Sergio Maroto-Izquierdo

Scopus Publications

Effectiveness of Different Neuromuscular Recovery Strategies in Elite Youth Female Football Players
Silvia Sedano and Sergio Maroto-Izquierdo
MDPI AG
This study aimed to assess the effectiveness of various active recovery strategies in youth female soccer players during competitive tournaments with limited recovery periods (i.e., 24–48 h). Twenty-two elite under-17 female football players participated in this randomized controlled trial, which encompassed fourteen 90 min official matches. Participants were randomly allocated to one of three recovery protocols: passive stretching, foam rolling, or lumbopelvic mobility exercises, which were implemented ten minutes after each match. Countermovement jump with free arm (CMJA) height was measured pre-intervention, immediately post-intervention, and 5 h post-intervention. Wellness perception was evaluated 24 h later. Significant enhancements in CMJA height were observed immediately after all recovery protocols and at 5 h post-intervention compared with pre-intervention (p < 0.001). The lumbopelvic mobility protocol yielded the most substantial improvement, significantly surpassing both stretching and foam rolling. Moreover, significant increases in wellness perception were observed following the foam rolling (p < 0.001, ES = 0.95) and mobility (p < 0.05, ES = 0.88) protocols, with the mobility protocol demonstrating a marginally larger effect size than stretching. Active recovery strategies significantly enhanced neuromuscular function and wellness perception in under-17 female soccer players. Lumbopelvic mobility exercises exhibited superior efficacy, suggesting that they should be prioritized in post-match recovery regimens.

Effects of flywheel training inter-set passive stretching on flexibility and neuromuscular capacity
Osvaldo Costa Moreira, Suene Franciele Nunes Chaves, Érike Augusto de Sousa Resende, Izabela Mendes Alves, Maria Eduarda Araújo Lara, Ítalo Santiago Alves Viana, Leonardo Silveira Goulart Silva, Sergio Maroto-Izquierdo, and Claudia Eliza Patrocínio de Oliveira
Springer Science and Business Media LLC

Cluster sets and traditional sets elicit similar muscular hypertrophy: a volume and effort-matched study in resistance-trained individuals
Salvador Vargas-Molina, Manuel García-Sillero, Sergio Maroto-Izquierdo, Eneko Baz-Valle, Borja Bautista-Mayorga, Mora Murri, Brad J. Schoenfeld, and Javier Benítez-Porres
Springer Science and Business Media LLC
Abstract Background and Objective Previous studies examining the effects of cluster sets (CS) compared to traditional sets (TS) protocols on muscle hypertrophy have primarily equated to volume load. This inevitably has resulted in a lower number of repetitions performed in TS compared to CS, thereby leading to a suboptimal hypertrophic stimulus. The present study aimed to compare the impact of CS and TS protocols, both performed with the same number of sets and repetitions, but with loads adjusted to the same range of repetitions in reserve (RIR) on muscle hypertrophy. Methods Ten resistance-trained volunteers (7 men and 3 women, 21.0 ± 1.5 years, 64.3 ± 6.9 kg, and 169.3 ± 6.2 cm) participated in this study. Participants performed two training protocols over an 8-week period, with two weekly sessions consisting of 5 sets of 12 repetitions of the leg press and leg extension exercises. The study employed a within-participant, unilateral design where one limb performed a TS protocol and the contralateral limb performed 3 clusters of 4 repetitions with a 20-s intra-set rest period of the same exercises (CS). Muscle thickness was assessed via ultrasound and thigh lean tissue mass was assessed by dual-energy X-ray absorptiometry pre- and post-study. Results Results showed similar increases in muscle thickness (p < 0.001, ES = 0.56, and p = 0.012, ES = 0.42, respectively) and lean tissue mass (p = 0.002, ES = 0.11, and p < 0.001, ES = 0.13, respectively) in both CS and TS conditions. Conclusion In conclusion, when sets, repetitions, and load adjustments were equalized based on RIR, a CS protocol elicits similar increases in muscle thickness and lean mass compared to a TS protocol.

Move Better, Live Better: A novel supervised combined training for peripheral arterial disease: A quasi-experimental approach
Saúl Peñín-Grandes, Susana López-Ortiz, Montserrat de la Fuente Gómez, José Pinto-Fraga, Simone Lista, Sergio Maroto-Izquierdo, Alejandro Lucia, Mª Lourdes del Río Solá, Juan Martín-Hernández, and Alejandro Santos-Lozano
Ovid Technologies (Wolters Kluwer Health)
ABSTRACT Objective: This study aimed to analyze the effect of a novel supervised exercise therapy (SET) program based on intermittent treadmill walking and circuit-based moderate-intensity functional training (MIFT) on walking performance and HRQoL in PAD patients. Design: All participants underwent a 12-week SET that involved 15 to 30 minutes of treadmill walking followed by a 15-minute moderate-intensity functional training (MIFT) continued by 12-week of follow-up. Maximum walking distance (MWD), pain-free walking distance (PFWD), gait speed and estimated peak oxygen uptake (peak VO2) were calculated through the 6-minute walk test (6-MWT) and HRQoL through the Short Form-36 (SF-36) and the Vascular Quality of Life Questionnaire-6 (VascuQol-6). Results: There were statistically significant differences (p < 0.05) between baseline and post-intervention for walking performance outcomes [MWD (MD: 88.53 m), PFWD (MD: 62.89 m), gait speed (MD: 0.24 m·s-1) and peak VO2 (MD: 2.04 ml·kg−1·min−1)] and for HRQoL [physical functioning in SF-36 (MD: 6.93 points) and VascuQol-6 (MD: 1.46 points)]; while no differences were found between baseline and 12-week follow-up. Conclusion: Results seem to show that 12-week of novel SET based on intermittent walking and MIFT induced significant clinical improvements in key functional variables of PAD while cessation of exercise leads to significant negative clinical changes in subsequent weeks of follow-up.

