Effects of Combined Preconditioning Strategies on Athletic Performance: A Randomized Crossover Trial

Post-activation performance enhancement (PAPE) is a physiological phenomenon that refers to an acute excitation of the neuromuscular system following intense exercise that ends in enhanced physical performance in a subsequent bout of exercise. The scientific literature has primarily examined the effectiveness of PAPE alone or combined with caffeine (CAF) intake in all-out tests lasting ≤10 s, as the effect of PAPE is transitory. The aim of the present study was to determine the effect of a protocol to induce PAPE alone or in combination with caffeine intake on the 30 s Wingate Anaerobic Test in highly trained boxers. Twenty-five male and highly trained boxers (mean age: 20 ± 1 years) participated in a double-blind, randomized crossover study consisting of three different experimental conditions: (i) control (CON), with no substance intake and no PAPE protocol before the Wingate Anaerobic Test; (ii) PAPE + PLA, involving the intake of a placebo 60 min before and a PAPE protocol comprising a 10 s cycling sprint overloaded with 8.5% of the participants' body weight 10 min before the Wingate Anaerobic Test; and (iii) PAPE + CAF, involving the intake of 3 mg/kg of caffeine 60 min before and the same PAPE protocol used in the (ii) protocol before the Wingate Anaerobic Test. In all conditions, the participants performed the 30 s version of the Wingate Anaerobic Test with a load equivalent to 7.5% of their body weight, while the cycle ergometer setting was replicated. Immediately following the Wingate test, heart rate (HR), the rating of perceived exertion (RPE), and blood lactate concentration (Bla) were measured. In comparison to CON, PAPE + PLA enhanced mean power (p = 0.024; Effect size [ES] = 0.37) and total work (p = 0.022; ES = 0.38) during the Wingate test, accompanied by an increase in post-test blood lactate concentration (p < 0.01; ES = 0.83). In comparison to CON, PAPE + CAF enhanced mean power (p = 0.001; ES = 0.57), peak power (p = 0.013; ES = 0.57), total work (p = 0.001; ES = 0.53), post-test blood lactate concentration (p < 0.001; ES = 1.43) and participants' subjective perception of power (p = 0.041). There were no differences in any variable between PAPE + PLA and PAPE + CAF. In summary, a PAPE protocol that involves a 10 s all-out sprint 10 min before the Wingate Anaerobic Test was effective in enhancing Wingate mean power in highly trained boxers. The addition of 3 mg/kg of caffeine to the PAPE protocol produced an effect on mean power of a higher magnitude than PAPE alone, and it enhanced peak power along with participants' subjective perception of power. From a practical point of view, PAPE before exercise seems to be an effective approach for increasing Wingate performance in highly trained boxers, while the addition of caffeine can increase some benefits, especially peak power.

