Skip to main content
SpringerLink
Log in

Effect of low-level phototherapy on delayed onset muscle soreness: a systematic review and meta-analysis

  • Review Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

To determine the effectiveness of low-level phototherapy (i.e. light-emitting diode therapy [LEDtherapy] or light amplification by stimulated emission of radiation therapy [LASERtherapy]) on pain, skeletal muscle injury (creatine kinase [CK] levels and edema) and skeletal muscle function (range of movement and strength) in people undergoing an exercise protocol. (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, SciELO and LILACS up to May 2014), we included randomized controlled trials, quasi-randomized controlled trials and crossover studies in which study participants were allocated to receive either low-level phototherapy or placebo treatment. Phototherapy should have been applied in a single treatment session, either before or after an exercise protocol. We identified 15 studies involving 317 participants. Meta-analyses were limited by substantial heterogeneity. Compared to the placebo group, reduction in CK levels was only observed when LASERtherapy was applied before an exercise protocol (standardized mean difference = −0.66; 95 % CI = -1.30, −0.02). No between-group difference in edema, range of movement and strength were detected when phototherapy was applied before or after exercise. Evidence from this review suggests that low-level phototherapy may not have substantial effect in the treatment of skeletal muscle injury and pain caused by exercise. Definitive conclusions are limited due to the small number of included studies in each meta-analysis, disparities across the included studies and small sample sizes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lewis PB, Ruby D, Bush-Joseph CA (2012) Muscle soreness and delayed-onset muscle soreness. Clin Sports Med 31:255–262

    Article  PubMed  Google Scholar 

  2. Choi SJ (2014) Cellular mechanism of eccentric-induced muscle injury and its relationship with sarcomere heterogeneity. J Exerc Rehabil 10:200–204

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hyldahl RD, Hubal MJ (2014) Lengthening our perspective: morphological, cellular, and molecular responses to eccentric exercise. Muscle Nerve 49:155–170. Available at http://www.ncbi.nlm.nih.gov/pubmed/24030935

  4. MacIntyre DL, Reid WD, McKenzie DC (1995) Delayed muscle soreness. The inflammatory response to muscle injury and its clinical implications. Sports Med (Auckland, NZ) 20:24–40

    Article  CAS  Google Scholar 

  5. Fédération Internationale de Natation (FINA). HistoFINA: Swimming medalists and statistics at Olympic Games (2013) November 16th 2014. Available from: http://www.fina.org/sites/default/files/HistoFINA_SWOG_1.pdf.

  6. Mailloux J, Finno M, Rainville J (2006) Long-term exercise adherence in the elderly with chronic low back pain. Am J Phys Med Rehabil 85:120–126

    Article  PubMed  Google Scholar 

  7. Cheung K, Hume P, Maxwell L (2003) Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med (Auckland, NZ) 33:145–164

    Article  Google Scholar 

  8. Hubscher M, Vogt L, Bernhorster M, Rosenhagen A, Banzer W (2008) Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness. J Altern Complement Med 14:1011–1016

    Article  PubMed  Google Scholar 

  9. Antonialli FC, De Marchi T, Tomazoni SS, Vanin AA, dos Santos Grandinetti V, de Paiva PRV, et al. (2014) Phototherapy in skeletal muscle performance and recovery after exercise: effect of combination of super-pulsed laser and light-emitting diodes. Lasers Med Sci 29(6):1967–76

  10. da Costa Santos VB, de Paula RS, Milanez VF, Corrêa JCM, de Andrade Alves RI, Dias IFL, Nakamura FY (2013) LED therapy or cryotherapy between exercise intervals in Wistar rats: anti-inflammatory and ergogenic effects. Lasers Med Sci 29:599–605

    Article  PubMed  Google Scholar 

  11. Wong-Riley MT, Liang HL, Eells JT, Chance B, Henry MM, Buchmann E, Kane M, Whelan HT (2005) Photobiomodulation directly benefits primary neurons functionally inactivated by toxins: role of cytochrome c oxidase. J Biol Chem 280:4761–4771. Available at http://www.ncbi.nlm.nih.gov/pubmed/15557336

  12. Liang HL, Whelan HT, Eells JT, Wong-Riley MT (2008) Near-infrared light via light-emitting diode treatment is therapeutic against rotenone- and 1-methyl-4-phenylpyridinium ion-induced neurotoxicity. Neuroscience 153:963–974. Available at http://www.ncbi.nlm.nih.gov/pubmed/18440709

  13. Vinck E, Coorevits P, Cagnie B, De Muynck M, Vanderstraeten G, Cambier D (2005) Evidence of changes in sural nerve conduction mediated by light emitting diode irradiation. Lasers Med Sci 20:35–40. Available at http://www.ncbi.nlm.nih.gov/pubmed/15895289

