Has the COVID-19 outbreak altered the prevalence of low back pain among physiotherapy students?

Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study

BACKGROUND

The vast majority of people have experienced the problem of back pain at least once in their lives for a variety of reasons. It is well known that regular physical activity at a moderate level has a number of health benefits regardless of age or gender with positive effects on the musculoskeletal, cardiovascular, respiratory or nervous systems improving fitness levels. During the pandemic, Poland experienced one of the longest periods of school lockdown in Europe. In Portugal, this period was considerably shorter. The aim of this study was to determine the level of physical activity and back pain as well as relationship between physical activity and back pain in a group of Polish and Portuguese students in the following year the COVID-19 pandemic.

METHODS

The study was conducted via the Internet among students from Poland and Portugal (398 respondents - 229 from Poland and 169 from Portugal) in October 2022. In the pilot study, the International Physical Activity Questionnaire and The Oswestry Disability Index and Neck Disability Index questionnaires were used to assess the level of back pain.

RESULTS

There are no statistically significant differences in the level of physical activity and pain complaints of respondents from the two countries. At least half of the students do not report any pain complaints (median in some groups being 0). In the Portuguese men, there is a correlation between the level of physical activity and the Neck Disability Index score (p = 0.0304).

CONCLUSIONS

The following year, after the pandemic COVID-19 was declared, the prevalence of back pain among students in Poland and Portugal is still significant.

Long COVID Symptoms vs. Back Pain and Physical Activity among Students in Poland-Cross-Sectional Study

BACKGROUND

Back pain (BP) is a common condition that affects people of all ages. Moderate- and vigorous-intensity physical activity (PA) is a key element in maintaining health. The purpose of this research was to determine the level of physical activity and back pain (BP) in students with long COVID symptoms and to determine the relationship between the level of PA and BP in students with and without long COVID.

METHODS

A survey was carried out among 402 students from Poland. The inclusion criteria were as follows: student status, age of over 18 years, history of COVID-19, and consent to participate in the study. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of PA. The Oswestry Disability Index (ODI) and the Neck Disability Index (NDI) were used to assess BP.

RESULTS

We found that at least half of the students surveyed did not experience any lumbosacral or cervical spine pain. The authors found no association between the level of PA in women and a history of long COVID symptoms, while there were statistically significant differences in intense PA in men (p = 0.0263), with those who did not report long COVID symptoms being more active. With regard to cervical and lumbar spine pain complaints, in our study, these were statistically significantly stronger in students who were observed to have long COVID symptoms. The difference was not significant only for lumbosacral complaints among men. No strong correlations were found between PA level and the severity of BP.

CONCLUSION

Additional investigation is required to comprehend the complex interaction between long COVID symptoms and levels of PA and BP. Special attention should be paid to the prevention of back pain mainly in the COVID-19 group of students.

Low Back Pain Prevalence among Distance Learning Students

Background: Low back pain as a symptom affects many individuals around the globe regardless of their economic status or sociodemographic characteristics. During the 2019 COVID-19 pandemic, students found themselves obligated to sit down for long periods of time. The aim of this current study is to investigate the impact of these prolonged periods of sitting down in front of computers on developing a new episode of low back pain. Methods and Materials: This research adopted an observational cross-section study design. Students who are currently enrolled or had experienced distance learning classes in the last 6 months were eligible to participate. An online-based questionnaire was developed by the investigators through reviewing the literature with relevant objectives. McNemar’s test was used to compare certain variables between two periods before and during online distance learning. We used paired t-tests to compare pain intensity before, during, and after online learning, while a chi-square test was used to investigate correlations between factors influencing low back pain. Results: A total of 84 students participated in the study—46 (54.8%) females and 38 (45.2%) males. Before online distance learning, only 42.9% of participants reported low back pain, while only 20% had a back injury. The mean pain scores before, during, and after online distance learning were (2.85 ± 2.16, 4.79 ± 2.6, and 4.76 ± 2.7), respectively. The pain scores before online learning were significantly lower than pain scores during and after online distance learning (p < 0.05), respectively. Conclusion: The study findings suggested that low back pain prevalence increased among students during the COVID-19 pandemic. Future research should study participants’ behavior during the online learning and assess the long-run impact of distance learning among high-school and undergraduate students.

COVID-19 Pandemic Increases the Impact of Low Back Pain: A Systematic Review and Metanalysis

In March 2019, the World Health Organization (WHO) recognized the COVID-19 pandemic as a global issue. To reduce the spread of this disease, health safety pathways were implemented worldwide. These extraordinary measures changed people's lifestyles, e.g., by being forced to isolate, and in many cases, to work remotely from home. Low back pain (LBP), the most common cause of disability worldwide, is often a symptom of COVID-19. Moreover, it is often associated with different lifestyle features (type of job, physical activity, body weight). Therefore, the purpose of this systematic review and meta-analysis was to estimate the effect of the COVID-19 lockdown on LBP intensity and prevalence compared with LBP rates before the pandemic. A systematic search was performed on Scopus, PubMed, and Cochrane Central. Overall, eight studies with 2365 patients were included in the analysis. We used the Joanna Briggs Institute (JBI) critical appraisal tool to evaluate the risk of bias: six studies (75%) were at moderate risk of bias and two studies (25%) were at low risk of bias. These studies showed an increase in both the prevalence and intensity of LBP during the COVID-19 lockdown.

Association between Psychological Stress and Neck Pain among College Students during the Coronavirus Disease of 2019 Pandemic: A Questionnaire-Based Cross-Sectional Study

The coronavirus disease of 2019 (COVID-19) greatly affected people’s lifestyles. We used an online, cross-sectional survey during a COVID-19-related lockdown in Israel, with the aim of investigating the effects of such lockdowns on students’ self-perceived stress and neck pain (NP). College students (N = 295) completed questions on sociodemographic characteristics, the Neck Disability Index (NDI), the Perceived Stress Scale, the Visual Analogue Scale (VAS), and NP frequency (four-point scale). Logistic regression models were calculated with the NDI as the dependent variable. In total, 35.6% of students experienced at least moderate NP-related disability (NDI ≥ 15), more during than before the lockdown. NP increased gradually, from a lifetime mean of 1.80 to a lockdown mean of 3.07 (χ² = 316.72; p < 0.001). Students’ self-perceived stress was moderate, and 59.3% reported experiencing study-related stress. Higher levels of self-perceived stress, study-related stress, sitting >3 h/day, and a higher VAS score were associated with a higher risk of an NDI ≥ 15 (Nagelkerke’s R² = 0.513, p < 0.001). The transition from on-campus to online learning seems to have exacerbated students’ NP, which was correlated to their study stress and lifestyles. These findings advocate for the need to promote the physical and mental health of students via e.g., mental health services and occupational and ergonomic consulting services.