Post-activation performance enhancement (PAPE) has demonstrated efficacy in acutely improving athletic performance. However, its distinction from general warm-up (GW) effects remains ambiguous, and experimental designs adopted in most PAPE studies exhibit important limitations. The aims of this work are to (i) examine the effects of research methodology on PAPE outcomes, (ii) explore PAPE outcomes in relation to comparison methods, performance measures, GW comprehensiveness, recovery duration, participants' characteristics, conditioning activity (CA) parameters, and (iii) make recommendations for future PAPE experimental designs on the basis of the results of the meta-analysis. Four databases were searched for peer-reviewed English-language literature. Risk of bias was assessed using a modified Cochrane Collaboration's tool and PEDro scale. PAPE groups were compared with control groups, pre-conditioning activity (pre-CA) performances were compared with post-conditioning activity (post-CA) performances throughout a verification test in PAPE groups, and control groups were compared before and after the "rest" period using a three-level meta-analysis. Further analyses, including subgroup analysis and both linear and nonlinear meta-regression methods, were used to explore the effect of different moderating factors on PAPE magnitude. A subgroup analysis of GW comprehensiveness was conducted using four classification methods. One method classified GW as non-comprehensive (stretching or jogging only), partially comprehensive (stretching, jogging, and low-intensity self-weighted dynamic exercises), and comprehensive (adding maximal or near-maximal intensity CAs to a partially comprehensive GW). The other three classifications were adjusted according to the type and number of GW exercises. Certainty of evidence was assessed using the GRADE approach. The final analysis included 62 PAPE studies (1039 participants, male: n = 857, female: n = 182) with a high risk of bias and low certainty of pooled evidence. A trivial PAPE effect was observed from pre- to post-CA (effect size [ES] = 0.12, 95% CI [0.06 to 0.19], prediction intervals [PI] = - 0.29 to 0.54); a small PAPE effect was observed when compared with a control group (ES = 0.30, 95% CI [0.20 to 0.40], PI [- 0.38 to 0.97]). The slightly greater effect against control resulted from a small decrease in performance in control groups (ES = - 0.08, 95% CI [- 0.13 to - 0.03], PI [- 0.30 to 0.14]), but there was no relationship with between PAPE recovery time (β = - 0.005, p = 0.149). Subgroup analyses showed that PAPE magnitude was greater for non-comprehensive GWs (ES = 0.16) than comprehensive (ES = 0.01) and partially comprehensive GWs (ES = 0.11). In contrast, the control group showed a decline in performance after comprehensive GW (ES = - 0.20). An inverted U-shaped PAPE was noted as a function of recovery time. In some cases, PAPE appeared to manifest at < 1min post CA. Additionally, participants with longer training experience (ES = 0.36) and higher training levels (ES = 0.38) had larger PAPE magnitudes. PAPE effect was higher in females (ES = 0.51) than males (ES = 0.32) and mixed groups (ES = 0.16) but did not reach a significant difference (p > 0.05). Plyometric exercise (ES = 0.42) induced greater PAPE amplitude than traditional resistance exercise (ES = 0.23), maximal isometric voluntary contraction (ES = 0.31) and other CA types (ES = 0.24). Although the overall pooled results for both PAPE pre- versus post-CA and PAPE versus control group comparisons showed significant improvement, the wider and past-zero prediction intervals indicate that future studies are still likely to produce negative results. The comprehensiveness of the GW, the time between GW and the pre-CA test, participant sex, training level, training experience, type of CA, number of CA sets, and recovery time after CA all influence the PAPE magnitude. The PAPE magnitude was trivial after comprehensive GW, but it was greater in studies with a control group (i.e., no CA) because performance decreased over the control period, inflating the PAPE effect. Finally, two theoretical models of PAPE experimental design and suggestions for methodological issues are subsequently presented. Future studies can build on this to further explore the effects of PAPE. The original protocol was prospectively registered (osf.io/v7sbt) with the Open Science Framework.

BackgroundBoth post-activation performance enhancement (PAPE) and caffeine (CAF) are known to acutely improve physical performance. However, their combined effects on multiple performance outcomes in recreationally active individuals remain underexplored.ObjectiveThis study explores the combined effects of PAPE and caffeine CAF supplementation on explosive power, sprint performance, and anaerobic capacity in recreationally active men.MethodsIn a double-blind, crossover design, 20 participants completed 4 sessions with distinct interventions: placebo (PLA) with usual warm-up (No-PAPE + PLA), PAPE + PLA, CAF without PAPE (No-PAPE + CAF), and PAPE + CAF. After CAF (6 mg CAF/kg body mass) or PLA ingestion, participants performed warm-ups. They underwent physical tests, including vertical jump height (VJH), standing long jump (SLJ), 40-yard dash, and the running-based anaerobic sprint test (RAST). Data were analyzed using 1- and 2-way repeated measures analysis of variance and Bonferroni post hoc tests (P < 0.05 considered significant).ResultsThe PAPE + CAF condition yielded significant improvements in VJH compared with other conditions (P < 0.01), although the 40-yard dash times improved significantly in No-PAPE + CAF, PAPE + PLA, and PAPE + CAF conditions compared with PLA (P < 0.001). VJH also showed significant gains in PAPE + CAF compared with PAPE + PLA and No-PAPE + CAF (P < 0.01). Additionally, PAPE + CAF, PAPE + PLA, and No-PAPE + CAF produced notable increases in RAST metrics, including peak power, average power, minimum power, total time, and anaerobic capacity compared with No-PAPE + PLA (P < 0.001), although fatigue index differences remained nonsignificant. No significant effects were found in SLJ (P > 0.05).ConclusionThese findings highlight a synergistic effect between PAPE and CAF in enhancing short-term explosive performance, offering practical strategies for optimizing high-intensity activities in recreationally active individuals.

