Influence of the COVID-19 pandemic on sleep quality, psychosocial aspects, and physical activity levels in patients with chronic pain in Brazil: COVIDor cross-sectional study
Influência da pandemia de COVID-19 na qualidade do sono, em aspectos psicoemocionais e no nível de atividade física de pacientes com dor crônica no Brasil: estudo observacional COVIDor
Thaís Alves Barreto Pereira; Annanda Oliveira Santos; Akeline Santos de Almeida; Maria Ivone Oliveira Dantas; Josimari Melo DeSantana
Abstract
BACKGROUND AND OBJECTIVES: The social distancing of COVID-19 pandemic exacerbated symptoms of chronic pain patients. Furthermore, it is necessary to consider the sociocultural context of coping with the pandemic in different countries. The objective of this study was to evaluate pain, psychoemotional symptoms, sleep quality, and level of physical activity in chronic pain patients during the COVID-19 pandemic in Brazil.
METHODS: Individuals with fibromyalgia, migraine and chronic low back pain were included. The survey was performed through a questionnaire elaborated by researchers on the Forms application, from Google Drive, in the period between October 2020 and March 2021, with straight and clear questions about pain, psychoemotional aspects, sleep quality, and level of physical activity. Binary or multinominal logistic regression analysis was performed to identify possible predictors.
RESULTS: 973 people were evaluated, 63.5% had fibromyalgia, and 98.3% were female. Anxiety increased the odds ratio in 395% of chronic pain patients to feel pain (ß: 1.375; OR: 3.956; p=0.001) and a greater intensity of pain increases in 62.3% the chance of these individuals not performing physical activity (ß: -0.474; OR: 0.623; p=0.001). Pain intensity increased the odds ratio of having insomnia by 186.9% (ß: 0.625; OR: 1.869; p=0.001) and the chance of taking sleep drugs by 160.4% (ß: 0.472; OR: 1.604; p=0.001).
CONCLUSION: The social isolation of COVID-19 pandemic maximized the vicious cycle between painful symptoms, anxiety, and sleep disorders in chronic pain patients in Brazil. The intensification of these factors is associated with the reduction of physical activity levels.
Keywords
Resumo
BACKGROUND AND OBJECTIVES: The social distancing of COVID-19 pandemic exacerbated symptoms of chronic pain patients. Furthermore, it is necessary to consider the sociocultural context of coping with the pandemic in different countries. The objective of this study was to evaluate pain, psychoemotional symptoms, sleep quality, and level of physical activity in chronic pain patients during the COVID-19 pandemic in Brazil.
METHODS: Individuals with fibromyalgia, migraine and chronic low back pain were included. The survey was performed through a questionnaire elaborated by researchers on the Forms application, from Google Drive, in the period between October 2020 and March 2021, with straight and clear questions about pain, psychoemotional aspects, sleep quality, and level of physical activity. Binary or multinominal logistic regression analysis was performed to identify possible predictors.
RESULTS: 973 people were evaluated, 63.5% had fibromyalgia, and 98.3% were female. Anxiety increased the odds ratio in 395% of chronic pain patients to feel pain (ß: 1.375; OR: 3.956; p= 0.001) and a greater intensity of pain increases in 62.3% the chance of these individuals not performing physical activity (ß: -0.474; OR: 0.623; p=0.001). Pain intensity increased the odds ratio of having insomnia by 186.9% (ß: 0.625; OR: 1.869; p=0.001) and the chance of taking sleep drugs by 160.4% (ß: 0.472; OR: 1.604; p=0.001).
CONCLUSION: The social isolation of COVID-19 pandemic maximized the vicious cycle between painful symptoms, anxiety, and sleep disorders in chronic pain patients in Brazil. The intensification of these factors is associated with the reduction of physical activity levels.
Palavras-chave
Referências
1 World Health Organization. (2022). WHO Coronavirus Disease (COVID-19) Dashboard.
2 Williams SN, Armitage CJ, Tampe T, Dienes K. Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK-based focus group study. BMJ Open. 2020;10(7):e039334.
3 COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700-12.
4 Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: knowledge in progress. Diabetes Res Clin Pract. 2020;162:108142.
5 Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: the need for prevention and early intervention. JAMA Intern Med. 2020;180(6):817-8.
