Chronobiology International

The Journal of Biological and Medical Rhythm Research

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Coronaphobia, musculoskeletal pain, and sleep

quality in stay-at home and continued-working
persons during the 3-month Covid-19 pandemic
lockdown in Turkey

Seyda Toprak Celenay, Yasemin Karaaslan, Oguzhan Mete & Derya Ozer
Kaya

To cite this article: Seyda Toprak Celenay, Yasemin Karaaslan, Oguzhan Mete & Derya Ozer
Kaya (2020) Coronaphobia, musculoskeletal pain, and sleep quality in stay-at home and continued-
working persons during the 3-month Covid-19 pandemic lockdown in Turkey, Chronobiology
International, 37:12, 1778-1785, DOI: 10.1080/07420528.2020.1815759

To link to this article: https://doi.org/10.1080/07420528.2020.1815759

Published online: 03 Sep 2020.

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CHRONOBIOLOGY INTERNATIONAL
2020, VOL. 37, NO. 12, 1778–1785
https://doi.org/10.1080/07420528.2020.1815759

Coronaphobia, musculoskeletal pain, and sleep quality in stay-at home and

continued-working persons during the 3-month Covid-19 pandemic lockdown in
Turkey
a b a c
Seyda Toprak Celenay , Yasemin Karaaslan , Oguzhan Mete , and Derya Ozer Kaya
a
Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey; bDepartment of
Physiotherapy and Rehabilitation, School of Health Sciences, Beykent University, Istanbul, Turkey; cHealth Sciences Faculty, Department of
Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey

ABSTRACT ARTICLE HISTORY

Studies related to the effects of the lockdown on musculoskeletal pain, coronaphobia, and sleep Received 11 August 2020
quality in individuals who stayed at home (SH) and in those who continued to work (CW) at Revised 19 August 2020
a workplace other than home during the Covid-19 pandemic are scarce. We compare the effects of Accepted 19 August 2020
a 3-month nationwide lockdown in Turkey on musculoskeletal pain, coronaphobia, and sleep quality KEYWORDS
in individuals who SH and in those who CW during the Covid-19 pandemic. Individuals who SH (n: COVID-19 pandemic; stay-at
375) and those who CW (n: 311) during the Covid-19 were included in this case-controlled study. Data home social isolation;
on musculoskeletal pain (Nordic Musculoskeletal Questionnaire, NMQ), coronaphobia (Covid-19 musculoskeletal pain; fear;
Phobia Scale, C19P-S), and sleep quality (Jenkins Sleep Scale, JSS) were collected via an online form. sleep
During the 3-month Covid-19 lockdown, low back pain was higher in the SH group than CW group
(p < .05). Rates of the neck, upper-back, shoulder, and hip/thigh pain were lower, and rate of low back
pain was higher in the SH group (p < .05); while, rates of the neck, upper back, shoulder, and elbow
pain were lower in the CW group (p < .05) during the Covid-19 pandemic lockdown than pre-
lockdown values. The total scores of the C19P-S and psychological, psychosomatic, social, and
economic subscales were higher in the SH group (p < .05). Sleep quality was similar in both groups
(p > .05). Individuals who SH had more low back pain and higher coronaphobia than individuals who
CW during the 3-month Covid-19 pandemic lockdown. Nonetheless, sleep quality was similar and the
rate of some types of musculoskeletal pain was lower in both groups.

