A new sports garment with elastomeric

technology optimizes physiological,

mechanical, and psychological acute
responses to pushing upper-limb resistance
exercises
Angel Saez-Berlanga1, Carlos Babiloni-Lopez1, Ana Ferri-Caruana1,
Pablo Jiménez-Martínez1,2, Amador García-Ramos3,4, Jorge Flandez5,
Javier Gene-Morales1 and Juan C. Colado1
1
Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical
Education and Sports, University of Valencia, Valencia, Spain
2
ICEN Institue, Madrid, Spain
3
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada,
Granada, Spain
4
Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad
Católica de la Santísima Concepción, Concepción, Chile
5
Institute of Education Sciences, Austral University of Chile, Ciudad de Valdivia, Chile

ABSTRACT
This study aimed to compare the mechanical (lifting velocity and maximum number
of repetitions), physiological (muscular activation, lactate, heart rate, and blood
pressure), and psychological (rating of perceived exertion) responses to upper-body
pushing exercises performed wearing a sports elastomeric garment or a placebo
garment. Nineteen physically active young adults randomly completed two training
sessions that differed only in the sports garment used (elastomeric technology or
placebo). In each session, subjects performed one set of seated shoulder presses and
another set of push-ups until muscular failure. The dependent variables were
measured immediately after finishing the set of each exercise. Compared to the
Submitted 15 November 2023
Accepted 5 February 2024
placebo garment, the elastomeric garment allowed participants to obtain greater
Published 6 March 2024 muscular activation in the pectoralis major (push-ups: p = 0.04, d = 0.49; seated
Corresponding author shoulder press: p < 0.01, d = 0.64), triceps brachialis (push-ups, p < 0.01, d = 0.77;
Javier Gene-Morales, seated shoulder press: p < 0.01, d = 0.65), and anterior deltoid (push-ups: p < 0.01,
[email protected] d = 0.72; seated shoulder press: p < 0.01, d = 0.83) muscles. Similarly, participants
Academic editor performed more repetitions (push-ups: p < 0.01; d = 0.94; seated shoulder press:
Manuel Jimenez p = 0.03, d = 0.23), with higher movement velocity (all p ≤ 0.04, all d ≥ 0.47), and
Additional Information and lower perceived exertion in the first repetition (push-ups: p < 0.01, d = 0.61; seated
Declarations can be found on shoulder press: p = 0.05; d = 0.76) wearing the elastomeric garment compared to
page 17
placebo. There were no between-garment differences in most cardiovascular
DOI 10.7717/peerj.17008
variables (all p ≥ 0.10). Higher diastolic blood pressure was only found after the
Copyright seated shoulder press wearing the elastomeric garment compared to the placebo
2024 Saez-Berlanga et al.
(p = 0.04; d = 0.49). Finally, significantly lower blood lactate levels were achieved in
Distributed under the push-ups performed wearing the elastomeric garment (p < 0.01; d = 0.91), but no
Creative Commons CC-BY 4.0
significant differences were observed in the seated shoulder press (p = 0.08). Overall,
the findings of this study suggest that elastomeric technology integrated into a sports

How to cite this article Saez-Berlanga A, Babiloni-Lopez C, Ferri-Caruana A, Jiménez-Martínez P, García-Ramos A, Flandez J,
Gene-Morales J, Colado JC. 2024. A new sports garment with elastomeric technology optimizes physiological, mechanical, and psychological
acute responses to pushing upper-limb resistance exercises. PeerJ 12:e17008 DOI 10.7717/peerj.17008
 garment provides an ergogenic effect on mechanical, physiological, and
psychological variables during the execution of pushing upper-limb resistance
exercises.

Subjects Anatomy and Physiology, Cardiology, Kinesiology, Biomechanics, Sports Medicine

Keywords Variable resistance training, Strength training, Elastic bands, Muscle activation, Mean
propulsive velocity, Metabolic and cardiovascular responses, Physical performance

INTRODUCTION
Resistance training has several health and performance benefits, such as cardiovascular,
body composition, biochemical, and functional improvements (Suchomel et al., 2018; Fritz
et al., 2018). To maximize these benefits, training variables (i.e., external and internal load
parameters, exercise selection, and materials used) must be carefully manipulated (Garber
et al., 2011; Halson, 2014). Accordingly, new tools or devices that can optimize training
stimuli may be considered in the field of sports. Within this context, there is a lack of
literature analyzing the external and internal load responses to exercises performed while
wearing sports garments that incorporate elastomeric technology.
Training load (internal and external) can be evaluated in different ways (Halson, 2014).
The main factor that provokes adaptations to resistance exercise is skeletal muscle
contraction, which is controlled by the nervous system (Alix-Fages et al., 2022). Therefore,
measuring neuromuscular responses to exercise provides relevant information regarding
specific resistance training methodologies (e.g., new training garments). Neuromuscular
strategies during muscle contraction can be assessed using non-invasive surface
electromyography (EMG) (Hermens et al., 2000). Mechanical performance (e.g., number of
repetitions completed, movement velocity, and kilograms lifted) provides further
information on the specific mechanical responses to each exercise (González-Badillo et al.,
2017). Alternatively, parameters of the internal load, such as metabolic responses to
exercise, may be evaluated through the cardiovascular system (e.g., heart rate (HR) and
blood pressure) and metabolites such as blood lactate (Wirtz et al., 2014). In this regard,
lactate and heart rate are commonly used to quantify training intensity, as they are
positively correlated with training intensity (Beneke, Leithäuser & Ochentel, 2011; Mann,
Lamberts & Lambert, 2013). Finally, the rating of perceived exertion (RPE) is correlated
with different exercise outcomes (e.g., weight used and HR) (Morishita et al., 2019). A wide
range of subjective scales has been validated to verify exercise intensity with different
training devices (e.g., elastic bands (EB) or weight plates) and populations (e.g., trained
youth and older adults) (Colado et al., 2012, 2014, 2018, 2020a, 2023).
These psychophysiological and/or biomechanical outcomes may be optimized using
different training methods and/or tools (Andersen et al., 2020; Babiloni-Lopez et al., 2022).
Historically, athletes have been instructed to lift external resistances as fast as possible to
maximize adaptations in their rate of force development (RFD). A disadvantage of this
instruction is that a large portion of the range of motion is spent decelerating the resistance
(Rhea, Kenn & Dermody, 2009). Different devices have appeared to overcome this

