Effects of vertical and horizontal plyometric training on jump performances and sprint force-velocity profile in young elite soccer players.

PURPOSE: During a soccer match, horizontal acceleration ability during short sprints is determinant for performance. Development of sprint force and velocity qualites have been reported after plyometric training. However, orientation of plyometric training exercises can influence the functional performance. The purpose of this study was to compare the horizontal and vertical orientation of plyometric training on explosiveness performances and sprint force-velocity profile in young soccer players. METHODS: Twenty-eight soccer players were recruited and divided in two groups: vertical (VG, n = 14) and horizontal (HG, n = 14) groups. Tests including jumps and sprint performances were conducted before and after the 8 week training period. Sprint force-velocity profile (FVP) was evaluated during a 30 m sprint test. RESULTS: The results demonstrated significant improvements in both VG and HG for jump performances (from + 4.9% to + 9.0%), sprint times (from -5.5% to -8.7%) and FVP parameters. Higher relative changes for the HG than for the VG were observed in 5 m and 15 m sprint times, horizontal jump lengths, and also in FVP parameters, especially improvements in maximal power (VG: + 16.4% vs. HG: + 28.1%) and in the decrease rate of horizontal orientation of force with increasing speed (HG: + 22.9%) during the 30 m sprint. CONCLUSIONS: Both horizontal and vertical plyometric training can be either used in young soccer players to improve vertical and horizontal performances in jump and sprint. However, horizontal plyometric training may result in a greater improvement in horizontal ballistic actions while similarly developing vertical jump qualities compared to vertical plyometric training in young soccer players.

Sex-related differences and effects of short and long trail running races on resting muscle-tendon mechanical properties.

The purpose of the study was to assess sex-related differences in resting mechanical properties and adaptations of skeletal muscles and tendons in response to trail running races of different distances using multi-site shear wave elastography assessments of the lower limb, force capacity and blood analyses. Sex differences in resting mechanical properties of knee extensor and plantar flexor muscles and tendons were characterized by shear wave velocity (SWV) measurements in healthy males (N = 42) and females (N = 25) trained in long-distance running. Effects of running distance on muscle and tendon properties were assessed in short (<60 km, N = 23) vs. long (>100 km, N = 26) distance races. Changes in isometric maximal voluntary contraction torque, serum C-reactive protein and creatine kinase activity were also quantified after running races. Higher SWV of relaxed triceps surae muscle was detected in females as compared to males before running races (+4.8%, p = 0.006), but the significant increases in triceps surae muscle group (+7.0%, p = 0.001) and patellar tendon SWV (+15.4%, p = 0.001) after short-distance races were independent of sex. A significant decrease in triceps surae muscle SWV was found after long-distance races in the whole experimental population (-3.1%, p = 0.049). Post-races increase in C-reactive protein and creatine kinase activity were significantly correlated to the relative decreases in triceps surae and quadriceps femoris skeletal muscle SWV (ρ = -0.56, p = 0.001 and ρ = -0.51, p = 0.001, respectively). Resting mechanical properties of muscles and tendons are affected by sex, and adaptations to trail races are related to running distance. Exercise-induced changes in resting skeletal muscle mechanical properties are associated with enhanced indirect markers of inflammation and muscle damage.

Effect of hip and knee joint angles on resting hamstring muscles rigidity in men and women.

PURPOSE: Hamstring muscle strains are one of the most common injuries in sports practice, for both men and women. However, sex disparities in the rate of muscle injuries have been observed. As these muscular injuries usually occur at long muscle length, this study aimed to determine the effect of sex on hamstring muscles' resting rigidity under different stretching conditions. METHODS: The shear wave speed (SWS) of resting hamstring muscles was measured in 12 men and 12 women in different hip and knee positions (hip extended with knee flexed, hip flexed with knee extended, both joints extended and both joints flexed). RESULTS: Combining all the positions, the SWS of the semitendinosus was higher in men than in women (2.96 vs. 2.71 m.s-1). Regardless of sex, a significant rise in SWS was systematically observed when the semimembranosus was stretched (1.86, 2.37, 2.76 and 4.39 m.s-1) but it was neither the case for the semitendinosus (p = 0.82) nor for the biceps femoris (p = 0.50). Finally, differences in SWS among the hamstring muscles were only observed at the longest muscle length, with greater SWS values for the semimembranosus and semitendinosus in comparison with the biceps femoris (4.39 and 4.12 vs. 3.38 m.s-1 respectively). CONCLUSION: In conclusion, a sex difference was only observed in the resting semitendinosus rigidity. Independently of sex, the increase in resting hamstring muscles SWS with stretch was muscle specific.

