Background: Sand-based training (SBT) is widely hypothesized to enhance sprint performance; however, its overall efficacy remains unclear due to inconsistencies in methodologies and findings across studies. This systematic review and meta-analysis aims to evaluate the magnitude of SBT`s impact on sprint performance in competitive athletes. Methods: Following PRISMA guidelines, five databases (PubMed/MEDLINE, Web of Science, Cochrane Library, SPORTDiscus, and Scopus) were systematically searched from inception to May 2025. We included randomized controlled trials (RCTs) examining competitive athletes undergoing SBT interventions (=4 weeks) compared to non-sand or no-intervention controls. The primary outcome was linear sprint performance. Meta-analyses were conducted using RevMan 5.3 and Stata 16.0; standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using random- or fixed-effects models. Results: Nineteen studies (N = 433 athletes) met the inclusion criteria. SBT significantly enhanced sprint performance in within-group (SMD = -0.92 [95% CI: -1.10, -0.74]; p < 0.001) and between-group comparisons (SMD = -0.64 [-0.87, -0.42]; p < 0.001). Subgroup analyses indicated that SBT demonstrated significantly greater improvements compared to alternative training modalities (SMD = -1.13, p = 0.001). In-season training and higher-frequency training (=3 sessions/week) were associated with larger performance gains (SMD = -0.87 and -1.12, respectively). Conclusion: Current evidence suggests that SBT is a promising strategy for improving sprint performance, with maximal benefits observed when implementing high-frequency protocols during the competitive season. Future research should prioritize standardized training methodologies, long-term adaptive responses, and applicability across diverse athletic populations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42025637332, identifier: CRD42025637332.
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