Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study

Fatih Bagcier ¹ ,Sibel Kibar ² ,Deniz Evcik ³ ,Ayşegül Ketenci ⁴ ,Dilşad Sindel ⁴ ,Birkan Sonel Tur ⁵ ,Zeliha Ünlü ⁶ ,Canan Tıkız ⁶ ,Dilek Keskin ⁷ ,Alev Alp ⁸ ,Saime Ay ⁹ ,Burcu Yanık ¹⁰ ,Duygu Geler Külcü ¹¹ ,Merve Karakaş ¹² ,Fatma Gülçin Ural Nazlıkul ¹³ ,Kübra Neslihan Kurt Oktay ¹⁴ ,Meliha Kasapoğlu Aksoy ¹⁵ ,Gülin Fındıkoğlu ¹⁶ ,Filiz Eser ¹⁷ ,Arzu Atıcı ¹⁸ ,Ozan Volkan Yurdakul ¹⁹ ,Fatmanur Aybala Koçak ²⁰ ,Emine Eda Kurt ²¹ ,Yasemin Özkan ²² ,Şebnem Koldaş Doğan ²³ ,Tuba Erdem Sultanoğlu ²⁴ ,Banu Ordahan ²⁵ ,Ebru Karaca Umay ²⁶ ,Esma Demirhan ²⁷ ,Hanife Çağlar Yağcı ²⁸ ,Özlem Balbaloğlu ²⁹ ,Nihal Tezel ²⁶ ,Serap Satış ³⁰ ,Sevgi Atar ²⁷ ,Mazlum Serdar Akaltun ³¹

¹ Department of Physical Therapy and Rehabilitation, Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye
² Department of Physical Therapy and Rehabilitation, Private Medical Center, Ankara, Türkiye
³ Department of Physical Therapy and Rehabilitation, Güven Hospital, Ankara, Türkiye
⁴ Department of Physical Medicine and Rehabilitation, Istanbul University Faculty of Medicine, Istanbul, Türkiye
⁵ Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Türkiye
⁶ Department of Physical Medicine and Rehabilitation, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
⁷ Department of Physical Medicine and Rehabilitation, Kırıkkale University Faculty of Medicine, Kırıkkale, Türkiye
⁸ Department of Physical Medicine and Rehabilitation, Uludağ University Faculty of Medicine, Bursa, Türkiye
⁹ Department of Physical Medicine and Rehabilitation, Ufuk University Faculty of Medicine, Ankara, Türkiye
¹⁰ Department of Physical Therapy and Rehabilitation, Çankaya Hospital, Ankara, Türkiye
¹¹ Department of Physical Medicine and Rehabilitation, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
¹² Department of Physical Therapy and Rehabilitation, Urla State Hospital, Izmir, Türkiye
¹³ Department of Physical Medicine and Rehabilitation, Yıldırım Bayezid University Faculty of Medicine, Ankara, Türkiye
¹⁴ Department of Physical Medicine and Rehabilitation, Yeditepe University Faculty of Medicine, Istanbul, Türkiye
¹⁵ Department of Physical Therapy and Rehabilitation, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye
¹⁶ Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
¹⁷ Department of Physical Therapy and Rehabilitation, Ankara City Hospital, Ankara, Türkiye
¹⁸ Department of Physical Therapy and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Türkiye
¹⁹ Department of Physical Medicine and Rehabilitation, Bezmialem University Faculty of Medicine, Istanbul, Türkiye
²⁰ Department of Physical Medicine and Rehabilitation, Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
²¹ Department of Physical Medicine and Rehabilitation, Alaaddin Keykubat University Faculty of Medicine, Antalya, Türkiye
²² Department of Physical Medicine and Rehabilitation, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
²³ Department of Physical Therapy and Rehabilitation, Antalya Training and Research Hospital, Antalya, Türkiye
²⁴ Department of Physical Medicine and Rehabilitation, Düzce University Faculty of Medicine, Düzce, Türkiye
²⁵ Department of Physical Therapy and Rehabilitation, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
²⁶ Department of Physical Therapy and Rehabilitation, Dışkapı Training and Research Hospital, Ankara, Türkiye
²⁷ Department of Physical Therapy and Rehabilitation, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Türkiye
²⁸ Department of Physical Medicine and Rehabilitation, Medeniyet University Faculty of Medicine, Istanbul, Türkiye
²⁹ Department of Physical Medicine and Rehabilitation, Bozok University Faculty of Medicine, Yozgat, Türkiye
³⁰ Department of Physical Medicine and Rehabilitation, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
³¹ Department of Physical Medicine and Rehabilitation, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye DOI : 10.5606/tftrd.2022.10053 Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients.

Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS.

Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385).

Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS. Keywords : Chronic low back pain, coronavirus disease 2019 pandemic, fibromyalgia