Combined effects of photobiomodulation and osteopathic manipulation on the physical performance of young adults subjected to exercise-induced muscle damage: a randomized placebo-controlled trial.

The short version

This randomized, sham-controlled trial with 48 physically active young men (45 analyzed for performance, aged 18 to 35) at a Brazilian university explored whether photobiomodulation (PBM) and osteopathic manipulation (OM) change recovery after exercise-induced muscle damage (EIMD). PBM applies red light from light-emitting diodes to the skin, a process the authors link to mitochondrial energy production in muscle fibers. OM is a manual therapy; here it meant high-velocity low-amplitude thrusts, quick, small-range joint manipulations. EIMD is the inflammation, strength loss and raised creatine kinase (CK, an enzyme leaking from damaged muscle fibers) that follow unaccustomed jumping or lowering exercise, usually peaking 24 to 72 hours later. Participants were randomized to placebo, PBM, OM, or PBM plus OM, 12 per group. PBM meant a 650 nm red light device pressed against 16 points on the right thigh and calf (144 joules in total, about 8 minutes). OM meant a lumbar roll and a pelvic manipulation by an osteopath. Both were given once before 100 drop jumps from a 50 cm platform, with sham versions for blinding. CK, quadriceps strength, knee flexibility and horizontal jump distance were measured before, right after, and at 24, 48 and 72 hours. The groups did not differ statistically on any outcome (CK group effect p = 0.950; strength p = 0.283; jump p = 0.199, meaning no measurable difference between the four arms). Within groups, CK rose immediately after exercise in placebo (p = 0.01) and OM (p = 0.02), but only at 24 hours in PBM and PBM plus OM, and the combined group showed a significant fall by 72 hours (p = 0.001, suggesting faster clearance of the damage marker). Strength dropped 6.3% to 12.4% after exercise; in exploratory tests the combined group regained significant strength by 48 hours (p = 0.036) and sat 1.4% from baseline. Jump distance rose 8.5 to 11.9 cm in all groups. CK did not track functional recovery. No adverse events were reported. The authors describe a possible modest, complementary benefit of combining the two approaches, while labeling the strength trend exploratory and non-significant. Limitations include 12 participants per group, a single session, only young men, red light that penetrates tissue less deeply than near-infrared light, and no formal check of blinding. Findings apply to physically active young men under acute jumping stress. The authors propose testing other light wavelengths and doses, repeated sessions, and a broader osteopathic approach in future trials.

Key findings

• In this sham-controlled trial of 45 physically active young men, red-light therapy (photobiomodulation) and a manual therapy using quick spine and pelvis thrusts (osteopathic manipulation) were given once before a muscle-damaging jump workout, and the four groups did not differ statistically on any outcome.
• Creatine kinase (CK, a blood enzyme that leaks from damaged muscle) rose immediately after exercise in the placebo and manipulation-only groups but only at 24 hours in the light-therapy and combined groups, and the combined group showed a significant drop by 72 hours (p = 0.001).
• Strength fell 6.3% to 12.4% right after exercise, and in exploratory tests the combined group regained significant strength by 48 hours (p = 0.036) and came within 1.4% of baseline, a trend the authors call non-significant between groups.
• No adverse events or increased pain or discomfort were reported, and the authors limit the findings to physically active young men after a single treatment session.

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