Background & Aims

Stress and musculoskeletal pain are common among university students, especially among students who study health-related degrees such as physical therapy. The relation between stress and pain is not clear. Individuals may have differences in pain perception under stress that may lead to a subsequent increase or decrease in pain.
Greater physical fitness levels and physical activity has been linked to lower levels of perceived stress and anxiety, as well as reduced levels of pain. The correlation between physical fitness and stress or pain is not known among university students. Therefore, the aim of our study was to investigate the level of stress, pain and fitness levels among Doctor of Physical Therapy (DPT) students during final exams compared with stress and pain after finals. A secondary aim was to examine the relationship between stress, pain, and fitness levels during finals.

Methods

Forty-three healthy female DPT students in Qassim University, Saudi Arabia between the ages of 18-27 years participated in our study. The outcome measures were collected during final exams which included perceived stress scale (PSS), Brief Pain Inventory (BPI) and general health questionnaire-28 (GHQ-28). In addition, physical fitness was assessed by grip strength and the YMCA step test. Participants were then asked to fill out the PSS, BPI, and GHQ-28 again about one week after final exams.

Results

Perceived stress was high during exams (PSS=21.7±6.0; GHQ=34.3±10.3) compared with after exams (PSS=17.9±5.7; GHQ=27.4±10.5; p<0.001). Pain severity was also high (2.6±2) during exams compared with after exams (1.6±1.7; p<0.001). Pain interference during exams (2.8±2.1) was not significantly different than after exams (2.1±2.5; p=0.07). More than half (51.2%) reported pain in the upper back, shoulder, and neck area, possibly related to studying positions. Fitness levels and grip strength were considered low. More than 2/3 of the students (67.4%) had a YMCA fitness level below average, poor or very poor. Grip strength was 19.2±3.8kg compared to the normal reference values of 28.1kg. BPI severity was significant correlated with PSS (r=0.41, p=0.007) and GHQ (r=0.342, p=0.02) indicating those who had higher stress values had also higher pain severity values. Lastly, heart rate following the YMCA test was significant correlated with BPI severity (r=0.35, p=0.023) and PSS (r=0.36, p=0.01).

Conclusions

In conclusion, DPT students experienced high levels of stress and pain during final exams compared with after exams. There was also a significant relationship between DPT students’ high stress levels during exam periods and pain severity. The student’s grip strength and aerobic fitness levels were also reduced which was related to both pain and stress. Strategies to manage stress levels during exams might be important for their well-being. Other strategies to increase fitness levels among DPT students are also important. Future studies should investigate the effect of stress and pain level on exam performance and whether enhancing fitness levels may help with pain and stress.

References

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Presenting Author

Taif Alkhudairy

Poster Authors

Ali Alsouhibani

PhD

Qassim University College of Applied Medical Sciences, Department of Physical Therapy

Lead Author

E-mail

Taif Alkhudairy

Qassim University

Lead Author

E-mail

Lamia Alharbi

Qassim University

Lead Author

E-mail

Norah Alanzi

Qassim University

Lead Author

E-mail

Rznah Alharbi DPT

Qassim University

Lead Author

E-mail

Taif Alenazi

Qassim University

Lead Author

E-mail

Topics

  • Mechanisms: Psychosocial and Biopsychosocial