Skeletal Muscle Damage Produced by Electrically Evoked Muscle Contractions.

Understanding the physiological/mechanical mechanisms leading to skeletal muscle damage remains one of the challenges in muscle physiology. This review presents the functional, structural, and cellular consequences of electrically evoked submaximal isometric contractions that can elicit severe and localized skeletal muscle damage. Hypotheses related to underlying physiological and mechanical processes involved in severe and localized muscle damage also are discussed.

A novel segmentation framework dedicated to the follow-up of fat infiltration in individual muscles of patients with neuromuscular disorders.

PURPOSE: To propose a novel segmentation framework that is dedicated to the follow-up of fat infiltration in individual muscles of patients with neuromuscular disorders. METHODS: We designed a semi-automatic segmentation pipeline of individual leg muscles in MR images based on automatic propagation through nonlinear registrations of initial delineation in a minimal number of MR slices. This approach has been validated for the segmentation of individual muscles from MRI data sets, acquired over a 10-month period, from thighs and legs in 10 patients with muscular dystrophy. The robustness of the framework was evaluated using conventional metrics related to muscle volume and clinical metrics related to fat infiltration. RESULTS: High accuracy of the semi-automatic segmentation (mean Dice similarity coefficient higher than 0.89) was reported. The provided method has excellent reliability regarding the reproducibility of the fat fraction estimation, with an average intraclass correlation coefficient score of 0.99. Furthermore, the present segmentation framework was determined to be more reliable than the intra-expert performance, which had an average intraclass correlation coefficient of 0.93. CONCLUSION: The proposed framework of segmentation can successfully provide an effective and reliable tool for accurate follow-up of any MRI biomarkers in neuromuscular disorders. This method could assist the quantitative assessment of muscular changes occurring in such diseases.

Muscle alterations induced by electrostimulation are lower at short quadriceps femoris length.

PURPOSE: This study aimed at determining through MRI investigations, force and soreness assessments whether the modulation of muscle length is a relevant strategy for minimising neuromuscular electrical stimulation (NMES)-induced muscle damage in young healthy participants. METHODS: Comparison of 2 NMES sessions (40 isometric electrically-evoked contractions of the knee extensors) was randomly performed on 1 knee flexed at 50° (short muscle length) and the contralateral at 100° (long muscle length) in a single group of healthy participants. Indirect markers of muscle damage including changes in maximal voluntary isometric contraction (MVC) force, muscle volume and transverse relaxation time (T2) were measured before, 2 days (D2), 4 days (D4) and 7 days (D7) after the NMES sessions in each limb of the ten participants. RESULTS: Although stimulation intensity was similar during the NMES session on both limbs, significantly lower force production was recorded at long muscle length (peak at 30 ± 5% MVC force) as compared to short muscle length (peak at 61 ± 12% MVC force). In the following days, MVC force at long muscle length was decreased from D2 to D7, whereas no significant change occurred at short muscle length. Increases in muscle volume and T2 were found at each time point in stimulated muscles at long muscle length, whereas no change was found at short muscle length. CONCLUSION: For the same stimulation intensity, NMES-induced isometric contractions generate higher knee extension force output and result in lower muscle tissues alterations that could be related to a lower intramuscular shear strain when exercise is performed at short muscle length.

Spatial difference can occur between activated and damaged muscle areas following electrically-induced isometric contractions.