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 limitation in the last decades, and scientists have analyzed their potential positive effects
(Youdas et al., 2010; Porcari et al., 2011; Parry, Straub & Cipriani, 2012; Borreani et al.,
2015; Calatayud et al., 2015b). In this regard, elastic devices can enhance physical
capabilities because of their verified results, inexpensive acquisition, and easy portability
(Colado et al., 2020b; Saez-Berlanga et al., 2022; Babiloni-Lopez et al., 2022). Furthermore,
the use of variable resistance provides benefits in hypertrophy, strength, and power
(Suchomel et al., 2018). Variable resistance is commonly incorporated while performing
free-weight exercises (Suchomel et al., 2018).
Resistance training with elastic bands allows exercisers to employ a mechanical
advantage to produce both high-power and high-force levels (Gaamouri et al., 2023).
Considering the elongation coefficient, the bands provide more resistance when stretched
and less when shortened (Gene-Morales et al., 2020). Therefore, depending on how they
are applied (i.e., in the same direction as the concentric or eccentric phase), elastic bands
can assist or resist movements. Participants can achieve higher muscle torque production
and muscle activation levels when elastic bands resist movement (Aboodarda et al., 2013).
In contrast, the elastic bands used for assistance allow exercisers to lift greater loads at
higher velocities (Andersen et al., 2019). Another key factor of elastic bands is that they
must be attached to a structure and bar to be lifted (Gene-Morales et al., 2020) or directly
grabbed with the hands (Treiber et al., 1998; Page et al., 2015). This could condition the
technique of certain movements and limits to work on-site and/or other constraints.
Consequently, new devices, such as sports garments incorporating elastomeric technology,
may overcome the limitations of traditional elastic bands. Specifically, a new sports
garment that incorporates front and back elastomers around the chest and along the arms
could allow for free movement and, depending on joint positioning, could assist or resist
movement. For instance, during the last degrees of the eccentric phase in pushing
exercises, when the chest is opened and the scapulae are retracted, the front elastomers are
stretched and assist the movement. Conversely, the back elastomers are slack and,
therefore, do not provide any resistance. Subsequently, with the progression of the
concentric phase, the front elastomers are shortened and do not provide resistance, and the
elastomers from the back begin to stretch and provide resistance. Bearing this in mind, the
question arises as to whether this new sports garment incorporating elastomeric
technology can further potentiate the benefits previously described for elastic variable
resistance training.
Therefore, this study aimed to compare the mechanical performance (lifting velocity
and maximum number of repetitions), physiological (neuromuscular activity, blood
lactate, heart rate, and blood pressure), and psychological (rating of perceived exertion)
responses during pushing exercises (seated shoulder press and push-up) performed
wearing or not wearing a new sports garment for the upper body that incorporates
elastomeric technology. Considering elastomeric properties, we hypothesized that the use
of the elastomeric garment would allow for the execution of more repetitions, greater
lifting velocities, and greater neuromuscular activity, while no significant differences were
expected for blood lactate concentration, cardiovascular responses, and perceived effort.

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 3/24

 MATERIALS AND METHODS
Participants
The inclusion criteria were: (a) young adults between 18 and 30 years old with a minimum
of 1 year of resistance training experience, and (b) the participants had to be free from
cardiovascular or osteoarticular disease history, or clinical, neuromotor, or cognitive
contraindications for the performance of the physical tests. Finally, 19 physically active
men were selected through convenience sampling and voluntarily participated in this
study. Participants were instructed not to eat, take stimulants (e.g., caffeine), or other
ergogenic substances 3 to 4 h before the sessions, and not to perform intense physical
activity or exercise for the upper limbs 24 h before the study. They were encouraged to
sleep for at least 8 h the night before data collection.
The participants were carefully informed about the potential risks and discomfort of the
project and signed a written consent form before the start of the study. The study protocol
was approved by the Human Research Ethics Committee of the University of Valencia
(H20190325095509) and conducted in accordance with the Declaration of Helsinki.

Procedures
A randomized, crossover, within-participant study design was used to explore the effects of
performing seated shoulder presses at 70% of one repetition maximum (1RM) and
push-ups while wearing a new sports garment for the upper body that incorporates
elastomeric technology. The study was conducted over 8 weeks at the Faculty of Physical
Activity and Sports Sciences of the University of Valencia (Spain). Each participant
completed three sessions separated by 48 h: (a) one for familiarization and preliminary
assessments, and (b) two experimental sessions. A subsample extracted from the general
sample participated in an additional session to assess intersession reliability. This
additional session was separated from the last experimental session by 72 h. The overall
study design is shown in Fig. 1. All sessions lasted approximately 60 min and were
conducted between 10:00 and 13:00 h to avoid circadian variations in the performance of
the dependent variables (Sundstrup et al., 2012). Each subject performed both
experimental sessions within the same hour. All measurements were conducted by the
same investigators and always performed in the same sports facility. A minimum ratio of
4:1 was maintained between the researchers and participants.

Familiarization
The familiarization session was used to (i) characterize the participants through an
interview and anthropometric measurements, (ii) teach the participants the specific
standardized protocol and technique of the exercises (Colado & García-Massó, 2009) using
the two sports garments (i.e., with elastomeric technology and without it, placebo); (iii)
report the RPE for active muscles at the first and last repetition of each set (Colado et al.,
2023); and (iv) estimate the 70% 1RM load for the seated shoulder press.
After a brief interview, body weight and fat percentage were measured using an
electrical bioimpedance device (Tanita BF-350, Tanita Corp., Tokyo, Japan). Body height
was determined to the nearest 0.5 cm during maximum inhalation using a wall stadiometer

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 Figure 1 Study design. Full-size  DOI: 10.7717/peerj.17008/fig-1

