Effects of percussive therapy dosages on recovery from acute exercise-induced muscle damage: a systematic review and meta-analysis

Percussive therapy (PT) is increasingly used for post-exercise recovery, but its effects and dose-related responses after exercise-induced muscle damage remain uncertain. This review evaluated the effects of PT on neuromuscular performance, muscle soreness, and biochemical markers after acute exercise.

The study adhered to PRISMA guidelines. A comprehensive search was conducted across PubMed, Embase, Web of Science, the Cochrane Library, and CNKI for Randomized Controlled Trials (RCTs) published through November 26, 2025. Risk of bias, methodological quality, and certainty of evidence were assessed using RoB 2, PEDro, and GRADE. Data analysis was performed using Stata-MP 18.0 software.

Twelve RCTs were included. PT improved countermovement jump recovery compared with control (k = 13, g = 0.78, 95% CI 0.26 to 1.29, p < 0.01; low certainty) and reduced creatine kinase levels (k = 7, g = − 0.87, 95% CI − 1.57 to − 0.17, p = 0.02; very low certainty). PT did not clearly improve maximum voluntary contraction recovery (k = 8, g = 0.12, 95% CI − 0.10 to 0.34, p = 0.28; moderate certainty) or delayed onset muscle soreness (k = 17, g = 0.14, 95% CI − 0.19 to 0.48, p = 0.40; very low certainty). Exploratory analyses suggested that longer treatment (> 5 min per muscle group) was associated with larger countermovement jump effects, whereas 2.5–5 min protocols at higher frequency (≥ 50 Hz) were associated with creatine kinase reduction. Longer treatment was also associated with higher delayed onset muscle soreness scores.

PT may improve explosive performance recovery and reduce early creatine kinase levels, but current evidence does not support clear benefits for maximum strength recovery or soreness relief. Dose-related findings are preliminary and should not be interpreted as prescriptive thresholds.