  14. Hsieh YL, Hong CZ, Chou LW, Yang SA, Yang CC (2014) Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model. Lasers Med Sci . Available at http://www.ncbi.nlm.nih.gov/pubmed/25190639

  15. Cidral-Filho FJ, Martins DF, More AO, Mazzardo-Martins L, Silva MD, Cargnin-Ferreira E, Santos AR (2013) Light-emitting diode therapy induces analgesia and decreases spinal cord and sciatic nerve tumour necrosis factor-alpha levels after sciatic nerve crush in mice. Eur J Pain 17:1193–1204. Available at http://www.ncbi.nlm.nih.gov/pubmed/23339021

  16. Higgins JPT, Green S (eds) (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. Available from http://www.cochrane-handbook.org

  17. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ (Clin Res Ed) 339:b2535. Available at http://www.ncbi.nlm.nih.gov/pubmed/19622551

  18. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Introduction to Meta-Analysis. Wiley, Sussex, United Kingdom

  19. Baroni BM, Leal Junior EC, Geremia JM, Diefenthaeler F, Vaz MA (2010) Effect of light-emitting diodes therapy (LEDT) on knee extensor muscle fatigue. Photomed Laser Surg 28:653–658. doi:10.1089/pho.2009.2688

    Article  PubMed  Google Scholar 

  20. Denis R, O'Brien C, Delahunt E (2013) The effects of light emitting diode therapy following high intensity exercise. Phys Ther Sport : Off J Assoc Chart Physiother Sports Med 14:110–115. Available at http://ac.els-cdn.com/S1466853X12000284/1-s2.0-S1466853X12000284-main.pdf?_tid=ed34a9f4-b35b-11e3-900e-00000aacb361&acdnat=1395669495_9020b32aa1658ca376b75e27d459a0be

  21. Leal Junior EC, Lopes-Martins RA, Dalan F, Ferrari M, Sbabo FM, Generosi RA, Baroni BM, Penna SC, Iversen VV, Bjordal JM (2008) Effect of 655-nm low-level laser therapy on exercise-induced skeletal muscle fatigue in humans. Photomed Laser Surg 26:419–424

    Article  PubMed  Google Scholar 

  22. Leal Junior EC, Lopes-Martins RA, Vanin AA, Baroni BM, Grosselli D, De Marchi T, Iversen VV, Bjordal JM (2009) Effect of 830 nm low-level laser therapy in exercise-induced skeletal muscle fatigue in humans. Lasers Med Sci 24:425–431. Available at http://download.springer.com/static/pdf/376/art%253A10.1007%252Fs10103-008-0592-9.pdf?auth66=1395842299_5773ad9ff7fc967ec190e850e65a1105&ext=.pdf

  23. Miranda EF, Leal-Junior EC, Marchetti PH, Dal Corso S (2014) Acute effects of light emitting diodes therapy (LEDT) in muscle function during isometric exercise in patients with chronic obstructive pulmonary disease: preliminary results of a randomized controlled trial. Lasers Med Sci 29:359–365. Available at http://download.springer.com/static/pdf/930/art%253A10.1007%252Fs10103-013-1359-5.pdf?auth66=1395842368_cec95eafe43913c03072391f2edbff80&ext=.pdf

  24. Toma RL, Tucci HT, Antunes HK, Pedroni CR, de Oliveira AS, Buck I, Ferreira PD, Vassao PG, Renno AC (2013) Effect of 808 nm low-level laser therapy in exercise-induced skeletal muscle fatigue in elderly women. Lasers Med Sci 28:1375–1382

    Article  PubMed  Google Scholar 

  25. Higashi RH, Toma RL, Tucci HT, Pedroni CR, Ferreira PD, Baldini G, Aveiro MC, Borghi-Silva A, de Oliveira AS, Renno AC (2013) Effects of low-level laser therapy on biceps braquialis muscle fatigue in young women. Photomed Laser Surg 31:586–594. doi:10.1089/pho.2012.3388

    Article  PubMed  CAS  Google Scholar 

  26. Parr JJ, Larkin KA, Borsa PA (2010) Effects of class IV laser therapy on exercise-induced muscle injury. Athl Train Sports Health Care 2(6):267–276

    Article  Google Scholar 

  27. Borges LS, Cerqueira MS, Dos Santos Rocha JA, Conrado LA, Machado M, Pereira R, Neto OP (2014) Light-emitting diode phototherapy improves muscle recovery after a damaging exercise. Lasers Med Sci 29:1139–1144

