Supplementary file 1_Effects of pre-competition conditioning strategies on acute sport performance in high-level athletes: a systematic review and network meta-analysis.docx

Four outcome-specific networks were constructed for explosive/jump, speed/change-of-direction, sport-specific, and endurance performance. No significant inconsistency was detected across networks. For explosive/jump performance, post-activation performance enhancement (PAPE) was superior to regular warm-up (WU) [SMD = 0.40, 95% CI 0.20–0.59] and ranked highest by SUCRA (91.5%).

For speed/change-of-direction performance, foam rolling showed the largest effect versus WU [SMD = 0.66, 95% CI 0.10–1.21], followed in the rankings by dynamic stretching and PAPE. For sport-specific performance, ischemic preconditioning (IPC) was superior to sham stimulation [SMD = 0.54, 95% CI 0.16–0.92]. For endurance performance, remote ischemic preconditioning (RIPC) was superior to WU [SMD = 0.62, 95% CI 0.20–1.05] and ranked highest (95.1%).

Sensitivity analyses did not materially alter the findings.</p>Conclusions<p>Acute pre-competition conditioning strategies exert outcome-specific effects rather than universal performance benefits in high-level athletes. PAPE may be most applicable to explosive performance; foam rolling, dynamic stretching, and PAPE to speed/change-of-direction tasks; IPC to sport-specific tasks; and RIPC to endurance performance. Confidence in Network Meta-Analysis (CINeMA) ratings ranged from high to very low across comparisons; therefore, SUCRA rankings should be interpreted alongside the certainty and amount of supporting evidence.

Further high-quality randomized crossover studies are needed.</p>Systematic review registration<p>crd.york.ac.uk/PROSPERO/view/CRD420261368915, identifier CRD420261368915.</p>