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In this randomized, placebo-controlled trial with participant blinding and blinded outcome assessment, 30 healthy young adults (age: 24.3\u2009\u00b1\u20093.7 years; 15 male, 15 female) received either PBM or placebo treatment applied to the lower-leg musculature before a fatiguing protocol. PBM parameters included a wavelength of 830 nm, average power of 1 W, and total energy of 300 J per limb. Ankle JPR was assessed before and after fatigue. Participants were stratified by Cumberland Ankle Instability Tool (CAIT) scores. All physical assessments were performed by independent outcome assessors blinded to group allocation, with each participant evaluated by the same designated assessor throughout the study. The primary analysis revealed no overall between-group difference in fatigue-related changes in ankle JPR. A secondary exploratory group \u00d7 CAIT interaction was observed, suggesting potential effect modification by perceived ankle instability. In the higher perceived instability subgroup, the estimated between-group difference was consistent with less post-fatigue worsening of JPR error following PBM; however, this estimate was based on small subgroup sizes and was not adjusted for multiple comparisons. The primary hypothesis was not supported; pre-exercise PBM showed no overall effect on fatigue-induced changes in ankle JPR. The exploratory group \u00d7 CAIT interaction suggests that perceived ankle instability may be an effect modifier the response to PBM. However, this hypothesis requires confirmation in a larger, preregistered trial prospectively powered for interaction testing and incorporating functional outcomes in populations with clinically diagnosed chronic ankle instability.<\/jats:p>","DOI":"10.1007\/s10103-026-04966-6","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T02:08:25Z","timestamp":1784858905000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of photobiomodulation on fatigue-related errors in ankle joint position reproduction: the moderating role of perceived ankle instability in a randomized, placebo-controlled trial"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-9154","authenticated-orcid":false,"given":"Yasunari","family":"Ikuta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuya","family":"Yamakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Toriyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Nakasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Mikami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Adachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"4966_CR1","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1136\/bjsports-2016-096188","volume":"50","author":"PA Gribble","year":"2016","unstructured":"Gribble PA, Bleakley CM, Caulfield BM et al (2016) 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. 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The study protocol was approved by the Hiroshima University Certified Review Board (approval no. CRB2023-0007).","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from all participants included in the study.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"UNITAC Co., Ltd. (Onomichi, Hiroshima, Japan) provided financial support and supplied the photobiomodulation device used in this study. The funder had no role in the study design; data collection, analysis, or interpretation; manuscript preparation; or the decision to submit the manuscript for publication.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Japan Registry of Clinical Trials, TRN: jRCTs062230104, Registration date: 7 March 2024.","order":4,"name":"Ethics","label":"Clinical trial number","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"162"}}