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The Effect of Photobiomodulation Therapy on Muscle Performance in Volleyball and Football Players: A Meta-Analysis of Randomized Controlled Trials

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Abstract

The use of photobiomodulation therapy (PBMT) as an adjunct to improve muscle performance and accelerate recovery in high-level volleyball and football players remains controversial.

Objective:

To determine whether PBMT improves skeletal muscle performance in ball sports athletes, and whether there are differences in the improvement of skeletal muscle performance by PBMT between volleyballers and footballers.

Data Sources:

A comprehensive search of the Web of Science, Medline, Scopus, and PubMed databases was conducted through April 10, 2025.

Study Selection:

Eligible studies included those explicitly categorized as randomized controlled trials (RCT) of PBMT interventions for high-level volleyballers and/or footballers; 14 studies met the inclusion criteria.

Study Design:

Meta-analysis.

Level of Evidence:

Level 2.

Data Extraction:

The primary outcome measures included maximal voluntary contraction force (MVC), number of repetitions, and creatine kinase (CK) levels. Means and standard deviations for each variable of interest were used to calculate standardized mean differences (SMDs).

Results:

The active laser had no significant effect on MVC (mean difference [MD], 19.67; 95% CI, 7.36 to 31.72; P = 0.31)]; however, it significantly increased the number of repetitions (SMD, 0.58; 95% CI, –0.05 to 1.21; P = 0.04) and significantly decreased CK levels (MD, –45.37; 95% CI, –55.52 to −35.22; P < 0.001).

Conclusion:

PBMT can delay muscle fatigue onset and reduce CK levels in ball sports athletes. The improvement in skeletal muscle performance induced by PBMT showed differences between volleyballers and footballers, as there was a significant increase the number of repetitions in volleyball players, whereas a significant decrease in CK levels was noted in footballers.

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white paper

Photobiomodulation as Medicine: Low-Level Laser Therapy (LLLT) for Acute Tissue Injury or Sport Performance Recovery

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Abstract

Background/Objectives:

Low-level laser therapy (LLLT) has gained traction in sports and exercise medicine as a non-invasive therapeutic for preconditioning the body, exertion recovery, repair and injury rehabilitation. LLLT is hypothesized to modulate cellular metabolism, tissue microenvironment(s) and to decrease inflammation while posing few adverse risks. This review critically examines the evidence-base for LLLT effectiveness focusing on immediate care settings and acute/subacute applications (<6 months post-injury).

Methods: A comprehensive literature search was conducted, prioritizing systematic reviews, meta-analyses and their primary research papers.

Results: Findings are relevant to trainers and athletes as they manage a wide range of issues from superficial abrasions to deeper tissue concerns. LLLT parameters in the research literature include wide ranges. For body surface structures, studies show that LLLT holds promise in accelerating wound healing. In sport performance studies, LLLT is typically delivered pre-exercise and reveals beneficial effects on exertion recovery, improvements in muscle strength, endurance and reduced fatigue. Evidence is less convincing for acute, deep tissue injury models, where most studies do not report significant benefits for functional outcomes over conventional therapeutic modalities.

Conclusions: Variability in LLLT delivery parameters and findings across studies underscores a need for clear treatment guidelines for the profession. Technical properties of laser light delivery to the body also differ materially from LED devices. Sport physiotherapists, team physicians, trainers and athletes should understand limitations in the current evidence-base informing photobiomodulation use in high-performance sport settings and weigh potential benefits versus shortcomings of LLLT use in the mentioned therapeutic contexts.

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The Effect of Intranasal Plus Transcranial Photobiomodulation on Neuromuscular Control in Individuals with Repetitive Head Acceleration Events

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Introduction
Approximately 3.8 million sport- and recreation-related concussions occur annually in the United States. The effects of concussion, including persistent long-term issues with concentration and physical skills is a growing concern. Equally concerning are the effects of repetitive head impacts (RHIs), also known as repetitive head acceleration events (RHAEs). RHAE has the same meaning as RHI; however, it is emerging as a preferred term because it inherently indicates that the brain is experiencing translational and/or rotational movement because of external forces regardless of the source (blast or mechanical blow) or location (head or body) of the impact forces. Although RHAE may include concussions or mild traumatic brain injury (mTBI), most do not result in any acute detectable clinical symptoms. However, the cumulative effect of RHAE, like concussion or mTBI, could progress to traumatic encephalopathy syndrome (TES), a clinical disorder associated with chronic traumatic encephalopathy (CTE). An athlete may experience over 100 RHAEs per season. Although the athlete may be asymptomatic, RHAEs result in microstructural and functional changes in the brain similar to that seen in concussion or mTBI, leading to altered motor unit recruitment strategies, increased acute corticomotor inhibition, and other neuromuscular impairments, such as reduced dynamic balance or reaction time, in the long-term.

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The Differences between Blast-Induced and Sports-Related Brain Injuries

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Abstract

Both blast-induced traumatic brain injury (TBI) and sports-related concussion are occasionally considered to have similar injury mechanisms by which repeated head impacts cause chronic traumatic encephalopathy (CTE). Patients with the two conditions experience comparable CTE symptoms, such as headache, light-headedness, memory loss, confusion, attention deficits, difficulty balancing, aggression, anxiety, depression, etc. (1). Another common feature is tau protein deposition around cerebral blood vessels in the frontal cortex (2, 3). However, it should be noted that these symptoms are non-specific, and can be the results of many different brain insults such as TBI, stroke, chemically induced neurotoxicity, infection by pathogenic microbes (HIV virus, bacteria, etc.), brain tumors, and neurodegenerative diseases (Parkinson’s, Alzheimer’s, ALS, Huntingtons, etc.). Abnormal or hyper-phosphorylated tau protein deposition is also non-specific and represents only disruption and dysfunction of microtubules in neuronal cells that are experiencing progressive death and degeneration. Therefore, having similar mental symptoms and tau protein deposition in the same regions of the brain does not conclude that the same basic injury mechanism existed in both blast-induced and sports-related brain injuries.

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