MScope: A Reliable Battery for Functional Status Assessment in Multiple Sclerosis
Daniel Lisardo, Susana López-Ortiz, Irati Jauregui-Fajardo, José Pinto-Fraga, Celia García-Chico, Alba Chavarría-Miranda, Nieves Téllez, and Sergio Maroto-Izquierdo
MDPI AG
Multiple sclerosis (MS) is a neurodegenerative disease that often leads to severe disability. Although exercise, particularly strength training, improves health outcomes in MS, no standardized, reliable tool exists for functional assessment to inform tailored exercise prescriptions and patients’ categorization. This study aimed to validate the reliability of the MScope battery, a comprehensive tool incorporating structural, functional, and neuromuscular assessments to objectively evaluate patients with MS. A reproducibility study was conducted with 40 MS patients who completed the MScope battery twice, 72 h apart. Tests included structural (muscle thickness of the vastus lateralis and rectus femoris), functional (sit-to-stand, timed up-and-go, 10 m and six-minute walking test), and neuromuscular tests (isometric strength during the squat and leg extension exercises and handgrip strength). Intraclass correlation coefficients (ICCs), Bland–Altman plots, and the coefficient of variation (CV) were used to evaluate intra- and inter-day reliability. The MScope battery showed high intra- and inter-day reliability, with ICC values ranging from 0.79 to 0.99. Muscle thickness measurements, along with handgrip strength, demonstrated excellent reliability (ICC > 0.9, CV < 5%). Functional tests, including the timed up-and-go, 10 m walk, and sit-to-stand variations, maintained consistent scores (ICC > 0.85, CV < 10%). The six-minute walking test exhibited excellent inter-day reliability (ICC = 0.94, CV < 4%). Neuromuscular assessments showed strong reliability with minor day-to-day variability (ICC = 0.75–0.95, CV < 8%). The battery’s overall consistency supports its use as a reliable tool for assessing functional status in MS patients.

High intensity interval training as a therapy: Mitophagy restoration in breast cancer
Kayvan Khoramipour, Afsaneh Soltany, Pouria Khosravi, Maryam Hossein Rezaei, Elham Madadizadeh, Celia García-Chico, Sergio Maroto-Izquierdo, and Karen Khoramipour
Elsevier BV

Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial
P Blanco-Giménez, J. Vicente-Mampel, P Gargallo, S Maroto-Izquierdo, J Martín-Ruíz, E Jaenada-Carrilero, and C Barrios
Springer Science and Business Media LLC
AbstractThe importance of incorporating lumbo-pelvic stability core and controlling motor exercises in patients with chronic low back pain (CLBP) reinforces the use of strategies to improve biopsychosocial beliefs by reducing biomedical postulations. However, clinical practice guidelines recommend multimodal approaches incorporating exercise and manual therapy (MT), and instead reject the application of kinesiotape (KT) in isolation. Therefore, the objectives of this study were to analyze the effects of 12 weeks of exercises combined with MT or KT on perceived low back pain using the visual analog scale (VAS) and muscle electric activity measured with electromyography (EMG) of the rectus abdominis and multifidus in CLBP (mild disability) and to explore the relationship between the rectus abdominis and multifidus ratios and pain perception after intervention. A blinded, 12-week randomized controlled trial (RCT) was carried out, involving three parallel groups of patients with CLBP. The study was registered at Clinicaltrial.gov and assigned the identification number NCT05544890 (19/09/22). The trial underwent an intention-to-treat analysis. The primary outcome revealed a multimodal treatment program supplemented by additional therapies such as MT and KT, resulting in significant reductions in perceived low back pain. The subjective assessment of individuals with CLBP indicated no discernible distinction between exclusive core stability exercises and control-motor training when combined with MT or KT. Notably, our findings demonstrated positive alterations in both the mean and peak EMG values of the right rectus abdominis in the exercise group, suggesting a beneficial impact on muscle activation. This study focused on assessing the activation levels of the trunk musculature, specifically the rectus abdominis (RA) and multifidus (MF), in individuals with CLBP exhibiting mild disability according to the Oswestry Disability Index. Importantly, improvements in the VAS values were observed independently of changes in muscle electrical activity.

