Physical activity: Benefits and challenges during the COVID-19 pandemic

Proof of Concept of a 6-Month Person-Oriented Exercise Intervention 'MultiPill-Exercise' among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial

Physical exercise has been shown to be effective in the treatment of non-communicable chronic diseases. However, patients with multiple chronic diseases (multimorbidity) have received little attention in health policy. This pilot trial served as a proof of concept of a 6-months person-oriented exercise intervention for people at risk of or with diagnosed cardiovascular diseases, diabetes mellitus type 2, overweight and/or hip/knee osteoarthritis, regarding effects on health outcomes as well as adherence and safety. The intervention (‘MultiPill-Exercise’) was designed to promote physical exercise participation, considering an individual perspective by addressing personal and environmental factors. Outcomes were assessed at baseline (t0) and after three- (t3) and six-months (t6). The primary outcome was self-reported physical exercise participation in minutes/week comparing t3 and t6 vs. t0. Secondary outcomes included cardio-respiratory fitness (maximum oxygen uptake VO2peak during incremental cycling ergometry), isometric peak torque of knee extensors and flexors, health-related quality of life (Veterans Rand 12 with its subscales of perceived general health (GH), mental health (MCS), and physical health (PCS)) and blood levels. Adherence to exercise (% of attended sessions during the first 12-weeks of the intervention) and adverse events were monitored as well. Data were analyzed using a non-parametric procedure for longitudinal data, estimating rank means (MRank) and relative treatment effects (RTE) as well as linear-mixed effect models for parametric data. The primary endpoint of physical exercise participation was significantly higher at t3 and t6 compared to baseline (t3 vs. t0: MRank = 77.1, p < 0.001, RTE: 0.66; t6 vs. t0: MRank = 70.6, p < 0.001, RTE = 0.60). Improvements at both follow-up time points compared to t0 were also found for relative VO2peak (t3 vs. t0 = 2.6 mL/kg/min, p < 0.001; t6 vs. t0 = 2.0 mL/kg/min, p = 0.001), strength of knee extensors (t3 vs. t0 = 11.7 Nm, p = 0.007; t6 vs. t0= 18.1 Nm, p < 0.001) and GH (t3 vs. t0 = 16.2, p = 0.003; t6 vs. t0 = 13.4, p = 0.008). No changes were found for MCS, PCS and for blood levels. Overall exercise adherence was 77%. No serious adverse events were recorded. Results of this pilot trial represent a first proof of concept for the intervention ‘MultiPill-Exercise’ that will now be implemented and evaluated in a real-world health care setting.

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030

We examined time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030 by sex, race/skin color, educational attainment, and state capitals. Self-reported body weight and height of 730,309 adults (≥ 18 years) from the Vigitel study were collected by telephone interview between 2006 and 2019. A multinomial logistic regression model was used to predict the prevalence of body mass index (BMI) categories as a function of time by 2030. The prevalence of obesity increased from 11.8% in 2006 to 20.3% in 2019. The projected prevalences by 2030 are estimated to be 68.1% for overweight, 29.6% for obesity, and 9.3% for obesity classes II and III. Women, black and other minority ethnicities, middle-aged adults, adults with ≤ 7 years of education, and in Northern and Midwestern capitals are estimated to have higher obesity prevalence by 2030. Our findings indicate a sustained increase in the obesity epidemic in all sociodemographic subgroups and across the country. Obesity may reach three out of 10 adults by 2030.

Exercise in Cold Weather for COVID-19-Recovered Individuals (CRI)

Background: The sedentary lifestyle caused by the COVID-19 quarantine has resulted in a devastating threat to human health due to stress and anxiety. Although infected individuals must stop exercising, exercise is not prohibited when without symptoms and complications. Whereas exercise can be effective in immune system reinforcement during the prevention, recovery, and post-recovery stages, COVID-19-recovered Individuals (CRI) must exercise under accurate considerations. Objectives: This study aimed to study exercise in cold weather for the CRI. Methods: This article overviews how different exercises affect the immune system. PubMed, Science Direct, and Google Scholar Databases and keywords including cold weather, COVID-19, immune system, and combined exercise were used to access scientific articles. Results: Recent reports show that different sports and exercises significantly improve COVID-19 symptoms, although there are many discrepancies among researchers in prescribing exercise programs (various training protocols, duration, and intensity). Also, CRI should avoid exercise in cold weather due to breathing complications Conclusions: Based on the present study, regular exercises (aerobic, resistance, and combined) with moderate intensity improve COVID-19 symptoms and the immune system.

