Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain

Countries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions, including social and physical distancing measures, may disproportionately impact those living with chronic pain and require rapid adaptation to treatment and care strategies. Using an online methodology, we investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N = 431) relative to a healthy control group (N = 88). Data were collected during the most stringent period of lockdown in the United Kingdom (mid-April to early-May 2020). In accordance with the fear-avoidance model, we hypothesised lockdown-related increases in pain and psychological distress, which would be mediated by levels of pain catastrophising. Responses indicated that people with chronic pain perceived increased pain severity, compared to their estimation of typical pain levels prior to lockdown (p < .001). They were also more adversely affected by lockdown conditions compared to pain-free individuals, demonstrating greater self-perceived increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise (p ⩽ .001). Hierarchical regression analysis revealed that pain catastrophising was an important factor relating to the extent of self-perceived increases in pain severity during lockdown (β = .27, p < .001) and also mediated the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also related to perceptions of increased pain (β = .15, p < .001). Interestingly, levels of pain intensity (measured at two time points at pre and during lockdown) in a subgroup (N = 85) did not demonstrate a significant change. However, individuals in this subgroup still reported self-perceived pain increases during lockdown, which were also predicted by baseline levels of pain catastrophising. Overall, the findings indicate that people with chronic pain suffer adverse effects of lockdown including self-perceived increases in their pain. Remote pain management provision to target reduction of pain catastrophising and increase health behaviours including physical activity could be beneficial for this vulnerable population.

Download Full-text

Adverse effects of COVID-19 related lockdown on pain, physical activity and psychological wellbeing in people with chronic pain

10.1101/2020.06.04.20122564 ◽

2020 ◽

Cited By ~ 3

Author(s):

Nicholas Fallon ◽

Christopher Brown ◽

Hannah Twiddy ◽

Eleanor Brian ◽

Bernhard Frank ◽

...

Keyword(s):

Physical Activity ◽

Chronic Pain ◽

Adverse Effects ◽

Physical Exercise ◽

Online Survey ◽

Pain Catastrophizing ◽

Control Group ◽

The United Kingdom ◽

Healthy Control ◽

Pain Symptoms

AbstractCountries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions disproportionately impact those living with chronic pain, requiring adaptation to treatment and care strategies. We investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N = 431) relative to a healthy control group (N = 88) using an online survey. In accordance with the fear-avoidance model, we hypothesised increases in perceived pain and psychological distress that would be mediated by pain catastrophizing. Survey questions answered during the lockdown period, probing patients’ self-perceived changes retrospectively, revealed that people with chronic pain perceived increases in their pain severity compared to before lockdown. They were also more adversely affected by lockdown compared to pain-free individuals, demonstrating greater increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise. Pain catastrophizing was found to be an important factor in predicting the extent of self-perceived increases in pain, and accounted for the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also independently predicted perceptions of increased pain. Interestingly, actual changes in pain symptoms (measured at two time points at pre- and post-lockdown in a subgroup, N = 85) did not change significantly on average, but those reporting increases also demonstrated greater baseline levels of pain catastrophizing. Overall, the findings suggest that remote pain management provision to target reduction of catastrophizing and increases to physical activity could be beneficial for chronic pain patients in overcoming the adverse effects of lockdown.

Download Full-text

Physical activity coaching for adults with mobility limitations: protocol for the ComeBACK pragmatic hybrid effectiveness-implementation type 1 randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-034696 ◽

2020 ◽

Vol 10 (11) ◽

pp. e034696

Author(s):

Leanne Hassett ◽

Anne Tiedemann ◽

Rana S Hinman ◽

Maria Crotty ◽

Tammy Hoffmann ◽

...

Keyword(s):

Physical Activity ◽

Well Being ◽

Text Messages ◽

Waiting List ◽

Randomised Control Trial ◽

Control Group ◽

Mobility Limitations ◽

Intervention Package ◽

Motivational Resources

IntroductionMobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity for adults with self-reported mobility limitations. Both are based on behaviour change theories and involve tailored advice from physiotherapists.Methods and analysisThis pragmatic hybrid effectiveness-implementation type 1 randomised control trial (n=600) will be undertaken among adults with self-reported mobility limitations. It aims to estimate the effects on physical activity of: (1) an enhanced 6-month intervention package (one face-to-face physiotherapy assessment, tailored physical activity plan, physical activity phone coaching from a physiotherapist, informational/motivational resources and activity monitors) compared with a less intensive 6-month intervention package (single session of tailored phone advice from a physiotherapist, tailored physical activity plan, unidirectional text messages, informational/motivational resources); (2) the enhanced intervention package compared with no intervention (6-month waiting list control group); and (3) the less intensive intervention package compared with no intervention (waiting list control group). The primary outcome will be average steps per day, measured with the StepWatch Activity Monitor over a 1-week period, 6 months after randomisation. Secondary outcomes include other physical activity measures, measures of health and functioning, individualised mobility goal attainment, mental well-being, quality of life, rate of falls, health utilisation and intervention evaluation. The hybrid effectiveness-implementation design (type 1) will be used to enable the collection of secondary implementation outcomes at the same time as the primary effectiveness outcome. An economic analysis will estimate the cost-effectiveness and cost-utility of the interventions compared with no intervention and to each other.Ethics and disseminationEthical approval has been obtained by Sydney Local Health District, Royal Prince Alfred Zone. Dissemination will be via publications, conferences, newsletters, talks and meetings with health managers.Trial registration numberACTRN12618001983291.

