Researchers in Sweden tracked 816 massage therapists and other hands-on healthcare workers for a year during the COVID-19 pandemic to see how the crisis affected their health and daily habits. They found that while these therapists generally maintained healthy lifestyles, they did move around less and spend more time sitting. Many also reported feeling worried and stressed about the pandemic. However, the good news is that most therapists actively worked to stay healthy by exercising, eating well, and getting better sleep. Overall, these healthcare workers showed they cared about their wellbeing even during challenging times.

The Quick Take

  • What they studied: How the COVID-19 pandemic changed the health habits and stress levels of manual therapists (people who do massage, chiropractic work, and similar hands-on treatments) in Sweden over one year
  • Who participated: 816 Swedish manual therapists who were actively working. The group included people of different ages and both men and women, with some working alone and others in clinics with colleagues
  • Key finding: Manual therapists moved around less and sat more during the pandemic year, and many felt stressed about COVID-19. However, they drank less alcohol and smoked less, and most actively tried to stay healthy through exercise, good food, and better sleep
  • What it means for you: If you’re a healthcare worker or anyone dealing with pandemic stress, this shows that staying active and focusing on healthy habits like sleep and nutrition can help you feel better. The therapists’ approach of intentionally working on their health is a good model to follow, though it’s normal to feel some stress during difficult times

The Research Details

This was a cohort study, which means researchers followed the same group of people over time to track changes. The 816 Swedish manual therapists filled out online surveys throughout one year of the COVID-19 pandemic. The surveys asked about how much they exercised, how much time they spent sitting, their stress and worry levels, how they coped with stress, and whether they smoked or drank alcohol. At the end, therapists also answered open-ended questions about how the pandemic affected their health and what they did to stay healthy.

Researchers used two main analysis methods: First, they used statistical tools to track how the group’s average answers changed over the year. Second, they carefully read through the written answers therapists gave and organized them into themes and patterns to understand their health strategies.

This approach is valuable because it captures both numbers (like how much physical activity decreased) and personal stories (like what specific health strategies people used), giving a complete picture of how the pandemic affected these workers.

Following the same people over time helps researchers see real changes that happen during stressful events like a pandemic. By including both measurements and personal stories, the study captures what actually matters to people’s lives, not just statistics. This is especially important for healthcare workers like manual therapists, who often help others but may neglect their own health during crises

This study is fairly reliable because it tracked a large group (816 people) over a full year, which is a good length of time to see real changes. The study was published in a respected journal (PLOS ONE) that requires careful review. However, the study only included Swedish therapists, so the results might be different in other countries. Also, people who were struggling more might have been less likely to fill out the surveys, which could make the results seem more positive than they actually are

What the Results Show

Over the year of the pandemic, manual therapists in Sweden moved around less than before. Their physical activity decreased, and they spent more time sitting down. This is similar to what happened to many people during lockdowns and pandemic restrictions. The therapists also reported that the pandemic affected their mental health and caused them worry and stress.

However, there was some good news: therapists’ unhealthy coping habits (like using alcohol or other substances to deal with stress) actually decreased over the year. Younger therapists drank less alcohol, and women therapists smoked less. These improvements suggest that people may have become more aware of their health during the pandemic.

When asked what they did to stay healthy, therapists reported focusing on three main areas: getting more physical activity, eating better, and improving their sleep. Many therapists seemed to take an active approach to protecting their health despite the pandemic stress.

The study found small differences between different groups of therapists. Younger therapists and women showed different patterns in alcohol and tobacco use compared to older therapists and men. However, these differences were very small and probably wouldn’t make a big difference in real life. Therapists working alone versus those working in clinics with others also showed slightly different patterns, but again, these differences were minor

This study fits with other research showing that many people became less active during the COVID-19 pandemic and spent more time sitting. The finding that therapists felt stressed and worried about the pandemic is also consistent with studies of other healthcare workers. However, the good news about decreased unhealthy coping and increased focus on health habits is encouraging and suggests that healthcare workers like manual therapists may be more resilient than expected

The study only looked at Swedish manual therapists, so we don’t know if the same patterns would happen in other countries with different pandemic responses. People who were struggling the most might not have answered the surveys, which could make the group seem healthier than it actually was. The study relied on people’s own reports about their habits, which might not always be completely accurate. Finally, the study didn’t compare these therapists to other types of workers, so we can’t say whether manual therapists were affected more or less than other groups

The Bottom Line

If you’re a healthcare worker or anyone dealing with stressful situations: (1) Try to maintain or increase physical activity, even if it’s just daily walks—this appears to be protective for both physical and mental health (moderate confidence); (2) Pay attention to sleep quality and nutrition, as these were the main strategies successful therapists used (moderate confidence); (3) Be aware of stress-related habits like increased drinking or smoking, and try to address stress in healthier ways (moderate confidence). These recommendations are based on what worked for the therapists in this study, but individual needs vary

This research is most relevant for healthcare workers, especially those in hands-on professions like massage therapy, physical therapy, and chiropractic care. It’s also valuable for anyone who experienced pandemic-related stress and wants to understand healthy coping strategies. People managing chronic stress or working in high-pressure jobs may find the therapists’ approach helpful. However, if you have specific health concerns or mental health struggles, you should talk to your doctor or mental health professional rather than relying only on these general findings

Changes in physical activity and stress levels can be felt within 2-4 weeks of making changes. Improvements in sleep quality often appear within 1-2 weeks. Mental health benefits from consistent exercise and good sleep habits typically become noticeable within 4-8 weeks. However, building lasting habits usually takes 2-3 months of consistent effort

Want to Apply This Research?

  • Track daily steps or minutes of moderate activity (like brisk walking) and daily sitting time in blocks. Set a goal of 150 minutes of activity per week and limit continuous sitting to no more than 60 minutes at a time. Log this weekly to see trends over a month
  • Use the app to set reminders for movement breaks every hour during work. Create a simple daily checklist for three health habits: (1) 30 minutes of activity, (2) 7-9 hours of sleep, (3) one nutritious meal. Track completion daily to build awareness and motivation
  • Review your activity and sitting patterns monthly. Notice correlations between your activity levels and how you feel mentally and physically. Set small, achievable goals each month (like adding 10 more minutes of activity or improving sleep by 30 minutes). Share progress with a friend or healthcare provider for accountability

This research describes what happened to Swedish manual therapists during the COVID-19 pandemic and should not be considered medical advice. If you’re experiencing significant stress, anxiety, depression, or other mental health concerns, please consult with a qualified healthcare provider or mental health professional. If you have questions about changing your exercise routine or diet, especially if you have existing health conditions, talk to your doctor first. This study provides general information about health patterns but cannot replace personalized medical guidance for your individual situation