A Hitchhiker's Guide to Physical and Cognitive Effort
Sports medicine (Auckland, N.Z.) · 2026
A conceptual map of how 'effort' is measured across fields, useful for researchers, not yet actionable for clinicians.
The paper
Narrative conceptual review, not a systematic review and not a primary study: no patients, participants, or empirical data. Published in Sports Medicine as a cross-disciplinary framework paper proposing how 'effort' should be defined and measured.
What they found
No empirical findings to report: the paper is a taxonomy proposing three effort conceptualizations (force-based, resource-based, mediation-based) and four categories of effort proxies (neurophysiological, metabolic, psychological, behavioral), with no data, effect sizes, or statistics presented.
The appraisal
This is a theoretical framework piece, so the usual risk-of-bias tools do not apply, but that also means there is nothing here to validate against clinical outcomes. The authors describe it as a 'descriptive and impartial overview' rather than a systematic review, so there is no stated search strategy, no registration, and selection of which literature to cover is left to the authors' judgement, which is a real source of bias in any review calling itself impartial. Useful as orientation, but it makes no claims that can be tested for clinical significance.
The gap
It is unclear whether any of these conceptual frameworks or proxy categories actually converge when applied to the same task, i.e. whether a psychological proxy and a metabolic proxy of 'effort' agree with each other in real athletes or patients, which is the question that would matter for choosing a measurement tool in practice.
Landmark context
This sits downstream of long-standing effort constructs clinicians already use indirectly, such as Borg's RPE scale and motivational intensity theory, and the broader cognitive-effort literature (e.g. cost-based models of mental effort). The paper does not test or extend any single landmark study; it tries to unify disconnected literatures rather than build on one empirical lineage.
What to do Monday
No, this does not change anything a clinician does on Monday. It may eventually help researchers standardize how effort is measured across studies, which matters for how future RPE or load-monitoring tools are validated, but there is no actionable change for patient care from this paper alone.
In practice
Nothing changes in your assessment or programming this week; there's no dataset here to act on. But it's a useful mental checklist next time you stack effort proxies: session RPE, HR/lactate, and force plate or velocity-loss data are not measuring the same construct, they're different windows (behavioural, metabolic, neurophysiological) onto something we still can't fully unify, so don't expect them to agree and don't discard one because it disagrees with another. In the clinic, that means keep taking patient-reported effort seriously during return-to-sport progressions even when your objective numbers look fine, rather than overriding it with 'more objective' data. On the S&C floor, it's a reason to keep RPE and velocity/force-based autoregulation running in parallel rather than assuming one has made the other redundant. Caveat: this paper gives no data on how much these proxies actually diverge in real athletes or patients, so treat multi-proxy monitoring as sound practice this review supports conceptually, not something it has proven necessary.
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