Lasers in Medical Science

, Volume 33, Issue 4, pp 719–727 | Cite as

When is the best moment to apply photobiomodulation therapy (PBMT) when associated to a treadmill endurance-training program? A randomized, triple-blinded, placebo-controlled clinical trial

  • Eduardo Foschini Miranda
  • Shaiane Silva Tomazoni
  • Paulo Roberto Vicente de Paiva
  • Henrique Dantas Pinto
  • Denis Smith
  • Larissa Aline Santos
  • Paulo de Tarso Camillo de Carvalho
  • Ernesto Cesar Pinto Leal-JuniorEmail author
Original Article


Photobiomodulation therapy (PBMT) employing low-level laser therapy (LLLT) and/or light emitting diode therapy (LEDT) has emerged as an electrophysical intervention that could be associated with aerobic training to enhance beneficial effects of aerobic exercise. However, the best moment to perform irradiation with PBMT in aerobic training has not been elucidated. The aim of this study was to assess the effects of PBMT applied before and/or after each training session and to evaluate outcomes of the endurance-training program associated with PBMT. Seventy-seven healthy volunteers completed the treadmill-training protocol performed for 12 weeks, with 3 sessions per week. PBMT was performed before and/or after each training session (17 sites on each lower limb, using a cluster of 12 diodes: 4 × 905 nm super-pulsed laser diodes, 4 × 875 nm infrared LEDs, and 4 × 640 nm red LEDs, dose of 30 J per site). Volunteers were randomized in four groups according to the treatment they would receive before and after each training session: PBMT before + PBMT after, PBMT before + placebo after, placebo before + PBMT after, and placebo before + placebo after. Assessments were performed before the start of the protocol and after 4, 8, and 12 weeks of training. Primary outcome was time until exhaustion; secondary outcome measures were oxygen uptake and body fat. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) significantly increased (p < 0.05) the percentage of change of time until exhaustion and oxygen uptake compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 4th, 8th, and 12th week. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) also significantly improved (p < 0.05) the percentage of change of body fat compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 8th and 12th week. PBMT applied before and after sessions of aerobic training during 12 weeks can increase the time-to-exhaustion and oxygen uptake and also decrease the body fat in healthy volunteers when compared to placebo irradiation before and after exercise sessions. Our outcomes show that PBMT applied before and after endurance-training exercise sessions lead to improvement of endurance three times faster than exercise only.


Low-level laser therapy Light emitting diode therapy Phototherapy Fatigue Exercise Aerobic training 


Funding information

This study was supported by research grants 2010/52404-0 from São Paulo Research Foundation—FAPESP (Professor Ernesto Cesar Pinto Leal-Junior), 472062/2013-1 and 307717/2014-3 from Brazilian Council of Science and Technology Development—CNPq (Professor Ernesto Cesar Pinto Leal-Junior), and 2014/01279-1 from São Paulo Research Foundation—FAPESP for Ph.D. scholarship (Larissa Aline Santos).

Compliance with ethical standards

Competing interests

Professor Ernesto Cesar Pinto Leal-Junior received research support from Multi Radiance Medical (Solon, OH, USA), a laser device manufacturer. The remaining authors declare that they have no conflict of interest.

Ethical aspects

All experimental procedures were submitted and approved by the Research Ethics Committee of Nove de Julho University (process number 553.831) and registered at Clinical (NCT02874976).


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2017

Authors and Affiliations

  • Eduardo Foschini Miranda
    • 1
  • Shaiane Silva Tomazoni
    • 2
  • Paulo Roberto Vicente de Paiva
    • 1
    • 3
  • Henrique Dantas Pinto
    • 1
    • 3
  • Denis Smith
    • 3
  • Larissa Aline Santos
    • 3
  • Paulo de Tarso Camillo de Carvalho
    • 3
  • Ernesto Cesar Pinto Leal-Junior
    • 1
    • 3
    Email author
  1. 1.Laboratory of Phototherapy in Sports and ExerciseNove de Julho UniversitySao PauloBrazil
  2. 2.Masters and Doctoral Programs in Physical TherapyUniversidade Cidade de São Paulo (UNICID)Sao PauloBrazil
  3. 3.Post-Graduate Program in Rehabilitation SciencesNove de Julho UniversitySao PauloBrazil

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