Deconstructing the Ergogenic Effects of Photobiomodulation: A Systematic Review and Meta-analysis of its Efficacy in Improving Mode-Specific Exercise Performance in Humans

Background: Photobiomodulation therapy (PBMT) is defined as non-thermal electromagnetic irradiation through laser or light-emitting diode sources. In recent decades, PBMT has attracted attention as a potential preconditioning method. The current meta-analysis was conducted to assess the effectiveness of PBMT in improving mode-specific exercise performance in healthy young adults. Methods: A computerized literature search was conducted, ending on 15 May 2022. The databases searched were PubMed, Cochrane Central Register of Controlled Trials, Embase, SPORTDiscus, and the Physiotherapy Evidence Database. Inclusion/exclusion criteria limited articles to crossover, double-blind, placebo-controlled studies investigating the PBMT effects as a preconditioning method. The included trials were synthesized according to exercise mode (single-joint, cycling, running, and swimming). All results were combined using the standardized mean differences (SMDs) method and the 95% confidence intervals (CIs) were described. Results: A total of 37 individual studies, employing 78 exercise performance measurements in 586 participants, were included in the analyses. In single-joint exercises, PBMT improved muscle endurance performance (SMD 0.27, 95% CI 0.12–0.41; p < 0.01) but not muscle strength performance (p = 0.92). In cycling, PBMT improved time to exhaustion performance (SMD 0.35, 95% CI 0.10–0.59; p < 0.01) but had no effect on all-out sprint performance (p = 0.96). Similarly, PBMT had no effect on time to exhaustion (p = 0.10), time-trial (p = 0.61), or repeated-sprint (p = 0.37) performance in running and no effect on time-trial performance in swimming (p = 0.81). Conclusion: PBMT improves muscle endurance performance in single-joint exercises and time to exhaustion performance in cycling but is not effective for muscle strength performance in single-joint exercises, running, or swimming performance metrics.