Counseling for Physical Activity in Adults during the COVID-19 Pandemic: A Scope Review

Objective: The aim of this scope review was to map the available scientific evidence on physical activity counseling for adults during the COVID-19 pandemic. Methods: The search was performed in PubMed, Web of Science, Scopus, SPORTDiscus, LILACS, SciELO, and CINAHL databases. Studies that described the population of adults over 18 years of age that used physical activity counseling during the COVID-19 pandemic context were selected. Data extracted were author, study location, sample, age group, sex, population characteristics, design, means used for intervention, time of intervention, professionals involved, and intervention or counseling strategy. Results: Physical activity counseling interventions were aimed at participants with insufficient levels of physical activity or with comorbidities; counseling was carried out in the online format; by health professionals, in the highest proportion of coaches, physicians, researchers, and nutritionists; through educational contents regarding the practice of physical activity; and using the transtheoretical model of behavior change as a reference method. Conclusions: The results of this review can provide tools for health professionals to assist in the process of coping with physical inactivity.

Differences in salient beliefs associated with voluntary exercise training among South Korean firefighters before and after COVID-19

Background

Participating in voluntary exercise training is important to meet occupational requirements as well as firefighters’ health and safety. The purpose of this study is to identify salient beliefs associated with voluntary exercise training among firefighters in the pandemic era by comparing outcomes with those from a previous elicitation study, which was carried out before the COVID-19 outbreak.

Methods

A total of 57 firefighters are recruited to participate in an elicitation study. Participants are requested to respond to six open-ended questions related to voluntary exercise training. Content analysis is used to create categories that combine similar factors in each belief. Beliefs mentioned by more than 30% of participants are used for comparison with the results of the previous research.

Results

“Improves my physical ability” (n = 44) and “cause injury” (n = 17) are identified as behavioral beliefs in the present study, whereas “makes me tired” and “takes too much time” were also elicited in Lee’s study. Normative beliefs are “family members” (n = 45) and “colleagues” (n = 27) and these results are consistent with those in Lee’s study. “Lack of time” (n = 28), “exercise facilities” (n = 19), and “COVID-19” (n = 19) are elicited as control beliefs in the present study, whereas “physical condition” (n = 21) and “exercise partners” (n = 14) were elicited as other control beliefs, and “COVID-19” was not mentioned in Lee’s study.

Conclusion

This study can contribute valuable information about salient beliefs associated with exercise training behavior among firefighters, particularly under pandemic conditions. Future researchers should develop tailored exercise training programs for firefighters based on current elicited beliefs.

The Impact of COVID-19 on Physical Activity and Life Satisfaction of Golfers: A Cross-Sectional Study in German-Speaking Countries

Golf is an outdoor sport played worldwide, and golfers of all ages benefit from regular exercise and social contact. The COVID-19 crisis has led to lockdowns, curfews, and closures of golf courses and other indoor and outdoor sports facilities. This study aimed to retrospectively assess how golfers perceived the impact of the crisis on physical activity and life satisfaction. We conducted a cross-sectional online survey among 1,115 golfers (61% men, mean age 55.0 years) in German-speaking countries, mainly Austria and Germany, from March to June 2021. When comparing ratings before and during the COVID-19 period, participants reported exercising more indoors at home independently or with online instructions. Likewise, the popularity of exercising outdoors in publicly accessible open spaces increased overall, especially in rural areas by about 10%. Life satisfaction decreased significantly by 24.2% (p < 0.001) during the pandemic. From a public health perspective, access to outdoor sports facilities such as golf courses might alleviate the negative psychosocial and health effects of home confinement and restricted access to indoor sports facilities. Further research is recommended to evaluate the longer-term impact of COVID-19-related measures on the physical activity and life satisfaction of golfers.