(Seca T214; Seca Ltd., Hamburg, Germany). Handgrip strength was assessed using a
dynamometer (Scacam-EH10117; ScacamÒ, South El Monte, California, United States of
America) based on the protocol of a previous study (Leong et al., 2015): (i) the participant
stood; (ii) with the elbow extended, and the shoulder, forearm, and wrist in a neutral
position; and (iii) the participant was required to exert maximal grip force for 5 s.
Two attempts were performed with 1 min of rest in between.
At this point, the participants were shown the devices that were used throughout the
study. A Smith machine (Multipower Powerline PSM144X; Powerline, Forest Park,
Illinois, United States) was used to perform the seated shoulder press. For the RPE, the
OMNI-Resistance Exercise Scale for elastic bands was chosen (Colado et al., 2018), which
was visible to the participants at every moment during the execution of the exercises.
Finally, participants were shown both garments to use in the study: the sports garment
with elastomeric technology (Pro-Advance; Menatechpro SystemÒ, Madrid, Spain) (see
Supplemental Figures) and an equivalent sports garment used as placebo (same garment
but not including elastomers). Menatechpro SystemÒ elastomeric technology is a
patented, sophisticated sportswear that generates elastic resistance in most planes of
motion through the elongation of the elastomers included in the garment. More
specifically, the elastomeric garment includes front and back elastomers around the chest.
These elastomers connect on the shoulders and descend to the hand through each arm
with two elastomer lines. According to the disposition of the elastomers, the garment may
also assist in certain parts of the movement and function in a certain manner as a
compression garment. This garment is composed of more than 20 pieces. Specifically, the
model used in the present study (Pro-Advance) provides a resistance of eight kilograms at
the maximum elongation. This sports garment is recommended for users with previous
training experience, who want to enhance both their physical performance and the
intensity of their resistance training. Twelve similar garments (six garments with
elastomeric technology and six placebo garments) were employed during the study to

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 better adapt the garment to the anthropometric characteristics of each participant. Fair to
excellent intersession relative reliability, with intraclass correlation coefficients (ICC)
between 0.60 and 0.99 for the conditions performed wearing the elastomeric garment and
between 0.57 and 0.99 for the conditions performed with the placebo garment were
obtained. Similarly, good-to-excellent intersession absolute reliability was observed, with
coefficients of variation between 2.54% and 24.33% for the conditions performed wearing
the elastomeric garment and between 2.29% and 21.91% for the conditions performed with
the placebo garment. The specific relative and absolute intersession reliability values for
each dependent variable are shown in Tables S1 and S2.
Subsequently, the participants were instructed on the standardized warm-up, which
consisted of dynamic stretching and isometric exercises, as in previous studies (Calatayud
et al., 2014; Gene-Morales et al., 2023). Movement intensities were gradually increased
during warm-up to prepare participants for peak performance during the strength test.
Subsequently, the technique of both exercises was explained. To homogenize the speed of
movement, the execution tempo for both exercises consisted of a maximum-speed
concentric phase and a three-second eccentric phase, with no pauses. The tempo of the
eccentric phase was controlled using a metronome (Ableton Live 6; Ableton AG, Berlin,
Germany) at 60 beats per minute. Additionally, the participants received constant verbal
and visual feedback to maintain a proper body position and range of motion. The
following techniques and positions were adopted for the seated shoulder press: (i) upright
seated position with back support, (ii) hips and knees at 90 flexion, (iii) feet on the floor at
hip width, (iv) elbows and shoulders flexed to align the bar with the chin, and (v)
standardized biacromial grip width. From this starting position (bar aligned with the chin),
the participant lifted the bar to a position with outstretched elbows. For the push-ups,
according to a previous study (Calatayud et al., 2015a), each participant (i) started in an
outstretched arms position, (ii) with fingers slightly abducted and extended, (iii) with
neutral spine and hips, and (iv) feet at hip width. By flexing their elbows, the participants
had to lower until their chest was aligned with their hand. Maintaining a neutral spine and
neutral hips was mandatory throughout the set.
Finally, we estimated the weight to be used for the seated shoulder press corresponding
to 70% 1RM of each participant. This estimation was based on the %1RM-velocity profile
(García-Ramos, Suzovic & Pérez-Castilla, 2021). More specifically, the participants
performed one repetition with an agreed weight of 70% of 1RM. If the MPV fell between
0.61 and 0.69 meters per second (García-Ramos, Suzovic & Pérez-Castilla, 2021), this was
the weight to use. If the MPV was outside this range, the weight was modified and another
attempt was performed after 5 min of passive rest. Once the appropriate weight was
obtained, a second repetition with the same load was performed, after a 5-min rest, to
ensure reliability. To end with the familiarization session, participants performed one set
to failure of each exercise (at 70% 1RM for the seated shoulder press and bodyweight for
the pushups), reporting the RPE at the first and last repetition of each set. A 5-min rest
period was allowed for these sets.

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 Table 1 Description of the physiological variables.
Variable Abbreviation Description
Pectoralis major neuromuscular RMSPEC Root mean square (RMS) of the electromyographic activity of the clavicular fibers of the
activation (mV) pectoralis major
Triceps brachii neuromuscular RMSTRI Root mean square (RMS) of the electromyographic activity of the long head of the triceps
activation (mV) brachii
Anterior deltoid neuromuscular RMSDELT Root mean square (RMS) of the electromyographic activity of the anterior deltoid
activation (mV)
Rectus abdominis neuromuscular RMSABD Root mean square (RMS) of the electromyographic activity of the upper rectus abdominis
activation (mV)
Blood lactate BL Metabolite mainly produced in the skeletal muscle that serves as an indicator of exercise
(mmol/L) intensity (Foucher & Tubben, 2023)
Heart rate (bpm) HR Number of heartbeats for 1 min
Systolic blood pressure (mmHg) SBP Peak arterial pressure when ventricles pump blood out of the heart (Rehman, Hashmi & Nelson,
2022)
Diastolic blood pressure (mmHg) DBP Minimum pressure between beats when the heart is filling with blood (Rehman, Hashmi &
Nelson, 2022)

Experimental sessions
The study consisted of two experimental sessions, one to be fully performed while wearing
the elastomeric garment and the other with the placebo garment. The order of the
experimental sessions was randomized (https://random.org/lists) for each participant.
Push-ups and seated shoulder presses were included in both experimental sessions.
Therefore, four conditions were performed: (a) push-ups wearing the elastomeric garment,
(b) seated shoulder press wearing the elastomeric garment, (c) push-ups wearing the
placebo garment, and (d) seated shoulder press wearing the placebo garment. The order in
which the exercises were performed was randomized in the first experimental session and
maintained for the second experimental session for each participant. Upon arrival at the
laboratory in both experimental sessions, the participants rested seated for 10 min while
listening to self-selected music (Greco et al., 2022) to induce similar inter-session resting
homeostatic conditions. The dependent variables, including the physiological, mechanical,
and psychological variables, are outlined in Tables 1–3.
In the first experimental session, after the warm-up, the participants performed seated
shoulder presses and push-ups in the pertinent order. A 10-min rest was allowed between
the exercises. The dependent variables were measured at this point. More specifically, the
mechanical variables (lifting velocity and maximum number of repetitions) were recorded
during the performance of the exercise, as was the RPE (psychological variable), which was
verbalized by each participant at the end of the first and last repetitions. The physiological
variables were measured immediately after each exercise. Measurements were taken with
the participant seated in an adjacent space separated from the exercise area by a partition
screen to blind the researcher in charge. The same procedure was followed in the second
experimental session.