An acute improvement in muscle function after high-intensity exercise is known as post-activation performance enhancement (PAPE). PAPE encompasses extensive mechanisms such as increased neuromuscular activation and elevated muscle temperature. These adaptations have attracted growing interest and are thought to facilitate explosive athletic performance. This cross-sectional survey investigated the knowledge and practices of elite European sports practitioners regarding PAPE. A total of 66 professionals from 8 sport disciplines and 24 countries completed an online questionnaire. The survey included demographic questions and sections tailored to PAPE users and non-users. Responses were analyzed using descriptive statistics and content analysis. Results showed that 82% of participants were familiar with PAPE, but only 57% of those knowledgeable reported applying it in practice. Users typically prescribed 1–4 sets of 3–8 repetitions of resistance, plyometric, Olympic, or isometric exercises, with rest intervals ranging from 2–8 min. Reported challenges included athletes’ limited awareness of PAPE, variability in optimal rest periods, and logistical constraints before competition. Among non-users, skepticism about effectiveness, difficulty applying PAPE to groups, and convincing athletes were the most cited barriers. Nonetheless, both groups emphasized the need for further research on long-term adaptations, sex-specific responses, hormonal influences, and team-based applications. In conclusion, PAPE is widely recognized among elite practitioners, yet its implementation remains inconsistent. Bridging the gap between scientific knowledge and practice will require clearer guidelines, targeted education, and applied research to optimize its integration into performance programs.

The study aimed to investigate the post-activation performance enhancement (PAPE) of flywheel training (FT) on lower limb explosive power performance. Using a randomized crossover design, 20 trained men (age = 21.5 ± 1.4years; training experience 5.5 ± 1.2years) completed seven main conditions after three familiarization sessions. The first three conditions tested the PAPE of the FT on the counter movement jump (CMJ) under three different inertial loads (0.041kg·m2 as L; 0.057kg·m2 as ML; and 0.122kg·m2 as P), whereas the following four conditions tested the PAPE of FT on the 30m sprint, which consisted of three inertial loads (L, ML, and P) and a control condition. Participants were required to perform the CMJ or 30m sprint at baseline (Tb) and immediately (T0), 4min (T4), 8min (T8), 12min (T12), and 16min (T16) after exercise, respectively. The results of the CMJ conditions showed that PAPE peaked at T4 (p < 0.01) and almost subsided at T12 (p > 0.05) in ML and P conditions. Meanwhile, PAPE appeared earlier in the P condition, and the effect was more significant (P:ES = 1.09; ML:ES = 0.79). 30m sprint results showed significant improvement only in the ML condition. The PAPE peaked at T4 (p < 0.05, ES = -0.47) and almost subsided at T8 (p > 0.05). It was mainly due to the significant enhancement of the 10-30m segmental timing performance at T4 (p < 0.05, ES = -0.49). This study indicates that the size of the inertial load could influence the magnitude of the PAPE produced by the explosive force of the lower limb. The PAPE of the vertical explosive force increased with increasing inertial load, but the PAPE of the horizontal explosive force did not appear at the maximum inertial load. The most effective elicitation of the PAPE was at 4-8min after the FT.

