Heald, Adrian, Perrin, Raymond, Walther, Andreas et al. · Cardiovascular endocrinology & metabolism · 2022 · DOI
This small study looked at whether a hands-on technique called the Perrin technique—involving gentle massage and movement exercises—could help reduce fatigue in people with Long COVID. Twenty patients received weekly treatment sessions and did daily self-massage at home. On average, both men and women reported about 50% improvement in their fatigue-related symptoms after treatment. While these early results are encouraging, the study is too small to prove this treatment works for everyone.
Long COVID and ME/CFS share overlapping fatigue symptoms and post-viral etiology, making non-pharmacological interventions relevant to both populations. Early case series data can generate hypotheses for larger controlled trials and offer patients additional perspectives on symptom management approaches. This study contributes to the emerging literature exploring whether manual therapies targeting lymphatic function may benefit post-viral fatigue conditions.
This case series does not prove the Perrin technique is effective for Long COVID, as it lacks a control or comparison group—improvements could result from natural recovery, placebo effects, or increased activity and attention rather than the specific intervention. The small sample size (n=20) and patient self-reporting without blinding cannot establish causation. Results cannot be generalized to other Long COVID populations or ME/CFS patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Heald, Adrian, Perrin, Raymond, Walther, Andreas, Stedman, Mike, Hann, Mark, Mukherjee, Annice, et al. (2022). Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention.. Cardiovascular endocrinology & metabolism. https://doi.org/10.1097/XCE.0000000000000261
BibTeX
@article{mecfsatlas-heald-2022-reducing-fatigue,
author = {Heald, Adrian and Perrin, Raymond and Walther, Andreas and Stedman, Mike and Hann, Mark and Mukherjee, Annice and Riste, Lisa},
title = {Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention.},
journal = {Cardiovascular endocrinology & metabolism},
year = {2022},
doi = {10.1097/XCE.0000000000000261},
note = {PubMed: 35441129},
url = {https://www.mecfsatlas.com/evidence/heald-2022-reducing-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/heald-2022-reducing-fatigue
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