A Study on the Correlation Between Undergraduate Students' Exercise Motivation, Exercise Self-Efficacy, and Exercise Behaviour Under the COVID-19 Epidemic Environment

The outbreak of COVID-19 epidemic has influenced human beings from various aspects including physical exercise behaviours. This study aims to explore the influence of the COVID-19 epidemic on exercise self-efficacy and exercise behaviour, as well as the intermediary effects of exercise motivation. A sample of 1,115 undergraduate students was investigated using the physical exercise behaviour scale, exercise self-efficacy scale, and exercise motivation scale, combined with the COVID-19 epidemic environment as an influencing factor. SPSS was used for statistical analysis and AMOS for the prediction model building. Logical analysis was undertaken to sort out and analyse the data. The structural equation model reveals that exercise self-efficacy has a positive effect on exercise motivation and exercise behaviour. Meanwhile, the COVID-19 epidemic environment negatively influences exercise behaviour through the intermediary role of exercise self-efficacy and exercise motivation. Moreover, the intermediary effect of exercise self-efficacy is greater than that of exercise self-efficacy and exercise motivation. This study provides both theoretical implications and practical guidelines for society and undergraduate students to improve their exercise behaviour during epidemic.

Initial Impact of the COVID-19 Pandemic on a US Orthopaedic Foot and Ankle Clinic

Background:

In the United States, the COVID-19 pandemic led to a nationwide quarantine that forced individuals to adjust their daily activities, potentially impacting the burden of foot and ankle disease. The purpose of this study was to compare diagnoses made in an orthopaedic foot and ankle clinic during the shelter-in-place period of the COVID-19 pandemic to diagnoses made during the same months of the previous year.

Methods:

A retrospective review of new patients presenting to the clinics of 4 fellowship-trained orthopaedic foot and ankle surgeons in a major United States city was performed. Patients in the COVID-19 group presented between March 22 and July 1, 2020, during the peak of the quarantine for this city. Patients in the control group presented during the same period of 2019. Final diagnosis, chronicity of symptoms (acute: ≤1 month), and mechanism of disease were compared between groups.

Results:

A total of 1409 new patient visits were reviewed with 449 visits in the COVID-19 group and 960 visits in the control group. The COVID-19 group had a significantly higher proportion of ankle fractures (8.7% vs 5.4%, P = .020) and stress fractures (4.2% vs 2.2%, P = .031), but a smaller proportion of Achilles tendon ruptures (0.7% vs 2.5%, P = .019). The COVID-19 group had a higher proportion of acute injuries (35.4% vs 23.5%, P < .001).

Conclusion:

There was a shift in prevalence of pathology seen in the foot and ankle clinic during the COVID-19 pandemic, which may reflect the adoption of different activities during the quarantine period and reluctance to present for evaluation of non-urgent injuries.

Level of Evidence:

Level III, retrospective cohort study.

Current Status of Physical Activity in South Korea

The health benefits of physical activity have been well established. However, more than a quarter of the adult population in the world is insufficiently active (not performing at least 150 minutes of moderate-intensity physical activity per week, 75 minutes of vigorous-intensity physical activity per week, or any equivalent combination of the two), and there has been little improvement since 2001. In South Korea, the prevalence of insufficient physical activity was 54.4% in adults and 94.1% in adolescents in 2020. There was continuous decrease in the prevalence of sufficient aerobic physical activity, from 58.3% in 2014 to 45.6% in 2020. However, daily duration of sedentary behavior increased from 7.5 to 8.6 hours in the same period. Interventions to promote physical activity are necessary in various fields including clinical and policy approaches. As physical activity has decreased during the coronavirus disease 2019 pandemic, safer and more effective strategies to promote physical activity are required.