6 Al-Hashel JY, Abokalawa F, Alenzi M, Alroughani R, Ahmed SF. Coronavirus disease-19 and headache; impact on pre-existing and characteristics of de novo: a cross-sectional study. J Headache Pain. 2021;22(1):97.
7 Shanthanna H, Nelson AM, Kissoon N, Narouze S. The COVID-19 pandemic and its consequences for chronic pain: a narrative review. Anaesthesia. 2022;77(9):1039-50.
8 Schroeder HT, Cavalheiro JCA, Martins ETJ, Bock PM. Cross-sectional evaluation of socioeconomic and clinical factors and the impact of fibromyalgia on the quality of life of patients during the COVID-19 pandemic. Sao Paulo Med J. 2022;141(2):138-45.
9 Saladino V, Algeri D, Auriemma V. The Psychological and Social Impact of Covid-19: New Perspectives of Well-Being. Front Psychol. 2020;11:577684.
10 Mun CJ, Campbell CM, McGill LS, Aaron RV. The Early Impact of COVID-19 on Chronic Pain: A Cross-Sectional Investigation of a Large Online Sample of Individuals with Chronic Pain in the United States, April to May, 2020. Pain Med. 2021;22(2):470-80
11 Hruschak V, Flowers KM, Azizoddin DR, Jamison RN, Edwards RR, Schreiber KL. Cross-sectional study of psychosocial and pain-related variables among patients with chronic pain during a time of social distancing imposed by the coronavirus disease 2019 pandemic. Pain. 2021;162(2):619-29.
12 Dassieu L, Pagé MG, Lacasse A, Laflamme M, Perron V, Janelle-Montcalm A, Hudspith M, Moor G, Sutton K, Thompson JM, Choinière M. Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study. Int J Equity Health. 2021;20(1):147.
13 DeSantana JM. What about patients with pain during and after the COVID-19 pandemic? BrJP. São Paulo, 2020;3(3):292-3
14 Fallon N, Brown C, Twiddy H, Brian E, Frank B, Nurmikko T, Stancak A. Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain. Br J Pain. 2021;15(3):357-68.
15 Hammami A, Harrabi B, Mohr M, Krustrup P. Physical activity and coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training. Managing Sport Leisure. 2022;(1/2):30-5.
16 Miller MB, Roumanis MJ, Kakinami L, Dover GC. Chronic Pain patients’ kinesiophobia and catastrophizing are associated with activity intensity at different times of the day. J Pain Res. 2020;13:273-84.
17 Larsson C, Ekvall Hansson E, Sundquist K, Jakobsson U. Impact of pain characteristics and fear-avoidance beliefs on physical activity levels among older adults with chronic pain: a population-based, longitudinal study. BMC Geriatr. 2016;24;16:50.
18 Xiong Y, Weng X, Snyder B, Ma L, Cong M, Miller EL, Van Scoy LJ, Lennon RP. Perceptions and knowledge regarding the COVID-19 pandemic between U.S. and China: a mixed methods study. Global Health. 2022;18(1):76.
19 Szwarcwald CL, Souza Júnior PRB. Malta DC, Barros MBA, Magalhães AFM, Xavier DR, Saldanha RF, Damacena GN, Azevedo LO, Lima MG, Romero D, Machado IE, Gomes CS, Werneck AO, Silva DRP, Gracie R, Pina MF. Adesão às medidas de restrição de contato físico e disseminação da COVID-19 no Brasil. Epidemiol Serv Saúde. 2020;29(5):e2020432.
20 Baqui P, Bica I, Marra V, Ercole A, van der Schaar M. Ethnic and regional variations in hospital mortality from COVID-19 in Brazil: a cross-sectional observational study. Lancet Glob Health. 2020;8(8):e1018-e1026.
21 Martins-Filho PR, de Souza Araújo AA, Quintans-Júnior LJ, Santos VS. COVID-19 fatality rates related to social inequality in Northeast Brazil: a neighbourhood-level analysis. J Travel Med. 2020;27(7):taaa128.
22 Rodrigues-de-Souza DP, Palacios-Ceña D, Moro-Gutiérrez L, Camargo PR, Salvini TF, Alburquerque-Sendín F. Socio-cultural factors and experience of chronic low back pain: a spanish and brazilian patients’ perspective. A qualitative study. PLoS One. 2016;11(7):e0159554.
23 Yoshikawa K, Brady B, Perry MA, Devan H. Sociocultural factors influencing physiotherapy management in culturally and linguistically diverse people with persistent pain: a scoping review. Physiotherapy. 2020;107:292-305.
