A Systematic Review and Meta-Analysis on the Impact of Military Foot Marches on Performance—Part 2: Cognitive Performance

ABSTRACT: Sax van der Weyden, M, Shaul, Y, Helton, WS, Merrigan, J, Barringer, N, Newman, K, and Martin, J. A systematic review and meta-analysis on the impact of military foot marches on performance-Part 2: cognitive performance. J Strength Cond Res 40(6): e647-e662, 2026-Military tasks and training require service members to have adequate physical and cognitive functioning. Foot marches are a common load carriage task for service members that may induce fatigue and reduce subsequent occupational performance. The purpose of part 2 of this systematic review and meta-analysis is to assess the impact of military style foot marches on cognitive performance outcomes. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched for studies assessing physical or cognitive performance before and after a foot march at least 10 minutes in length. Subject data, performance variables, and foot march data were extracted. Three-level random-effects meta-analyses were conducted using standardized mean differences (SMDs; Hedge's g). Eighteen studies ( n = 382 subjects) were included for final review. All studies were fair to good quality based on the Downs and Black checklist, but most had significant bias because of confounding variables when scored on the ROBINS-I tool. After adjusting for outliers and publication bias, the meta-analysis revealed significant ( p < 0.05) decrements in visual (SMD = -0.33, [0.06, 0.59]) and auditory cognitive performance (SMD = 0.85, [0.04, 1.66]). There was no significant change in memory (SMD = 0.55, [-0.48, 1.49]) or executive function performance (SMD = -0.18, [-0.37, 0.02]). Variations in cognitive responses after foot marches may be because of differing study protocols and subject populations. Nevertheless, commanders should aim to keep the intensity of foot marches moderate, reduce loads, improve fit of load carriage equipment, and allocate rest breaks, when possible, to mitigate cognition declines postfoot march.