Introduction were closed, and a permanent lockdown for the elderly

and/or with chronic illnesses was declared, which was
The coronavirus disease 2019 (Covid-19) originated in
followed by weekend curfews. Additionally, staying
Wuhan, China at the end of December 2019. It was
home, unless unfeasible, and working from home, if
recognized as a pandemic on 11 March 2020 by the
possible, were encouraged (Wikipedia 2020).
World Health Organization and it has been continuing
Staying at home, one of the coping strategies for con­
to spread out throughout the world ([WHO] World
trolling Covid-19 transmission, is an effective way to
Health Organization 2020a). As of the beginning of
prevent infection and reduce fatality (Fowler et al. 2020).
August 2020, the Covid-19 had affected about
Although voluntary or a compulsory stay-at-home strat­
18 million people worldwide and caused over 690,000
egy is quite effective for preventing Covid-19 exposure
deaths ([WHO] World Health Organization 2020b).
(Fowler et al. 2020), it may bring about problems, like
Since there is no exact cure or vaccine as yet for
physical inactivity, weight gain, behavioral addiction, and
Covid-19, preventive measures must be taken to reduce
social isolation (Lippi et al. 2020; Öztürk and Bayraktar
its transmission (Rothan and Byrareddy 2020; Sohrabi
2020). Previous studies have indicated that prolonged
et al. 2020). To control the spread of and exposure to
stay-at-home isolation may be associated with psycholo­
Covid-19, governments have responded to this pan­
gical disorders (Lippi et al. 2020), sleep disturbance
demic process with different nationwide lockdown stra­
(Mucci et al. 2020), and serious phobias (Asmundson
tegies (Gostin and Wiley 2020). In Turkey, in the
and Taylor 2020; Fallon et al. 2020).
beginning of March 2020, the government introduced
Alteration of musculoskeletal conditions and pain
several restrictions to prevent the transmission of
may also increase with physical inactivity (Holth et al.
Covid-19. First, schools and all public gathering places

CONTACT Seyda Toprak Celenay sydtoprak@hotmail.com Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim
Beyazit University, Ankara, Turkey
© 2020 Taylor & Francis Group, LLC

