zheng","sequence":"first","affiliation":[{"name":"College of Physical Education and Health Science, Chongqing Normal University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2019an","family":"Sun","sequence":"additional","affiliation":[{"name":"College of Sports and Health, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziren","family":"Zhao","sequence":"additional","affiliation":[{"name":"College of Physical Education and Health Science, Chongqing Normal University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Physical Education and Health Science, Chongqing Normal University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangyuting","family":"Shang","sequence":"additional","affiliation":[{"name":"Sports Coaching College, Beijing Sport University","place":["Beijing, China"]},{"name":"College of Physical Education and Health Management, Chongqing University of Education","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Athletic Performance, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaixiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"College of Physical Education and Health Science, Chongqing Normal University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Girard","sequence":"additional","affiliation":[{"name":"School of Human Sciences (Exercise and Sport Science), University of Western Australia","place":["Perth, WA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s40279-015-0344-5","article-title":"Role of ratings of perceived exertion during self-paced exercise: What are we actually measuring","volume":"45","author":"Abbiss","year":"2015","journal-title":"Sports Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1177\/1094428112470848","article-title":"Best-practice recommendations for defining, identifying, and handling outliers","volume":"16","author":"Aguinis","year":"2013","journal-title":"Organizational Res. 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