Download Full-text

Effects of an 8-Week Yoga-Based Physical Exercise Intervention on Teachers’ Burnout

Sustainability ◽

10.3390/su13042104 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2104

Author(s):

Francesca Latino ◽

Stefania Cataldi ◽

Francesco Fischetti

Keyword(s):

Physical Exercise ◽

Exercise Intervention ◽

Maslach Burnout Inventory ◽

Well Being ◽

Emotional Awareness ◽

Body Awareness ◽

Control Group ◽

Professional Burnout ◽

Yoga Practice ◽

Professional Educators

The purpose of this quasi-experimental study was to investigate the efficacy of an 8-week yoga-based physical exercise program to improve mental and emotional well-being and consequently reduce burnout among teachers. We considered yoga because it is a discipline that enhances body awareness and encourages the contact with nature and the respect for every form of life, with a view to a more sustainable and greener global system. We recruited 40 professional educators (40–47 years), teachers in a public high school who reported perceiving signs of stress and emotional discomfort. We randomly assigned the 40 professional educators to either an experimental yoga practice (~60 min, twice a week) group (n = 20) or a control group (n = 20) that received a nonspecific training program (~60 min, twice a week). At baseline and after training we administered the Maslach Burnout Inventory: Educators Survey (MBI-ES) and the State Mindfulness Scale (SMS) to assess teachers’ perceived level of awareness and professional burnout. We found a significant Time × Group interaction for the MBI-ES and SMS, reflecting a meaningful experimental group improvement (p < 0.001). No significant pre–post changes were found in the control group. The results suggest that an 8-week yoga practice could aid teachers to achieve a greater body and emotional awareness and prevent professional burnout.

Download Full-text

The Covid-19 lockdown in the United Kingdom and subjective well-being: Have the self-employed suffered more due to hours and income reductions?

International Small Business Journal Researching Entrepreneurship ◽

10.1177/0266242620986763 ◽

2021 ◽

pp. 026624262098676 ◽

Cited By ~ 1

Author(s):

Wei Yue ◽

Marc Cowling

Keyword(s):

United Kingdom ◽

Rare Events ◽

Well Being ◽

The Self ◽

Subjective Well Being ◽

Data Set ◽

The United Kingdom ◽

Hours Of Work ◽

Period Data ◽

The Uk

It is well documented that the self-employed experience higher levels of happiness than waged employees even when their incomes are lower. Given the UK government’s asymmetric treatment of waged workers and the self-employed, we use a unique Covid-19 period data set which covers the months leading up to the March lockdown and the months just after to assess three aspects of the Covid-19 crisis on the self-employed: hours of work reductions, the associated income reductions and the effects of both on subjective well-being. Our findings show the large and disproportionate reductions in hours and income for the self-employed directly contributed to a deterioration in their levels of subjective well-being compared to waged workers. It appears that their resilience was broken when faced with the reality of dealing with rare events, particularly when the UK welfare support response was asymmetric and favouring waged employees.

Download Full-text

ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

Biochemistry and Cell Biology ◽

10.1139/bcb-2020-0073 ◽

2020 ◽

Author(s):

Janet Elizabeth Berrington ◽

William McGuire ◽

NIcholas David Embleton

Keyword(s):

United Kingdom ◽

Preterm Infants ◽

Late Onset ◽

Disease Onset ◽

Intervention Group ◽

Control Group ◽

Bovine Lactoferrin ◽

The United Kingdom ◽

Late Onset Sepsis ◽

The Uk

Previous studies suggested that supplemental bovine lactoferrin (BLF) given to preterm infants (<32 weeks gestation) may reduce late onset sepsis (LOS) and necrotising enterocolitis (NEC), but have been underpowered. The Enteral Lactoferrin in Neonates (ELFIN) study, performed in the United Kingdom (UK), aimed to further address this issue with a well powered double blinded placebo controlled trial of >2200 preterm infants. ELFIN did not demonstrate a reduction in LOS or NEC, or several other clinically important measures. 316 (29%) of 1093 infants in the intervention group developed late-onset sepsis versus 334 (31%) of 1089 in the control group with an adjusted risk ratio of 0·95 (95% CI 0·86–1·04; p=0· 233). Reasons for the differences in ELFIN trial results and other studies may include population differences, the routine use of antifungals in the UK, timing of administration of the lactoferrin in relation to disease onset, or specific properties of the lactoferrin used in different trials. Further exploration is being undertaken in the UK NIHR funded Mechanisms Affecting the Guts of Preterm Infants in Enteral feeding trials (MAGPIE) study, for which results should be available soon.

