Photobiomodulation with Structured Rehabilitation Improves Mechanical Function and Functional Aging in Degenerative Musculoskeletal Disease: A Controlled Cohort Study

BACKGROUND: Degenerative musculoskeletal disorders involve progressive mechanical dysfunction and accelerated functional aging. Conventional measures fail to capture multidimensional recovery. We developed a Composite Mechanical Dysfunction Index (CMDI) combining functional, gait, asymmetry, mobility, strength, and anthropometric metrics to quantify global impairment and a Composite Multidomain Improvement Index (CMII) to quantify treatment-related recovery. We evaluated whether photobiomodulation therapy plus structured rehabilitation (PBMT + SR) improves CMII and influences functional aging metrics. METHODS: = 108) for 16 weeks. Mechanical function was assessed across six domains (WOMAC, gait, asymmetry, mobility, strength, anthropometrics) and combined into the CMII. Functional aging was evaluated using a performance-based regression model derived from controls. A limitation is that single-therapy groups (PBMT alone, rehabilitation alone) were not included. The intervention group achieved a CMII of 2.01 (ΔCMII = 1.73 between groups). Improvements spanned pain, gait, and neuromuscular symmetry domains. CMII changes correlated with functional performance-based age estimates, indicating an estimated ∼3-year favorable shift in functional age alignment relative to controls. CONCLUSION: PBMT combined with SR was associated with substantial multidomain improvements in degenerative musculoskeletal disorders, captured by the CMII. These improvements correlated with favorable shifts in functional aging metrics. However, the absence of single-therapy arms limits causal inferences, and randomized trials are needed to isolate the effects of PBMT versus rehabilitation.