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.
Freitas J, Bocchi M, et al. • Lasers in medical science • 2026
Combined photobiomodulation and osteopathic manipulation may have contributed to improved CK kinetics and selected functional outcomes following exercise-induced muscle damage, though strength recovery should be interpreted strictly as a non-significant and exploratory trend.
Key Findings
Results
The PBM+OM combined group demonstrated a distinct CK recovery pattern with elevated levels at 24 hours followed by a pronounced reduction at 72 hours.
CK levels in the PBM+OM group increased at 24 hours post-intervention but showed a pronounced reduction by 72 hours (p = 0.001)
CK levels were evaluated using the Friedman test with significance set at p < 0.05
This pattern differed from the placebo, PBM-only, and OM-only groups
CK was measured before, immediately after, and at 24, 48, and 72 hours post-intervention
Results
Only the PBM+OM group presented muscle strength percentage values near baseline within 48 hours post-exercise-induced muscle damage.
The PBM+OM group showed strength values within -1.4% of baseline at 48 hours
The authors explicitly note this strength recovery should be 'interpreted strictly as a non-significant and exploratory trend'
Repeated measures ANOVA was used for muscle strength analysis
Strength was assessed before, immediately after, and at 24, 48, and 72 hours post-intervention
Results
The PBM+OM group showed a trend toward early improvement in horizontal jump performance within 24 hours.
The trend toward early horizontal jump improvement at 24 hours was observed only in the PBM+OM group
This finding was described as a trend, not a statistically significant result
Horizontal jump performance was assessed at all time points: before, immediately after, and at 24, 48, and 72 hours post-intervention
Repeated measures ANOVA was used for jump performance analysis
Methods
The study used a red-light LED at 650 nm wavelength delivering 144 J of energy to the right lower limb in the PBM and PBM+OM groups.
Photobiomodulation was delivered using a red-light emitting diode (LED) at λ = 650 nm
Total energy delivered was 144 J applied to the right lower limb
Osteopathic manipulation consisted of bilateral lumbar and pelvic manipulation
Interventions were administered before the exercise-induced muscle damage (EIMD) protocol
Four groups were used: placebo (PL), PBM only, OM only, and PBM+OM combined
Methods
The randomized placebo-controlled trial enrolled 45 physically active male individuals assigned to four treatment groups.
Total sample size was 45 physically active male participants
Participants were randomized into four groups: placebo (PL), PBM, OM, and PBM+OM
Data normality was assessed using the Kolmogorov-Smirnov test
Variables analyzed included creatine kinase, muscle strength, flexibility, and horizontal jump performance
Measurements were taken before, immediately after, and at 24, 48, and 72 hours post-intervention
Results
Flexibility was among the outcomes measured but no significant combined treatment effect was specifically highlighted for this variable.
Flexibility was assessed at all five time points alongside CK, muscle strength, and horizontal jump
Repeated measures ANOVA was used for flexibility analysis
The abstract does not report a specific significant finding for flexibility in any group
Primary highlighted outcomes were CK kinetics, strength, and jump performance
What This Means
This research suggests that combining two recovery therapies — light therapy (photobiomodulation using a red LED) and hands-on spinal manipulation (osteopathic manipulation) — may help the body recover more efficiently after intense exercise that causes muscle damage. In the study, 45 active young men were divided into four groups: a placebo group, a light therapy-only group, a manipulation-only group, and a combined therapy group. All participants underwent a protocol designed to cause exercise-induced muscle damage, and their recovery was tracked over 72 hours using blood markers, strength tests, flexibility, and jump performance.
The combined therapy group (PBM+OM) showed a notably different pattern of recovery in creatine kinase (CK), a blood marker that rises when muscles are damaged. Their CK levels went up at 24 hours but dropped substantially by 72 hours, suggesting a faster clearing of muscle damage markers. This group also had muscle strength values that returned close to their pre-exercise baseline by 48 hours (within 1.4%), and showed an early trend toward better jumping performance at 24 hours — though these latter findings were not statistically significant and should be considered preliminary.
This research suggests that using light therapy and osteopathic manipulation together, before exercise, may offer some complementary benefits for muscle recovery that neither treatment provides alone. However, the authors caution that strength recovery findings were exploratory and not statistically confirmed, meaning larger studies are needed before firm conclusions can be drawn. The study only included physically active young males, so results may not apply to other populations.
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Freitas J, Bocchi M, Rodrigues Junior B, Machado M, Rezende H, de Oliveira D, et al.. (2026). 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.. Lasers in medical science. https://doi.org/10.1007/s10103-026-04907-3