Long Haulers, Vocal Fatigue and Respiration: An Interdisciplinary Manual Therapy Approach

Coronavirus disease (COVID-19) is an infectious disease that is caused by the SARS-CoV-2 virus and is spread by respiratory droplets and small aerosols when a person coughs, breathes, or speaks. A subset of patients who recovered from the acute phase of COVID-19 reported persistent symptoms. These patients have been classified as suffering from PASC (Post-Acute Sequelae of SARS-CoV-2 infection) or “long COVID,” with the patients often being referred to as “long haulers.”

The purpose of the research was to determine the efficacy of a collaborative physical therapy and speech therapy intervention via telehealth on COVID-19 “long haulers.” These individuals complained of overall fatigue, breathlessness with activities of daily living, and vocal fatigue.

While there is research supporting the benefit of an interdisciplinary approach to therapy, little is known about the benefits of a combination of physical and speech therapy in addressing vocal fatigue related to COVID symptoms.

We followed a non-randomized controlled AB single-subject research design, where patients’ baseline measurements were compared to those after a 4-week treatment period of self manual stretching of the diaphragm, rib cage, and thoracic and cervical spine.

Overall, positive outcomes were seen with the pulse oximeter readings and modified Borg scale readings after the four-week treatment course of exercises and self manual techniques. It is hoped that this study will inform practitioners of this interdisciplinary approach to mitigate some of the effects of COVID-19 on “long haulers”.

Keywords: Long COVID; Long-haulers; Vocal fatigue; Voice; Diaphragm; Physical therapy; Speech therapy; SARS-CoV-2; Exercise; Telerehabilitation