    PubMed  Google Scholar 

  28. Craig JA, Barlas P, Baxter GD, Walsh DM, Allen JM (1996) Delayed-onset muscle soreness: lack of effect of combined phototherapy/low-intensity laser therapy at low pulse repetition rates. J Clin Laser Med Surg 14(6):375–380. doi: 10.1089/clm.1996.14.375. Available at http://www.cebp.nl/vault_public/filesystem/?ID=2506; http://www.ncbi.nlm.nih.gov/pubmed/9467328; http://www.liebertonline.com/pho

  29. Craig JA, Barron J, Walsh DM, Baxter GD (1999) Lack of effect of combined low intensity laser therapy/phototherapy (CLILT) on delayed onset muscle soreness in humans. Lasers Surg Med 24:223–230. doi:10.1002/(SICI)1096-9101(1999)24:3<223::AID-LSM7>3.0.CO;2-Y/asset/7_ftp.pdf?v=1&t=ht5tg7cz&s=a8a46267c04b298aea74e0d8534e602632a1ae56

    Article  PubMed  CAS  Google Scholar 

  30. Dos Reis FA, da Silva BA, Laraia EM, de Melo RM, Silva PH, Leal-Junior EC, de Carvalho Pde T (2014) Effects of pre- or post-exercise low-level laser therapy (830 nm) on skeletal muscle fatigue and biochemical markers of recovery in humans: double-blind placebo-controlled trial. Photomed Laser Surg 32:106–112. doi:10.1089/pho.2013.3617

    Article  PubMed  Google Scholar 

  31. Douris P, Southard V, Ferrigi R, Grauer J, Katz D, Nascimento C, Podbielski P (2006) Effect of phototherapy on delayed onset muscle soreness. Photomedicine and Laser Surgery 24(3):377–382. doi: 10.1089/pho.2006.24.377. Available at http://www.ncbi.nlm.nih.gov/pubmed/16875447; http://www.liebertonline.com/pho

  32. Felismino AS, Costa EC, Aoki MS, Ferraresi C, de Araujo Moura Lemos TM, de Brito Vieira WH (2014) Effect of low-level laser therapy (808 nm) on markers of muscle damage: a randomized double-blind placebo-controlled trial. Lasers Med Sci 29:933–938. Available at http://www.ncbi.nlm.nih.gov/pubmed/24005882

  33. Baroni BM, Leal Junior EC, De Marchi T, Lopes AL, Salvador M, Vaz MA (2010) Low level laser therapy before eccentric exercise reduces muscle damage markers in humans. Eur J Appl Physiol 110:789–796. Available at http://download.springer.com/static/pdf/626/art%253A10.1007%252Fs00421-010-1562-z.pdf?auth66=1395841948_5fc24232ad5602b12f8893fd39f77980&ext=.pdf

  34. De Marchi T, Leal Junior EC, Bortoli C, Tomazoni SS, Lopes-Martins RA, Salvador M (2012) Low-level laser therapy (LLLT) in human progressive-intensity running: effects on exercise performance, skeletal muscle status, and oxidative stress. Lasers Med Sci 27:231–236

    Article  PubMed  Google Scholar 

  35. Leal Junior EC, de Godoi V, Mancalossi JL, Rossi RP, De Marchi T, Parente M, Grosselli D, Generosi RA, Basso M, Frigo L, Tomazoni SS, Bjordal JM, Lopes-Martins RA (2011) Comparison between cold water immersion therapy (CWIT) and light emitting diode therapy (LEDT) in short-term skeletal muscle recovery after high-intensity exercise in athletes—preliminary results. Lasers Med Sci 26:493–501. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119799/pdf/10103_2010_Article_866.pdf

  36. Leal Junior EC, Lopes-Martins RA, Baroni BM, De Marchi T, Rossi RP, Grosselli D, Generosi RA, de Godoi V, Basso M, Mancalossi JL, Bjordal JM (2009) Comparison between single-diode low-level laser therapy (LLLT) and LED multi-diode (cluster) therapy (LEDT) applications before high-intensity exercise. Photomed Laser Surg 27:617–623. doi:10.1089/pho.2008.2350

    Article  PubMed  Google Scholar 

  37. Leal Junior EC, Lopes-Martins RA, Baroni BM, De Marchi T, Taufer D, Manfro DS, Rech M, Danna V, Grosselli D, Generosi RA, Marcos RL, Ramos L, Bjordal JM (2009) Effect of 830 nm low-level laser therapy applied before high-intensity exercises on skeletal muscle recovery in athletes. Lasers Med Sci 24:857–863

    Article  PubMed  Google Scholar 

  38. Leal Junior EC, Lopes-Martins RA, Frigo L, De Marchi T, Rossi RP, de Godoi V, Tomazoni SS, Silva DP, Basso M, Filho PL, de Valls CF, Iversen VV, Bjordal JM (2010) Effects of low-level laser therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to postexercise recovery. J Orthop Sports Phys Ther 40:524–532