This study introduces a novel methodology combining rapid stretch compound training with blood flow restriction (BFR) to investigate post activation performance enhancement (PAPE) in basketball players, a field that has been predominantly explored for lower limbs. We aimed to assess the efficacy of this combined approach on upper limb muscle performance in athletes. We employed a randomized, self-controlled crossover trial with ten male basketball players. The bench press throw (BPT) served as the primary metric, with players undergoing four interventions post-baseline: (1) STR-plyometric training; (2) BFR-blood flow restriction; (3) COMB-STR integrated with BFR; and (4) CON-control. Innovatively, we utilized an intelligent tracking sensor to precisely measure peak power (PP), peak velocity (PV), mean power (MP), and mean velocity (MV) at 4, 8, and 12 min post-intervention, providing a detailed temporal analysis of PAPE. The COMB intervention demonstrated superior PAPE effects at 4 min, significantly outperforming STR and BFR alone and the control group across all measured indices (p < 0.05). Notably, the COMB group maintained these improvements for PV, PP, and H up to 12 min post-intervention, suggesting a prolonged effect. (1) The COMB stimulation has been shown to successfully induce PAPE more effectively than STR and BFR modality alone. (2) It appears that the optimal effects of PAPE are achieved within 4 min of exercising under this COMB. By the 12 min mark, only the COMB group continued to show significant improvements in PV, PP, and H compared to both the baseline and the CON group, while the effects in the STR and BFR groups further diminished. This suggests that although the PAPE effect is maintained over time, its optimal performance may peak at the 4 min mark and then gradually weaken as time progresses.

BackgroundWhile both post-activation performance enhancement (PAPE) and caffeine (CAF) independently enhance performance, their combined effects on physical performance and the levels of central and peripheral fatigue remain unexplored.ObjectivesThis study assessed the impact of the PAPE method and CAF supplementation on central and peripheral fatigue following a fatigue-inducing protocol in elite male volleyball athletes.MethodsThe study employed a convenience sampling method to recruit 40 voluntary participants (18–30 y), who were then divided into 4 groups: PAPE group (N = 10), CAF group (N = 10), PAPE + CAF group (CAF + PAPE, N = 10), and control group (CG, N = 10). The CAF group received a CAF supplement of 6 mg/kg of body mass 20 min before the warming up for 10 min, whereas the PAPE group performed 2 sets of back squats at 80% of 1RM (4 reps/set) 2 min before the protocol.ResultsBetween-group comparisons revealed that the PAPE + CAF group demonstrated a significant improvement in the performance variables, including time to exhaustion, number of rounds, and serum dopamine concentrations, compared with all other groups (P < 0.05), whereas serum ammonia, serotonin, and prolactin concentrations decreased significantly compared with all other groups (P < 0.05). The CAF group also showed higher values in these performance and biochemical measures than the CG and PAPE groups, but these were lower than those in the CAF + PAPE group (P < 0.05). No significant differences were found for rating of perceived exertion or uric acid (P > 0.05).ConclusionsThis study confirms CAF's primary role in enhancing performance and reducing fatigue. The combined CAF + PAPE intervention provided a distinct advantage only for the number of rounds completed, but showed no significant benefit over CAF alone for time to exhaustion or most biochemical markers.

Remote Ischemic Preconditioning: Is the Groove in the Heart?