Force Production and Electromyographic Activity during Different Flywheel Deadlift Exercises
Sergio Maroto-Izquierdo, David García-López, Marco Beato, Iker J. Bautista, José L. Hernández-Davó, Javier Raya-González, and Fernando Martín-Rivera
MDPI AG
This study aimed to characterize and compare force production and muscle activity during four flywheel deadlift exercises (bilateral [Bi] vs. unilateral [Uni]) with different loading conditions (vertical [Ver] vs. horizontal [Hor]). Twenty-three team-sport athletes underwent assessments for exercise kinetics (hand-grip force), along with surface electromyography (sEMG) of the proximal (BFProx) and medial biceps femoris (BFMed), semitendinosus (ST), and gluteus medius (GM). Mean and peak force were highest (p < 0.001) in Bi + Ver compared with Bi + Hor, Uni + Ver, and Uni + Hor. Although no significant differences were observed between Bi + Hor and Uni + Ver, both variants showed higher (p < 0.001) average force and peak eccentric force when compared with Uni + Hor. The presence of eccentric overload was only observed in the vertically loaded variants. Bi + Ver and Uni + Ver showed higher (p < 0.05) sEMG levels in BFProx and BFMed compared with the Uni + Hor variant. In addition, Uni + Ver registered the largest GM and ST sEMG values. In conclusion, the vertical variants of the flywheel deadlift exercise led to higher muscle force production and sEMG compared with their horizontal counterparts. Both Bi + Ver and Uni + Ver may be effective in promoting an increase in hamstring muscles activity and muscle force at long muscle length, while the Uni + Ver variant may be more effective in promoting GM and ST involvement.

Pumping up the Fight against Multiple Sclerosis: The Effects of High-Intensity Resistance Training on Functional Capacity, Muscle Mass, and Axonal Damage
Sergio Maroto-Izquierdo, Patricia Mulero, Héctor Menéndez, José Pinto-Fraga, Simone Lista, Alejandro Santos-Lozano, and Nieves Téllez
MDPI AG
Background: Resistance training (RT) has been recognized as a beneficial non-pharmacological intervention for multiple sclerosis (MS) patients, but its impact on neurodegeneration is not fully understood. This study aimed to investigate the effects of high-intensity RT on muscle mass, strength, functional capacity, and axonal damage in MS patients. Methods: Eleven relapsing–remitting MS patients volunteered in this within-subject counterbalanced intervention study. Serum neurofilament light-chain (NfL) concentration, vastus lateralis thickness (VL), timed up-and-go test (TUG), sit-to-stand test (60STS), and maximal voluntary isometric contraction (MVIC) were measured before and after intervention. Participants performed 18 sessions of high-intensity RT (70–80% 1-RM) over 6 weeks. Results: Significant (p < 0.05) differences were observed post-intervention for VL (ES = 2.15), TUG (ES = 1.98), 60STS (ES = 1.70), MVIC (ES = 1.78), and NfL (ES = 1.43). Although moderate correlations between changes in VL (R = 0.434), TUG (R = −0.536), and MVIC (R = 0.477) and changes in NfL were observed, only the correlation between VL and MVIC changes was significant (R = 0.684, p = 0.029). Conclusions: A 6-week RT program significantly increased muscle mass, functional capacity, and neuromuscular function while also decreasing serum NfL in MS patients. These results suggest the effectiveness of RT as a non-pharmacological approach to mitigate neurodegeneration while improving functional capacity in MS patients.

The Inclusion of Preplanned and Random and Unanticipated/Unexpected Events During Strength Training Improves the Ability to Repeat High-Intensity Efforts Under Uncertainty
Oliver Gonzalo-Skok, Julio Tous-Fajardo, Sergio Maroto-Izquierdo, Javier Raya-González, and Javier Sánchez-Sánchez
Human Kinetics
Purpose: To compare the effects of unilateral flywheel training (FT), using a rotational conical pulley, including multidirectional movements with either preplanned or random unanticipated/unexpected executions on functional performance in football players. Methods: A total of 32 young male football players were randomly assigned to an FT program including preplanned unilateral multidirectional movements (PTG, n = 11), an FT executing the same unilateral movements through random (ie, right or left leg) unanticipated (ie, verbal or visual cue) or unexpected (ie, moment where the cue was provided) situations (UTG, n = 11), or a control group (n = 10) that followed their football training routine. FT consisted of 1 set × 5–12 repetitions of 4 exercises performed once a week for 10 weeks. Intermittent endurance performance, repeated unilateral and bilateral jumping ability, change-of-direction (COD) ability, linear sprint velocity, preplanned repeated-sprint ability (RSA), and uncertainty RSA (RSA-RANDOM) were assessed preintervention and postintervention. Results: Significant improvements were found in RSA-RANDOM performance (P < .05, effect size [ES] range: UTG [1.83–2.16], PTG [0.69–0.73]) and COD (P < .05, ES: UTG = 1.34, PTG = 0.98]) in both training groups. Furthermore, significant improvements were also found in intermittent endurance performance (P = .016, ES = 0.37) and sprinting (P = .006, ES = 0.45) in UTG. No changes in any variable were found in the control group. No significant between-groups differences (P > .05) were reported between UTG and PTG, while differences were observed to the control group in unilateral jumping ability, COD, and RSA-RANDOM for UTG, and in RSA-RANDOM for PTG. Conclusions: A 10-week unilateral FT improved RSA-RANDOM and COD ability in youth football players, so both preplanned and unexpected situations should be included on strength training.

