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- MakaleAçık Erişim2026Scopus SJRQ2Eccentric Isokinetic Rehabilitation for Chronic Lateral Epicondylitis in Female Swimmers: A Randomized Controlled Trial of Bilateral Neuromuscular Adaptations and Functional Performance
Dhahbi, Wissem; Ghouili, Hatem; Ceylan, Halil İbrahim; Adhadhi, Nessrine; Bchini, Souhail; Bessifi, Manel; Ceylan, Nagihan Burçak; Stefanica, Valentina; Ouerghi, Nejmeddine; Hammami, Nadhir
Background and Objectives: This study investigated the efficacy of eccentric isokinetic muscle strengthening versus passive motion protocols on neuromuscular function and performance capacity in female swimmers with chronic lateral epicondylitis. Materials and Methods: Twenty-five swimmers (age 46.1 ± 3.1 years) with lateral epicondylitis exceeding three months’ duration completed a randomized controlled trial comparing eccentric training in Controlled Active Motion mode (experimental group (EG), n = 13) against passive motion in Continuous Passive Motion mode (control group (CG), n = 12). Both groups performed 18 supervised sessions over six weeks (60°/s angular velocity, progressive loading 1–12 sets × 5 repetitions). Bilateral concentric peak torque of elbow extensors and flexors constituted the primary outcomes. Secondary measures included push-up performance, explosive power assessed by the Seated Medicine Ball Chest Push Test, and goniometric range of motion. Linear mixed-effects models and analysis of covariance with baseline adjustment were employed. Results: Eccentric training produced side-specific strength adaptations in elbow flexors (confirmed interaction: F1,23 = 8.56, p = 0.008, ηp2 = 0.271), with the experimental group demonstrating balanced bilateral gains, whereas the control group exhibited asymmetric responses favoring the non-dominant limb. EG demonstrated superior functional gains: push-up repetitions increased 4.15 ± 1.77 versus 2.17 ± 1.27 in CG (adjusted difference = 3.21 repetitions, 95% CI [1.52, 4.90], p = 0.001, d = 1.31), while explosive power improved 0.32 ± 0.09 m versus 0.10 ± 0.06 m (adjusted difference = 0.35 m, 95% CI [0.25, 0.45], p < 0.001, d = 1.20). Range of motion remained unchanged across groups (all p > 0.65). Conclusions: Eccentric isokinetic strengthening confers substantial advantages over passive motion protocols for restoring upper-body muscular endurance and ballistic force production in swimmers with lateral epicondylitis, supporting its integration into rehabilitation frameworks for the management of tendinopathy.
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İncele - MakaleAçık Erişim2026Scopus SJRQ1Differential Time-of-Day Effects of Caffeine Capsule and Mouth Rinse on Physical Performance and Volleyball-Specific Skills in Adolescent Male Volleyball Players
Amor, Salma Belhaj; Dhahbi, Wissem; Souaifi, Marouen; Ceylan, Halil İbrahim; Padulo, Johnny; Vando, Stefano; Ceylan, Nagihan Burçak; Muntean, Raul Ioan; Souissi, Nizar
Objective: This study compared the acute effects of caffeine capsule ingestion and caffeine mouth rinsing on physical performance and volleyball-specific skills at different times of day in trained adolescent male volleyball players. Methods: Twenty-four well-trained male volleyball players (age: 16.9 ± 0.7 years) completed a randomized, double-blind, placebo-controlled crossover study involving three supplementation conditions, caffeine capsule (CAFcap, 3 mg·kg−1), caffeine mouth rinse (CAFrinse, 3 mg·kg−1), and placebo (PLA), administered via a double-dummy procedure (nine sessions per participant: 3 conditions × 3 times of day) at 08:00, 12:00, and 18:00. Participants completed squat jump (SJ), countermovement jump (CMJ), block jump, attack jump, 10 × 10 m t-test, spike accuracy, and serve accuracy assessments. Data were analyzed using two-way repeated-measures ANOVA. Results: Significant main effects of condition and time of day were observed for all outcomes. Significant condition × time-of-day interactions were found for SJ, CMJ, attack jump, and change-of-direction speed, indicating that caffeine-related ergogenic effects were most evident in the morning and at midday, whereas these benefits were attenuated in the evening when baseline performance was highest. At 08:00 and 12:00, both CAFcap and CAFrinse improved jump performance and agility compared with PLA, with capsule ingestion showing a small-to-moderate advantage over mouth rinsing for selected lower-limb power outcomes at midday (mean difference range: 0.51–0.57 cm; dz = 0.57–0.65). For block jump, spike accuracy, and serve accuracy, both caffeine conditions improved performance relative to placebo, while a progressive improvement across the day was observed under all conditions, including placebo, confirming a diurnal rhythm effect independent of supplementation. Overall, the data indicate that caffeine partially reduced the amplitude of diurnal variation in several physical performance measures. Conclusions: Both caffeine capsule ingestion and caffeine mouth rinsing enhanced physical and volleyball-specific performance in trained adolescent male volleyball players. The ergogenic effects were more pronounced earlier in the day, suggesting that caffeine may be particularly useful for attenuating morning and midday performance decrements, while mouth rinsing represents a practical non-ingestive alternative with meaningful efficacy.