KEY POINTS: T2 mapping combined to image registration and statistical parametric mapping analysis is a suitable methodology to accurately localize and compare the extent of both activated and damaged muscle areas. Activated muscle areas following electrically-induced isometric contractions are superficial, but damaged regions are muscle specific and can be related to the muscle morphology and/or the relative spatial position within a muscle group leading to potential intramuscular muscle shear strain. Tissues other than active skeletal muscle fibres can be altered during unaccustomed neuromuscular electrical stimulation-induced isometric contractions. ABSTRACT: Skeletal muscle isometric contractions induced by neuromuscular electrical stimulation (NMES) exercise can generate damage within activated muscles. This study aimed at comparing the localization and the extent of NMES-activated muscle areas and induced damage regions using magnetic resonance imaging. Thirteen healthy subjects performed a single bout of NMES-induced isometric contractions known to induce a decrease in maximal voluntary isometric contraction (MVC) and increase in muscle volume and transverse relaxation time (T2 ). All the parameters were measured before, immediately after (POST), 7 days (D7), 14 days (D14) and 21 days (D21) after the NMES session. Spatial normalization of T2 maps were performed to compare the localization of muscle activation areas and damaged muscle regions from statistical mapping analyses. A significant decrease in MVC was found at POST (-26 ± 9%) and in delayed time at D7 (-20 ± 6%) and D14 (-12 ± 5%). Although muscle activation was statistically detected through T2 increase at POST in superficial parts of the two muscles located beneath the stimulation electrodes (i.e. vastus lateralis and vastus medialis), alterations quantified in a delayed time from increased T2 were mainly located in the deep muscle region of the vastus lateralis (+57 ± 24% of mean T2 ) and superficial area of the vastus medialis (+24 ± 16% of mean T2 ) at D7 and were still observed in whole muscle at D21. The discrepancy between activated and damaged areas in the vastus lateralis implies that tissues other than active skeletal muscle fibres were altered during unaccustomed NMES-induced isomeric contractions.

Diffusion Properties and 3D Architecture of Human Lower Leg Muscles Assessed with Ultra-High-Field-Strength Diffusion-Tensor MR Imaging and Tractography: Reproducibility and Sensitivity to Sex Difference and Intramuscular Variability.

Purpose To demonstrate the reproducibility of the diffusion properties and three-dimensional structural organization measurements of the lower leg muscles by using diffusion-tensor imaging (DTI) assessed with ultra-high-field-strength (7.0-T) magnetic resonance (MR) imaging and tractography of skeletal muscle fibers. On the basis of robust statistical mapping analyses, this study also aimed at determining the sensitivity of the measurements to sex difference and intramuscular variability. Materials and Methods All examinations were performed with ethical review board approval; written informed consent was obtained from all volunteers. Reproducibility of diffusion tensor indexes assessment including eigenvalues, mean diffusivity, and fractional anisotropy (FA) as well as muscle volume and architecture (ie, fiber length and pennation angle) were characterized in lower leg muscles (n = 8). Intramuscular variability and sex differences were characterized in young healthy men and women (n = 10 in each group). Student t test, statistical parametric mapping, correlation coefficients (Spearman rho and Pearson product-moment) and coefficient of variation (CV) were used for statistical data analysis. Results High reproducibility of measurements (mean CV ± standard deviation, 4.6% ± 3.8) was determined in diffusion properties and architectural parameters. Significant sex differences were detected in FA (4.2% in women for the entire lower leg; P = .001) and muscle volume (21.7% in men for the entire lower leg; P = .008), whereas architecture parameters were almost identical across sex. Additional differences were found independently of sex in diffusion properties and architecture along several muscles of the lower leg. Conclusion The high-spatial-resolution DTI assessed with 7.0-T MR imaging allows a reproducible assessment of structural organization of superficial and deep muscles, giving indirect information on muscle function. ©RSNA, 2018 Online supplemental material is available for this article.

Impaired muscle force production and higher fatigability in a mouse model of sickle cell disease.

Skeletal muscle function has been scarcely investigated in sickle cell disease (SCD) so that the corresponding impact of sickle hemoglobin is still a matter of debate. The purpose of this study was to investigate muscle force production and fatigability in SCD and to identify whether exercise intensity could have a modulatory effect. Ten homozygous sickle cell (HbSS), ten control (HbAA) and ten heterozygous (HbAS) mice were submitted to two stimulation protocols (moderate and intense) to assess force production and fatigability. We showed that specific maximal tetanic force was lower in HbSS mice as compared to other groups. At the onset of the stimulation period, peak force was reduced in HbSS and HbAS mice as compared to HbAA mice. Contrary to the moderate protocol, the intense stimulation protocol was associated with a larger decrease in peak force and rate of force development in HbSS mice as compared to HbAA and HbAS mice. These findings provide in vivo evidence of impaired muscle force production and resistance to fatigue in SCD. These changes are independent of muscle mass. Moreover, SCD is associated with muscle fatigability when exercise intensity is high.

Fast measurement of the quadriceps femoris muscle transverse relaxation time at high magnetic field using segmented echo-planar imaging.

