The effects of light emitting diode therapy following high intensity exercise

Effects of Low-Level Laser Therapy on Muscular Performance and Soreness Recovery in Athletes: A Meta-analysis of Randomized Controlled Trials

CONTEXT

Athletes must maintain their peak state of strength. Previous studies have investigated the effect of low-level laser therapy (LLLT) on muscular performance. A previous systematic review and meta-analysis has investigated this issue in healthy participants but not in physically active athletes.

OBJECTIVE

To investigate whether LLLT can improve muscular performance and soreness recovery in athletes.

DATA SOURCES

PubMed, EMBASE, and Cochrane Library.

STUDY SELECTION

Published randomized controlled trials and crossover studies till December 2020.

STUDY DESIGN

Systematic review and meta-analysis.

LEVEL OF EVIDENCE

Level 3.

DATA EXTRACTION

Assessment of study quality was rated using the risk of bias assessment method for randomized trials (Cochrane Handbook for Systematic Reviews of Interventions).

RESULTS

A total of 24 studies were included. LLLT application before exercise significantly improved lower-limb muscle strength in 24-hour, 48-hour, 96-hour, and 8-week follow-up groups. Furthermore, decreased soreness index, serum creatine kinase concentrations, interleukin-6, and thiobarbituric acid reactive substance concentrations and a trend toward the improvement of contract repetition number and VO₂ kinetic outcomes were observed.

CONCLUSION

Although a definite therapeutic effect of LLLT is yet to be established, the current evidence supports that LLLT use improves muscular performance in physically active athletes. Additional trials with large sample sizes and robust design should be conducted before strong recommendations are made.

Photobiomodulation 30 min or 6 h Prior to Cycling Does Not Alter Resting Blood Flow Velocity, Exercise-Induced Physiological Responses or Time to Exhaustion in Healthy Men

Purpose

The aim of the current study was to investigate the effects of photobiomodulation therapy (PBMT) applied 30 min or 6 h prior to cycling on blood flow velocity and plasma nitrite concentrations at rest, time to exhaustion, cardiorespiratory responses, blood acid-base balance, and K⁺ and lactate concentrations during exercise.

Methods

In a randomized, crossover design, 13 healthy untrained men randomly completed four cycling bouts until exhaustion at the severe-intensity domain (i.e., above respiratory compensation point). Thirty minutes or 6 h prior to the cycling trials, participants were treated with PBMT on the quadriceps, hamstrings, and gastrocnemius muscles of both limbs using a multi-diode array (11 cm × 30 cm with 264 diodes) at doses of 152 J or a sham irradiation (with device turned off, placebo). Blood samples were collected before and 30 min or 6 h after treatments to measure plasmatic nitrite concentrations. Doppler ultrasound exams of the femoral artery were also performed at the same time points. Cardiorespiratory responses, blood acid-base balance, and K⁺ and lactate concentrations were monitored during exercise sessions.

Results

PBMT did not improve the time to exhaustion (p = 0.30). At rest, no differences were found in the peak systolic velocity (p = 0.97) or pulsatility index (p = 0.83) in the femoral artery, and in plasma nitrite concentrations (p = 0.47). During exercise, there were no differences for any cardiorespiratory response monitored (heart rate, p = 0.15; oxygen uptake, p = 0.15; pulmonary ventilation, p = 0.67; carbon dioxide output, p = 0.93; and respiratory exchange ratio, p = 0.32), any blood acid-base balance indicator (pH, p = 0.74; base excess, p = 0.33; bicarbonate concentration, p = 0.54), or K⁺ (p = 0.22) and lactate (p = 0.55) concentrations.

Conclusions

PBMT at 152 J applied 30 min or 6 h before cycling at severe-intensity did not alter resting plasma nitrite and blood flow velocity in the femoral artery, exercise-induced physiological responses, or time to exhaustion in healthy untrained men.

Does Previous Application of Photobiomodulation Using Light-Emitting Diodes at Different Energy Doses Modify the Peak Running Velocity and Physiological Parameters? A Randomized, Crossover, Double-Blind, and Placebo-Controlled Study