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 Table 2 Description of the mechanical variables.
Variable Abbreviation Description
Mean propulsive velocity of the first repetition (m/s) st
1 MPV The average velocity achieved during the acceleration phase
(García-Ramos et al., 2018) of the first repetition
Mean propulsive velocity of the last repetition (m/s) LMPV The average velocity achieved during the acceleration phase
(García-Ramos et al., 2018) of the last repetition
Mean propulsive velocity peak (m/s) PMPV Highest mean propulsive velocity of the set
Mean propulsive velocity average (m/s) AMPV The average mean propulsive velocity of the set
Number of repetitions Rep Total number of valid repetitions executed

Table 3 Description of the psychological variables.

Variable Abbreviation Description
Rating of perceived exertion of the first repetition st
1 RPE Perceived effort (between 0 and 10) of the first repetition
Rating of perceived exertion of the last repetition LRPE Perceived effort (between 0 and 10) of the last repetition

Measurement equipment and data acquisition

Physiological variables: neuromuscular activation
The EMG signal was obtained using two two-channel handheld devices (Realtime
Technologies Ltd., Dublin, Ireland) with 16-bit analog-to-digital (A/D) conversion. EMG
data were monitored using validated mDurance software for Android (mDurance
Solutions S.L., Granada, Spain). Surface Electromyography for the Non-Invasive
Assessment of Muscles criteria (SENIAM) (Hermens et al., 2000) and previous studies in
this field (Calatayud et al., 2017) were followed.
To ensure consistency in electrode placement, each participant was shaved and cleaned
with a cotton swab moistened with alcohol (Calatayud et al., 2014). Surface electrodes were
placed on the anterior deltoid, clavicular fibers of the pectoralis major, upper rectus
abdominis, and the long head of the triceps brachii. Chlorinated silver pre-gelled bipolar
surface electrodes (KendallTM Medi-Trace, Coividien, Barcelona, Spain) were placed at an
inter-electrode distance of 10 mm. The reference electrode was placed over the nearest
bone prominence (in our study, the acromion and the superior iliac spine). A mark was
made on the skin of the participants around each electrode with a permanent marker to
easily place the electrodes in the next session and to ensure reliability. One device collected
EMG data from the anterior deltoid and clavicular bundles of the pectoralis major muscles,
while the other collected data from the upper rectus abdominis and long head of the triceps
brachii muscles. The sampling rate was planned at 1,024 Hz.
Data were collected as described by Ferri-Caruana et al. (2022) and Gene-Morales et al.
(2023). Specifically, all the EMG signals were stored on a hard disk for subsequent
evaluation. mDurance software digitally filtered the raw signals automatically using a
fourth-order “Butterworth” bandpass filter between 20 and 450 Hz. A high-pass cut-off
frequency of 20 Hz was employed to reduce any “artifacts” that might occur throughout

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 the movement to have a minimum impact on the total power recorded by the EMG (Ferri-
Caruana et al., 2022). Before carrying out the tests, the participants performed one
repetition of the seated shoulder press and another of push-ups to check for proper signal
saturation. Finally, the average EMG signals (measured by the root-mean-square (RMS))
of all the effective repetitions performed in each set were retained for analysis.

Physiological variables: blood lactate

BL concentrations were measured from capillary blood extracted from the fingertips.
Blood samples were collected before the session and immediately after each exercise and
were analyzed using a portable lactate analyzer (Lactate Pro 2; Arkray Inc., Kyoto, Japan).

Physiological variables: cardiovascular parameters

Pre- and post-test heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP) were
monitored via digital wrist blood pressure monitor (RS4-model; Omron Electronics Iberia
SAU, Valencia, Spain).

Mechanical variables: mean propulsive velocity and number of repetitions

A linear position transducer (ADR Encoder, ADR, Toledo, Spain) was used to collect the
MPV (m/s). More specifically, we analyzed the (i) MPV of the first repetition (1stMPV) (ii)
and last repetition (LMPV), (iii) peak MPV of the set (PMPV), (iv) average MPV of the set
(AMPV), and (v) the number of repetitions. For the seated shoulder press, the transducer
was attached to the bar, allowing it to be moved vertically at maximum velocity (Naclerio
et al., 2011). For the push-ups, each participant wore a strap around their chest at the level
of the xiphoid process. The transducer was attached to this strap.

Psychological variables: rating of perceived exertion

Participants reported the RPE for the active muscles at the end of the first (1stRPE) and last
repetition (LRPE). The OMNI-RES Scale for Elastic Bands (Colado et al., 2012) was always
used regardless of the condition analyzed. Previous research demonstrated that the 1stRPE
could be used independently of the age, sex, or fitness level of the participants (Pincivero,
Timmons & Elsing, 2010; Babiloni-Lopez et al., 2022; Colado et al., 2023)

Statistical analyses
Statistical analyses were performed using commercial software (SPSS version 28.0; IBM
Corp., Armonk, New York, USA). The assumption of normality of the dependent variables
was verified using the Shapiro-Wilk test. Almost all the variables showed a normal
Gaussian distribution. The variables showing a nonnormal distribution were the
electromyographic activity of the triceps brachii (RMSTRI), 1stMPV, number of
repetitions, and RPE of both exercises; the electromyographic activity of the anterior
deltoid (RMSIDELT) and rectus abdominis (RMSABD) of the seated shoulder press; and
the SBP, and DBP of the push-ups. Results are reported as the mean ± standard deviation
(SD). The level of statistical significance was set at p ≤ 0.05.
Parametric two-tailed Student’s t-test of related samples or nonparametric Wilcoxon
test assessed the differences between performing each exercise wearing the elastomeric
garment or the placebo garment. The effect size was calculated by means of Cohen’s d,