PURPOSE: To assess and validate a technique for transverse relaxation time (T2 ) measurements of resting and recovering skeletal muscle following exercise with a high temporal resolution and large volume coverage using segmented spin-echo echo-planar imaging (sSE-EPI). MATERIALS AND METHODS: Experiments were performed on a 3T magnetic resonance imaging (MRI) scanner using a multislice sSE-EPI technique applied at different echo times (TEs). T2 measurements were first validated in vitro in calibrated T2 phantoms (range: 25-152 ms) by comparing sSE-EPI, standard spin-echo (SE), and multislice multiecho (MSME) techniques (using a fitting procedure or a 2-TEs calculation). In vivo measurements of resting T2 quadriceps femoris (QF) muscle were performed with both sSE-EPI and MSME sequences. Finally, sSE-EPI was used to quantify T2 changes in recovering muscle after an exercise. RESULTS: T2 values measured in vitro with sSE-EPI were similar to those assessed with SE (P > 0.05). In vitro and in vivo T2 measurements obtained with sSE-EPI were independent of the T2 determination procedure (P > 0.05). In contrast, both in vitro and in vivo T2 values derived from MSME were significantly different when using 2-TEs calculation as compared to the fitting procedure (P < 0.05). sSE-EPI allowed the detection of increased T2 values in the QF muscle immediately after exercise (+14 ± 9%), while lower T2 values were recorded less than 2 min afterwards (P < 0.05). CONCLUSION: sSE-EPI sequence is a relevant method to monitor exercise-induced T2 changes of skeletal muscles over large volume coverage and to detect abnormal patterns of muscle activation. LEVEL OF EVIDENCE: 1 J. Magn. Reson. Imaging 2017;45:356-368.

Volume measurements of individual muscles in human quadriceps femoris using atlas-based segmentation approaches.

OBJECTIVES: Atlas-based segmentation is a powerful method for automatic structural segmentation of several sub-structures in many organs. However, such an approach has been very scarcely used in the context of muscle segmentation, and so far no study has assessed such a method for the automatic delineation of individual muscles of the quadriceps femoris (QF). In the present study, we have evaluated a fully automated multi-atlas method and a semi-automated single-atlas method for the segmentation and volume quantification of the four muscles of the QF and for the QF as a whole. SUBJECTS AND METHODS: The study was conducted in 32 young healthy males, using high-resolution magnetic resonance images (MRI) of the thigh. The multi-atlas-based segmentation method was conducted in 25 subjects. Different non-linear registration approaches based on free-form deformable (FFD) and symmetric diffeomorphic normalization algorithms (SyN) were assessed. Optimal parameters of two fusion methods, i.e., STAPLE and STEPS, were determined on the basis of the highest Dice similarity index (DSI) considering manual segmentation (MSeg) as the ground truth. Validation and reproducibility of this pipeline were determined using another MRI dataset recorded in seven healthy male subjects on the basis of additional metrics such as the muscle volume similarity values, intraclass coefficient, and coefficient of variation. Both non-linear registration methods (FFD and SyN) were also evaluated as part of a single-atlas strategy in order to assess longitudinal muscle volume measurements. The multi- and the single-atlas approaches were compared for the segmentation and the volume quantification of the four muscles of the QF and for the QF as a whole. RESULTS: Considering each muscle of the QF, the DSI of the multi-atlas-based approach was high 0.87 ± 0.11 and the best results were obtained with the combination of two deformation fields resulting from the SyN registration method and the STEPS fusion algorithm. The optimal variables for FFD and SyN registration methods were four templates and a kernel standard deviation ranging between 5 and 8. The segmentation process using a single-atlas-based method was more robust with DSI values higher than 0.9. From the vantage of muscle volume measurements, the multi-atlas-based strategy provided acceptable results regarding the QF muscle as a whole but highly variable results regarding individual muscle. On the contrary, the performance of the single-atlas-based pipeline for individual muscles was highly comparable to the MSeg, thereby indicating that this method would be adequate for longitudinal tracking of muscle volume changes in healthy subjects. CONCLUSION: In the present study, we demonstrated that both multi-atlas and single-atlas approaches were relevant for the segmentation of individual muscles of the QF in healthy subjects. Considering muscle volume measurements, the single-atlas method provided promising perspectives regarding longitudinal quantification of individual muscle volumes.

Muscle and tendon stiffness assessment using the alpha method and ultrafast ultrasound.