Physical Fitness of Chinese Primary School Students across the Coronavirus (COVID-19) Outbreak: A Retrospective Repeated Cross-Sectional Study

Social distancing measures against COVID-19 imposed restrictions on students that may have affected their physical health and fitness. The objective of this study was to investigate the change in physical fitness of primary school students across the coronavirus outbreaks from 2019 to 2021. This was a retrospective repeated cross-sectional study. We obtained the annual physical and fitness assessment data measured every November for all students at the same primary school in Guangzhou, China. There was a total of 6371 observations in the dataset for three years. The physical fitness of the students was evaluated with an overall physical fitness score, body mass index (BMI), lung vital capacity, physical flexibility (via a sit-and-reach test) and sports task performances (sprint, shuttle run, rope-jumping, and sit-up). Generalised estimating equations were used to determine any significant changes from 2019 to 2021, adjusted for confounders. After the COVID-19 outbreak in 2021, there was a significant elevation in BMI of 0.64 kg/m2 in 2020 and 0.39 kg/m2 in 2021 (p < 0.001). The overall physical fitness score was significantly increased by 2.1 and 4.1 points, respectively, in 2020 and 2021 (p < 0.001). Lung vital capacity and rope-jumping performance were significantly improved in both 2020 and 2021 compared with 2019, and sit-up performance was marginally significantly improved in 2020 and significantly improved in 2021. However, students demonstrated poorer flexibility and sprint and shuttle run performance in 2021 compared with 2019. A health promotion programme during and after COVID-19, including online physical education classes, television broadcasts, and a rope-jumping campaign, could account for these positive outcomes, along with the ease of administering rope-jumping and sit-ups at home.

Correlates of and changes in aerobic physical activity and strength training before and after the onset of COVID-19 pandemic in the UK: findings from the HEBECO study

OBJECTIVES

Understanding changes in moderate to vigorous aerobic physical activity (MVPA) and muscle-strengthening activity (MSA) at the start of the COVID-19 pandemic and their correlates (socio-demographics, health characteristics, living and exercise conditions and pre-pandemic MVPA/MSA) can inform interventions.

DESIGN

A cross-sectional analysis of retrospective and concurrent data on MVPA/MSA.

SETTING

An online survey in the UK.

PARTICIPANTS

2657 adults (weighted n=2442, 53.6% women) participating in the baseline survey (29 April 2020-14 June 2020) of the HEalth BEhaviours during the COVID-19 pandemic (HEBECO) study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Meeting WHO-recommended levels for MVPA/MSA/both (vs meeting neither) during the first lockdown and changes in MVPA/MSA from before to since the COVID-19 pandemic following stratification for pre-pandemic MVPA/MSA.

RESULTS

A third of adults maintained (30.4%), decreased (36.2%) or increased (33.4%) MVPA. For MSA, the percentages were 61.6%, 18.2% and 20.2%, respectively. MVPA increased or decreased by an average of 150 min/week and 219 min/week, respectively, and MSA by 2 days/week. Meeting both MSA+MVPA recommendations since COVID-19 (vs meeting neither) was positively associated with meeting MVPA+MSA before COVID-19 (adjusted OR (aOR)=16.11, 95% CI 11.24 to 23.07) and education: post-16 years of age (aOR=1.57, 95% CI 1.14 to 2.17), and negatively associated with having obesity (aOR=0.49, 95% CI 0.33 to 0.73), older age (65+ years vs ≤34 years; aOR=0.53, 95% CI 0.32 to 0.87) and annual household income of <50 000 GBP (aOR=0.65, 95% CI 0.46 to 0.91). The odds for decreasing MVPA were lower for white ethnicity (aOR=0.62, 95% CI 0.44 to 0.86), education: post-16 years of age (aOR=0.73, 95% CI 0.58 to 0.91) and access to garden/balcony (aOR=0.75, 95% CI 0.60 to 0.94), and were higher for those living in total isolation (aOR=3.81, 95% CI 2.33 to 6.23), with deteriorated psychological well-being (aOR=1.40, 95% CI 1.15 to 1.71) and conditions limiting physical activity (aOR=1.74, 95% CI 1.27 to 2.39). The odds for decreasing MSA were higher for having overweight (aOR=1.88, 95% CI 1.39 to 2.55), obesity (aOR=23.38, 95% CI 2.23 to 5.14) and being employed (aOR=1.81, 95% CI 1.34 to 2.46).