    Article  PubMed  Google Scholar 

  39. Leal Junior EC, Lopes-Martins RA, Rossi RP, De Marchi T, Baroni BM, de Godoi V, Marcos RL, Ramos L, Bjordal JM (2009) Effect of cluster multi-diode light emitting diode therapy (LEDT) on exercise-induced skeletal muscle fatigue and skeletal muscle recovery in humans. Lasers Surg Med 41:572–577

    Article  PubMed  Google Scholar 

  40. de Almeida P, Lopes-Martins RA, De Marchi T, Tomazoni SS, Albertini R, Correa JC, Rossi RP, Machado GP, da Silva DP, Bjordal JM, Leal Junior EC (2012) Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better? Lasers Med Sci 27:453–458

    Article  PubMed  PubMed Central  Google Scholar 

  41. Maciel TdS, Silva Jd, Jorge FS, Nicolau RA (2013) The influence of the 830 nm laser on the jump performance of female volleyball athletes. [A influência do laser 830 nm no desempenho do salto de atletas de voleibol feminino]. Rev Bras Eng Bioméd :199–205. Available at http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1517-31512013000200010&lang=pt

  42. Leal-Junior EC, Vanin AA, Miranda EF, de Carvalho PD, Dal Corso S, Bjordal JM (2013) Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis. Lasers Med Sci. Available at http://download.springer.com/static/pdf/397/art%253A10.1007%252Fs10103-013-1465-4.pdf?auth66=1395842312_8495c08f38670da14c325fc84d145561&ext=.pdf

  43. Borsa PA, Larkin KA, True JM (2013) Does phototherapy enhance skeletal muscle contractile function and postexercise recovery? A systematic review. J Athl Train 48:57–67. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554033/pdf/i1062-6050-48-1-57.pdf

  44. Dall Agnol MA, Nicolau RA, de Lima CJ, Munin E (2009) Comparative analysis of coherent light action (laser) versus non-coherent light (light-emitting diode) for tissue repair in diabetic rats. Lasers Med Sci 24:909–916

    Article  PubMed  Google Scholar 

  45. Kelencz CA, Munoz IS, Amorim CF, Nicolau RA (2010) Effect of low-power gallium-aluminum-arsenium noncoherent light (640nm) on muscle activity: a clinical study. Photomed Laser Surg 28:647–652. Available at http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/994/CN-00782994/frame.html

  46. Overgaard K, Lindstrom T, Ingemann-Hansen T, Clausen T (2002) Membrane leakage and increased content of Na + −K+ pumps and Ca2+ in human muscle after a 100-km run. J Appl Physiol 92:1891–1898. Available at http://www.ncbi.nlm.nih.gov/pubmed/11960939 http://jap.physiology.org/content/92/5/1891.full.pdf

  47. Fredsted A, Gissel H, Madsen K, Clausen T (2007) Causes of excitation-induced muscle cell damage in isometric contractions: mechanical stress or calcium overload? Am J Physiol Regul Integr Comp Physiol 292:R2249–R2258. Available at http://www.ncbi.nlm.nih.gov/pubmed/17332163 http://ajpregu.physiology.org/content/292/6/R2249.full.pdf

  48. Jones DA, Newham DJ, Clarkson PM (1987) Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. Pain 30:233–242

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physiology, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil

    Fernando Kenji Nampo & Enilton Aparecido Camargo

  2. Department of Physical Therapy, Universidade Federal de Sergipe, Lagarto, SE, Brazil

    Fernando Kenji Nampo

  3. Latin American Institute of Life and Natural Sciences, Universidade Federal da Integração Latino-Americana, 1000 Tarquínio Joslin dos Santos ave, 85870-650, Foz do Iguaçu, PR, Brazil

    Fernando Kenji Nampo

  4. School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia

    Vinícius Cavalheri

  5. Department of Histology, Universidade Estadual de Londrina, Londrina, PR, Brazil

    Solange de Paula Ramos

Authors
  1. Fernando Kenji Nampo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vinícius Cavalheri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Solange de Paula Ramos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Enilton Aparecido Camargo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fernando Kenji Nampo.

Ethics declarations

Funding

EAC is beneficiary of Conselho Nacional de Pesquisa e Desenvolvimento Científico (CNPq) productivity grant. Remaining authors had no financial support for the submitted work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nampo, F.K., Cavalheri, V., Ramos, S.d.P. et al. Effect of low-level phototherapy on delayed onset muscle soreness: a systematic review and meta-analysis. Lasers Med Sci 31, 165–177 (2016). https://doi.org/10.1007/s10103-015-1832-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-015-1832-4

Keywords

Search

Navigation