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 which was interpreted as a low (<0.50), moderate (0.50–0.79), or large effect (≥0.80)
(Cohen, 1988).
The test-retest relative reliability was assessed using the intraclass correlation coefficient
(ICC, model 3.1) (Yen & Lo, 2002). As previously suggested, ICC values were interpreted as
poor (<0.50), moderate (0.50–0.75), good (0.75–0.90), and excellent (>0.90) reliability
(Koo & Li, 2016). On the other hand, the absolute reliability was evaluated as previously
described (Hopkins, 2000; Gene-Morales et al., 2022). More specifically, we used the
coefficient of variation (CV = (standard error of measurement/mean of both
measurements) × 100; where the standard error of measurement is the standard deviation
of the difference between the two measurements divided by the square root of the number
of measurements per subject) (Hopkins, 2000). We defined excellent absolute reliability as
CV ≤ 10%, good with a CV between 10–20%, acceptable with a CV between 20–30%, and
poor as CV > 30% (Aronhime et al., 2014). Data for the reliability calculations were
obtained from an additional session in which a subsample of participants performed for a
second time the same exercises under the same conditions (i.e., push-ups wearing the
elastomeric garment, seated shoulder press wearing the elastomeric garment, push-ups
wearing the placebo garment, and seated shoulder press wearing the placebo garment).

RESULTS
Participants
The sample size was determined using G Power 3.1 software (Faul et al., 2009) based on
previous pilot studies (Gene-Morales et al., 2023). This a-priori analysis was performed to
reduce the probability of type II error and determine the minimum number of participants
required to reject the null hypothesis at the p < 0.05 level of confidence (Beck, 2013).
The calculation indicated that 18 volunteers were necessary to meet the required power of
0.90, a of 0.05, and effect size dz of 0.82. Finally, a total of 19 healthy, trained subjects were
included. None of the participants dropped out of the study. Descriptive data of the
participants in this study were: age = 24.7 ± 4.9 years; height = 178.8 ± 4.5 cm; body
mass = 78.1 ± 9.0 kg; body fat percentage = 14.1 ± 4.1%; manual dynamometry = 48.2 ±
8.5 kg, resistance training experience = 2.8 ± 1.8 years; weekly training frequency = 3.9 ±
1.0 days/week.

Physiological variables
Descriptive and inferential analyses of the physiological outcomes included in the study are
presented in Table 4. Furthermore, Fig. 2 shows the graphical representation of the EMG
results.

Neuromuscular activation
Wearing the elastomeric garment to perform the seated shoulder press and push-ups
entailed greater neuromuscular activation in the pectoralis major (RMSPEC, push-ups:
p = 0.04, d = 0.49; seated shoulder press: p < 0.01, d = 0.64), triceps brachialis (RMSTRI,
push-ups: p < 0.01, d = 0.77; seated shoulder press: p < 0.01, d = 0.65), and anterior deltoid
(RMSDELT, push-ups: p < 0.01, d = 0.72; seated shoulder press: p < 0.01, d = 0.83)

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 Table 4 Mechanical performance outcomes to both exercises performed wearing the elastomeric garment or the placebo. Significant difference
(p < 0.05). Results are presented as mean ± standard deviation, mean difference (m.d.), 95% confidence interval between brackets, significance (p),
and effect size measured through Cohens’d (interpreted as low (<0.50), moderate (0.50–0.79), or large (≥0.80)). 1stMPV, mean propulsive velocity of
the first repetition; LMPV, mean propulsive velocity of the last repetition; PMVP, peak mean propulsive velocity of the set; AMVP, average mean
propulsive velocity of the set; m/s, meters per second.
Variable Push-ups Seated shoulder press

Placebo Elastomeric garment Paired differences Placebo Elastomeric garment Paired differences
RMSPEC (mV) 689.76 ± 198.98 777.45 ± 226.17 m.d. = 87.68 569.69 ± 243.84 668.23 ± 307.77 m.d. = 98.54
(48.81–174.55) (24.54–172.53)
p = 0.04* d = 0.49 p = 0.01* d = 0.64
RMSTRI (mV) 246.09 ± 107.53 300.21 ± 137.73 m.d. = 54.11 296.86 ± 118.27 392.36 ± 164.98 m.d. = 95.50
(20.13–88.10) (24.12–166.87)
p < 0.01* d = 0.77 p < 0.01* d = 0.65
RMSDELT (mV) 523.51 ± 166.03 614.78 ± 204.37 m.d. = 91.27 903.10 ± 316.42 1053.84 ± 288.89 m.d. = 150.73
(30.28–152.27) (63.53–237.93)
p < 0.01* d = 0.72 p < 0.01* d = 0.83
RMSABD (mV) 68.68 ± 19.12 70.78 ± 16.75 m.d. = 2.10 70.63 ± 16.78 73.55 ± 32.97 m.d. = 2.92
(−4.07 to 8.28) (−10.82 to 16.67)
p = 0.48 p = 0.44
Blood Lactate 7.42 ± 1.60 6.61 ± 1.52 m.d. = 0.81 5.01 ± 1.19 4.63 ± 1.25 m.d. = 0.37
(mmol/L) (0.38–1.24) (−0.05 to 0.80)
p < 0.01* d = 0.91 p = 0.08
Heart Rate 93.21 ± 18.86 88.47 ± 14.73 m.d. = 4.73 78.95 ± 11.73 82.47 ± 19.98 m.d. = 3.52
(bpm) (−2.70 to 12.18) (−3.98 to 11.04)
p = 0.19 p = 0.33
SBP (mmHg) 132.84 ± 16.48 132.21 ± 18.09 m.d. = 0.63 127.00 ± 14.47 133.84 ± 10.03 m.d. = 6.84
(−8.83 to 10.10) (−1.51 to 15.20)
p = 0.98 p = 0.10
DBP (mmHg) 92.16 ± 16.87 93.53 ± 17.87 m.d. = 1.36 85.84 ± 11.20 93.58 ± 11.12 m.d. = 7.73
(−6.49 to 9.23) (0.15–15.32)
p = 0.88 p = 0.04* d = 0.49
Note:
* Significant difference (p < 0.05). Results are presented as mean ± standard deviation, mean difference (m.d.), 95% confidence interval between brackets, significance (p),

and effect size measured through Cohens’d (interpreted as low (<0.50), moderate (0.50–0.79), or large (≥0.80)). RMSPEC, root-mean-square of the pectoralis major
activation; RMSTRI, root-mean-square of the triceps brachialis activation; RMSDELT, root-mean-square of the anterior deltoid activation; RMSABS, root-mean-square
of the rectus abdominis activation; mV, microvolts; mmol/L, millimole per liter; bpm, beats per minute; mmHg, millimeters of mercury.

compared to the same exercises performed with the placebo garment. Nonsignificant
differences were found in the RMSABD (push-ups: p = 0.48; seated shoulder press:
p = 0.44).

