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CompletedNCT07790016Updated Aug 31, 2026

Photobiomodulation on NMES-Induced Muscle Fatigue and Damage

An interventional study of Photobiomodulation Therapy (PBMT) and Sham Photobiomodulation in Muscle Fatigue (C23.888.592.612.612), Delayed Onset Muscle Soreness (DOMS) and Muscle Damage, sponsored by Federal University of Rio Grande do Sul. Completed at 1 site in Brazil. Open to participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-31.

Sponsored by Federal University of Rio Grande do Sul · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
12
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
All
01

Study summary

Neuromuscular electrical stimulation (NMES) is effective for strength training and rehabilitation, but non-selective motor unit recruitment often induces rapid fatigue, discomfort, and muscle damage. Photobiomodulation therapy (PBMT) has been proposed to attenuate muscle fatigue and accelerate recovery, yet evidence regarding its acute prophylactic effects against NMES-induced fatigue remains limited. This randomized, single-blind, sham-controlled crossover pilot trial evaluates the acute effects of pre-exercise PBMT on knee extensor neuromuscular fatigability, muscle damage, discomfort, and functional recovery following a standardized NMES fatigue protocol in healthy adults.

Read the detailed description

This study utilizes a randomized, single-blind, sham-controlled crossover design to evaluate the acute effects of photobiomodulation therapy (PBMT) on neuromuscular electrical stimulation (NMES)-induced fatigue in healthy individuals.

Participants undergo testing across two intervention blocks separated by a 7-day washout period between limbs:

Intervention Phase: Five minutes prior to an electrically evoked fatigue protocol, participants receive either active PBMT (multi-diode GaAlAs laser cluster; 810 nm; 200 mW per diode; 30 J per point across 8 quadriceps sites; total energy dose: 240 J) or sham PBMT (identical positioning with the device inactive and acoustic blinding).

NMES Fatigue Protocol: The protocol is performed on an isokinetic dynamometer with the knee fixed at 90° flexion. Rectangular biphasic symmetrical pulses (100 Hz; 1 ms pulse width; 5 s on, 10 s off) are delivered over 20 minutes to evoke 60 isometric contractions adjusted to an initial torque of 20% maximal voluntary isometric contraction (MVIC).

Evaluation Timeline: Neuromuscular and functional assessments are conducted at Baseline, Immediately Post-Fatigue, and at 24, 48, and 72 hours post-protocol. Tests include maximal voluntary isometric torque, resting supramaximal evoked twitches, transverse ultrasound echointensity of the rectus femoris and vastus lateralis, pressure pain thresholds via algometry, Visual Analog Scales for discomfort, and horizontal Single Hop Test performance.

02

Conditions studied

  • Muscle Fatigue (C23.888.592.612.612)
  • Delayed Onset Muscle Soreness (DOMS)
  • Muscle Damage
  • Photobiomodulation (PBM)
  • Neuromuscular Electrical Stimulation (NMES)

Keywords

  • Photobiomodulation
  • Low-Level Laser Therapy
  • Neuromuscular Electrical Stimulation
  • Muscle Fatigue
  • Pilot Study
03

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Healthy male and female adults aged between 18 and 40 years.
  • Engaging in regular physical activity (minimum of twice a week).
  • No history of hospitalization for COVID-19 in the past 12 months.
  • Demonstrated ability to tolerate neuromuscular electrical stimulation (NMES).
  • Capable of fully understanding and complying with the experimental protocol and procedures.

Exclusion criteria

Exclusion Criteria:

  • Presence of any sensory impairments or neurological alterations.
  • Ingestion of caffeine, coffee, energy drinks, or other stimulants in the 12 hours preceding the testing sessions.
  • Body Mass Index (BMI) greater than 30 kg/m².
  • Any medical contraindication to performing maximal physical exertion or presenting an abnormal cardiovascular/blood pressure response after maximal effort.
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Participant)
Enrollment
12 participants (actual)

Study arms

  • Experimental
    Active PBMT + NMES

    Participants receive active Photobiomodulation Therapy (PBMT) applied to the knee extensor muscles 5 minutes prior to undergoing a 20-minute neuromuscular electrical stimulation (NMES) fatigue protocol on the randomized lower limb.

    Device: Photobiomodulation Therapy (PBMT)

  • Sham comparator
    Sham PBMT + NMES

    Participants receive sham Photobiomodulation Therapy (device turned off, identical positioning and acoustic blinding) applied to the knee extensor muscles 5 minutes prior to undergoing a 20-minute neuromuscular electrical stimulation (NMES) fatigue protocol on the contralateral lower limb.

