PROFESSIONAL & PRACTITIONER RESOURCES
‘Breathing retraining and manual therapy for long COVID’ – A literature review
Breathing retraining and manual therapy for long COVID – A literature review
Rosalba Courtney, Zoe Steele and Imogen Collyer
A B S T R A C T
Background: Long COVID continues to have health impacts globally. Dyspnoea, fatigue, exercise intolerance and musculoskeletal symptoms are common and have been linked to pathophysiological mechanisms such as dysfunctional breathing, dysautonomia and neurolymphatic dysfunction that might be assisted by breathing
retraining and manual therapy.
Objective: This review sought to identify research describing breathing retraining and manual therapy protocols that might be beneficial for long COVID.
Methods: A literature review was undertaken to identify research describing treatment protocols that included either manual therapy or breathing retraining approaches for long COVID.
Results: There were 17 articles that fit the inclusion criteria; 9 randomised control trials, 4 case series, 3 uncontrolled studies, and one case report. Whilst methodologies varied, all implemented interventions and reported
outcomes involving breathing re-training and/or manual therapy, in four broad categories: manual therapy, singing-based breathing protocols, respiratory muscle training – device assisted, and breathing techniques.
Conclusion: Clinical protocols integrating multimodal interventions and patient self-care should be refined through pilot studies targeting specific phenotypes. High-quality research is needed to compare intervention effectiveness and assess long-term outcomes.