Efficacy of structured exercise & relaxation techniques in managing post-COVID paraspinal myalgia in manual labourers of Belagavi, Karnataka: A quasi-experimental study

Background & objectives This study compared the effectiveness of Progressive Muscle relaxation technique (PMRT) and Spinal Muscle Training (SMT) against Standard Neurosurgical Care (SNC) for the management of post-acute-COVID-19 syndrome (PACS)-associated paraspinal myalgia (PM), via changes in serum interleukin (IL)-17 and functional independence measured by Katz index of activities of daily living (ADL). Methods Male manual labourers aged 40-50 yr with PACS-associated PM were enrolled and allocated to the experimental group receiving PMRT and SMT and the control group receiving SNC delivered via telerehabilitation over 12 wk. IL-17 and ADL were measured pre- and post-intervention. Data analysis involved paired and unpaired t-tests, with a P value < 0.05 being statistically significant. Results There was a notable decrease in IL-17 in the experimental and control groups, from (31.13±3.68 pg/mL) to (18.96±2.56 pg/mL) and (31.05±4.24 pg/mL) to (28.89±4.58 pg/mL), respectively. The experimental group's ADL scores increased from 2.93±0.94 to 5.03±0.85, while the control improved from 2.5±1.13 to 3.53±1.04. The experimental intervention was supported by large effect sizes and statistically significant differences in IL-17 reduction and ADL improvement on inter-group comparisons. Interpretation & conclusions The combination of PMRT and SMT was significantly efficacious than SNC at lowering systemic inflammation and improving functional independence in PACS patients with PM. This study also highlighted the role of telerehabilitation in intervention delivery to socio-demographically limited populations. Future studies should investigate long-term effects and generalizability to larger populations.