Winners do what they fear: exercise and peripheral arterial disease—an umbrella review
Saúl Peñín-Grandes, Susana López-Ortiz, Sergio Maroto-Izquierdo, Héctor Menéndez, José Pinto-Fraga, Juan Martín-Hernández, Simone Lista, Alejandro Lucia, and Alejandro Santos-Lozano
Oxford University Press (OUP)
Abstract Aims This systematic review aims to evaluate and summarize findings from published meta-analyses on the effects of regular exercise in patients with peripheral arterial disease (PAD). The review will assess the impact of exercise on functional parameters, health-related quality of life, haemodynamic parameters, physical activity levels, adverse events, and mortality. Methods and results A systematic search was performed in PubMed, Web of Science, Scopus, and Cochrane Library databases (up to May 2023) to identify meta-analyses including randomized controlled trials that examined the effects of regular exercise in patients with PAD. Sixteen studies, with a total of 198 meta-analyses, were identified. Results revealed with strong evidence that patients with PAD who exercised improved functional and health-related quality of life parameters. Specifically, supervised aerobic exercise (i.e. walking to moderate–maximum claudication pain) improves maximum walking distance [mean difference (MD): 177.94 m, 95% confidence interval (CI) 142.29–213.60; P &lt; 0.00001; I2: 65%], pain-free walking distance (fixed MD: 68.78 m, 95% CI 54.35–83.21; P &lt; 0.00001; I2: 67%), self-reported walking ability [i.e. distance score (MD: 9.22 points, 95% CI 5.74–12.70; P &lt; 0.00001; I2: 0%), speed score (MD: 8.71 points, 95% CI 5.64–11.77; P &lt; 0.00001, I2: 0%), stair-climbing score (MD: 8.02 points, 95% CI 4.84–11.21; P &lt; 0.00001, I2: 0%), and combined score (MD: 8.76 points, 95% CI 2.78–14.74; P &lt; 0.0001, I2: 0%)], aerobic capacity (fixed MD: 0.62 mL/kg/min, 95% CI 0.47–0.77, P &lt; 0.00001, I2: 64%), and pain score (MD: 7.65, 95% CI 3.15–12.15; P = 0.0009; I2: 0%), while resistance exercise improves lower limb strength (standardized mean difference: 0.71, 95% CI 0.29–1.13, P = 0.0009; I2: 0%]. Regarding other outcomes, such as haemodynamic parameters, no significant evidence was found, while physical activity levels, adverse events, and mortality require further investigation. Conclusion Synthesis of the currently available meta-analyses suggests that regular exercise may be beneficial for a broad range of functional tasks improving health-related quality of life in patients with PAD. Supervised aerobic exercise is the best type of exercise to improve walking-related outcomes and pain, while resistance exercise is more effective to improve lower limb strength.

Current Guidelines for the Implementation of Flywheel Resistance Training Technology in Sports: A Consensus Statement
Marco Beato, Kevin L. de Keijzer, Alejandro Muñoz-Lopez, Javier Raya-González, Marco Pozzo, Björn A. Alkner, Antonio Dello Iacono, Jordi Vicens-Bordas, Giuseppe Coratella, Sergio Maroto-Izquierdo,et al.
Springer Science and Business Media LLC
Abstract Background Flywheel resistance training has become more integrated within resistance training programs in a variety of sports due to the neuromuscular, strength, and task-specific enhancements reported with this training. Objective This paper aimed to present the consensus reached by internationally recognized experts during a meeting on current definitions and guidelines for the implementation of flywheel resistance training technology in sports. Methods Nineteen experts from different countries took part in the consensus process; 16 of them were present at the consensus meeting (18 May 2023) while three submitted their recommendations by e-mail. Prior to the meeting, evidence summaries were developed relating to areas of priority. This paper discusses the available evidence and consensus process from which recommendations were made regarding the appropriate use of flywheel resistance training technology in sports. The process to gain consensus had five steps: (1) performing a systematic review of systematic reviews, (2) updating the most recent umbrella review published on this topic, (3) first round discussion among a sample of the research group included in this consensus statement, (4) selection of research group members—process of the consensus meeting and formulation of the recommendations, and (5) the consensus process. The systematic analysis of the literature was performed to select the most up-to-date review papers available on the topic, which resulted in nine articles; their methodological quality was assessed according to AMSTAR 2 (Assessing the Methodological Quality of Systematic Review 2) and GRADE (Grading Recommendations Assessment Development and Evaluation). Statements and recommendations scoring 7–9 were considered appropriate. Results The recommendations were based on the evidence summary and researchers’ expertise; the consensus statement included three statements and seven recommendations for the use of flywheel resistance training technology. These statements and recommendations were anonymously voted on and qualitatively analyzed. The three statements reported a score ranging from 8.1 to 8.8, and therefore, all statements included in this consensus were considered appropriate. The recommendations (1–7) had a score ranging from 7.7 to 8.6, and therefore, all recommendations were considered appropriate. Conclusions Because of the consensus achieved among the experts in this project, it is suggested that practitioners and researchers should adopt the guidelines reported in this consensus statement regarding the use of flywheel resistance technology in sports.

