Photobiomodulation therapy (PBMT) in skeletal muscle regeneration: A comprehensive review of mechanisms, clinical applications, and future directions

Photobiomodulation therapy (PBMT) emerged as a significant non-invasive method of stimulating regeneration of the skeletal muscle tissue. This review considers the pathophysiologic and molecular mechanisms of muscle repair, with a focus on the imperative of inflammation resolution, activation of satellite cells, mitochondrial ATP generation, and angiogenesis, with consideration of the role of PBMT. We systematically evaluate preclinical and clinical studies, highlighting the translational gaps caused by differences between controlled experimental models and the complex, heterogeneous nature of human muscle injuries. Variability in PBMT parameters-such as wavelength, fluence, and pulse mode-and the lack of standardized protocols are identified as major barriers to consistent therapeutic outcomes. Furthermore, we discuss the effects of PBMT in acute and chronic muscle injury models and provide an in-depth analysis of laser parameters to elucidate dose-response relationships. Future directions for research involve the application of real-time biofeedback devices, the utilization of artificial intelligence-based individualized therapeutic approaches, as well as the integration of photobiomodulation therapy with nanotechnology, biomaterials, and multiple mechanical stimulation methods. In concusion, while PBMT has significant potential for muscle regeneration therapies, its clinical application requires more complete mechanistic validation, rigorous standardization, and interdisciplinary technological development.