CONCLUSION

Aerobic and strength training were differently impacted during the first UK lockdown, with poorer outcomes associated with older age, lower education and higher body mass index. Targeted interventions may be required to avoid pandemic-related inequities in physical activity.

Function of Perceived Corporate Social Responsibility in Safety of Sports Activities and Home Aerobic Equipment in the Late Period of COVID-19

The pandemic has impacted various industries, including the sports industry. However, corporate social responsibility (CSR) can mitigate the adverse effects of the crisis and promote the sports industry. To analyze the effect of CSR, the study examined the impact of perceived corporate social responsibility on injury prevention expectation, injury risk perception, and health up-gradation with the mediation of sports safety measures. There are 259 sportsmen of local sports bodies provided the data through a self-administered survey. Data analysis was conducted through Smart-PLS and SEM techniques. The outcome of the analysis showed that perceived corporate social responsibility leads to injury prevention expectation, injury risk perception, and health up-gradation. Also, the study found that sports safety measure mediates the relationship between perceived corporate social responsibility and injury prevention expectation, between perceived corporate social responsibility and injury risk perception, and between perceived corporate social responsibility and health up-gradation among sportsmen of local sports bodies. The theoretical implications were presented related to the significance of CSR and sports safety measure and their impact on sportsmen injury prevention expectation, health, and risk perception. The practical implications were related to the management of local sports bodies and how they can induce CSR initiatives and programs. Some limitations related to sample size, incorporating other variables, examining the model in other contexts, and using different study designs, have also been mentioned in the study.

Promoting Physical Activity Among University Students During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial

Background

Since the beginning of the COVID-19 pandemic, sanitary context and e-learning have greatly modified student lifestyles and led to deteriorations in their mental health. An increase in anxiety and depressive symptoms and sedentary behaviors, reduction in physical activity, and a stronger tendency to move toward unhealthy diet have been demonstrated. This finding highlights the need for innovative interventions to promote healthy lifestyle among students.

Objective

This research protocol aims to evaluate the effects of an intervention program on the lifestyle and psychological state of students.

Methods

Students from University of Nîmes were recruited and randomly assigned to 1 of 2 following conditions: an intervention group and a control group. Participants in the intervention group were engaged in an 8-week physical activity program. Prior to the start of the program, design-based innovative workshops were conducted with participants to ensure that the program was co-constructed by the users and met their specific needs. Students in the control group did not receive any intervention. For each group, measures of physical activity, sedentary time, anthropometric data, sleep, physical condition, and psychological variables (eg, anxiety, depression, motivation, body appreciation, perceived control, well-being) were conducted at baseline and 9 weeks later.

Results

A total of 110 participants were initially included. Reporting of the results is projected for the spring of 2022.

Conclusions

It is anticipated that this innovative intervention co-constructed by pairs will promote a healthier lifestyle and psychological health in students. There is every reason to believe that a mobilized co-construction approach is a promising strategy to limit unhealthy habits and promote physical activity while increasing motivation. The development and evaluation of interventions to address the specific needs of university students is essential and could be transferred to other vulnerable populations such as people with chronic diseases or older people.

Trial Registration

ClinicalTrials.gov NCT05019482; https://clinicaltrials.gov/ct2/show/NCT05019482

International Registered Report Identifier (IRRID)

DERR1-10.2196/36429

Changes in health-related lifestyles and food insecurity and its association with quality of life during the COVID-19 lockdown in Malaysia

BACKGROUND

The pandemic of SARS CoV2 virus has severely impacted the entire world population. The lockdown imposed during the pandemic has created enormous challenges particularly on the health, economic and social life of most individuals. This study aimed to investigate the changes in health-related lifestyle and food security during the lockdown and how they influenced the quality of life (QoL) of Malaysian adults.

METHODS

An online survey using a structured questionnaire consisting of sociodemographic, body weight, diet quality, physical activity, sleep quality, food insecurity, and QoL was conducted among adult respondents across Malaysia. Multivariate linear regression analyses were conducted to assess the associations between the changes in each component and QoL based on the total score before and during the lockdown.