Repetitions in Reserve: An Emerging Method for Strength Exercise Prescription in Special Populations
Sergio Maroto-Izquierdo, Susana López-Ortiz, Saúl Peñín-Grandes, and Alejandro Santos-Lozano
Ovid Technologies (Wolters Kluwer Health)
ABSTRACT This review briefly outlines the benefits and limitations of traditional methods for prescribing resistance training (RT) exercise intensity (i.e., the percentage of 1 repetition maximum, velocity-based training, and rating of perceived exertion) for special populations based on mechanical and psychological indicators. Given these limitations, the repetition in reserve (RIR) method, which quantifies the discrepancy between potential and actual repetitions, has been proposed as a safer, more effective, and adaptable alternative to optimize RT in special populations. This study provides an overview of the main RIR scales used in scientific literature and synthesizes RIR validation studies. Although the validity and reliability of the RIR method have not been extensively tested across different special populations, and a scarcity of studies applying it in clinical contexts has been detected, this review proposes a practical application that integrates existing scales for prescribing RT in rehabilitation settings and for individuals with chronic health conditions. In conclusion, the RIR method shows promise for broader application in clinical settings, and further research is needed to validate its effectiveness in diverse population groups.

Dry needling in people with fibromyalgia: A randomized controlled trial of its effects on pain sensitivity and pain catastrophizing influence
J. Vicente‐Mampel, I. J. Bautista, I. Salvat, S. Maroto‐Izquierdo, E. Lluch Girbés, and F. Ros Bernal
Wiley
AbstractBackgroundDry needling (DN) has been demonstrated as an effective treatment for patients with fibromyalgia (FM). It is crucial to take into consideration catastrophizing, a psychological construct that could potentially undermine the short‐term efficacy of DN.ObjectiveTo analyze the effects of DN in the infraspinatus muscle on both local and remote pressure pain thresholds (PPTs) and its relationship with baseline levels of pain catastrophizing in patients with FM.DesignRandomized controlled trial.MethodsAll participants were randomly assigned to one of three interventions: DN, sham DN, and no intervention. Hong's fast‐in and fast‐out technique was implemented during the DN intervention.Main Outcomes MeasuresThe primary study outcome pain sensitivity (local and remote PPTs) was assessed at baseline, immediately post, and 24 h post intervention to evaluate short‐term effect. Pain catastrophizing was measured at baseline in all participants using the Pain Catastrophizing Scale. To analyze the effect of DN on local and remote PPTs, an analysis of covariance was performed using catastrophism as covariate. Additionally, to examine the possible influence of catastrophism on local PPTs ratings in the subsequent assessment we performed a moderation analysis.PatientsA total of 120 women diagnosed with FM. However, during the follow‐up period, 24 participants discontinued their involvement, leaving a final cohort of 96 patients who successfully concluded the study.ResultsDN showed significant differences in both local PPTs immediately post intervention and 24 h post intervention (MD [95% confidence interval] = 3.21 [0.40–6.02] kg/cm2, p = .019; and 2.84 [0.10–5.58] kg/cm2, p = .039, respectively) compared to sham and no‐intervention groups. In addition, DN group results suggest that moderate values of catastrophizing (<35) diminish the effect of DN immediately postintervention.ConclusionsThe infraspinatus DN led to a notable reduction in local PPTs among individuals with FM. Additionally, the effectiveness of the DN treatment was influenced by pain catastrophizing.

Biological maturity vs. relative age: Independent impact on physical performance in male and female youth handball players
Alfonso de la Rubia, Adam Leight Kelly, Jorge García-González, Jorge Lorenzo, Daniel Mon-López, and Sergio Maroto-Izquierdo
Termedia Sp. z.o.o.