2008), and severity of psychological disorders
(McFarlane 2007), reduction in sleep quality, (Tüzün
2007), and development of phobias (Vlaeyen and
Linton 2000) may additionally occur. In an expert opi­
nion, it was emphasized that health risks, including
musculoskeletal disorders, may increase during pro­
longed Covid-19 lockdowns (Lippi et al. 2020). One
study found that pain severity in people with chronic
pain increased during the most stringent period of lock­
down compared to the pre-lockdown period (Fallon
et al. 2020). Even though musculoskeletal disorders
have been assessed in a few Covid-19 studies (Fallon
et al. 2020; Lippi et al. 2020), no study has compared
the effect of the lockdown on musculoskeletal pain com­
plaints, coronaphobia (fear of catching the current strain
of the human coronavirus Covid-19), and sleep quality
in individuals who stayed at home (SH) and in those
who continued to work (CW) at a workplace other than
home during the Covid-19 pandemic. Moreover, to the
best of our knowledge, this is the first case-controlled
study comparing musculoskeletal pain complaints, cor­
onaphobia, and sleep quality in individuals who SH and
in those who CW during the Covid-19 pandemic.
Therefore, the study aimed to compare the effects of
lockdown on alterations of musculoskeletal pain, sleep
quality, plus aspects of coronaphobia in individuals who
SH and in those who CW during the Covid-19 pan­
demic. It was hypothesized that individuals who SH
would have more alterations in musculoskeletal pain,
greater coronaphobia, and poorer sleep quality com­
pared to those who CW.
Materials and methods
Study design and participants
This case-controlled study was conducted in line with
the principles of the Declaration of Helsinki (General
Assembly of the World Medical Association 2014). It
was approved by Ankara Yildirim Beyazit University
Ethics Committee (Approval date and number:
84892257–604.01.02-E.18218–19.06.2020) and was con­
ducted in accordance with international ethical stan­
dards for human biological rhythm research
(Portaluppi et al. 2010). It was carried out as a web-
based assessment via an online form. Individuals in an
age range of 20–65 y and who volunteered to participate
were involved in the study. Those with a history of
Covid-19, severe psychological disorders, and those
unable to fulfill the questionnaires were excluded.
Individuals who SH, except unless absolutely necessary
to leave home (going to pharmacy or hospital and shop­
ping for necessities), during the 3-month nationwide
CHRONOBIOLOGY INTERNATIONAL 1779
lockdown in Turkey formed the SH group, and those
who had to work in their usual occupation setting dur­
ing the 3-month nationwide lockdown in Turkey
formed the CW group. A signed informed consent
form was obtained from the participants.
Outcomes
Primary outcome
The demographic and physical characteristics (age,
weight, height, gender, education, occupation, marital
status, place of residence, chronic diseases, and pre- and
peri- lockdown exercise habits) of participants were
recorded. Musculoskeletal pain alternations, corona­
phobia, and sleep quality were assessed using an online
form.
Musculoskeletal pain alterations
The standardized Turkish version of the Nordic
Musculoskeletal Questionnaire (NMQ) was used
(Kahraman et al. 2016) to assess alterations of muscu­
loskeletal pain among individuals who SH and those
who CW before and during the Covid-19 pandemic
process during the 3-month nationwide lockdown. The
NMQ is designed to assess the presence of musculoske­
letal alterations covering nine different parts of the body,
i.e, neck, shoulders, upper back, elbows, wrists/hands,
lower back, hips/thighs, knees, and ankles/feet. All items
are dichotomous, i.e., asks for a ‘yes/no’ (Kahraman et al.
2016).
Secondary outcomes
Coronaphobia
Coronaphobia was assessed by the Covid-19 Phobia
Scale (C19P-S) developed by Arpaci et al. to assess the
level of coronaphobia. C19P-S is a self-reported ques­
tionnaire consisting of 20 items and four, i.e., psycholo­
gical, psychosomatic, economic, and social, subscales.
All items are rated on a 5-point scale from “strongly
disagree (1)” to “strongly agree (5)”. The total score
ranges from 20 to 100 points;,the higher the score, the
higher is the level of coronaphobia (Arpaci et al. 2020).
Sleep quality
The Turkish version of the Jenkins Sleep Scale (JSS-T)
was used to assess the quality of sleep during the pre­
vious month (Duruöz et al. 2018). The JSS-T is a simple,
non-time-consuming self-reported questionnaire. It
consists of four Likert scale items relating to trouble
falling asleep, awakening during sleep and being able
or unable to fall back to sleep, and feeling tired when
1780 S. TOPRAK CELENAY ET AL.
awaking from sleep, rated as 0 “not at all”, 1 or happen­
ing “1–3 days”, 2 “4–7 days”, 3 “8–14 days”, 4 “15–
21 days”, and 5 “22–28 days”. The total score can
range from 0 to 20; the higher the score, the more severe
the sleep disturbance (Jenkins et al. 1988).
Statistical analysis
The distributions of the continuous variables were
examined by the Shapiro-Wilk’s test and normality
plots. Numeric variables were reported by median
(interquartile range), and frequency (%) was given for
categorical variables. Age, BMI, and C19P-S and JSS
scale scores were compared by the Mann-Whitney
U test for the groups. For categorical variables,
intragroup comparisons were analyzed with the
Pearson Chi-Square test, and intergroup comparisons
were analyzed with the McNemar’s test. A p-value less
than 0.05 was considered as evidence for a statistically
significance difference. All statistical analyzes were per­
formed via IBM SPSS Statistics 22.0 (IBM Corp.
Released 2012. IBM SPSS Statistics for Windows,
Version 22.0. Armonk, NY: IBM Corp.)
CASES
“Stayed at home” group
Assessed for eligibility (n = 395)
Excluded (n =20)
Not in the age range of 20-65 y
(n=5)
Those who filled the form
incomplete or incorrectly (n=15)
Analyzed
(n = 375)
Figure 1. The flowchart diagram of the participants.
Results
A total of 395 individuals composed the SH group, and
341 individuals composed the CW group. However, 375
individuals in the SH group and 311 individuals in the
CW group were included in data analysis. Details of the
included and excluded individuals are presented as
a flowchart of Figure 1. There were no significant differ­
ences between groups in terms of baseline physical and
demographic characteristics for education, place of resi­
dence, chronic diseases, and pre- and peri-lockdown
exercise habits (p > .05). However, age (p < .001), BMI
(p < .001), gender (p < .001), marital status (p < .001),
and occupation (p < .001) differed between groups
(Table 1). Nonetheless, there were no differences
between groups in terms of pre-lockdown musculoske­
letal pain and complaints (p > .05).
Comparisons of pre- and peri-lockdown musculos­
keletal pain levels in individuals who SH and those who
CW are shown in Table 2. During the lockdown, low
back pain (p = .003) was higher in the SH group than
CW group. Pre- vs. peri-lockdown within-SH group
comparisons showed that neck pain (p < .001), upper
back pain (p < .001), shoulder pain (p = .001), and hip/
CONTROLS
“Continued to work” group
Assessed for eligibility (n = 341)
Excluded (n =30)
Not in the age range of 20-65 y (n=9)
Those who filled the form incomplete
or incorrectly (n=21)
Analyzed
(n = 311)
 CHRONOBIOLOGY INTERNATIONAL 1781