Blood lactate
Significantly (p < 0.01; d = 0.91) less blood lactate was accumulated after performing
push-ups wearing the elastomeric garment compared to the placebo. Nonsignificant
differences were found after the seated shoulder press (p = 0.08).

Heart rate
Nonsignificant differences were found in the heart rate after any of the exercises (push-ups:
p = 0.19; seated shoulder press: p= 0.33).

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 11/24

 Figure 2 Interindividual variation of the neuromuscular activation when performing a seated shoulder press (top graphs) and push-ups
(bottom graphs) wearing the elastomeric garment or placebo. RMS, root mean square of the electromyographic values measured in mV
(microvolts). An asterisk ( ) indicates significant differences ( p < 0.05) between the condition performed with the elastomeric garment and the
placebo garment. Full-size  DOI: 10.7717/peerj.17008/fig-2

Systolic and diastolic blood pressure

Participants achieved greater post-exercise DBP when performing the seated shoulder
press with the elastomeric garment compared to the placebo (p = 0.04; d = 0.49).
Nonsignificant effects were found in the SBP after any of the exercises (push-ups: p = 0.98;
seated shoulder press: p = 0.10) or the DBP in the push-ups (p = 0.88).

Mechanical variables
Table 5 presents the descriptive and inferential statistical comparisons of the mechanical
performance.

Mean propulsive velocity

The participants achieved greater 1stMPV (p < 0.01; d = 1.14), PMPV (p < 0.01; d = 0.92),
and AMPV (p < 0.01; d = 0.47) performing the push-ups with the elastomeric garment
compared to the placebo. In the shoulder press, participants obtained greater 1stMPV
(p < 0.01; d = 1.05) and PMPV (p = 0.04; d = 0.47) wearing the elastomeric garment
compared to the placebo.

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 12/24

 Table 5 Mechanical performance outcomes to both exercises performed wearing the elastomeric garment or the placebo.
Variable Push-ups Seated shoulder press

Placebo Elastomeric garment Paired differences Placebo Elastomeric garment Paired differences
st
1 MPV (m/s) 0.57 ± 0.08 0.63 ± 0.10 m.d. = 0.06 0.54 ± 0.05 0.57 ± 0.06 m.d. = 0.03
(0.03–0.09) (0.01–0.04)
p < 0.01* d = 1.14 p < 0.01* d = 1.05
LMPV (m/s) 0.19 ± 0.03 0.18 ± 0.03 m.d. = 0.01 0.20 ± 0.04 0.20 ± 0.04 m.d. = 0.00
(−0.01 to 0.03) (−0.01 to 0.03)
p = 0.30 p = 0.57
PMPV (m/s) 0.60 ± 0.09 0.65 ± 0.10 m.d. = 0.05 0.55 ± 0.05 0.57 ± 0.06 m.d. = 0.23
(0.02–0.09) (0.00–0.04)
p < 0.01* d = 0.92 p = 0.04* d = 0.47
AMPV (m/s) 0.45 ± 0.07 0.48 ± 0.08 m.d. = 0.03 0.40 ± 0.04 0.43 ± 0.06 m.d. = 0.01
(0.00–0.05) (0.00–0.04)
p = 0.01* d = 0.47 p = 0.12
Repetitions 18.68 ± 4.48 21.37 ± 5.51 m.d. = 2.68 9.16 ± 2.36 9.68 ± 1.70 m.d. = 0.52
(1.30–4.06) (−0.60 to 1.65)
p < 0.01* d = 0.94 p = 0.03* d = 0.23
Note:
* Significant difference (p < 0.05). Results are presented as mean ± standard deviation, mean difference (m.d.), 95% confidence interval between brackets, significance (p),

and effect size measured through Cohens’d (interpreted as low (<0.50), moderate (0.50–0.79), or large (≥0.80)). 1stMPV: mean propulsive velocity of the first repetition;
LMPV: mean propulsive velocity of the last repetition; PMVP: peak mean propulsive velocity of the set; AMVP: average mean propulsive velocity of the set; m/s: meters
per second.

Table 6 Psychological responses to both exercises performed wearing the elastomeric garment or the placebo.
Variable Push-ups Seated shoulder press

Placebo Elastomeric garment Paired differences Placebo Elastomeric garment Paired differences
st
1 RPE 2.00 ± 0.66 1.53 ± 0.61 m.d. = 0.47 3.16 ± 0.76 2.79 ± 0.78 m.d. = 0.36
(0.17–0.76) (0.00–0.73)
p < 0.01* d = 0.61 p = 0.05* d = 0.76
LRPE 9.58 ± 0.50 9.47 ± 0.51 m.d. = 0.10 9.68 ± 0.47 9.58 ± 0.50 m.d. = 0.10
(−0.11 to 0.32) (−0.11 to 0.32)
p = 0.31 p = 0.31
Note:
* Significant difference (p < 0.05). Results are presented as mean ± standard deviation, mean difference (m.d.), 95% confidence interval between brackets, significance (p),

and effect size measured through partial Cohens’d (interpreted as low (<0.50), moderate (0.50–0.79), or large (≥0.80)). 1stRPE, rate of perceived exertion of the first
repetition; LRPE, rate of perceived exertion of the last repetition.

Number of repetitions
The use of the elastomeric garment allowed significantly more repetitions compared to the
placebo in both exercises (push-ups: p < 0.01; d = 0.94; seated shoulder press: p = 0.03,
d = 0.23).

