Post activation performance enhancement in female athletes: a systematic review and Bayesian three level meta-analysis

Abstract Background Conditioning activities are widely used to elicit post-activation performance enhancement (PAPE), yet female-specific evidence remains uncertain and physiologically under-characterized. To quantify acute PAPE effects on jumping, sprinting, change-of-direction (COD), and sport-specific performance in female athletes and assess whether current evidence supports female-specific interpretation. Methods Four databases were searched. Risk of bias was assessed using RoB 2 and ROBINS-I. Primary synthesis was restricted to conditioning activity versus control comparisons and used Bayesian three-level random-effects models to account for dependent effect sizes. Supplementary jumping outcomes, exploratory time-course analyses, sport-specific outcomes, and designs not included in the primary analysis were considered separately. Menstrual and hormonal reporting and methodological indicators relevant to PAPE were summarized descriptively. Results Twenty-four studies were included. Primary controlled syntheses showed no clear benefit for jumping (g = 0.29, 95% CrI: -0.07 to 0.68), sprinting (g = 0.15, 95% CrI: -0.73 to 0.94), or COD (g =-0.08, 95% CrI: -1.21 to 0.97). Supplementary jumping analysis was positive but uncertain (g = 0.34, 95% CrI: -0.33 to 1.02). Exploratory analyses did not identify a consistent recovery profile, and sport-specific evidence was limited and inconsistent. Twenty studies (83.3%) reported no menstrual cycle or hormonal information. Conclusions Current controlled evidence does not establish a consistent, reproducible, or broadly transferable acute PAPE benefit in female athletes. Positive secondary signals suggest responses may occur, but do not yet support generalized prescriptions. The evidence base is female in sample composition yet insufficiently characterized physiologically for robust interpretation in the context of female athletes.