Neuromuscular Rehabilitation for Balance and Gait Impairments in Long COVID Condition: A Randomized Controlled Trial

Abstract

Introduction: The World Health Organization (2026) defines ongoing/long COVID as Symptoms that persist beyond the initial infection phase, including cognitive difficulties like brain fog.
Current rehabilitation emphasizes integrated strategies targeting neuromuscular control and breathing–posture coordination. Dynamic Neuromuscular Stabilization, grounded in developmental kinesiology, addresses these mechanisms; however, evidence for its effectiveness remains limited. This RCT investigated the effectiveness of Dynamic Neuromuscular Stabilization (DNS) in people with post-COVID condition, focusing on improvement of balance and gait-related neuromuscular impairments.
Methodology: 58 participants with predefined criteria were allocated randomly to two groups (n = 29). Group A received conventional physiotherapy, while Group B received DNS exercises. Outcome measures included the Tinetti Balance and Gait Assessment score.
Result: The analysis was done using SPSS Software. Normality testing of data was checked by the Kolmogorov–Smirnov test, which supported the use of parametric statistical methods. A two-way RM- ANOVA was conducted to test both within-group effects across different time durations (baseline,3rd, and 6th Week) and between-group differences (control and experimental groups). When the assumption of sphericity was not met, appropriate corrections were applied, and Bonferroni-adjusted post-hoc analyses were used for pairwise comparisons. Results revealed a statistically significant time-by-group interaction and a pronounced main effect of time for balance outcomes, F(2,112) = 110.52, p < .001, reflecting continuous enhancement in Tinetti Balance Scores over the course of the intervention. Similarly, gait outcomes showed a significant main effect of time, F(2,112) = 124.82, p < .001, indicating progressive improvements across evaluation periods.
Conclusion: DNS significantly improves balance and gait problems over six weeks, supporting its effectiveness as a targeted physiotherapy neuromuscular rehabilitation intervention in long-term COVID.