Table 1. Comparison of the physical and demographic characteristics of the groups.

SH group CW group
Characteristics (n = 375) (n = 311) p
Age (y) [median (IQR)]* 32.00 (18.00) 38 (16.00) <0.001‡
BMI (kg/m2) [median (IQR)]* 23.42 (5.86) 25.81 (4.72) <0.001‡
Gender [n (%)]† 296 (78.9) 116 (37.3) <0.001‡
Female 79 (21.1) 195 (62.7)
Male
Marital status [n (%)]† 198 (52.8) 206 (66.2) <0.001‡
Married 177 (47.2) 105 (33.8)
Single
Education [n (%)]† 8 (2.1) 6 (1.9) 0.107
Primary school 9 (2.4) 8 (2.6)
Secondary school 31 (8.3) 44 (14.1)
High school 327 (87.2) 253 (81.4)
Graduate
Occupation [n (%)]† 78 (20.8) 3 (1.0) <0.001‡
Student 55 (14.7) 8(2.6)
Teacher 20 (5.3) 20 (6.4)
Engineer 73 (19.5) 112 (36.0)
Medical staff 13 (3.5) 33 (10.6)
Officer 8 (2.1) 23 (7.4)
Employee 50 (13.3) 81 (26.0)
Private sector 22 (5.9) 11 (3.5)
Retired 24 (6.4) 17 (5.5)
Academician 22 (8.5) 3 (1.0)
Housewife
Place of residence [n (%)]† 273 (72.8) 223 (71.7) 0.942
Metropolis 39 (10.4) 34 (10.9)
City 56 (14.9) 50 (16.1)
County 7 (1.9) 4 (1.3)
Town/Village
Chronic Diseases [n (%)]† 64 (17.1) 50 (16.1) 0.729
Yes 311 (82.9) 261 (83.9)
No
Exercise habits before the Covid-19 pandemic [n (%)]† 220 (58.7) 187 (60.1) 0.698
Yes 155 (41.3) 124 (39.9)
No
Exercise habits during the Covid-19 pandemic [n (%)]† 188 (50.1) 161 (51.8) 0.670
Yes 187 (49.9) 150 (48.2)
No
SH: Stayed at home, CW: Continued to work; n: number; IQR: Interquartile Range, %: percentage, BMI: Body Mass
Index, y: years, kg: kilogram, m: meter, n: number.
*Mann Whitney U.
†Pearson Chi-Square.
‡ Significant at p < 0.05.

