Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention, 2022, Heald, Perrin et al

[Andy]

Abstract

Introduction
In the early days of the first global wave of the COVID-19 pandemic, the potential for a postviral syndrome to manifest following COVID-19 infection was first recognized. Here, we present an analysis of a case series of the first 20 patients’ data collected in clinical practice to evaluate the potential of a possible alternative treatment for Long COVID.

Methods
Face-to-face treatment sessions with Perrin technique practitioners occurred weekly involving effleurage/other manual articulatory techniques. The individuals being treated also undertook daily self-massage along with gentle mobility exercises. Patients recorded symptom severity using the self-report 54-item profile of fatigue-related states (PFRS) before and after treatment.

Results
The mean age of male patients was 41.8 years (range, 29–53 years), and for female patients, 39.3 years (range, 28–50 years). None of the participants had a prior diagnosis of chronic fatigue syndrome, and all were new attendees to the clinics at the time of initial assessment. The average number of treatment sessions was 9.7 in men and 9.4 in women. The reduction in PFRS scores was 45% in men and 52% in women. The highest subscale scores on average were for fatigue, with the lowest for somatic symptoms. All subscale scores showed, on average, a similar reduction of approximately 50% postintervention, with the reduction in score relating to a decrease in the severity of symptoms.

Conclusion
Our findings suggest that a specific manual lymphatic drainage intervention may help to reduce fatigue symptoms related to Long COVID. Perhaps preventing acute symptoms through early intervention.

Open access, https://journals.lww.com/cardiovasc...ucing_fatigue_related_symptoms_in_Long.3.aspx

 

[Trish]

We have looked at Perrin's research and his technique before for it's use in ME/CFS. The evidence is not there. He's an osteopath who developed a massage technique that he claims works.
https://www.s4me.info/threads/perrin-technique.8269/

 

[InitialConditions]

Once again, a totally meaningless study, because most of these patients will improve over time regardless of the intervention.

 

[InitialConditions]

 

[Hutan]

Patients seen by a qualified Perrin™ practitioner (osteopath or physiotherapist) were asked to complete the PFRS prior to entry (baseline) and again around 3 months after receiving a manual treatment protocol for fatigue-related to Long COVID. ...We asked practitioners to submit the patients’ completed questionnaires as anonymized data to RP by the end of January 2021.

The authors would like to thank the members of the Perrin Technique Practitioner Network who contributed anonymized patient data for inclusion in this analysis.

So, Perrin™ practitioners (who make a living providing this therapy) mailed in anonymised patient data? What could possibly go wrong?

 

[Hutan]

This isn't science. This is an advertisement.

Yes, the authors acknowledge that the study is uncontrolled and that it's exploratory, but that isn't enough. A study like this shouldn't be published because its flaws make it worthless.

So, what is this journal doing?

Cardiovascular Endocrinology & Metabolism publishes peer-reviewed research in vascular disease, endocrinology, diabetes and metabolism. Particular emphasis is placed on studies that illuminate the interaction between these disciplines and foster effective collaboration between cardiologists, endocrinologists and diabetologists.

The journal serves as a single resource for research and clinical communities specialising in cardiology, endocrinology, diabetology, and metabolism. High quality state-of-the-art reviews, invited editorials, and expert commentaries place original articles in context at the interface of basic and clinical research.

I can't see a way to make a comment on the study. But here are the contact details for the Editor. I think he has to be accountable if advertisements are published as science in his journal.
Editor-in-Chief
Prof. Andrew J. Krentz MB ChB, MD, FRCP, FFPM, FRSA
Institute for Cardiovascular & Metabolic Research, University of Reading, UK
Department of Population Heath Sciences, King’s College London, UK
cardiovascularendocrinology@gmail.com

 

[rvallee]

My favorite thing about papers like this is that according to the caricature invented for the biopsychosocial model, we should be all over this. "It drains the lymphatic system!" sounds medical and technical and biological and stuff. We should be gushing over this, or whatever. It validates the biologicals!

Whoever wrote to Leng saying we wouldn't care if the NICE guidelines were published without the evidence review is a twit who knows nothing about us or this disease. This is what happens when you build a caricature and can't figure out why it doesn't match with reality.

 

[InitialConditions]

This isn't science. This is an advertisement.

Yes, the authors acknowledge that the study is uncontrolled and that it's exploratory, but that isn't enough. A study like this shouldn't be published because its flaws make it worthless.

So, what is this journal doing?


I can't see a way to make a comment on the study. But here are the contact details for the Editor. I think he has to be accountable if advertisements are published as science in his journal.
Editor-in-Chief
Prof. Andrew J. Krentz MB ChB, MD, FRCP, FFPM, FRSA
Institute for Cardiovascular & Metabolic Research, University of Reading, UK
Department of Population Heath Sciences, King’s College London, UK
cardiovascularendocrinology@gmail.com

There's a lot of dodgy stuff going on. In the current issue of the journal there are 4 papers, and 3 are by the same author, Adrian Heald, who is lead author on this paper. I suspect Heald has a link to this journal and has suggested publication here.

And the Conflicts of Interest is a joke. No mention of Perrin's LTD company, his training and workshop of practitioners, his book sales, etc.

 

[InitialConditions]

Could we do a S4ME letter to editor and publisher?

 

[Trish]

One for @dave30th perhaps.

 

[InitialConditions]

One for @dave30th perhaps.

I thought that, but Perrin seems like small fry compared with the BPS lot. I have known about him for years and still can't decide if he has good intentions or not.

 

[Trish]

I expect his intentions are sincere, and he really believes in what he's doing and thinks he's being scientific. But he doesn't do science, he does advertising. That needs to be stopped. People shouldn't be persuaded into spending £450 on useless nonsense. And this is a journal facilitating that nonsense.

 

[Hutan]

Yes, I don't think Perrin is the problem here, or at least not the biggest one. It's the journal, and the people behind the journal, who are subverting science.
Here's another one of the papers coauthored by Adrian Heald:

Actiste diabetes management as a service innovation – impact on everyday life – Swedish patients experience assessed by validated MedTech20 questionnaire

Heald, Adrian Ha,b; Malm, Elisabethc; Darwiche, Ghassand; Putri, Adintyac; Zdravkovic, Draganc

There are no conflicts of interest declared.

Actiste is a system of devices and apps for diabetics - claiming to help them manage their illness.

https://actiste.com

Smart solutions for daily diabetes care.
Actiste devices and services are designed for daily diabetes management, with smart features aimed at helping to keep your blood glucose under control.

Find out which one is right for you.

Here's what the paper in the journal concluded:

Participants indicated poor ability for current SOC devices to remind them to take insulin (16%), identify missed doses (26%) and engage them in diabetes treatment (21%). In total 82% of patients would recommend the [Actiste Diabetes Management Service] approach to a relative/friend with insulin-treated T2DM.

Spotting the trend?