Role of structured exercise and relaxation techniques in managing post-COVID paraspinal myalgia

We would like to acknowledge the study titled, “Efficacy of structured exercise and relaxation techniques in managing post-COVID paraspinal myalgia in manual labourers of Belagavi, Karnataka: A quasi-experimental study,” published in the September 2025 issue of the Indian Journal of Medical Research.¹ The authors have made a commendable effort in investigating the effectiveness of interventions for back pain among manual labourers in Belagavi, Karnataka.

The study’s exploration of the efficacy of Progressive Muscle Relaxation Technique (PMRT) and Spinal Muscle Training (SMT) in managing paraspinal myalgia is highly commendable, as both techniques are well-recognised techniques to reduce muscle tension and improve muscular function, which are crucial factors in alleviating back pain related to paraspinal myalgia but still require further investigation for their specific applications.

The usage of the term ‘Efficacy’ in the title suggests that the trial mentioned is an explanatory trial, which helps in assessing whether the said intervention produces the expected result under ideal circumstances. Whereas the term that has been used in the objective and the abstract section is Effectiveness. Our understanding of the term effectiveness trial is a pragmatic trial that assesses the benefit of the intervention under real world clinical settings.^2,3 Again, the term ‘efficacious’ has been used in the conclusion section, thus in need of clarification. Also, the term paraspinal myalgia has been used by the author, which appreciates the amount of morbidity caused due to COVID-19, but that particular reference for term usage can be cited.

It is unclear whether this study was registered as a trial or not. Inclusion criteria specified that participants must have a confirmed history of COVID-19 infection to be eligible for the study, reinforcing the relevance of the sample to post-COVID paraspinal myalgia research. It would be useful to confirm whether the study utilized official online records for COVID-19 confirmation as it was made mandatory during the period. Additionally, clarification is needed on whether patients’ COVID-19 vaccination history and prior history of chronic back issues were considered during participant selection or analysis. These factors are critical for accurately interpreting outcomes, as unaccounted chronic conditions unrelated to post-COVID paraspinal myalgia could potentially confound the results leading to misinterpretation. Discussion mentions about telerehabilitation and its importance in overcoming rural socio-economic barriers. To align this with the results and methods, the study should have clearly described the background of study population, including socio-demographic characteristics. Explicitly mentioning these factors in methods or results sections provides the necessary context to support the statement made in the discussion about telerehabilitation’s key role in ensuring supervised rehabilitation and adherence beyond these barriers.

While the study duration is currently reported as starting from November, it should be noted that recruitment actually began in October 2023. It is more precise to state that the intervention period spanned from November to January. Additionally, the recruitment process can be better explained by specifying that out of 127 individuals screened, 60 participants were ultimately enrolled.