Does delayed exercise-based priming improve subsequent athletic performance? A systematic review and multilevel meta-analysis.

Clinical Snapshot

Key Findings

• P Value: p = .002 (primary model); p = .004 (cluster-robust inference)

• Effect Size: Hedges' g = 0.232 (small positive effect)

• Primary Outcome: Subsequent athletic performance following delayed exercise-based priming compared to control

• Nnt Or Sensitivity: Prediction interval: -0.265 to 0.730 (crosses zero, indicating effect direction is not consistent across all plausible future studies); GRADE certainty: Low

• Confidence Interval: 95% CI [0.092, 0.372]

Clinical Application

Delayed exercise-based priming is logistically feasible in most competitive sport settings as it requires only a structured preparatory exercise bout within existing warm-up windows. No specialised equipment is required beyond standard training facilities. The key practical requirement is individual protocol trialling in training before competition deployment, as recommended by the authors. Coaching staff and sports scientists would need to individualise rest interval duration and priming intensity based on athlete response. In the Australian context, this evidence is most relevant to high-performance sport programs operating under the Australian Institute of Sport (AIS) framework and state-based institutes. Australian sports coaches and sports scientists working with Swimming Australia, Athletics Australia, Cycling Australia, and team sport programs (AFL, rugby, netball) may find this strategy applicable within existing pre-competition protocols. There are no PBS or TGA regulatory implications as this is a non-pharmacological intervention. RACGP guidelines do not directly address exercise priming strategies; however, sports and exercise medicine physicians (ACSP/ACSEP members) advising elite athletes on competition preparation would find this evidence relevant. The low GRADE certainty rating means this should not be adopted as a universal standard of care but rather as an individualised, evidence-informed option within high-performance sport science practice. Competitive athletes across sport disciplines who have structured pre-competition preparation windows (warm-up to competition intervals). Most applicable to sports with defined competition schedules allowing planned priming bouts 15–60 minutes prior to performance. Less applicable to recreational exercisers or clinical rehabilitation populations.

Abstract

This systematic review and multilevel meta-analysis examined whether delayed exercise-based priming improves subsequent athletic performance. Following PRISMA 2020 principles, 3,095 records were identified; after removing 1,107 duplicates, 1,988 unique records were screened, 212 full-text reports were assessed, 186 reports were excluded at eligibility, and 26 studies were included. Eighteen studies contributed 46 effect sizes to the quantitative synthesis. Risk of bias was assessed with RoB 2 principles calibrated for crossover exercise trials, and certainty was evaluated using GRADE. A three-level random-effects model showed a small positive average effect of delayed priming on subsequent performance (g = 0.232, 95% CI [0.092, 0.372], p = .002), with cluster-robust inference supporting the same conclusion (p = .004). The prediction interval crossed zero (-0.265 to 0.730), and the overall certainty of evidence was low. Delayed exercise-based priming can be used as a practical competition-day strategy when embedded in planned preparation windows, although protocol selection and athlete response should be checked in training before competition use.

References

1. 1.Wang, Z., Li, H., Xia, W., Jin, Z., Fu, S., & Nie, Z. (2026). Does delayed exercise-based priming improve subsequent athletic performance? A systematic review and multilevel meta-analysis. PLoS ONE. https://doi.org/10.1371/journal.pone.0354720