24 Pereira TAB, Santos AO, Almeida AS, Dantas MIO, Desantana JM. Physical inactivity predisposes worst pain, anxiety, and sleep quality in chronic pain during COVID-19 pandemic : COVID-or survey study. Res Soc Dev. 2022;11(16):1-12.
25 Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27(1):117-26.
26 Sonza A, da Cunha de Sá-Caputo D, Sartorio A, Tamini S, Seixas A, Sanudo B, Süßenbach J, Provenza MM, Xavier VL, Taiar R, Bernardo-Filho M. COVID-19 Lockdown and the behavior change on physical exercise, pain and psychological well-being: an international multicentric study. Int J Environ Res Public Health. 2021;18(7):3810.
27 Yamada K, Wakaizumi K, Kubota Y, Murayama H, Tabuchi T. Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan. Sci Rep. 2021;11(1):18643.
28 Pires LN, Carvalho L, Xavier LL. COVID-19 e desigualdade: a distribuição dos fatores de risco no Brasil.
29 Bradley LA. Pathophysiology of fbromyalgia. Am J Med. 2009;122:1-13.
30 De Ridder D, Adhia D, Vanneste S. The anatomy of pain and suffering in the brain and its clinical implications. Neurosci Biobehav Rev. 2021;130:125-46.
31 Fioratti I, Fernandes LG, Reis FJ, Saragiotto BT. Strategies for a safe and assertive telerehabilitation practice. Braz J Phys Ther. 2021;25(2):113-6.
32 Palazzo C, Klinger E, Dorner V, Kadri A, Thierry O, Boumenir Y, Martin W, Poiraudeau S, Ville I. Barriers to home-based exercise program adherence with chronic low back pain: patient expectations regarding new technologies. Ann Phys Rehabil Med. 2016;59(2):107-13.
33 Dhondt E, Van Oosterwijck J, Cagnie B, Adnan R, Schouppe S, Van Akeleyen J, Logghe T, Danneels L. Predicting treatment adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain. J Back Musculoskelet Rehabil. 2020;33(2):277-93.
34 Sun Y, Laksono I, Selvanathan J, Saripella A, Nagappa M, Pham C, Englesakis M, Peng P, Morin CM, Chung F. Prevalence of sleep disturbances in patients with chronic non-cancer pain: A systematic review and meta-analysis. Sleep Med Rev. 2021;57:101467.
35 Juan W, Rui L, Wei-Wen Z. Chronic neck pain and depression: the mediating role of sleep quality and exercise. Psychol Health Med. 2020;25(8):1029-35.
36 Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205-16.
37 Xie Y, Liu S, Chen XJ, Yu HH, Yang Y, Wang W. Effects of exercise on sleep quality and insomnia in adults: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12:664499.
38 Xie Y, Liu S, Chen XJ, Yu HH, Yang Y, Wang W. Effects of exercise on sleep quality and insomnia in adults: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12:664499.
39 Estévez-López F, Maestre-Cascales C, Russell D, Álvarez-Gallardo IC, Rodriguez-Ayllon M, Hughes CM, Davison GW, Sañudo B, McVeigh JG. Effectiveness of exercise on fatigue and sleep quality in fibromyalgia: a systematic review and meta-analysis of randomized trials. Arch Phys Med Rehabil. 2021;102(4):752-61.
40 Sluka KA, Frey-Law L, Hoeger Bement M. Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain. 2018;159(Suppl 1):S91-S97.
41 Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;1(1):CD011279.
42 Larsson C, Ekvall Hansson E, Sundquist K, Jakobsson U. Impact of pain characteristics and fear-avoidance beliefs on physical activity levels among older adults with chronic pain: a population-based, longitudinal study. BMC Geriatr. 2016;24;16:50.
43 Boutevillain L, Dupeyron A, Rouch C, Richard E, Coudeyre E. Facilitators and barriers to physical activity in people with chronic low back pain: A qualitative study. PLoS One. 2017;12(7):e0179826.
44 Mathieu E, Ritchie R, Rodés-Guirao L, Appel C, Giattino C, Hasell J, Macdonald B, Dattani S, Beltekian B. Coronavirus Pandemic (COVID-19). Published online at OurWorldInData.org.
Submetido em:
06/05/2023
Aceito em:
26/10/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
Email