Effects of different recovery and regeneration modalities on delayed-onset muscle soreness and post-exercise muscle damage markers: a systematic review and network meta-analysis
- 1chool of Strength and Conditioning, Shenyang Sport University, Shenyang, China
Abstract
ObjectiveThis study employed a systematic review and Bayesian network meta-analysis to compare the effects of multiple post-exercise interventions during the early recovery period, examine whether these effects varied across recovery time points, and provide evidence to inform the selection of post-exercise recovery strategies.MethodsPubMed, Embase, the Cochrane Library, and Web of Science were systematically searched, and randomized controlled trials, including parallel-group and crossover designs, were included. A Bayesian random-effects network meta-analysis was used to estimate mean differences (MDs) and 95% credible intervals (CrIs). The revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Confidence in Network Meta-Analysis (CINeMA) framework were used to assess risk of bias and confidence in the evidence, respectively. Sensitivity analyses and exploratory univariable network meta-regression analyses were also performed.ResultsA total of 35 studies were included in this review. For delayed-onset muscle soreness (DOMS), whole-body cryotherapy (WBC) and photobiomodulation/phototherapy-related interventions (PHO) showed relatively large reductions in soreness at both 24 and 48 h after exercise. Compared with the combined control/placebo condition (CON/PBO), the effect estimates for WBC were MD = −38.92 (95% CrI: −69.08 to −9.15) at 24 h and MD = −40.03 (95% CrI: −67.74 to −12.44) at 48 h. The corresponding estimates for PHO were MD = −18.20 (95% CrI: −32.91 to −3.72) and MD = −19.46 (95% CrI: −33.55 to −5.99), respectively. For creatine kinase (CK), low-level laser therapy (LLLT) and PHO were associated with lower CK levels at both 24 and 48 h, with the largest estimated effect for LLLT at 48 h (MD = −499.96, 95% CrI: −831.59 to −203.59). For interleukin-6 (IL-6), CWI showed favorable estimates at both 24 and 48 h, although the evidence base was limited and the network was sparse.ConclusionWBC and PHO showed relatively consistent favorable effects on DOMS at 24 and 48 h, whereas LLLT and PHO showed relatively consistent associations with lower CK levels. The IL-6 findings should be interpreted as exploratory because of the limited evidence base. Selection of post-exercise recovery strategies should consider the target outcome, recovery time window, evidence certainty, and network structure.
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BibTeX
@article{li2026effects,
title = {{Effects of different recovery and regeneration modalities on delayed-onset muscle soreness and post-exercise muscle damage markers: a systematic review and network meta-analysis}},
author = {Jianxin Li and Siyu Wang and Ming Wei and Weipeng Liu},
journal = {Frontiers in Bioengineering and Biotechnology},
year = {2026},
month = oct,
doi = {10.3389/fbioe.2026.1956053},
url = {https://doi.org/10.3389/fbioe.2026.1956053},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of different recovery and regeneration modalities on delayed-onset muscle soreness and post-exercise muscle damage markers: a systematic review and network meta-analysis
AU - Jianxin Li
AU - Siyu Wang
AU - Ming Wei
AU - Weipeng Liu
PY - 2026
DA - 2026/10/26
JO - Frontiers in Bioengineering and Biotechnology
DO - 10.3389/fbioe.2026.1956053
UR - https://doi.org/10.3389/fbioe.2026.1956053
AB - ObjectiveThis study employed a systematic review and Bayesian network meta-analysis to compare the effects of multiple post-exercise interventions during the early recovery period, examine whether these effects varied across recovery time points, and provide evidence to inform the selection of post-exercise recovery strategies.MethodsPubMed, Embase, the Cochrane Library, and Web of Science were systematically searched, and randomized controlled trials, including parallel-group and crossover designs, were included. A Bayesian random-effects network meta-analysis was used to estimate mean differences (MDs) and 95% credible intervals (CrIs). The revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Confidence in Network Meta-Analysis (CINeMA) framework were used to assess risk of bias and confidence in the evidence, respectively. Sensitivity analyses and exploratory univariable network meta-regression analyses were also performed.ResultsA total of 35 studies were included in this review. For delayed-onset muscle soreness (DOMS), whole-body cryotherapy (WBC) and photobiomodulation/phototherapy-related interventions (PHO) showed relatively large reductions in soreness at both 24 and 48 h after exercise. Compared with the combined control/placebo condition (CON/PBO), the effect estimates for WBC were MD = −38.92 (95% CrI: −69.08 to −9.15) at 24 h and MD = −40.03 (95% CrI: −67.74 to −12.44) at 48 h. The corresponding estimates for PHO were MD = −18.20 (95% CrI: −32.91 to −3.72) and MD = −19.46 (95% CrI: −33.55 to −5.99), respectively. For creatine kinase (CK), low-level laser therapy (LLLT) and PHO were associated with lower CK levels at both 24 and 48 h, with the largest estimated effect for LLLT at 48 h (MD = −499.96, 95% CrI: −831.59 to −203.59). For interleukin-6 (IL-6), CWI showed favorable estimates at both 24 and 48 h, although the evidence base was limited and the network was sparse.ConclusionWBC and PHO showed relatively consistent favorable effects on DOMS at 24 and 48 h, whereas LLLT and PHO showed relatively consistent associations with lower CK levels. The IL-6 findings should be interpreted as exploratory because of the limited evidence base. Selection of post-exercise recovery strategies should consider the target outcome, recovery time window, evidence certainty, and network structure.
SN - 2296-4185
ER -