Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Study Protocol

Effect of pre-game photobiomodulation on muscle recovery in professional soccer players: study protocol for a randomized, cross-over, sham-controlled, triple-blind, clinical trial.

Igor Phillip dos Santos Glória, Ernesto Cesar Pinto Leal Junior, Fabiano Politti, Carolina Marciela Herpich, Denis Smith, Leandro Silva de Carvalho, Cid André Fidelis de Paula Gomes, Tabajara de Oliveira Gonzalez, Daniela Aparecida Biasotto-Gonzalez

Downloads: 0
Views: 35


Background: Photobiomodulation with low-level laser therapy (LLLT) has been widely used in clinical practice for diverse purposes, such as modulation of the inflammatory process, acceleration of the tissue repair process, pain relief and the enhancement of post-exercise recovery. Studies have demonstrated a beneficial interaction between photobiomodulation and the production of creatine kinase, with a reduction in the release of this marker of muscle damage when laser and/or LEDs is administered prior to high-intensity physical activity. Objective: The aim of the proposed study is to determine the influence of pre-exercise phototherapy on post-exercise muscle recovery. Methods: A randomized, cross-over, sham-controlled, double-blind, clinical trial is proposed. The participants will be healthy professional soccer players aged 15 to 20 years from the same team with a body mass index within the ideal range (20 to 25 kg/m2 ) and no history of lower limb musculoskeletal injuries or surgery or back surgery in the previous six months. The athletes will be allocated to two groups based on the previously calculated sample size and will be blinded to allocation. Creatine kinase will be measured and the subjective perception of fatigue will be determined for each participant. The volunteers will then be randomly allocated to Group A, which will receive active phototherapy, and Group B, which will receive sham phototherapy. The athletes will undergo reevaluations immediately after as well as 48 hours after a football match. The data will be submitted to statistical analysis and the level of significance will be set to 5%. This study is registered with Clinical Trials under protocol number: NCT03416998.


Phototherapy; Photobiomodulation; Creatine kinase; Soccer; LLLT; Muscle Damage; Skeletal Muscle Recovery; Lasers.


1. Huang YY, Chen AC, Carroll JD, Hamblin MR. Biphasic dose response in low level light therapy. Dose Response 7:358–383. 2009.

2. Lin F, Josephs SF, Alexandrescu DT, Ramos F, Bogin V, Gammill V et al., Lasers, stem cells, and COPD. J Transl Med. 8:16. 2010.

3. Mester E, Szende B, Gärtner P. The effect of laser beams on the growth of hair in mice. Radiobiol Radiother. 9:621–626. 1968.

4. Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol. 49:1–17. 1999.

5. Karu TI. Multiple roles of cytochrome c oxidase in mammalian cells under action of red and IR-A radiation. IUBMB Life. 62: 607–610. 2010.

6. Marini I, Gatto MR, Bonetti GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain. 26:611-616. 2010.

7. Andrade TNC, Frade JC. Estudo comparativo entre os efeitos de técnicas de terapia manuais isolados e associada a laserterapia de baixa potência sobre a dor em pacientes com disfunção temporomandibular. Rev Gauch Odontol. 56: 287-295. 2008.

8. Goldman JA, Chiapella J, Casey H, Bass N, Graham J, Mcclatchey W et al. Laser therapy of rheumatoid arthritis. Lasers Surg Med. 1:93-101. 1980.

9. Bjordal JM. Effect of 830 nm low-level laser therapy applied before highintensity exercises on skeletal muscle recovery in athletes. Lasers Med Sci. 24: 857–863. 2009.

10. Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pin: a systematic review metaanalysis of randomized placebo or active-treatment controlled trials. Lancet. 374: 897-908. 2009.

11. Hadian ME, Moghagdam B. The effects of low power laser on electrophysiological parameters of sural nerve in normal subjects: a comparison between 670 and 780nm wavelengths. Acta Med Iran. 41:138-42. 2003.

12. Hagiwara S, Iwasaka H, Okuda K, Noguchi T. GaAlAs (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med. 39:797-802. 2007.

13. Ceylan Y, Hizmetli S, Slig Y. The effects of infrared laser and medical treatments on pain and serotonin degradation products in patients with myofascial pain syndrome. A controlled trial. Rheumatoll Int. 24: 260-3. 2004.

14. Ferreira MC, Brito VN, Gameiro J, Costa MRS, Vasconcellos ECS, Cruz-Hofling MAC. Effects of HeNe laser irradiation on experimental paracoccidioidomycotic lesions. J Photochem Photob B: Biol. 84:141-9. 2006.

