COVID-19 pandemic and exercising: a cross-sectional study with 1156 patients with fibromyalgia, 2021, Martins et al

SUMMARY

OBJECTIVE:
The aim of this study was to analyze the effects of pandemic in the exercising practice and impact of the disease in patients with Fibromyalgia.

METHODS:
This is a cross-sectional, Internet-based survey answered by 1156 individuals with Fibromyalgia diagnosis. Questions were on epidemiology, social distancing habits, and exercise practice before and after COVID-19 pandemic, including subtypes of exercises (for resistance, flexibility, balance, and strength). The Fibromyalgia Impact Questionnaire was applied.

RESULTS:
In the whole sample, 57.7% of individuals practiced exercises before pandemic; during pandemic, only 34.8% practiced and 39.6% left this practice. Among those taking quarantine (n=440), 52.9% used to do exercises prior to pandemic; in the pandemic, 28.1% (reduction of 53.2%). The median Fibromyalgia Impact Questionnaire among those who practiced exercises in the pandemic was 73.6 (61.1–83.2) and that among those who did not was 80.4 (71.9–86.9), with p<0.0001. The Fibromyalgia Impact Questionnaire did not change according to the type of physical exercise (p=0.27).

CONCLUSION:
A high proportion of patients with Fibromyalgia stopped exercising during COVID-19 pandemic; as a result, the impact of the disease during this period was worse among those not practicing exercises.

Open access, https://www.scielo.br/j/ramb/a/F8SpxD85TDtM4NGxfqwK3TL/?lang=en

 

Quotes from the paper.

"The obtained data on physical exercise neglecting during pandemic is alarming and deserves attention. Patients with FM are known to have low adherence to exercises under normal circumstances and our results showed that even before pandemic only half of them used to exercise11. During pandemic, another half of those who practiced exercise abandoned this routine.

Practicing exercises in public spaces favors social interaction, and this has also beneficial aspect in FM as those patients are prone to depression and anxiety11. Therefore, closing of gyms, sports clubs, and public spaces not only affects the physical conditioning but also aggravates the social isolation and its psychological repercussions."

"Therefore, until now, it cannot be said that there is evidence that one exercise is more efficient than another. Despite of this, the FIQ of those who practice any type of exercise was better than those not exercising. It is shown that they do influence pain, sleep, and general well-being, in addition to improving cardiovascular conditioning and overall morbidity and mortality16,17."

"This study has several limitations. It was based on information that the patients had a FM diagnosis and it was not possible to grade the amount of exercises done. Also, the FM tendency for pain catastrophizing, which is characterized as a negative psychosocial construction of the pain, may suffer influence of other aspects than changes in the physical exercising19. Quarantine brought stress, which is a precipitating factor for augmentation in the pain perception, and this may have resulted in a momentary distortion of the FIQ score19,20."

Naturally they don't seem to consider that those patients who are worse affected might be incapable of exercise, leading to the worse outcomes, rather than "pain catastrophizing".

 

If you ask questions about "practicing" or "doing" exercises, you cannot draw any valid conclusions about whether people "exercise".

 

I sure do love judgmental pseudoresearch that serves no purpose. It's really great knowing that while there is no funding for research in chronic illness, there is always funding for pseudoresearch made for the purpose of not doing any real research.

These people really should "characterize" fewer things. I have no idea why vague woo concepts that are "characterized" make any sense in scientific research. Because otherwise it would imply they genuinely have no idea what pain is. And frankly, yeah, this is definitely the case.

It's the superficiality of it that makes it so much worse. They build a strawman and even that is too deep for them, they then only take the most superficial overview of their imaginary model. This is anti-science, period. As in not just that it's not science, it's exactly how not to do science.

 

The FIQ and later revised of FIQ-R (fibromyalgia impact questionnaire) was developed at OHSC (univ of oregon health science center) by the group led by London-trained rheumatologist, Dr. Robert Bennett, recently deceased, a compassionate and excellent scientist/clinician who discovered the low growth hormone levels in people with fibromyalgia, among other things (low levels of GH because of alpha intrusion into sleep, people with FM did not have enough stage 4 sleep to secrete normal levels of GH).

He had over 5k FM patients in his Portland, Oregon university-based multi-disciplinary clinic and he and his team wrote invaluable research articles. I was lucky that he was actively researching fibro (his website is still up at www.myalgia.com) while I was first struggling with it in 1998 onward.

Here is the FIQ-R (the Brazilians used the FIQ, an earlier version):

https://www.pfizerpro.com/sites/def...315-01_fm_pain_and_function_checklist_fiq.pdf

My n=1 (anecdotal experience):
Just walking on my block briefly to see the sun or feel the wind on my face, hear some crows, get a feel for the sky, say hello to a neighbor, perhaps a conversation, seeing a dog, feeling my legs walk lifts my mood, makes me more part of the world.

I wish I lived next door to a natural setting because the effort (driving to a natural setting requires mental acuity i often don't have due to fatigue) needed and the fatigue or sensory overload result in "why did i bother doing that?" The beneficial effects on mood and pain are not as clear cut as the researchers keep telling us. Yes, sometimes. No, quite a lot of the time better off staying home doing the quiet stuff.

The FIQ or FIQ-R are really quite blunt instruments. They can't capture the nuances of the human being negociating mood/pain/a sense of self/etc.

And as for real exercise, since I am losing muscle mass (highly visible to me) and l like a fool with a new year's resolution or Ponce de Leon's search for the fountain of youth, I went on an uphill hike two days ago. I had omicron-cabin fever. It was much more strenuous on my legs than i have done in 8 years and I walked twice as long as I usually do. Two days later, I became angry, very angry for no apparent reason and stayed angry until it dawned on me that it must be the over-activity and I took a dose bit of muscle relaxant and it worked, I became calm.

So much for the panacea of exercise. And another thing: the subjects were not representative. A self-selected online (probably members of a FM associaton/support group).

And do you suppose that all the fears (after all Mr. Bolsonaro did not address the pandemic in a scientific manner) engendered by the pandemic, those fears and restrictions, the suffering of everyday Brazilians, the deaths: that is stress and stress leads to depression and stress leads to more pain and less sleep. Those are not lack of exercise effects.