Association of 24-h movement behaviors during Covid-19 pandemic with spinal musculoskeletal disorders in undergraduate students: a cross-sectional study

Background and Aims: Musculoskeletal disorders (MSD) are an important health problem, and the Covid-19 pandemic affected several lifestyle and health aspects worldwide, including moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB) and sleep time, which compose the 24-h movement guidelines (24-hMG). It is unclear whether meeting 24-hMG during pandemic have been associated with MSD in adult population and this study aimed to analyze the association of meeting 24-hMG with spinal MSD in undergraduate students during Covid-19 pandemic. Methods: A sample of 71 undergraduate students were assessed (24.0 ± 6.6 years, 52% of women). MVPA was assessed by accelerometer, while daily time of SB and sleep were assessed by questionnaires. Spinal MSD was assessed by the Nordic questionnaire. Logistic regression models analyzed the association of meeting 24-hMG (individually and combined) with MSD, independently of age, sex, and body mass index. Results: Spinal MSD affected 78.9% of sample. Only 11.3% of sample fully met the 24-hMG. Participants who did not meet both MVPA and SB guidelines were more likely to have MSD in low back (OR:3.45, p = 0.049) and spine (OR:3.78, p = 0.048) even after multiple adjustment. Otherwise, not meeting SB guideline was inversely associated with upper back MSD (OR:0.22, p = 0.012). Conclusion: Meeting 24-hMG during Covid-19 pandemic were differently associated with spinal MSD, where combination of MVPA and SB shows to be protective against MSD in low back and in spine. However, the determinants of association between meeting SB guideline and higher upper back MSD still needs to be investigated.