    Device: Sham Photobiomodulation

Interventions

  • DevicePhotobiomodulation Therapy (PBMT)

    Multi-diode cluster probe (GaAlAs laser; 5 diodes; wavelength: 810 nm; power output: 200 mW per diode; continuous mode) applied across 8 points over the quadriceps femoris (3 on rectus femoris, 3 on vastus lateralis, and 2 on vastus medialis) for 30 seconds per point (30 J/point), delivering a total energy dose of 240 J per limb.

  • DeviceSham Photobiomodulation

    Identical probe positioning over the 8 quadriceps locations for 30 seconds per point with the laser device completely turned off. Auditory headphones are used to blind participants against sound cues.

05

What researchers measure

Primary outcomes

  1. Maximal Voluntary Isometric Contraction (MVIC) Torque

    Knee extensor peak isometric torque measured on an isokinetic dynamometer (Biodex System 3 Pro) during 5-second maximal isometric contractions with the knee fixed at 90° flexion, expressed in Newton-meters (N.m).

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

Secondary outcomes

  1. Muscle Damage via Ultrasound Echointensity

    Quantitative grayscale histogram analysis (0 = black, 255 = white) of transverse ultrasound images (ImageJ software) of the rectus femoris (at 40%, 50%, and 60% of the femur length) and vastus lateralis (at 50% of the femur length) muscles to assess structural muscle damage.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  2. Supramaximal Evoked Twitch Torque

    Knee extensor evoked torque produced by single supramaximal electrical twitches (1 Hz, 500 µs rectangular biphasic pulses at rest) delivered to the rectus femoris motor point, measured in Newton-meters (N.m) on the isokinetic dynamometer to evaluate peripheral muscle fatigue.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  3. Evoked Neuromuscular Efficiency

    Ratio between the supramaximal evoked twitch peak torque and the applied current intensity (Nm/mA) during resting single pulses.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  4. Sitting Muscle Discomfort

    Subjective sensation of discomfort/pain in the quadriceps femoris evaluated while seated at rest using a 10 cm Visual Analog Scale (VAS), where 0 cm represents 'no discomfort' and 10 cm represents 'maximum discomfort'.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  5. Pain Pressure Threshold (PPT)

    Mechanical pain sensitivity measured using a digital pressure algometer (applied at 90° in kgf/cm²) over the rectus femoris, vastus lateralis, and vastus medialis muscle bellies to identify delayed onset muscle soreness.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  6. Single Hop Test (SHT) Functional Performance

    Maximal horizontal single-leg hop distance normalized to limb length, calculated as: \[Hop Distance (cm) / Limb Length (cm)\] \* 100.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  7. Discomfort During Stair Ascent and Descent

    Level of discomfort reported on a 10 cm Visual Analog Scale (VAS) immediately after ascending and descending a 10-step staircase.

    Time frame: Baseline, Immediately post-fatigue protocol, 24 hours, 48 hours, and 72 hours post-fatigue.

  8. Total Mechanical Work During Fatigue Protocol

    Cumulative mechanical work quantified by the sum of the torque-time integral (TTI) across all 60 evoked contractions during the 20-minute NMES protocol (expressed in N.m.s).

    Time frame: During the 20-minute NMES fatigue protocol.

  9. Fatigue Index (% Work Decline)

    Percentage reduction in work performed between the first 5 evoked contractions and the last 5 evoked contractions of the NMES fatigue protocol, calculated as: \[(Initial Work - Final Work) / Initial Work\] \* 100.

    Time frame: During the 20-minute NMES fatigue protocol.

06

Study locations

1 site
  • Laboratório de Pesquisa do Exercício
    Porto Alegre, Rio Grande do Sul 90690200, Brazil
07

References and documents

Individual participant data

Plan to share: Undecided — Individual participant data will not be publicly shared to protect participant confidentiality in accordance with the local ethics committee approval.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07790016
Lead sponsor
Federal University of Rio Grande do Sul
Collaborators
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Responsible party
Marco Aurélio Vaz, PhD (Full Professor, Federal University of Rio Grande do Sul) — Principal investigator
First posted
Aug 27, 2026
Start date
Nov 1, 2022
Primary completion
Aug 1, 2023
Completion
Dec 1, 2023
Last update
Aug 31, 2026

Study contacts

Marco A Vaz, PhD
study chair · Federal University of Rio Grande do Sul
Marco A Vaz, PhD
principal investigator · Federal University of Rio Grande do Sul

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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