Effects of ankle position during the Nordic Hamstring exercise on range of motion, heel contact force and hamstring muscle activation
Juan Vicente-Mampel, Iker J. Bautista, Fernando Martín, Sergio Maroto-Izquierdo, Bas Van Hooren, and Luis Baraja-Vegas
Informa UK Limited
One of the main benefits of the Nordic Hamstring Exercise (NHE) is that it can be performed without the need of any extra material. However, numerous technical execution variables such as the ankle and pelvis position can influence the performance. The primary aims of this study were to investigate the effects of ankle position (i.e., plantar or dorsal flexion) on Nordic Hamstring Break Point (NHBP), repetition time and heel contact force. A secondary aim was to investigate differences in biceps femoris long head and semitendinosus muscle activation. Male professional field hockey players (n = 12) volunteered for the study. Paired t-tests were used to analyse the effect of ankle position on muscle NHBP, eccentric peak torque and repetition time. Ankle dorsal flexion resulted in a higher NHBP (p = 0.002, effect size [ES] = 1.48 [0.57 to 2.38]), repetition time (p = 0.004, ES = 0.98 [0.24 to 1.72]) and both absolute and relative heel contact force (p = 0.028, ES = 0.67 [0.01 to 1.34], p = 0.017, ES = 0.76 [0.07 to 1.44], respectively) compared to plantar flexion. Muscle activation was not significant different. This study showed a higher NHBP, absolute and relative heel contact force and repetition time with a dorsal flexed ankle vs. a plantar flexed ankle in the NHE, without changes in hamstrings muscle activation.

Effects of exchange vs. controlled diet on biochemical, body composition and functional parameters in elite female soccer players
Sandra Antón San Atanasio, Sergio Maroto-Izquierdo, and Silvia Sedano
Public Library of Science (PLoS)
Due to the increasing level of professionalism, the high frequency of competitions, and the alarming injury rate observed in elite female soccer players, multidisciplinary strategies, including nutritional monitoring, need to be implemented. This study aimed to quantify energy, macronutrient and micronutrient intakes during the competitive period and to analyze the effects of two different nutritional interventions on nutritional knowledge, anthropometric data, biochemical values and physical performance. 19 elite female soccer players were randomly divided into two groups: the controlled-diet group (CG, n = 10), that followed a diet based on pre-established menus, and the exchange-diet group (EG, n = 9), that designed their own menus with an exchanged list. A cross-sectional study was designed to evaluate the dietary intake, while an experimental randomized controlled trial was designed to compare the effects of both 12-week nutritional interventions. Total energy, CHO, PROT, fibre and micronutrients intakes were below the general recommendations for athletes while, total and saturated fat intakes were above these. Moreover, there were no differences in diet during weekdays, pre-competition and competition days. The study also revealed a low nutritional knowledge and exchanged diet has demonstrated to be a better strategy to improve this. Biochemical monitoring showed that participants presented decreased concentration of haemoglobin and controlled diet may lead to greater effects on haemoglobin concentration and in anemia prevention. Both EG and CG showed significant reduction on skinfolds sum after intervention, but no significant differences were observed in thigh and calf indices. However, no significant changes were observed in soccer-related skills for any group.

Effect of resistance exercise training on plasma neurofilaments in multiple sclerosis: a proof of concept for future designs
Patricia Mulero, Sergio Maroto-Izquierdo, Natán Redondo, Hugo Gonzalo-Benito, Alba Chavarría-Miranda, Hugo Calvo, María I. Cabero, Marita Hernandez, María Luisa Nieto, and Nieves Tellez
Springer Science and Business Media LLC

Acute Effects of Blood Flow Restriction Training on Movement Velocity and Neuromuscular Signal during the Back Squat Exercise
Manuel García-Sillero, Sergio Maroto-Izquierdo, María Galván-García, Javier Benitez-Porres, Salvador Vargas-Molina, and Jose Manuel Jurado-Castro
MDPI AG
The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back squat exercise. Methods: Twenty-four university students participated in this study. In two randomized sessions 72 h apart, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity (MPV), peak concentric velocity (Vmax), and the effort index (EI)). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. Results: The BFR condition showed higher (p < 0.05) EI, peak, and rooted mean square normalized EMG in Set 1 compared to Set 2. Similar MPV and Vmax were observed in each set for both the BFR and control conditions. No significant differences were observed between conditions in any set. Conclusions: BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less excitation of the muscles involved.

Validity and Reliability of Inertial Measurement System for Linear Movement Velocity in Flywheel Squat Exercise
Sergio Maroto-Izquierdo, Kazunori Nosaka, Jesús Alarcón-Gómez, and Fernando Martín-Rivera
MDPI AG
The aim of this study was to examine the validity and reliability of an Inertial Measurement System integrated into a secondary pulley (IMS) for determining linear velocity during flywheel squat exercises. Thirty-one male participants who were highly experienced in a flywheel resistance exercise training performed flywheel squat exercises with three incremental loads, and mean velocity (MV), mean propulsive velocity (MPV) and max velocity (Vmax) of the exercises were simultaneously recorded with a validated linear encoder and the IMS, in two different sessions. Validity was analyzed using ordinary least products regression (OLP), Lin’s concordance correlation coefficient (CCC), and Hedge’s g for the values from the linear encoder and the IMS. Test-retest reliability was determined by coefficient of variation (CV), Intraclass correlation coefficient (ICC), and standard error of measurement (SEM). Results showed a high degree of validity (OLP intercept = −0.09–0.00, OLP slope = 0.95–1.04, CCC = 0.96–0.99, Hedge’s g < 0.192, SEM = 0.04–0.08) and reliability (CV < 0.21%, ICC > 0.88, SEM < 0.08). These results confirm that the IMS provides valid and reliable measures of movement velocity during flywheel squat exercises.

