key: cord-0850210-sxauctkr authors: Kalia, Varun title: Effect of gentle exercises on injection site reaction after Covid-19 vaccination. A case report date: 2021-09-29 journal: J Bodyw Mov Ther DOI: 10.1016/j.jbmt.2021.09.010 sha: 05e7c88d5efefd843ae99ef2abfa8009858195bd doc_id: 850210 cord_uid: sxauctkr INTRODUCTION: A series of atypical acute respiratory diseases were caused in Wuhan, China in December 2019 by a novel coronavirus (COVID-19). Over six million confirmed COVID-19 cases have been reported worldwide and total deaths in the USA from 1 March to 30 May 2020 were approximately 7,81,000. Worldwide scientists are developing many potential COVID-19 vaccines. Few of the companies got success in the development of a vaccine for COVID-19 but most of the recipients reported injection site reactions like pain, redness, or erythema after vaccination. The present study aimed to evaluate the effect of gentle upper limb exercises to reduce injection site reactions and here we present a case with post vaccination site reaction that reported pre-assessment score 7 for visual analog scale for pain and score 2 for redness and erythema with Investigator-reported and rated injection site reactions. Then he performed gentle upper limb exercises after 8 and 24 hours of vaccination. RESULT: The study reported a beneficial effect of these exercises to reduce pain and redness or erythema after Covid-19 vaccination. DISCUSSION: The potential benefit of gentle exercises may be due to their blood flow boost-up and anti-inflammatory effects. However, high-quality controlled trials are warranted further to evaluate the potential benefit of upper limb gentle exercises for the reduction of injection site reactions after the Covid-19 vaccination injection. CONCLUSION: The clinical experience with the subect shows that gentle exercises for upper limb may reduce the inection site reaction after COVID-19 vaccination. A series of atypical acute respiratory diseases were caused in Wuhan, China in December 2019 by a novel coronavirus called SARS-CoV-2. The disease caused by this virus is termed Corona Virus . The virus is transmittable among humans by droplets and contact routes and has caused pandemics worldwide . Over six million confirmed cases have been reported worldwide and total deaths in the USA from 1 March to 30 May 2020 were approximately 7,81000 whereas in India, case positivity rate and a fatality rate were reported 6.5 and 2.8 percent respectively on July 3, 2020 . Worldwide scientists are developing many potential COVID-19 vaccines. These vaccines are intended to train the human immune system to safely identify and block the COVID-19 virus. AstraZeneca's vaccine reported 79% effectiveness to prevent symptomatic COVID-19 cases and 100% effective in stopping severe cases and hospitalization . Worldwide, 4.19 % and 1.63% population have been taken at least 1 st dose and fully vaccinated respectively and in India, 3.95% population received at least 1 st dose, and 0.66% population got fully vaccinated till 30 th March 2021. Whereas, post-vaccination responses of the human body reported in the literature like pain, redness, or erythema at the site of injection , and the present study reported the effects of gentle upper limb exercises to reduce injection pain and redness or erythema after COVID-19 vaccination. A 34-year-old male subject who is right-handed received a vaccination injection against COVID-19 on 31 March 2021 and at the time of vaccination, he was free from any symptom of COVID-19. Additionally, he was not having any pain or inflammation in his body. . The subject underwent post-treatment assessment and 1 st follow up assessment same as preassessment after 24 and 48 hours of injection respectively and he reported Visual analog scale score as 3 and 0 and Investigator-reported and rated injection site reactions score as 1 (mild) and 0 (absent) at post-treatment and 1 st follow-up assessment respectively. In the whole world, vaccination drive against COVID-19 is going-on on large scale, and most of the subjects reporting pain and redness or erythema post-vaccination on the injection site. The present case report is reporting the beneficial effect of gentle upper limb exercises to reduce pain and redness or erythema on injection site post-vaccination and this beneficial effect may be achieved because injection in deltoid induced microtrauma and results in the production of metabolic byproducts that can produce injection site reactions. Whereas, gentle exercises induce movements in the muscle fibers and increases blood flow to the affected muscle and remove the metabolic byproducts (chemicals) from the affected muscles and reduce pain, redness, or erythema . In addition, Dimitrova et al reported that active muscle contractions that occur with gentle movement may potentially disperse localized edema, or swelling, to some extent . So might be these are the reasons behind the beneficial effect of gentle upper limb exercises to reduce pain, redness, or erythema after COVID-19 vaccination injection. However, it is recommended for a high degree of controlled trials are necessary with the optimal sample size to evaluate the significant role of upper limb gentle exercises for the reduction of injection site reactions after the COVID 19 vaccination injection. The clinical experience with the subect shows that gentle exercises for upper limb may reduce the inection site reaction after COVID-19 vaccination. The authors have no relevant financial conflict of interest. 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