thigh pain (p = .027) decreased, and low back pain Discussion

(p = .049) increased. However, such comparisons in
The current study yielded the following findings.
the SH group revealed elbow pain (p = .344), wrist/
Individuals who stayed at home or worked regularly
hand pain (p = .093), knee pain (p = 1.000), and ankle/
during the 3-month pandemic underwent similar pre-
feet pain (p = .087) did not change (Table 2). In the CW
versus peri-lockdown alternations in musculoskeletal
group, such pre- vs. peri-lockdown comparisons found
pain. During the 3-month lockdown, those who SH
neck pain (p < .001), upper back pain (p < .001),
had more musculoskeletal complaints related to low
shoulder pain (p < .001), and elbow pain (p = .007)
back pain. However, complaints of neck, upper back,
decreased, but wrist/hand pain (p = .210), hip/thigh
shoulder, and hip/thigh pain decreased in this group.
pain (p = .804), knee pain (p = .607), and ankle/feet
Neck, upper back, shoulder, and elbow pain decreased in
pain (p = .720) unchanged (Table 2).
the CW group during the lockdown. Even though higher
Intergroup comparisons revealed that during the lock­
coronaphobia was observed in people who SH than CW,
down the C19P-S-psychological (p < .001), C19P-S-psyho-
sleep quality of the two groups was similar.
somatic (p = .002), C19P-S-social (p < .001),
Stay-at-home isolation is an effective way to prevent
C19P-S-economic (p = .019), and C19P-S-total scores
the transmission of the Covid-19 virus (Fowler et al.
(p < .001) were higher in the SH than CW group (Table
2020). However, it may be problematic in terms of
3); however, JSS-T scores reveled sleep quality was similar
effects on the musculoskeletal system. First of all, the
in both groups (p > .05) (Table 3).
1782 S. TOPRAK CELENAY ET AL.

Table 2. Comparisons of musculoskeletal pain alternations of groups’ at before and during the 3-month Covid-19 lockdown.
Before the 3-month Covid-19 lockdown During the 3-month Covid-19 lockdown Within Group Comparisons
SH group (n = 375) CW group (n = 311) SH group (n = 375) CW group (n = 311)
n (%) n (%) p n (%) n (%) p pSH pCW
Neck 126 (33.6) 96 (30.9) 0.446* 76 (20.3) 52 (16.7) 0.234* <0.001**† <0.001**†
Yes 249 (66.4) 215 (69.1) 299 (79.7) 259 (83.3)
No
Upper back 113 (30.1) 84 (27) 0.367* 70 (18.7) 51 (16.4) 0.437* <0.001**† <0.001**†
Yes 262 (69.9) 227 (73) 305 (81.3) 260 (83.6)
No
Low back 58 (15.5) 42 (13.5) 0.468* 73 (19.5) 35 (11.3) 0.003*† 0.049**† 0.324**
Yes 317 (84.5) 269 (86.5) 302 (80.5) 276 (88.7)
No
Shoulder 86 (22.9) 66 (21.2) 0.591* 60 (16.0) 34 (10.9) 0.053* 0.001**† <0.001**†
Yes 289 (77.1) 245 (78.8) 315 (84.0) 277 (89.1)
No
Elbow 9 (2.4) 15 (4.8) 0.086* 5 (1.3) 4 (1.3) 0.957* 0.344** 0.007**†
Yes 366 (97.6) 296 (95.2) 370 (98.7) 307 (98.7)
No
Wrist hand 25 (6.7) 21 (6.8) 0.964* 16 (4.3) 14 (4.5) 0.881* 0.093** 0.210**
Yes 350 (93.3) 290 (93.2) 359 (95.7) 297 (95.5)
No
Hip/Thigh 32 (8.5) 17 (5.5) 0.117* 21 (5.6) 15 (4.8) 0.649* 0.027**† 0.804**
Yes 343 (91.5) 294 (94.5) 354 (94.4) 296 (95.2)
No
Knee 35 (9.3) 17 (5.5) 0.054* 36 (9.6) 20 (6.4) 0.128* 1.000** 0.607**
Yes 340 (90.7) 294 (94.5) 339 (90.4) 291 (93.6)
No
Ankles feet 34 (9.1) 29 (9.3) 0.907* 24 (6.4) 26 (8.4) 0.327* 0.087** 0.720**
Yes 341 (90.9) 282 (90.7) 351 (93.6) 285 (91.6)
No
SH: Stayed at home, CW: Continued to work, n: number, %: percentage,
*Pearson Chi-Square test, **McNemar’s test, † Significant at p < 0.05.