Effects of submaximal and supramaximal accentuated eccentric loading on mass and function
Sergio Maroto-Izquierdo, Fernando Martín-Rivera, Kazunori Nosaka, Marco Beato, Javier González-Gallego, and José A. de Paz
Frontiers Media SA
Introduction: Eccentric-overload (EO) resistance training emerges as an alternative to more optimally prescribe intensity relative to the force generation capabilities of the eccentric muscle contraction. Given the difficulties to individually prescribe absolute eccentric loads relative to each person’s eccentric ability, setting the load relative to the concentric one-repetition maximum (1-RM) is the most used EO training approach. Therefore, we investigated the effects of submaximal and supramaximal (i.e., eccentric loads above 100% of 1-RM) accentuated eccentric training on changes in lean mass, anabolic hormonal responses and muscle function.Methods: Physically active university students (n = 27) were randomly assigned to two training groups. Participants in the training groups performed dominant leg isotonic training twice a week for 10 weeks (four sets of eight repetitions). Isotonic resistance was generated by an electric-motor device at two different percentages of 1-RM for the eccentric phase; 90% submaximal load, SUB group) and 120% (supramaximal load, SUPRA group). Concentric load was the same for both groups (30% of 1-RM). Changes in total thigh lean mass (TTLM), anabolic hormonal responses (growth hormone, IGF-1, IL-6, and total testosterone), unilateral leg-press 1-RM, maximal voluntary isometric contractions (MVIC), local muscle endurance (XRM), muscle power at 40 (PP40), 60 (PP60) and 80% (PP80) of the 1-RM, and unilateral vertical jump height before and after training were compared between groups.Results: After training, both SUB and SUPRA groups showed similar increases (p &lt; 0.05) in MVIC (19.2% and 19.6%), XRM (53.8% and 23.8%), PP40 (16.2% and 15.7%), TTLM (2.5% and 4.2%), IGF-1 (10.0% and 14.1%) and IL-6 (58.6% and 28.6%). However, increases in 1-RM strength (16.3%) and unilateral vertical jump height (10.0%–13.4%) were observed for SUPRA only. Indeed, SUPRA was shown to be more favorable than SUB training for increasing 1-RM [ES = 0.77 (1.49–0.05)]. Unilateral muscle power at medium and high intensity (10.2% and 10.5%) also increased in SUB but without significant differences between groups.Discussion: Similar functional and structural effects were demonstrated after 10 weeks EO training with submaximal and supramaximal eccentric loads. Although supramaximal loading might be superior for increasing 1-RM, the use of this approach does not appear to be necessary in healthy, active individuals.

Editorial: The science of flywheel training: exercise physiology and practical applications
Marco Beato, Javier Raya-González, Jose’ Luis Hernandez-Davo, and Sergio Maroto-Izquierdo
Frontiers Media SA
Flywheel resistance training was initially designed and implemented to mitigate the negative effects in the absence of gravity on astronauts during space travels (Alkner and Tesch, 2004; Norrbrand et al., 2008). Later on, sport scientists and practitioners understood the advantages offered by this methodology and they started to use flywheel resistance training for several purposes, such as performance development of athletes, injury prevention and clinical rehabilitation (Tesch et al., 2017; Beato and Dello Iacono, 2020; Beato et al., 2021a). Flywheel resistance training offers some specific and unique advantages compared to traditional resistance training, which has increased the popularity of this training methodology. In detail, flywheel training is characterized by the use of rotational inertia to generate resistance throughout the entire range of motion. During the concentric phase, the force applied causes the connected cord/strap to unwind, resulting in the rotation and energy storage of the flywheel–the kinetic energy increases with rotational speed. Upon completing the concentric phase, the cord/strap rewinds, and the user must resist the pull of the flywheel through a braking eccentric phase. By employing the appropriate technique, selecting the right exercise, and using an adequate momentum of inertia, users can achieve an eccentric overload in terms of force and power values (Maroto-Izquierdo et al., 2017; Maroto-Izquierdo et al., 2022). It is important to highlight that the mechanical load performed during both concentric and eccentric phases is the mechanism by which neural and morphological adaptations happen (de Hoyo et al., 2015; Maroto-Izquierdo et al., 2017; De Keijzer et al., 2022). This statement is supported by recent research which reports that flywheel training is a valid method leading to positive morphological changes of muscle structure and architecture, hypertrophy, and strength gains (Maroto-Izquierdo et al., 2017; Allen et al., 2021). Although in the last decade, several researchers have studied the physiological effects of flywheel training and the related acute and chronic adaptations, much OPEN ACCESS

