{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:36:47Z","timestamp":1793129807773,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>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 \u00b1 3.1 years) with lateral epicondylitis exceeding three months\u2019 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\u00b0\/s angular velocity, progressive loading 1\u201312 sets \u00d7 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, \u03b7p2 = 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 \u00b1 1.77 versus 2.17 \u00b1 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 \u00b1 0.09 m versus 0.10 \u00b1 0.06 m (adjusted difference = 0.35 m, 95% CI [0.25, 0.45], p &lt; 0.001, d = 1.20). Range of motion remained unchanged across groups (all p &gt; 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.<\/jats:p>","DOI":"10.3390\/medicina62030494","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T11:52:11Z","timestamp":1772711531000},"page":"494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Eccentric Isokinetic Rehabilitation for Chronic Lateral Epicondylitis in Female Swimmers: A Randomized Controlled Trial of Bilateral Neuromuscular Adaptations and Functional Performance"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-546X","authenticated-orcid":false,"given":"Wissem","family":"Dhahbi","sequence":"first","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"},{"name":"Training Department, Police College, Qatar Police Academy, Doha 12903, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5448","authenticated-orcid":false,"given":"Hatem","family":"Ghouili","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2214-4667","authenticated-orcid":false,"given":"Halil \u0130brahim","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Physical Education of Sports Teaching Department, Faculty of Sports Sciences, Atat\u00fcrk University, 25240 Erzurum, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessrine","family":"Adhadhi","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souhail","family":"Bchini","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Bessifi","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagihan Bur\u00e7ak","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Graduate Education Institute, Bayburt University, 69000 Bayburt, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-1412","authenticated-orcid":false,"given":"Valentina","family":"Stefanica","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport, Faculty of Sciences, Physical Education and Informatics, National University of Science and Technology Politehnica Bucharest, Pite\u0219ti University Center, 060042 Pite\u0219ti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8840-1735","authenticated-orcid":false,"given":"Nejmeddine","family":"Ouerghi","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"},{"name":"Faculty of Medicine of Tunis, University of Tunis El Manar, Rabta Hospital, LR99ES11, Tunis 1007, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5256-2887","authenticated-orcid":false,"given":"Nadhir","family":"Hammami","sequence":"additional","affiliation":[{"name":"Research Unit \u201cSport Sciences, Health and Movement\u201d (UR22JS01), High Institute of Sport and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref_1","unstructured":"Morrey, B.F., Sotelo, J.S., and Morrey, M.E. 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