Acute Physical, Mental and Sequential Combined Fatigue Protocols Differentially Affect Basketball Shooting and Psychomotor Vigilance: A Randomized Crossover Study

Basketball shooting and attention may respond differently to cognitive and physical demands. We compared isolated and sequential combined fatigue protocols within the same players. Twelve male players completed a randomized four-period crossover: documentary control, 30 min AX Continuous Performance Task (AX-CPT), 90 s maximal burpees, and AX-CPT followed by burpees. Performance models accounted for participant, period, sequence and applicable baselines. False discovery rate correction used three outcome domains. Combined reduced dynamic shooting accuracy, relative to control (odds ratio 0.53, 95% confidence interval (CI) 0.41–0.67; Holm p < 0.001) and mental (0.66, 0.52–0.85; Holm p = 0.004). Compared with control, combined increased brief psychomotor vigilance test reaction time by 23.69 ms (95% CI 7.10–40.27; Holm p = 0.027) and reduced application-reported accuracy by 12.39 percentage points (95% CI 6.22–18.57; Holm p < 0.001). Mental-versus-control vigilance contrasts were also significant. Free-throw and vigilance variability findings were model-sensitive. Tracking, physiological and neuromuscular outcomes, and factorial interactions, were non-significant after correction. The sequential AX-CPT-then-burpee protocol was associated with lower dynamic shooting accuracy. Mental and combined protocols were associated with poorer end-of-session vigilance.