15. Rodrigo SM, Cunha A, Pozza DH, Blaya DS, Moraes JF, Weber JBB, et al. Analysis of the systemic effect of red and infrared laser therapy on wound repair. Photomed Laser Surg. 27:929-35. 2009.

16. Reihmane D, Jurka A, Tretjakovs P, Dela F. Increase in IL-6, TNF-α, and MMP-9, but not sICAM-1, concentrations depends on exercise duration. European J Appl Physiology. 113:851-858. 2013.

17. Leal-Junior ECP, Lopes-Martins RAB, Baroni BM, De Marchi T, Taufer D, Manfro DS et al. 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. 2009.

18. Xu X, Zhao X, Liu TC, Pan H. Low-intensity laser irradiation improves the mitochondrial dysfunction of C2C12 induced by electrical stimulation. Photomed Laser Surg. 26:197-202. 2008.

19. Karu TI, Pyatibrat LV, Kolyakov SF, Afanasyeva NI. Absorption measurements of cell monolayers relevant to mechanisms of laser phototherapy: reduction or oxidation of cytochrome c oxidase under laser radiation at 632.8 nm. Photomed Laser Surg. 26:593–599. 2008.

20. Leal-Junior ECP, Vanin AA, Miranda EF, De Carvalho PTC, Dal Corso S, Bjordal JM. Effect of phototherapy (low-level laser therapy and lightemitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis. Lasers Med Sci. 30: 925-939. 2015.

21. Ferraresi C, Dos Santos RV, Marques G, Zangrande M, Leonaldo R, Hamblin MR et al. Light-emitting diode therapy (LEDT) before matches prevents increase in creatine kinase with a light dose response in volleyball players. Lasers Med Sci. 30(4):1281-7. 2015.

22. Leal-Junior ECP, Lopes-Martins RAB, Baroni BM, Marchi T, Rossi RP, Grosselli D et al. 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. 2009.

23. Timpka T, Risto O, Bjormsjo M. Boys soccer league injuries: a communitybased study of time-loss from sports participation and long-term sequelae. Eur J Public Health. 18:19–24. 2008.

24. Reilly T, Ekblom B. The use of recovery methods post-exercise. J Sports Sci. 23: 619-27. 2005.

25. Paus V, Torrengo F, Del Compare P. Incidence of injuries in juvenile soccer players. Rev Asoc Argent Traumatol Deporte. 10(1):28-34. 2003.

26. Reilly T, Drust B, Clark N. Muscle fatigue during football match-play. Sports Medicine, 38(5), 357-367, 2008.

27. Svensson M, Drust B. Testing soccer players. J Sports Sci. 23:601-618. 2005.

28. Andersson H, Raastad T, Nilsson J, Paulsen G, Garthe I, Kadi F. Neuromuscular fatigue and recovery in elite female soccer: effects of active recovery. Med Sci Sports Exerc. 40:372-80. 2008.

29. Ascensão A, Rebelo A, Oliveira E, Marques F, Pereira L, Magalhães J. Biochemical impact of a soccer match - analysis of oxidative stress and muscle damage markers throughout recovery. Clin Biochem. 41:841-51. 2008.

30. Ispirlidis I, Fatouros IG, Jamurtas AZ, Nikolaidis MG, Michailidis I, Douroudos I et al. Time-course of Changes in Inflammatory and Performance Responses Following a Soccer Game. Clin J Sport Med. 18:423-31. 2008.

31. Magalhães J, Rebelo A, Oliveira E, Silva JR, Marques F, Ascensão A. Impact of Loughborough Intermittent Shuttle Test versus soccer match on physiological, biochemical and neuromuscular parameters. Eur J Appl Physiol. 108:39-48. 2010.

32. Schulz KF, Altman DG, Mohe D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials CONSORT Statement.

33. Borg G. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 14:377-381. 1982.

34. Laurent CM, Green JM, Bishop PA, Sjokvist J, Schumacker RE, Richardson MT et al. A practical approach to monitoring recovery: Development of a perceived recovery status scale. J Strength Cond Res. 25: 620–628. 2011.

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

36. De Paiva PRV, Shaiane Silva Tomazoni SS, Johnson DS, Vanin AA, Albuquerque-Pontes GM, Machado CSM et al. Photobiomodulation therapy (PBMT) and/or cryotherapy in skeletal muscle restitution, what is better? A randomized, double-blinded, placebo-controlled clinical trial. Lasers Med Sci, 31: 1925-1933. 2016.

5dd82eda0e88257e2e13f286 mtprehab Articles
Links & Downloads

Man. Ther., Posturology Rehabil. J.

Share this page
Page Sections