AtıfScopus2WoS2OpenAlex2İncele - MakaleAçık Erişim2026Scopus SJRQ1Progressive Smartphone Restriction Combined with Psychoeducational Guidance and Pre-Sleep Autonomic Regulation Improves Sleep Efficiency and Time-of-Day Cognitive Performance in Physically Active Students with Nomophobia: A Randomized Controlled Trial
Alaya, Wiem Ben; Dhahbi, Wissem; Souissi, Mohamed Abdelkader; Jebabli, Nidhal; Ceylan, Halil İbrahim; Ceylan, Nagihan Burçak; Muntean, Raul Ioan; Souissi, Nizar
Aim: This study compared the effects of standard evening smartphone restriction with an adapted intervention combining progressive restriction, psychoeducational guidance, and pre-sleep relaxation on sleep, psychological state, cognitive performance, and physical performance in physically active physical education students with moderate-to-high nomophobia. Methods: Thirty participants (age 21.9 ± 1.2 years; intermediate chronotype) completed a randomized controlled trial consisting of a 7-day baseline period, a 14-day intervention phase, and post-intervention assessments. The standard group (n = 15) implemented a 2-h pre-bedtime smartphone restriction combined with general sleep hygiene guidance. The adapted group (n = 15) followed a progressive restriction protocol (30→60→120 min) supplemented with psychoeducational guidance targeting smartphone-related anxiety and a nightly slow-paced breathing routine. Objective sleep parameters were quantified using wrist-worn actigraphy. Subjective sleep quality, pre-sleep anxiety, and stress were assessed using visual analog scales. Cognitive performance (psychomotor vigilance task and choice reaction time) and physical performance (vertical jumps and agility) were evaluated at both morning and afternoon time points. Results: The adapted intervention produced significantly greater improvements in sleep efficiency (time × group: F(1,28) = 6.84, p = 0.014, ηp2 = 0.20; d = 0.78) and sleep onset latency (F(1,28) = 5.97, p = 0.021, ηp2 = 0.18; d = 0.72) compared with standard restriction. Significant reductions were also observed in pre-sleep anxiety (F(1,28) = 7.12, p = 0.012, ηp2 = 0.20; d = 0.81) and stress (F(1,28) = 6.45, p = 0.017, ηp2 = 0.19; d = 0.74). Cognitive performance showed significant time × group × time-of-day interactions, with improvements during afternoon assessments in psychomotor vigilance (F(1,28) = 7.48, p = 0.011; d = 0.83) and choice reaction time (F(1,28) = 6.89, p = 0.014; d = 0.79) exclusively in the adapted group. Physical performance outcomes remained stable across interventions. Conclusions: Progressive smartphone restriction combined with psychoeducational strategies and pre-sleep relaxation yields clinically meaningful improvements in sleep continuity, psychological arousal, and afternoon cognitive performance, exceeding the benefits achieved through behavioral restriction alone.
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