Objective: This study aimed to verify the acute effects of photobiomodulation (PBM) using different doses of LED on peak running velocity (V_peak) and physiological parameters. Materials and methods: The study had a randomized, crossover, double-blind, and placebo-controlled format, in which 15 physically active males were submitted, besides the control (CON), to four conditions performed 5 min before the maximal incremental treadmill tests for the determination of V_peak: placebo (PLA) and three conditions of PBM application at different doses: PBM applied with 30 J per area (PBM₁), PBM applied with 120 J per area (PBM₂), and PBM applied with 180 J per area (PBM₃). The LED was applied using an equipment with 56 diodes of red light (660 nm; 50 mW/cm² and 1.5 J/cm² each diode) and 48 diodes of infrared light (850 nm; 150 mW/cm² and 4.5 J/cm² each diode). The PBM was applied in two regions of the quadriceps muscle, two regions of the femoral biceps muscle, and one region of the gastrocnemius muscle in both legs. Results: There was no difference among the outcomes from PBM irradiations and PLA condition for the variables, V_peak (CON = 13.4 ± 1.6; PLA = 13.4 ± 1.6; PBM₁ = 13.5 ± 1.7; PBM₂ = 13.4 ± 1.6; PBM₃ = 13.4 ± 1.7 km/h), similar to other variables associated with aerobic running performance analyzed during the maximal incremental treadmill tests for V_peak determination: lactate peak, heart rate, and rating of perceived exertion. Conclusions: We concluded that the application of different doses of PBM using LEDs did not modify V_peak and physiological and perceptual parameters.

Evidence-based post-exercise recovery strategies in rugby: a narrative review

In the sport of rugby, athletes need a multitude of sport-specific skills along with endurance, power, and speed to optimize performance. Further, it is not unusual for athletes to play several competitive matches with insufficient recovery time. Rugby requires repeated bouts of high-intensity actions intermixed with brief periods of low-to-moderate active recovery or passive rest. Specifically, a match is characterized by repeated explosive activities, such as jumps, shuffles, and rapid changes of direction. To facilitate adequate recovery, it is necessary to understand the type of fatigue induced and, if possible, its underlying mechanisms. Common approaches to recovery may include nutritional strategies as well as active (active recovery) and passive recovery (water immersions, stretching, and massage) methods. However, limited research exists to support the effectiveness of each strategy as it related to recovery from the sport of rugby. Therefore, the main aim of the current brief review is to present the relevant literature that pertains to recovery strategies in rugby.

Effects of integrated treatment with LED and microcurrent on muscle tone and stiffness in the calf muscle during moderate aerobic exercise

[Purpose] This study aimed to investigate the effects of the therapeutic device combined with LED and microcurrent (MC) on muscle tone and stiffness in the calf muscle after its application during moderate aerobic exercise. [Subjects and Methods] Twenty healthy adult subjects were randomized to either the test group of the therapeutic device combined with LED and MC or the control group, and they walked on a 10%-sloped treadmill with a 5 km/hr speed for 30 minutes. Each of the subjects in the test group performed treadmill exercise with the therapeutic device attached to the edge of his or her calf muscle. After the exercise, the muscle tone and stiffness at the edge of the calf muscle were measured. [Results] With respect to the muscle tone, a statistically significant difference was found between the two groups only 5 minutes after the exercise. Concerning muscle stiffness, significant differences were shown between the two groups right after the exercise and 5 minutes after the exercise. [Conclusion] Integrated treatment with LED and MC on is considered helpful for lowering the muscle tone 5 minutes after the exercise, and for lowering the muscle stiffness right after the exercise and 5 minutes after the exercise.

LED session prior incremental step test enhance VO2max in running

This study aimed to investigate the effect of prior LED sessions on the responses of cardiorespiratory parameters during the running incremental step test. Twenty-six healthy, physically active, young men, aged between 20 and 30 years, took part in this study. Participants performed two incremental load tests after placebo (PLA) and light-emitting diode application (LED), and had their gas exchange, heart rate (HR), blood lactate, and rating of perceived exertion (RPE) monitored during all tests. The PLA and LED conditions were compared using the dependent Student t test with significance set at 5%. The T test showed higher maximum oxygen uptake (VO_2max) (PLA = 47.2 ± 5.7; LED = 48.0 ± 5.4 ml kg^-1 min^-1, trivial effect size), peak velocity (V_peak) (PLA = 13.4 ± 1.2; LED = 13.6 ± 1.2 km h^-1, trivial effect size), and lower maximum HR (PLA = 195.3 ± 3.4; LED = 193.3 ± 3.9 b min^-1, moderate effect size) for LED compared to PLA conditions. Furthermore, submaximal values of HR and RPE were lower, and submaximal VO₂ values were higher when LED sessions prior to the incremental step test were applied. A positive response of the previous LED application in the blood lactate disappearance was also demonstrated, especially 13 and 15 min after the test. It is concluded that LED sessions prior to exercise modify cardiorespiratory response by affecting running tolerance during the incremental step test, metabolite clearance, and RPE. Therefore, LED could be used as a prior exercise strategy to modulate oxidative response acutely in targeted muscle and enhance exercise tolerance.

