The relationship between match-play decision making and fatigue in elite women’s water polo: A novel recurrent events approach

Fatigue is anecdotally associated with declines in decision-making performance. This study aimed to examine if the hazard of poor decisions increased over the course of an international water polo match and a tournament. Thirteen female water polo players played six games during the 2022 FINA World Championships, reporting their fatigue before and after each match. Offensive, on-ball actions were judged as either good or poor decisions. A linear mixed model revealed that fatigue was significantly higher post-match compared to pre-match, and on the days of match 5 and 6 compared to the day of match 2 (<i>p</i> < 0.05). A total of 4491 decisions were evaluated, and piece-wise exponential additive models applied for recurrent events analyses were used to model the hazard of poor decisions. There was great variation between matches and teams in how hazard for poor decisions evolved over time. A general increase in hazard throughout match play appeared negligible in scale. Within the tournament, the cumulative hazard of poor decisions did not increase with each match. Thus, despite the development of fatigue, there was no universal increase over time in poor offensive decisions, reinforcing the relevance of also considering other factors that may influence decision-making performance.