The hypothesis that sarcolemmal Na+/H+ exchanger activity may contribute to myocardial injury during ischemia and reperfusion was first published in 1985,1 preceding by 1 year the first description of the ischemic preconditioning phenomenon.2 Initial pharmacological evidence in support of the Na+/H+ exchanger hypothesis was subsequently provided by Karmazyn,3 who showed that amiloride (an inhibitor of the exchanger) enhanced the postischemic recovery of contractile function and reduced creatine kinase leakage in rat hearts subjected to global ischemia and reperfusion. Since then, a number of Na+/H+ exchange inhibitors, including highly specific novel inhibitors such as HOE-694, HOE-642 (cariporide), and EMD-85131, have been shown to afford cardioprotective benefit in a variety of animal models of ischemia and reperfusion.4 Nevertheless, as an innovative approach to the protection of ischemic myocardium, Na+/H+ exchange inhibition has failed to capture the imagination of cardiologists (experimental and clinical alike) to quite the same extent as ischemic preconditioning. Indeed, a survey of articles published in Circulation and Circulation Research over the past decade reveals only 14 articles whose title or abstract contains the keywords “Na+/H+ exchange(r) and ischemia,” whereas 115 articles are identified when the combination “preconditioning and ischemia” is used. Is this a fair reflection of the relative cardioprotective efficacy, and perhaps the therapeutic potential, of these interventions? In this issue of Circulation , Gumina and colleagues5 report on a comparison of the efficacy of Na+/H+ exchange inhibition (achieved with BIIB-513, the latest addition to the family of novel Na+/H+ exchange inhibitors) versus ischemic preconditioning in limiting infarct size in dog hearts subjected to regional ischemia and reperfusion in vivo. This is the first such comparison in a large animal, and the …

This study aimed to examine the effects of post-activation performance enhancement (PAPE) on swim start performance and lower body power performance after different warm-up protocols. Ten male national-level swimmers performed three different warm-ups: (i) a swim-specific warm-up (SW, control protocol); (ii) PAPE (an experimental protocol); and (iii) SW followed by PAPE (SW + PAPE, an experimental protocol). PAPE consisted of performing three series of 5 drop jumps. A repeated-measures ANOVA showed significant differences between the protocols in the swim start performance (F = 8.89; P < 0.001) and countermovement jump (F = 2.22; P = 0.047). SW + PAPE induced greater improvements in swim start time to 15 m (ES = − 0.47, P = 0.017) and entry time (ES = − 1.83, P < 0.001), the countermovement jump reactive strength index modified (ES = − 1.83, P < 0.001), eccentric rate of force development (ES = 0.69, P = 0.047), and index of explosive strength (ES = 0.94, P = 0.005) compared to SW. The current findings of this study indicate that the drop jump PAPE protocol, in addition to SW, is an effective tool because it could improve athletes' capacity for a more efficient swim start and their countermovement jump performance. Furthermore, the results of this study indicate that PAPE induced by drop jumps could be time-efficient and practically applicable in facilities with limited resources.

Preconditioning

The aim of this research was to investigate the effects of different stretching techniques used during warm-up exercises prior to post-activation performance enhancement (PAPE) on the explosive lower extremity strength performance of soccer players. This cross-sectional study involved the participation of 13 male soccer players with an average age of 22.38 ± 1.75, body height of 174.38 ± 3.94, and body mass of 72.30 ± 4.13. To determine the participants’ maximal strength performance, one repeated maximal strength (1-RM) squat exercise was applied. The PAPE protocol was then implemented with a squat exercise consisting of three repetitions at 80% of 1-RM. The warm-up protocols consisted of 5 min of cycling, followed by dynamic stretching, static stretching, or proprioceptive neuromuscular facilitation (PNF) stretching exercises. These protocols were applied on four different days with a 72 h interval. A vertical jump test was conducted to measure the participants’ explosive strength performance. The research data were analyzed using IBM Statistics (SPSS version 26.0, Armonk, NY, USA) software. The findings of this study revealed statistically significant differences in vertical jump performance values after PAPE among participants based on the different stretching techniques used during warm-up (p = 0.00). In this context, the research concluded that dynamic stretching is the optimal stretching technique during warm-up exercises before PAPE to maximize its effects. On the other hand, static stretching was found to negatively affect performance by absorbing the PAPE effect.