Table 3. Comparisons of coronaphobia and sleep quality of back pain in the SH group before and during the
groups during the Covid-19 pandemic. 3-month lockdown. This may be related to prolonged
SH group CW group sitting duration in a flexion posture due to the altera­
(n = 375) (n = 311)
median (IQR) median (IQR) p tions of daily life activities with increased time spent at
Coronaphobia (C19P-S) 18.00 (6.00) 17.00 (7.00) <0.001† home. Second, sedentary behavior and physical inactiv­
Psychological* 10.00 (5.00) 9.00 (4.00) 0.002† ity are main outcomes of homestay. Physical inactivity
Psychosomatic* 14 (6.00) 12.00 (5.00) <0.001†
Social* 8.00 (3.00) 8.00 (4.00) 0.019† has been reported to be associated with alterations of
Economic* 51.00 (16.00) 45.00 (18.00) <0.001† musculoskeletal complaints, especially spinal pain
Total*
Sleep Quality (JSS Score)* 4.00 (8.00) 4.00 (9.00) 0.054 (Mahdavi and Kelishadi 2020; Sun et al. 2020).
SH: Stayed at home, CW: Continued to work, C19P-S: Covid-19 Phobia Scale, Increased sedentary behavior due to the pandemic lock­
JSS: Jenkins Sleep Scale, n: number, IQR: Interquartile Range. down might bring greater load to the low back area
*Mann Whitney U.
†Significant at p < 0.05.
(Fallon et al. 2020; Lippi et al. 2020; Norbury et al.
2020). The prevalence of low back pain, one of the
most common musculoskeletal disorders, is associated
time spent on technology-based activities for education, with increased time spent on technology-based activities
communication, and entertainment related to homestay (Shan et al. 2013), and this may cause spinal postural
might probably increase the time of sitting (Garcia- dysfunction (Jung et al. 2016) and physical inactivity
Priego et al. 2020; King et al. 2020; Sun et al. 2020). (Lin et al. 2011). In the current study, the SH subjects
Prolonged sitting, especially in a flexion posture, may were generally people working at home, like teachers,
cause/worsen low back pain because of increased inter­ academicians, or students, who spent much time doing
vertebral disk pressure due to alteration of nutrition of technology-based activities. However, the CW subjects
the intervertebral disc (Patel and Ogle 2000; Sato et al. were generally medical staff or private sector workersof
1999; Wilke et al. 1999). Spinal load is highly dependent the transportation, security, and other occupations, who
on the angulation in the motion segment and positional were physically active during the 3-month nationwide
alterations caused by the intervertebral pressure (Sato lockdown. The increase in low back pain in the those
et al. 1999). Therefore, the low back region can be who SH compared to those who CW during the pan­
considered a major risk area. We found increased low demic and lockdown might be attributed to the increase