Download Full-text

Comparative Effects of Physical Exercise and Other Behavioral Interventions on Functional Status Outcomes in Mild Cognitive Impairment

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000485 ◽

2021 ◽

pp. 1-8

Author(s):

Anne L. Shandera-Ochsner ◽

Melanie J. Chandler ◽

Dona E. Locke ◽

Colleen T. Ball ◽

Julia E. Crook ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Physical Exercise ◽

Behavioral Interventions ◽

Functional Decline ◽

Well Being ◽

Control Group ◽

Lifestyle Modifications ◽

Clinical Dementia Rating ◽

Group Sessions

Abstract Objectives: Lifestyle modifications for those with mild cognitive impairment (MCI) may promote functional stability, lesson disease severity, and improve well-being outcomes such as quality of life. The current analysis of our larger comparative effectiveness study evaluated which specific combinations of lifestyle modifications offered as part of the Mayo Clinic Healthy Action to Benefit Independence in Thinking (HABIT) program contributed to the least functional decline in people with MCI (pwMCI) over 18 months. Methods: We undertook to compare evidence-based interventions with one another rather than to a no-treatment control group. The interventions were five behavioral treatments: computerized cognitive training (CCT), yoga, Memory Support System (MSS) training, peer support group (SG), and wellness education (WE), each delivered to both pwMCI and care partners, in a group-based program. To compare interventions, we randomly withheld one of the five HABIT® interventions in each of the group sessions. We conducted 24 group sessions with between 8 and 20 pwMCI–partner dyads in a session. Results: Withholding yoga led to the greatest declines in functional ability as measured by the Functional Activities Questionnaire and Clinical Dementia Rating. In addition, memory compensation (calendar) training and cognitive exercise appeared to have associations (moderate effect sizes) with better functional outcomes. Withholding SG or WE appeared to have little effect on functioning at 18 months. Conclusions: Overall, these results add to the growing literature that physical exercise can play a significant and lasting role in modifying outcomes in a host of medical conditions, including neurodegenerative diseases.

Download Full-text

Review of Barriers to Engaging Black and Minority Ethnic Groups in Physical Activity in the United Kingdom

Global Journal of Health Science ◽

10.5539/gjhs.v1n2p85 ◽

2009 ◽

Vol 1 (2) ◽

Cited By ~ 8

Author(s):

Sejlo Koshoedo ◽

Padam Simkhada ◽

Edwin Van. Teijlingen

Keyword(s):

Physical Activity ◽

United Kingdom ◽

Ethnic Groups ◽

The United Kingdom ◽

Minority Ethnic Groups ◽

Minority Ethnic

Download Full-text

Physical exercise during pregnancy and its influence in the type of birth

Einstein (São Paulo) ◽

10.1590/s1679-45082012000400003 ◽

2012 ◽

Vol 10 (4) ◽

pp. 409-414 ◽

Cited By ~ 3

Author(s):

Lílian Cristina da Silveira ◽

Conceição Aparecida de Mattos Segre

Keyword(s):

Physical Activity ◽

Physical Exercise ◽

Basic Education ◽

Exercise Program ◽

Regular Physical Activity ◽

Control Group ◽

Significance Level ◽

Vaginal Deliveries ◽

Significant Difference ◽

Primiparous Women

OBJECTIVE: To verify if medium intensity exercise performed during pregnancy can influence in the type of delivery, and to observe compliance to an exercise program among primiparous women with different levels of schooling. METHODS: A study carried out at the Centro de Incentivo ao Aleitamento Materno, in São Sebastiao (SP), between April 7, 2008, and April 14, 2009. A prospective study involving 66 primiparous women who were divided into two groups: an Exercise Group, engaged in regular physical activity during pregnancy, and the Control Group, that did not participate in regular physical activity during the same period. Significance level in this project was 5% (p=0.05). RESULTS: The group that did engage in regular exercise had a higher rate of vaginal deliveries, with a statistically significance difference evaluated by the χ² test (p=0.031). The pregnant women with the highest level of schooling showed greater compliance with the exercise program, with a statistically significant difference (p=0.01736). CONCLUSION: Physical exercise in primiparous women increased the chances of vaginal deliveries, and there was greater compliance with the exercise program among those with a higher level of schooling when compared to those with a basic education.

Download Full-text