PURPOSE: The alpha method enables the dissociation of the passive (i.e., tendinous tissues) and active (i.e., fascicles) part of muscle-tendon stiffness. It is based on two main assumptions (i.e., a constant tendon stiffness and a muscle stiffness proportional to the torque produced), which have not been approved in vivo. The purpose of this study was to validate these two assumptions using ultrafast ultrasound, and to compare fascicle and tendon stiffness as determined by both methods. METHODS: Ten healthy males performed a fast-stretch experiment on the ankle plantar flexors. The mathematical model of the alpha method allowed to estimate the stiffness of muscle and tendinous tissues on the basis of the assumptions associated to the behaviors of muscle fascicles and tendinous tissues. Muscle and tendon stiffness of the gastrocnemius medialis were also calculated from ultrafast ultrasound measurements. RESULTS: Muscle stiffness measured by the ultrasound method increased from 217 ± 83 to 720 ± 265 N/mm with an increasing level of force (from 30 to 90 % MVC). Tendinous stiffness measured by the ultrasound method remained constant across the force level (P < 0.001). However, the stiffness values obtained with both methods were significantly different (P < 0.001). CONCLUSIONS: In conclusion, these findings validate the two main assumptions underlying the alpha method using ultrasound. Differences in stiffness values obtained with alpha and ultrasound methods could be associated with physiological and geometrical differences between the whole plantar flexors muscles characterized by the alpha method and the gastrocnemius medialis assessed with the ultrasound method.

Effect of knee joint angle on vastus medialis and vastus lateralis rigidity during isometric submaximal voluntary knee extensions.

The use of shear wave elastography during voluntary contraction has enabled the non-invasive assessment of load sharing strategies between agonist muscles. However, the change in joint angle and voluntary contraction intensity can modify contribution between muscles. The aim of this study was to investigate the effect of knee joint angle on the local mechanical properties of the vastus medialis (VM) and the vastus lateralis (VL) during isometric submaximal voluntary contractions from shear wave elastography mapping. The VM and VL Young's modulus at rest and during constant isometric submaximal voluntary contractions (i.e., 25%, 50% and 75% of maximal voluntary contraction [MVC]) were assessed for two knee angles (50° and 100° | knee fully extended = 0°) in twelve participants. No significant difference was found in the VM Young's modulus among all torque levels and knee angles (p > 0.05). VL Young's modulus was significantly higher at 25% MVC for a knee angle of 100° than at 75% MVC for the same knee angle and was greater at 25% MVC for a knee angle of 100° than for 50° (p < 0.05). In contrast to the VM, the contribution of the VL to the knee joint torque production during isometric voluntary contraction appears to depend on the muscle length and the relative knee extension torque level.

Effects of plyometric training on passive stiffness of gastrocnemii muscles and Achilles tendon.

Plyometric training is commonly used to improve athletic performance; however, it is unclear how each component of the muscle-tendon complex (MTC) is affected by this intervention. The effects of 14 weeks of plyometric training on the passive stiffness of the gastrocnemii muscles and Achilles tendon was determined simultaneously to assess possible local adaptations of elastic properties. The passive force-length relationship of the gastrocnemii MTC and elongation of the gastrocnemii muscles were determined using ultrasonography during passive cyclic stretching in 19 subjects divided into trained (n = 9) and control (n = 10) groups. An upward trend in stiffness of the gastrocnemii MTC (P = 0.09) and a significant increase in the intrinsic gastrocnemii muscle stiffness were found (P < 0.05). In contrast, no significant change in gastrocnemii tendon stiffness, or in muscle and tendon geometry, was determined (P > 0.05). Considering the lack of change in gastrocnemii muscle geometry, the change in the gastrocnemii muscle stiffness may be mainly due to a change in the intrinsic mechanical properties of the muscular tissues.

Effects of plyometric training on both active and passive parts of the plantarflexors series elastic component stiffness of muscle-tendon complex.

The aims of this study were to determine the effects of plyometric training on both active and passive parts of the series elastic component (SEC) stiffness, and on geometrical parameters [i.e., muscle architecture, muscle and tendon cross-sectional area (CSA)] of the plantarflexors muscle-tendon complex to assess possible specific adaptations of the elastic properties. Nineteen subjects were randomly divided into a trained group and a control group. Active and passive components of the SEC stiffness were determined using a fast stretch during submaximal voluntary isometric plantarflexor activity. Geometrical parameters of the triceps surae muscles and the Achilles tendon were determined using ultrasonography. A significant increase in the passive component of the SEC stiffness was found (p < 0.05). In contrast, a significant decrease in the active part of the SEC stiffness was observed (p < 0.05). No significant changes in plantarflexor muscles CSA, architecture and Achilles tendon CSA were seen (p > 0.05). Thus, plyometric training led to specific adaptations within each part of the SEC. Theses adaptations could increase both the efficiency of the energy storage-recoil process and muscular tension transmission leading to an increase in jump performances.