in sitting time and physical inactivity, as stated pre­
viously (Mahdavi and Kelishadi 2020; Norbury et al.
2020; Sun et al. 2020). In the current study, the duration
of sitting time, technology-based activities, or physical
activity were not assessed. They should be ascertained in
future studies.
Even though low back pain increased in the SH group,
neck pain, upper back pain, shoulder pain, and hip/thigh
pain decreased. Furthermore, in the CW group neck pain,
upper back pain, shoulder pain, and elbow pain decreased
during the 3-month lockdown. It is well-known that exces­
sive physical (mechanical) workload that requires awkward
postures, repetitive movements, forceful exertions, and
working long hours may cause musculoskeletal pain and
disorders (Bernard 1997; Punnett and Wegman 2004;
Waters et al. 2006). Due to the lockdown in Turkey, most
people stayed at home, and people who had to work spent
less time in the workplace to avoid crowds. Therefore, work
hours and work-related physical stress exposures might
have been reduced. Reduction of the rate of some muscu­
loskeletal complaints in both groups we hypothesize may
be attributed to the decreased work hours, and thus
reduced exposure to work-related physical stress.
The Covid-19 pandemic has had negative economic,
social, and psychological repercussions. These negative
effects have introduced a new phobia: coronaphobia
(Arpaci et al. 2020; Patnaik and Maji 2020). Mertens
et al. emphasized that the self-health anxiety, the fear
of the loss of the loved ones, and increased social media
exposure, may be associated with the coronaphobia of
the current Covid-19 pandemic (Mertens et al. 2020). It
can be clearly seen in the aforementioned remarks that
the pandemic has evolved to coronaphobia. Moreover,
our study found coronaphobia, involving psychological,
psycho-somatic, economic, and social factors, was
higher in the SH group than CW group. This is not an
unexpected finding. Previous studies have pointed out
that the level of psychological disorders, including anxi­
ety, and social media usage increased during the lock­
down/stay-at-home (Kashif and Aziz-Ur-Rehman 2020;
Ozamiz-Etxebarria et al. 2020). The higher coronapho­
bia in those who SH compared to those who CW may be
due to the increased anxiety level and social media
exposure (Mertens et al. 2020).
Even though current evidence about sleep disorders due
to the Covid-19 pandemic is scarce, it is claimed that sleep
disorders are increasing as a consequence of the disruption
of daily life habits (Majumdar et al. 2020; Vindegaard and
Benros 2020). Beck et al. found that sleep complaints
increased due to the Covid-19 lockdown (Beck et al.
2020). Marelli et al. concluded that the Covid-19 lockdown
had a negative effect on sleep quality (Marelli et al. 2020).
In contrast to these studies, we found that sleep quality was
CHRONOBIOLOGY INTERNATIONAL 1783
similar between SH and CW groups. Similarly, Sun et al.
found that, although spending time at home increased
during the lockdown compared to pre-lockdown condi­
tion, sleep duration did not change (Sun et al. 2020). The
similarity of sleep quality in SH and CW groups in the
current study may be due to differences in the physical and
demographic features of the participants of the two groups.
Previous studies indicated that sleep quality may vary
depending on gender and age (Beck et al. 2020; Marelli
et al. 2020).
The current study had some limitations. First, it is
difficult to make causal inferences, as the data presented
here and the relevant analyzes are derived from a cross-
sectional design. Second, we used a web-based survey
method to avoid possible infection risk; therefore, the
participants consisted of those with an ability to fill out
an online form. Thus, the possibility of a selection bias
should be considered. Third, we did not assess the dura­
tion of technology-based activities, level of physical activ­
ity, and psychological status. Thus, the possible
relationship between musculoskeletal pain complaints,
coronaphobia, and sleep quality require further study.
Lastly, some demographic and physical features of the
groups (age, BMI, gender, marital status, and occupation)
were different. Future studies should attempt to standar­
dize these covariants or use a study design to evaluate their
potential influence to strengthen methodological quality.
In conclusion, we identified that individuals who SH
had more musculoskeletal complaints, including low
back pain, and higher coronaphobia than those who
CW during the Covid-19 lockdown. Even though stay-
at-home is an effective way to prevent the transmission
of Covid-19, it should be noted that it can also lead to
negative consequences, especially for the lower back.
Therefore, to prevent the negative consequences of the
stay-at-home practice, precautions should be taken.
Declaration of interest
The authors declare no conflicts of interest.
ORCID
Seyda Toprak Celenay http://orcid.org/0000-0001-6720-
4452
Yasemin Karaaslan http://orcid.org/0000-0001-5664-0849
Oguzhan Mete http://orcid.org/0000-0002-6585-7617
Derya Ozer Kaya http://orcid.org/0000-0002-6899-852X
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