UCL Centre for Neurorehabilitation Seminar: Professor Manoj Sivan
The stigma and disbelief in autonomic nervous system dysfunction in the rehabilitation of post-infection long-term conditions.
This event will take place in person from 17:30-19:00 with no online attendance option.
Please join us after the event for refreshments and networking.
Dysautonomia, or autonomic dysfunction, is a well-recognised phenomenon frequently observed in conditions associated with chronic fatigue—particularly in neurological disorders and long-term post-infectious syndromes such as Long COVID, ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), and Fibromyalgia. A defining feature of these conditions is post-exertional malaise, a key symptom of dysautonomia. This dysfunction plays a central role in both the development and persistence of symptoms in these long-term conditions.
Despite robust documentation in the scientific literature, significant stigma and scepticism still surround these syndromes.
In this interactive talk, we will explore diagnostic approaches for dysautonomia, including the NASA Lean Test, drawing on insights from our clinical experience and findings from the NIHR LOCOMOTION study. We will examine the adapted Autonomic Profile (aAP)—a home-based test co-developed with the UCL Autonomic Unit. We will also discuss the role of heart rate variability (HRV) as an indirect marker of autonomic dysfunction, with particular reference to the HEARTLOC study, which investigates HRV biofeedback using diaphragmatic breathing interventions.
Additionally, we will discuss medical and rehabilitation strategies for managing dysautonomia in the context of chronic fatigue and post-exertional malaise.
The goal of this session is to increase awareness of dysautonomia and advocate for compassionate, evidence-based care for those affected.
Manoj Sivan is a Clinical Professor and Honorary NHS Consultant in Physical and Rehabilitation Medicine in Leeds. He is the past President and current Research Chair of the British Society of Physical and Rehabilitation Medicine (BSPRM).
He ranks 135th globally in the field of "Rehabilitation" according to the 2024 Scopus scientist citation scores—placing him in the top 0.5% of researchers worldwide in this field. With over 250 peer-reviewed publications and more than 8,000 citations, his work includes contributions to leading journals such as The Lancet and The BMJ.
Over the past six years, he has secured more than £10 million in research funding from major organisations including the UK’s MRC, NIHR, EPSRC, and Australia's MRFF.
Professor Sivan is the Editor-in-Chief of both the SAGE journal Advances in Rehabilitation Science and Practice and the Oxford Handbook of Rehabilitation Medicine. He also holds the role of Clinical Research Lead at the UK’s National Rehabilitation Centre (NRC), and served as a WHO Consultant for COVID-19 rehabilitation in the European region during the pandemic.
His contributions to research and clinical care have been recognised through numerous prestigious awards, including:
- 2024 ISPRM Sidney Licht Lectureship Award
- 2022 George Burniston Oration/Medal for Rehabilitation Medicine (Australia)
- 2021 BMJ Clinical Leadership Award
- 2014 European Academy of Rehabilitation Medicine Prize
- 2014 Philip Nichols Research Prize for Rehabilitation