Acute Effects of Osteopathic Treatment in Long COVID-19 Patients with Fatigue Symptoms: A Randomized, Controlled Trial Article Swipe
Ulrich M. Zissler
,
Tino Poehlmann
,
Rainer Gloeckl
,
Sami M Ibrahim
,
Kerstin Klupsch
,
Tessa Schneeberger
,
Inga Jarosch
,
Andreas Rembert Koczulla
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/jcm14176066
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/jcm14176066
Background: Persistent fatigue is among the most commonly reported symptoms in patients suffering from post-acute sequelae of SARS-CoV-2 infection (long COVID). Autonomic dysfunction, measurable via heart rate variability, has been implicated as a contributing factor. Osteopathic manipulative treatment is a manual therapeutic approach that targets autonomic balance and may offer a novel intervention for long COVID-related fatigue. Methods: In this single-blind, randomized controlled trial, 42 participants (mean age 51 ± 11 years; fatigue severity score: 31 ± 5 points) with long COVID and persistent fatigue ≥12 weeks post-infection were allocated to either a 45 min standardized osteopathic treatment (n = 21) or a sham-treatment group (n = 21). Heart rate variability was assessed using a 10 min resting electrocardiogram before intervention, immediately after, and again 48 h later. The analysis of heart rate variability encompassed time-domain indices, including the root mean square of successive differences, the standard deviation of normal-to-normal intervals, mean heart rate, and mean RR interval. Additionally, frequency-domain measures such as low-frequency, high-frequency, total power, and the LF/HF ratio were considered. Results: The osteopathy group showed a statistically significant increase in root mean square of successive differences post-treatment (p < 0.01), accompanied by a decrease in the stress index (p < 0.05) and an increase in the mean of the standard deviations of RR intervals (p < 0.05). Significant between-group differences were observed for mean heart rate and mean of RR intervals (p < 0.05). Frequency-domain measures also improved significantly from baseline in the intervention group. Outlier patterns suggest potential subgroup effects, possibly due to underlying dysautonomia. Conclusions: A single session of osteopathic treatment significantly enhanced short-term heart rate variability in long COVID patients with fatigue. These findings highlight the potential role of manual autonomic modulation as a supportive therapy in long COVID management. Further research is needed to assess the long-term effects and optimal treatment frequency of osteopathic manipulative treatment in this population.
Related Topics
Concepts
Medicine
Coronavirus disease 2019 (COVID-19)
Randomized controlled trial
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
2019-20 coronavirus outbreak
Physical therapy
Internal medicine
Virology
Outbreak
Disease
Infectious disease (medical specialty)
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/jcm14176066
- https://www.mdpi.com/2077-0383/14/17/6066/pdf?version=1756352785
- OA Status
- gold
- References
- 41
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4413773164
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4413773164Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/jcm14176066Digital Object Identifier
- Title
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Acute Effects of Osteopathic Treatment in Long COVID-19 Patients with Fatigue Symptoms: A Randomized, Controlled TrialWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-08-27Full publication date if available
- Authors
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Ulrich M. Zissler, Tino Poehlmann, Rainer Gloeckl, Sami M Ibrahim, Kerstin Klupsch, Tessa Schneeberger, Inga Jarosch, Andreas Rembert KoczullaList of authors in order
- Landing page
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https://doi.org/10.3390/jcm14176066Publisher landing page
- PDF URL
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https://www.mdpi.com/2077-0383/14/17/6066/pdf?version=1756352785Direct link to full text PDF
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YesWhether a free full text is available
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-
goldOpen access status per OpenAlex
- OA URL
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https://www.mdpi.com/2077-0383/14/17/6066/pdf?version=1756352785Direct OA link when available
- Concepts
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Medicine, Coronavirus disease 2019 (COVID-19), Randomized controlled trial, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 2019-20 coronavirus outbreak, Physical therapy, Internal medicine, Virology, Outbreak, Disease, Infectious disease (medical specialty)Top concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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41Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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