Effects of Preceding Transcranial Direct Current Stimulation on Movement Velocity and EMG Signal during the Back Squat Exercise
Manuel Garcia-Sillero, Iván Chulvi-Medrano, Sergio Maroto-Izquierdo, Diego A. Bonilla, Salvador Vargas-Molina, and Javier Benítez-Porres
MDPI AG
This study aimed to evaluate the effects of preceding anodal transcranial direct stimulation (a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) during the back squat exercise on movement velocity and surface electromyographic (sEMG) activity. Thirteen healthy, well-trained, male firefighters (34.72 ± 3.33 years; 178 ± 7.61 cm; 76.85 ± 11.21 kg; 26.8 ± 4.2 kg·m−2; back squat 1-repetition maximum 141.5 ± 16.3 kg) completed this randomised double-blinded sham-controlled crossover study. After familiarisation and basal measurements, participants attended the laboratory on two occasions separated by 72 h to receive either Sham or a-tDCS (current intensity of 2 mA for 20 min). Immediately after stimulation, participants completed three sets of 12 repetitions (70% of 1-RM) with three minutes of recovery between sets monitored with a linear position transducer. The sEMG of the rectus femoris (RF) and vastus lateralis (VL) of both legs were recorded. No significant differences were observed between a-tDCS and Sham interventions on mean concentric velocity at any set (p > 0.05). Velocity loss and effort index were significantly higher (p < 0.05) in set 3 compared to set 1 only in the a-tDCS group. The right-leg RM and right-leg VL elicited the greatest muscle activation during set 1 after a-tDCS and Sham, respectively (p < 0.05). Our results revealed that a-tDCS over the DLPFC might impact movement velocity or fatigue tolerance in well-trained individuals. Notwithstanding, significant differences in dominant-leg muscle activity were found both in a-tDCS and Sham.

Use of concentric linear velocity to monitor flywheel exercise load
Fernando Martín-Rivera, Marco Beato, Vicente Alepuz-Moner, and Sergio Maroto-Izquierdo
Frontiers Media SA
Purpose: To propose the concentric linear velocity measurement as a valid method to quantify load and individualise the prescription of flywheel training, we investigated the relationship between inertial load and mean concentric linear velocity (MCLV) during the flywheel squat exercise in a wide spectrum of intensities. In addition, we compared MCLV and subjective rating of perceived exertion (RPE) after each load.Methods: Twenty-five physically active men volunteered for this study (26.5 ± 2.9 years, 179.5 ± 4.2 cm, 81.6 ± 8.6 kg). After familiarization, all participants performed two inertial progressive load tests on separated days to determine the flywheel load-velocity profile and its reliability. Each participant performed 5 set of 6 repetitions of the flywheel squat exercise with different inertial loads (0.047, 0.104, 0.161, 0.245, 0.321 kg m2) selected in a counterbalanced and randomized order for each testing day. Average MCLV and RPE for each load were compared.Results: The inter-session intraclass correlation coefficient (ICC) showed values above 0.9 in all the included outcomes (MCLV: ICC = 0.91; RPE: ICC = 0.93). A significant correlation (p &lt; 0.01, R2 = 0.80) between inertial load and MCLV was found. Similarly, significant correlation models (p &lt; 0.01) were observed between RPE and load (R2 = 0.87) and (R2 = 0.71) between RPE and MCLV.Conclusion: The control of MCLV during flywheel exercise can be proposed as a valid method to quantify load and to individualize the prescription of flywheel training. In addition, RPE responses have demonstrated significant correlations with load and velocity. Therefore, RPE has been proposed as a valid and reliable alternative to control flywheel training.

The influence of calculation method and relative strength on the load-velocity relationship in bench press exercise
Iker J Bautista, Fernando Martín-Rivera, Isidoro Martínez, Gregory G Haff, and Sergio Maroto-Izquierdo
SAGE Publications
Purpose The objective of this study was: (1) to compare the effect of the calculation method using average (Avalue), and best value (Bvalue) of Mean Propulsive Velocity (MPV) on the Load Velocity Profile (LVprofile) during the barbell bench press exercise in elite handball players. In addition, (2) to analyze the relationship between the individual coefficient of variation (CVind) of an incremental load protocol in the bench press exercise with relative strength (Frel) in professional handball players. Methods Nineteen elite international handball players (age 18 [±1] y; body mass 93 [±14] kg; height 191 [±6] cm) performed an incremental test during the barbell bench press exercise. General and individual LVprofile, Frel, and CVind were modelled through MPV and two calculation models (Avalue, vs Bvalue). Results There were significant differences (p < 0.05) between both conditions (Bvalue vs. Avalue). There was an inverse relationship between the Frel and the CVind (r = −0.66, p < 0.001). When CVind was >10% significant differences were found between the two calculations method (Avalue, vs Bvalue). However, no significant differences were found between Avalue, vs Bvalue when the CVind was <10%. Conclusions The calculation method used to assess the barbell bench press LVprofile impacts the nature of the relationship. Regardless CVind values, Avalue is a good choice to determine the LVprofile when the CVind is >10%, if the CVind is <10%, Bvalue will be the better option to determine the LVprofile.

Sergio Maroto-Izquierdo

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