Relationship Between Explosive Strength Capacity of the Knee Muscles and Deceleration Performance in Female Professional Soccer Players.

The present study aimed to investigate the relationship between linear deceleration performance and explosive strength capacity of the knee muscles. Fourteen female professional soccer players completed the maximal sprint deceleration tests and knee flexor (KF) and knee extensor (KE) isokinetic concentric (240° and 60°.s-1) and eccentric contractions (30°.s-1). Linear deceleration performance was evaluated from horizontal breaking force (F H), power (P H), and impulse (I H) during a maximal linear deceleration. The peak torque (PT) of KF and KE, PT ratio between KF and KE (conventional and functional H/Q ratio), rate of torque development (RTD) for each muscle group, and RTD between KF and KE (RTD H/Q) were extracted from the isokinetic contractions. Pearson's correlation coefficients revealed that the eccentric (30°.s-1) and concentric (60°.s-1, 240°.s-1) KE peak torque, and the concentric KF peak torque (240°.s-1) were significantly correlated with FH, PH , and IH (-0.75

Is Accelerometry an Effective Method to Assess Muscle Vibrations in Comparison to Ultrafast Ultrasonography?

OBJECTIVE: The purpose of this study was to assess whether accelerometry effectively reflects muscle vibrations measured with ultrafast ultrasonography. METHODS: Vibration characteristics initiated on the vastus lateralis muscle by an impactor were compared when assessed with accelerometry and ultrasonography. Continuous wavelet transforms and statistical parametric mapping (SPM) were performed to identify discrepancies in vibration power over time and frequency between the two devices. RESULTS: The SPM analysis revealed that the accelerometer underestimated the muscle vibration power above 50 Hz during the first 0.06 seconds post impact. Furthermore, the accelerometer overestimated the muscle vibration power under 20 Hz, from 0.1 seconds after the impact. Linear regression revealed that the thicker the subcutaneous fat localized under the accelerometer, the more the muscle vibration frequency and damping were underestimated by the accelerometer. CONCLUSION: The skin and the fat tissues acted like a low-pass filter above 50 Hz and oscillated in a less damped manner than the muscle tissue under 20 Hz. SIGNIFICANCE: To eliminate some artifacts caused by the superficial tissues and assess the muscle vibration characteristics with accelerometry, it is suggested to 1) high-pass filter the acceleration signal at a frequency of 20 Hz, under certain conditions, and 2) include participants with less fat thickness. Therefore, the subcutaneous thickness must be systematically quantified under each accelerometer location to clarify the differences between subjects and muscles.

The Immediate Effects of Self-Myofacial Release on Flexibility, Jump Performance and Dynamic Balance Ability.

Self-myofascial release (SMR) is a popular method to potentially increase the compliance and extensibility of the fascia and reduce muscle stiffness. The purpose of this study was to examine the acute effects of posterior muscle chain SMR on flexibility, vertical jump performance and balance ability. Eighteen young participants volunteered to take part in this crossover design study. They performed two self-massage sessions in randomized order separated by at least one week. One session consisted of posterior muscle chain SMR whereas the other one was performed on the upper limbs as a control intervention (CON). Flexibility was measured with the Toe Touch Test (TTT), Weight-Bearing Lunge Test (WBLT), and Straight Leg Raise Test (SLR). Jump performance was evaluated during a squat jump, a counter movement jump and a stiffness jump. Dynamic balance ability was assessed through the Star Excursion Balance Test. All these variables were measured before and after each intervention. A significant increase in flexibility (+3.5 ± 1.8 cm, +1.6 ± 1.0°, and +7.7 ± 4.0° for the TTT, WLBT, and SLR, respectively, p < 0.003) and balance performance (4.8 ± 3.9 cm, p < 0.003) was observed following SMR intervention compared to CON. Conversely, jumping performance was unchanged in both groups. SMR improves joint flexibility and dynamic balance ability.