PhD Academy Award Publication

Liosis, L.-D., Martinez-Santos, R., & Santos-Concejero, J. (2025). Post-activation performance enhancement as a multi-purpose tool for developing power output in youth athletes, preserving functional ability of the ageing population, and preventing anterior cruciate ligament injuries in team sport athletes (PhD Academy Award). British Journal of Sports Medicine. Advance online publication.

Authors

Loudovikos-Dimitrios Liossis, Raul Martinez-Santos & Jordan Santos-Concejero

DOI

https://doi.org/10.1136/bjsports-2025-110896

Abstract

This study investigated three core tenets of post-activation performance enhancement (PAPE): (i) the acute manifestation of bilateral lower-body PAPE under varying volume-load conditions in trained youth athletes, (ii) the acute manifestation of unilateral lower-body PAPE under varying volume-load conditions in moderately trained, middle-aged recreational athletes, and (iii) the short-term manifestation of bilateral, unilateral, and upper-body PAPE following combination training mesocycles in trained youth athletes. Power-to-strength ratio (PSR), lower-limb stiffness (LLS), and strength-to-mass ratio (SMR) were examined as confounding variables, and PAPE was additionally explored as a potential anterior cruciate ligament (ACL) injury prevention strategy.

Two experiments employed randomized repeated-measures crossover designs. In trained youth athletes, hang power clean conditioning contractions at 60–90% 1RM elicited significant acute PAPE responses; however, outcomes were highly dependent on individual characteristics. Athletes with higher PSR demonstrated the greatest power improvements at 70% 1RM (p < 0.001, ES = 1.36, 95% CI: 0.6–2.1), whereas those with higher LLS exhibited the most pronounced rate of force development at 90% 1RM (p = 0.001, ES = 1.2, 95% CI: 0.48–1.97). In middle-aged recreational athletes, high-volume unilateral lower-body PAPE protocols combined with upper-body and core stabilization active rest improved non-dominant single-leg countermovement jump power (3 sets: p < 0.001, ES = 0.65, 95% CI: 0.39–0.94) and dominant-leg drop jump reactive strength index (4 sets: p = 0.009, ES = 0.30, 95% CI: 0.14–0.48).

The third experiment used a 6-week parallel-group design comparing complex, contrast, and French contrast training. All strategies are eligible for use as part of periodized strength–power mesocycles, with ensuing adaptations influenced by SMR. Athletes with higher upper-body SMR experienced their greatest upper-body power PAPE following FCT (p = 0.0002, d = 3.52; CI 95%: 1.69–5.36), while athletes with lower upper-body SMR exhibited unilateral non-dominant LLS PAPE regardless of the applied mixed training strategy (p < 0.0001, d = 1.79; CI 95%: 0.96–2.62).

These findings indicate that combination training is a viable complementary tool for performance enhancement and ACL injury risk reduction when individual characteristics are considered.