Preconditioning describes the phenomenon by which a traumatic or stressful stimulus confers protection against subsequent injury. Originally recognized in dog heart subjected to ischemic challenges, preconditioning has been demonstrated in multiple species, can be induced by various stimuli, and is applicable in different organ systems. Tremendous progress has been made elucidating the signal transduction cascade of preconditioning. Preconditioning represents a potent tissue-protective condition, and mechanistic understanding may allow safe clinical application. This review recalls the history of preconditioning and how it relates to the history of the investigation of endogenous adaptation; summarizes the current mechanistic understanding of acute preconditioning; outlines the signal transduction cascade leading to the development of delayed preconditioning; discusses preconditioning in noncardiac tissue; and explores the potential of using preconditioning clinically.

(1) Background: Enhancing repeated sprint ability (RSA) is critical to soccer performance. Post-activation performance enhancement (PAPE) protocols, particularly those utilizing heavy resistance preloading, have shown promise in improving RSA. Yet, the optimal preloading intensity for amateur players is still unknown. This study investigated the effects of two PAPE protocols using different preloading intensities (85% and 90% of 1 RM back squat) on RSA. (2) Methods: A double-blind, randomized, two-period crossover design was used, and 18 amateur male players were included in this study. RSA was assessed using a 6 × 35 m sprint protocol with 10 s rest intervals (RAST). (3) Results: While the main effect of time significantly (p = 0.01, η2 = 0.71) influenced performance decline across all groups, there was no significant (p = 0.65, η2 = 0.01) interaction between time and condition. Individual responses to PAPE varied, highlighting the importance of individual differences. Interestingly, the BS85% group exhibited a less pronounced decline in performance compared to the control group, while the BS90% group only showed significant differences in three sprint levels. (4) Conclusions: Our findings suggest that a lower preload of 85% of 1 RM may be as adequate as a higher preload of 90% of 1 RM in enhancing RSA in amateur soccer players. These results may indicate a potential fatigue-delaying effect of PAPE protocols and emphasize the importance of individualized approaches for optimizing PAPE strategies.

Introduction: Post-activation performance enhancement (PAPE) cannot be clearly distinguished from and may be explained in large by warm-up effects. To disentangle PAPE from a systemic warm-up effect, we conducted three randomized crossover trials (RCT). Methods: Each RCT consisted of a familiarization/one-repetition-maximum (1RM) assessment session followed by two interventional sessions (random order). In Study I, 18 participants (age: 26 ± 4years; height: 1.84 ± 0.06m; mass: 83.7 ± 8.7kg; Squat-1RM: 146 ± 19kg) performed either a 3-s isometric squat at 130%1RM or a 6-s isometric squat at 65%1RM. In Study II, 28 participants (11 female; age: 23 ± 3 years; height: 1.77 ± 0.08m; mass: 76.5 ± 10.4kg; Squat-1RM: 109 ± 38kg) completed either Squat (3 × 3 repetitions, 85%1RM) or local electromyostimulation of the quadriceps muscle (85% of individual pain threshold). In Study III, 20 participants (6 female, age: 25.0 ± 3.5 years, mass: 78.5 ± 15.8kg, height: 1.75 ± 0.08m; SQ-1RM: 114 ± 33kg, chest-press-1RM: 74 ± 29kg) performed either squats or chest press (4 repetitions, 80%1RM). Counter-Movement-Jump height (CMJ) was assessed after a general (PRE) and/or muscle-specific warm-up (POST_WU) and for up to 11min after the PAPE protocols. To identify possible differences in CMJ between the experimental conditions, mixed-design ANOVA models were used for each study individually, with condition and time modelled as fixed effects, while participants were included as a random effect blocking factor. The level of statistical significance was set at α = 5%. Results: In studies I and II, significant effects for time (p < 0.05, ωp 2 = 0.06 and p < 0.001, ωp 2 = 0.43) were found with the highest CMJ compared to all other time points at PRE (≤8.2 ± 4.6%, standardized mean difference: ≤0.39), regardless of condition. In study III, no significant effects were observed. Discussion: Thus, PAPE protocols do not further improve jumping performance compared to a general and muscle-specific traditional warm-up. Prior to tasks requiring explosive strength, general and sport-specific warm-up strategies should be used.