Psychological variables
Descriptive and inferential comparisons of the rate of perceived exertion outcomes are
presented in Table 6.

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 13/24

 Rating of perceived exertion
Both exercises performed wearing the elastomeric garment entailed lower 1stRPE (push-
ups: p < 0.01, d = 0.61; seated shoulder press: p = 0.05; d = 0.76) compared to the same
exercises performed with the placebo garment. Nonsignificant differences were
encountered in the LRPE (push-ups: p = 0.31; seated shoulder press: p = 0.31).

DISCUSSION
To the best of our knowledge, this is the first study analyzing the physiological, mechanical,
and psychological responses to a seated shoulder press and push-ups performed wearing a
new sports garment that incorporates elastomeric technology. The main finding was that
performing both exercises wearing the elastomeric garment significantly improved
physiological, mechanical, and psychological responses compared to the placebo garment.
Although only one pilot study analyzed this specific garment (Gene-Morales et al., 2023),
the results are consistent with the well-known positive effects of training with variable
resistances such as elastic bands and chains (Suchomel et al., 2018; Colado et al., 2020b;
Hammami et al., 2022).

Physiological variables
Regarding muscular activation, the elastomeric garment allowed participants to obtain
higher muscular activation on all muscles, except the rectus abdominis. This is probably
due to the additional eight kilograms provided by the elastomeric garment at maximum
elbow extension, being the weight a main factor that conditions muscular activation
(Schoenfeld et al., 2014). The nonsignificant differences reported in the rectus abdominis
may be due to the elastomeric garment not resisting the trunk movements. Apart from the
additional load provided by the elastomeric garment, it is worth considering the elongation
coefficient (Andersen et al., 2020). The elastomers display the resistance progressively
throughout the range of motion, providing less load at the “sticking region” (see Kompf &
Arandjelović, 2016 for further information), and greater resistance during the
biomechanically advantageous phase after the sticking point (Iversen et al., 2017). As a
result, the elastomeric garment could help to overcome the sticking region and, therefore,
optimize the neuromuscular response to resistance exercise (Kompf & Arandjelović, 2016).
Another factor that could facilitate greater neuromuscular activation is the overload
generated by the elastomeric garment during the first degrees of the eccentric phase, which,
although not measured in this study, could help to increase the stimulus. This has been
proven by previous research, which found that the use of elastic bands increases the
resistance used in the eccentric phase and does not modify the technique or the
neuromuscular performance during the concentric response (Aboodarda et al., 2014).
Besides the positive results obtained in terms of muscle activation, a significantly
reduced blood lactate concentration was observed after the push-ups performed with the
elastomeric garment compared to the placebo garment. This can be attributed to the fact
that wearing compressive garments can increase venous blood flow (Liu et al., 2008).
In this sense, the compression of the superficial tissues of the extremities reduces the
diameter of the underlying veins, speeding the blood flow and improving the venous return

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 14/24

 (Liu et al., 2008). Another reason for the increased blood flow and post-exercise lactate
reduction may be linked to venular-arteriolar communication. External compression can
reduce the venular lumen and increase shear stress, which would trigger the release of
endothelial dilators (Paszkowiak & Dardik, 2003) and cause an eventual dilation in
neighboring arteries (Bochmann et al., 2005). The nonsignificant differences observed in
the seated shoulder press could be due to the shorter duration (approximately nine
repetitions for the shoulder press compared to approximately 20 push-ups) and lower
volume of muscles involved, which could be insufficient to provoke significant metabolic
acute adaptations.
The responses of the cardiovascular parameters (HR, SBP, and DBP) were in line with
previous studies evaluating hemodynamic changes with the use of compression garments
(Lee et al., 2022). It must be mentioned that, although more repetitions with greater loads
and muscle activation were performed, nonsignificant differences were observed in almost
all the cardiovascular parameters analyzed. Only a significantly greater DBP was obtained
after performing the seated shoulder press wearing the elastomeric garment. Considering
the compressive property of the elastomeric garment, this increase in DBP may be due to
abdominal compression increasing mean arterial pressure and sympathetic nerve activity,
which may increase cardiovascular responses (Platts et al., 2009; Stenger et al., 2013).
However, this could be recognized as a normal physiological finding considering that DBP
increases after exercise, including resistance training at maximal intensities, in healthy
participants (MacDougall et al., 1985; Wilborn et al., 2004; Lee et al., 2022). This increase in
DBP could be explained by the mechanical pressure of the muscles on the blood vessels
and the pressor reflex generated during contraction (Iglesias-Soler et al., 2015; Gjovaag
et al., 2016). Furthermore, the cardiovascular response to strength training is affected by
several factors, including body position (MacDougall et al., 1985; Wilborn et al., 2004).
More specifically, a previous study (MacDougall et al., 1985) reported further increases in
DBP after performing resistance exercises (80, 90, 95, and 100%1RM) to muscle failure in
an upright position compared to supine. Although we did not control this, another reason
to consider is elevated intrathoracic and intraabdominal pressure during the Valsalva
maneuver, which may increase DBP (Wilborn et al., 2004). Considering that our sample
consisted of healthy young adults, the acute increase in DBP after exercise cannot be
extrapolated to other participants, such as older adults. Therefore, new studies are
warranted to monitor the effect of performing resistance training using elastomeric
compressive garments on blood pressure responses in vulnerable populations.

Mechanical variables
In our study, the use of the elastomeric sports garment for the push-ups allowed
participants to perform a greater number of repetitions until the muscular failure, with
significantly greater 1stMVP, PMVP, and AMPV. Similarly, participants performed
significantly more repetitions with greater 1stMVP and PMVP in the seated shoulder press
wearing the elastomeric garment compared to the placebo. These results may be due to the
elastomeric garment allowing to overcome the sticking region in each repetition as
previously mentioned, therefore, allowing greater movement speed with more kilograms.