Photobiomodulation therapy for the improvement of muscular performance and reduction of muscular fatigue associated with exercise in healthy people: a systematic review and meta-analysis

Researches have been performed to investigate the effects of phototherapy on improving performance and reduction of muscular fatigue. However, a great variability in the light parameters and protocols of the trials are a concern to establish the efficacy of this therapy to be used in sports or clinic. The aim of this study is to investigate the effectiveness, moment of application of phototherapy within an exercise protocol, and which are the parameters optimally effective for the improvement of muscular performance and the reduction of muscular fatigue in healthy people. Systematic searches of PubMed, PEDro, Cochrane Library, EMBASE, and Web of Science databases were conducted for randomized clinical trials to March 2017. Analyses of risk of bias and quality of evidence of the included trials were performed, and authors were contacted to obtain any missing or unclear information. We included 39 trials (861 participants). Data were reported descriptively through tables, and 28 trials were included in meta-analysis comparing outcomes to placebo. Meta-analysis was performed for the variables: time until reach exhaustion, number of repetitions, isometric peak torque, and blood lactate levels showing a very low to moderate quality of evidence and some effect in favor to phototherapy. Further investigation is required due the lack of methodological quality, small sample size, great variability of exercise protocols, and phototherapy parameters. In general, positive results were found using both low-level laser therapy and light-emitting diode therapy or combination of both in a wavelength range from 655 to 950 nm. Most of positive results were observed with an energy dose range from 20 to 60 J for small muscular groups and 60 to 300 J for large muscular groups and maximal power output of 200 mW per diode.

Photobiomodulation in human muscle tissue: an advantage in sports performance?

Photobiomodulation (PBM) describes the use of red or near-infrared (NIR) light to stimulate, heal, and regenerate damaged tissue. Both preconditioning (light delivered to muscles before exercise) and PBM applied after exercise can increase sports performance in athletes. This review covers the effects of PBM on human muscle tissue in clinical trials in volunteers related to sports performance and in athletes. The parameters used were categorized into those with positive effects or no effects on muscle performance and recovery. Randomized controlled trials and case-control studies in both healthy trained and untrained participants, and elite athletes were retrieved from MEDLINE up to 2016. Performance metrics included fatigue, number of repetitions, torque, hypertrophy; measures of muscle damage and recovery such as creatine kinase and delayed onset muscle soreness. Searches retrieved 533 studies, of which 46 were included in the review (n = 1045 participants). Studies used single laser probes, cluster of laser diodes, LED clusters, mixed clusters (lasers and LEDs), and flexible LED arrays. Both red, NIR, and red/NIR mixtures were used. PBM can increase muscle mass gained after training, and decrease inflammation and oxidative stress in muscle biopsies. We raise the question of whether PBM should be permitted in athletic competition by international regulatory authorities.

Acute LED irradiation does not change the anaerobic capacity and time to exhaustion during a high-intensity running effort: a double-blind, crossover, and placebo-controlled study : Effects of LED irradiation on anaerobic capacity and performance in running

The purpose of this study was to investigate the acute effects of photobiomodulation therapy using cluster light-emitting diodes (LEDT; 104 diodes) (wavelength 660 and 850 nm; energy density 1.5 and 4.5 J/cm(2); energy 60 J at each point; total energy delivered 600 J) on alternative maximal accumulated oxygen deficit (MAODALT) and time to exhaustion, during a high-intensity running effort. Fifteen moderately active and healthy males (age 25.1 ± 4.4 years) underwent a graded exercise test and two supramaximal exhaustive efforts at 115 % of the intensity associated with maximal oxygen uptake performed after acute LEDT or placebo irradiation in a double-blind, crossover, and placebo-controlled study design. The MAODALT was assumed as the sum of both oxygen equivalents estimated from the glycolytic and phosphagen metabolism pathways during each supramaximal effort. For the statistical analysis, a paired t test was used to determine differences between the treatments. The significance level was assumed as 95 %. In addition, a qualitative analysis was used to determine the magnitude of differences between groups. No significant differences were found for the values of oxygen equivalents from each energetic metabolism (P ≥ 0.28), for MAODALT values between the LEDT and placebo conditions (P ≥ 0.27), or for time to exhaustion (P = 0.80), except for the respiratory exchange ratio (P = 0.01). The magnitude-based inference of effect size reported only a possibly negative effect of photobiomodulation on MAODALT when expressed in units relative to body mass and on the glycolysis pathway (26 %). In summary, LEDT after a high-intensity running effort did not alter the MAODALT, metabolic energy pathways, or high-intensity running performance.

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

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.