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    Acute Caffeine Ingestion, Calendar-Based Menstrual-Cycle Window, Time of Day, and Match-Induced Fatigue Independently and Interactively Influence Psychophysiological, Cognitive, and Physical Performance in Elite Female Volleyball Players: A Randomized Double-Blind Placebo-Controlled Crossover Design Study
    (MDPI, 2026) Seddik, Meher; Dhahbi, Wissem; Bessifi, Manel; Moussa-Chamari, Imen; Ceylan, Halil Ibrahim; Ceylan, Nagihan Burcak; Souissi, Nizar
    Aim: Female athletic performance is shaped by the convergence of menstrual-cycle timing, circadian rhythms, fatigue, and ergogenic supplementation; yet no prior study has examined these factors simultaneously in a sport-specific setting. This study investigated the independent and combined effects of acute caffeine ingestion, calendar-based testing window, time of day, and match-induced fatigue on psychophysiological, cognitive, and physical performance in trained female volleyball players. Methods: Thirteen elite eumenorrheic female volleyball players (age: 24.23 +/- 4.06 years) completed a randomized, double-blind, placebo-controlled crossover protocol comprising 12 sessions corresponding to all combinations of testing window (menstrual, follicular, luteal), supplementation (caffeine 6 mg & centerdot;kg(-1) vs. placebo), and time of day (08:00 h vs. 18:00 h). Assessments included the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Spiegel questionnaire, Profile of Mood States, Hooper Index, Stroop task, Countermovement Jump (CMJ), Modified Agility T-Test (MAT), and Reactive Agility Test (RAT), administered before and after a one-hour simulated match. Results: Significant main effects of testing window, caffeine, time of day, and fatigue state were observed across all outcome domains (all p < 0.05). Caffeine reduced daytime sleepiness (F(1,12) = 23.84, p < 0.001, eta p(2) = 0.665), enhanced vigor (F(1,12) = 114.10, p < 0.001, eta p(2) = 0.905), and improved MAT performance (F(1,12) = 33.27, p < 0.001, eta p(2) = 0.735). The follicular window was associated with superior cognitive, neuromuscular, and mood-related outcomes relative to the menstrual and luteal windows. Exploratory higher-order interactions suggested condition-specific caffeine benefits for MAT, RAT, and CMJ, particularly in afternoon post-fatigue conditions; these patterns require replication in larger samples. Conclusions: Acute caffeine ingestion improved several psychophysiological, cognitive, and neuromuscular outcomes in trained female volleyball players, with effects that varied across calendar-based testing windows, time of day, and fatigue state. Individualized supplementation strategies incorporating cycle timing and circadian context remain investigational; prescriptive recommendations require replication in larger, hormonally verified samples before clinical or applied adoption.
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    Eccentric Isokinetic Rehabilitation for Chronic Lateral Epicondylitis in Female Swimmers: A Randomized Controlled Trial of Bilateral Neuromuscular Adaptations and Functional Performance
    (MDPI, 2026) Dhahbi, Wissem; Ghouili, Hatem; Ceylan, Halil Ibrahim; Adhadhi, Nessrine; Bchini, Souhail; Bessifi, Manel; 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 degrees/s angular velocity, progressive loading 1-12 sets & times; 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: F-1,F-23 = 8.56, p = 0.008, eta(2)(p) = 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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    Network comparison methods detect temporal reorganization of psychophysiological integration invisible to conventional univariate analysis: Proof-of-concept using lunar-phase-timed measurements in elite athletes
    (Taylor & Francis Inc, 2026) Yousfi, Narimen; Dhahbi, Wissem; Ghouili, Hatem; Mejri, Mohamed Arbi; Bessifi, Manel; Ceylan, Halil Ibrahim; Chamari, Karim
    Field studies using conventional univariate methods fail to detect physiological rhythms (melatonin, cortisol, sleep architecture) that are consistently documented under laboratory-controlled conditions, suggesting that temporal factors operate on systemic organization rather than isolated metrics. Network analysis quantifies conditional dependencies among variables simultaneously, enabling the detection of organizational changes independent of mean-level shifts. As an exploratory proof-of-concept, this study examines whether network comparison methods detect temporal reorganization of psychophysiological integration invisible to conventional repeated-measures analysis in elite athletes; no confirmatory causal inference is drawn. Twelve elite male athletes completed psychophysiological assessments (mood states, subjective well-being, neurocognitive performance, postural control, intermittent endurance) at three lunar phases (New Moon, First Quarter, Full Moon) in a counterbalanced design. Conventional repeated-measures ANOVA detected no temporal effects on isolated variables (all F < 2.87, p > 0.05, eta(2)p < 0.21). Network comparison revealed marked organizational differences: New Moon versus Full Moon networks exhibited distinct architecture (M = 0.31, padj = 0.008) and connectivity (S = 8.42, padj = 0.029). Centrality systematically redistributed from capacity and well-being constructs (New Moon: vigour z = 1.82) to recovery markers (Full Moon: stress z = 2.13). Twelve connections differed significantly, including enhanced stress-confusion coupling (Delta r = +0.39, p = 0.003). This proof-of-concept demonstrates that temporal measurements can exhibit systemic reorganization despite stable component means, resolving apparent contradictions between laboratory-detected physiological rhythms and field-based null findings. Temporal control measurements and multi-cycle replication are required to definitively attribute observed reorganization to lunar periodicity rather than generic temporal variation.