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 15/24

 In this sense, it could be suggested that the elastomeric garment, as elastic bands do, allows
for a greater peak force and power (Wallace, Winchester & McGuigan, 2006; Argus et al.,
2011; Andersen et al., 2020; Babiloni-Lopez et al., 2022). Furthermore, the increased time
under tension (larger number of push-ups) increases glycolysis metabolism and could
promote superior muscle adaptations by stimulating delayed muscle protein synthesis at
24–30 h of recovery (Aboodarda et al., 2012).
From a biomechanical point of view, the resistance provided by the elastomeric garment
seems to match the resistance profile of both exercises. Additionally, attention should be
paid to the potential assistance the elastomeric garment provides during the initial degrees
of the concentric phase of these exercises. In this concern, the chest is opened (i.e., scapulae
retracted) at the lowest position of both exercises. Therefore, the front elastomers are
stretched and assist the movement. Oppositely, the back elastomers are slack and,
therefore, do not provide any resistance. This combination of factors would function as an
elastic band attached to the ceiling to assist the movement, which allows a higher execution
velocity (Tran et al., 2012). After that, when the concentric phase starts, the elastomers
from the back begin to stretch and provide resistance until eight kilograms at the end of the
range of motion. Finally, due to elastic properties, the maximum elongation of the
elastomers at the end of the concentric phase may prestress and accelerate the next
movement to be performed (i.e., eccentric phase) (Bartolini et al., 2011).

Psychological variables
Previous studies demonstrated strong inverse relationships between MPV and RPE
(r = −0.79 to −0.87) (Helms et al., 2017). Controversially, participants from our study,
although performing at greater MPV, perceived the use of the elastomeric garment for both
exercises as less demanding (significantly lower RPE) compared to the placebo. This could
be attributed to the properties of the elastomers and the decreased weight in the lower
phases of both exercises. As for the RPE of the last repetition, no significant differences were
observed between both garments in any of the exercises. The nonsignificant differences
between the garments are interesting due to the participants using eight more kilograms,
performing approximately three more push-ups, and 0.5 more repetitions of the seated
shoulder press wearing the elastomeric garment compared to the placebo.

Limitations and future research

It is crucial to acknowledge that the outcomes of this study are constrained by the specific
independent and dependent variables examined and the sample size. Consequently, new
variables could be analyzed, such as open or closed kinetic chains, exercises with
displacement, and/or maximum joint mobility in all planes of motion simultaneously.
Additionally, future studies should include larger samples to compare different physical
fitness levels and training experience levels, group ages, and genders. Similarly, it would be
interesting to analyze the movement velocity differentiating by specific phases of the range
of motion, e.g., (i) from the beginning to the first half of the range of movement, where the
front elastomer is supposed to assist the movement; (ii) from the middle to the final point
of the movement, where the rear elastomer resists. Performing the exercises with the

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 16/24

 transition between eccentric and concentric phases at maximum velocity would provide
new information on the potential effects of the elastomeric garment on the
stretch-shortening cycle. Finally, considering that the resistance provided by the
elastomeric garment is approximately eight kilograms, the relative load (e.g., %1RM) used
by each participant may slightly differ. This different relative load cannot be considered a
bias in our present study as we applied a within-participant design. Future studies with a
between-participant design should consider potential differences in the relative load.

CONCLUSIONS
Wearing the elastomeric garment to perform both exercises allowed participants to obtain
greater muscular activation, lifting velocity, and time under tension (more maximum
number repetitions). Furthermore, the exercises performed with the elastomeric garment
were not perceived as more strenuous, provoked less post-exercise blood lactate (in the
push-ups), and showed no significant differences in HR and SBP compared to the placebo
garment. This fact confirms that the use of the elastomeric garment can optimize the
external load parameters while maintaining similar values of the internal load.
The present findings help to generate more practical, efficient, and healthy workouts
based on assisting and resisting movement through the incorporation of elastomers in a
sports garment. Traditional elastic band training is effective in generating positive
neuromuscular adaptations, but they limit users for example, to single-plane movements,
work on-site, and/or a determinate type of exercises. These limitations led us to believe that
the training sessions could be improved if new tools were applied. Fortunately, the present
sports garment, through elastomeric technology, may solve most of the limitations
previously described for traditional elastic bands. Exercisers can now use the elastic
variable resistance incorporated in their sportswear with no need to hold a handle or a
complex setup.

ACKNOWLEDGEMENTS
We thank the participants for their voluntary collaboration. We would also like to thank
Menatechpro SystemÒ for providing us with elastomeric and placebo garments.

ADDITIONAL INFORMATION AND DECLARATIONS

Funding
The authors received no funding for this work.

Competing Interests
This research has been developed under the advice and technical support contract signed
between the University of Valencia (Spain) and Menatechpro SystemÒ. Dr. Juan C.
Colado is the professor responsible for the University. The rest of the coauthors are
members of the research group led by Dr. Juan C. Colado. Amador García-Ramos is an
Academic Editor for PeerJ.

Saez-Berlanga et al. (2024), PeerJ, DOI 10.7717/peerj.17008 17/24

 Author Contributions
 Angel Saez-Berlanga conceived and designed the experiments, performed the
experiments, analyzed the data, prepared figures and/or tables, authored or reviewed
drafts of the article, and approved the final draft.
 Carlos Babiloni-Lopez conceived and designed the experiments, performed the
experiments, authored or reviewed drafts of the article, and approved the final draft.
 Ana Ferri-Caruana conceived and designed the experiments, authored or reviewed
drafts of the article, and approved the final draft.
 Pablo Jiménez-Martínez conceived and designed the experiments, performed the
experiments, prepared figures and/or tables, authored or reviewed drafts of the article,
and approved the final draft.
 Amador García-Ramos analyzed the data, prepared figures and/or tables, authored or
reviewed drafts of the article, and approved the final draft.
 Jorge Flandez analyzed the data, authored or reviewed drafts of the article, and approved
the final draft.
 Javier Gene-Morales conceived and designed the experiments, performed the
experiments, analyzed the data, prepared figures and/or tables, authored or reviewed
drafts of the article, and approved the final draft.
 Juan C. Colado conceived and designed the experiments, analyzed the data, prepared
figures and/or tables, authored or reviewed drafts of the article, and approved the final
draft.

Human Ethics
The following information was supplied relating to ethical approvals (i.e., approving body
and any reference numbers):
The study protocol was approved by the Human Research Ethics Committee of the
University of Valencia (H20190325095509).

Data Availability
The following information was supplied regarding data availability:
The raw data is available in the Supplemental Files.

Supplemental Information
Supplemental information for this article can be found online at http://dx.doi.org/10.7717/
peerj.17008#supplemental-information.

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