RESULTS

A total of 759 valid responses were included in the final analysis (75% female and 24.5% male). There was a significant improvement in diet quality during the lockdown while sleep quality and food insecurity worsened significantly. As for physical activity, metabolic equivalents (METs) in moderate activity increased significantly, whilst there was a significant decrease in the METs in walking and total minutes spent on physical activity during the lockdown. Overall, independent of age, gender, ethnicity, and religion, there were significant associations between QoL during lockdown and changes in BMI, METs of moderate activity, sleep quality, and food insecurity.

CONCLUSIONS

The unprecedented COVID-19 outbreak and the lockdown measure during the pandemic have caused significant negative changes in health-related lifestyles and affected the QoL of Malaysian adults. Despite the new norms and rules to prevent disease transmission, efforts to maintain a healthy lifestyle and food security among the population must be rolled out to improve the QoL and prevent further adverse mental and physical health outcomes.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

Feasibility and benefits of a videoconferencing-based home exercise programme for paediatric cancer survivors during the coronavirus disease 2019 pandemic

Objective

We aimed to determine the feasibility and benefits of a videoconferencing‐based home exercise programme to improve health‐related quality of life (HRQOL), posttraumatic growth and physical strength levels of paediatric cancer survivors during the coronavirus disease 2019 (COVID‐19).

Methods

Eight paediatric cancer survivors participated in the intervention for 8 weeks. The programme comprised home exercise sessions administered using Zoom, a videoconferencing platform. The supervised exercise sessions were performed two times per week; the participants were taught to perform joint exercises at home for the remaining 5 days of the week. HRQOL, posttraumatic growth and physical strength levels were assessed at baseline and after the intervention.

Results

The rates of recruitment, retention and attendance were 52.9%, 88.9% and 98.4%, respectively. There were no cases of adverse events. The programme significantly improved flexibility (z = −2.21, p = 0.03), muscle strength (z = −2.67, p = 0.01) and power (z = −2.41, p = 0.02) among five domains of physical fitness measured using a physical activity promotion system and also improved total physical strength (z = −2.67, p = 0.01). Posttraumatic growth decreased slightly, whereas HRQOL improved slightly; however, the change was not statistically significant.

Conclusion

The study findings present preliminary evidence of the feasibility and benefits of this videoconferencing‐based home exercise programme among paediatric cancer survivors.

Changes in Diet, Lifestyle, and Orthorexia Nervosa Tendency During the COVID-19 Pandemic: A Web-Based Study

Objective

During the COVID-19 pandemic, our diet and lifestyle have changed significantly. In this study, it was aimed to determine the changes in diet, body weight and Orthorexia Nervosa (ON) tendency in the pandemic.

Method

This cross-sectional study was carried out among adults (n = 945). An online questionnaire was used to determine nutrition, lifestyle factors and ON tendency (via Google Docs). The questionnaire was also shared on social media groups and pages (instagram, twitter and facebook) managed by registered dietitians.

Results

During the COVID-19 pandemic individuals' body weight and total food consumption increased by 51.0% and 57.2%, respectively. Increased screen time (OR: 1.912, 95% CI: 1.374–2.661 p < 0.001), sleeping time (OR: 3.630, 95% CI: 2.551–5.166 p < 0.001) and decreased physical activity (OR: 2.051, 95% CI: 1.198–3.509 p < 0.01) were associated with weight gain. The ON tendency increased in all groups according to the change in food consumption status (p < 0.05).

Conclusions

Considering the ongoing pandemic, individuals should be provided with adequate nutritional support. It is very important to get that support from nutritionists in order to monitor and control body weight and ON tendency.

Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions

BACKGROUND

This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia.

METHODS

This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age.

RESULTS

A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications.

CONCLUSION

mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.

Analyzing the Difficulties of Continuing Physical Activity during the COVID-19 Crisis in France

Physical activity (PA) and limiting sedentary behavior have been recognized as health-promoting behaviors for many years. Since the COVID-19 pandemic, changes in lifestyle habits have occurred, causing disparities in PA practice. This article aimed to examine the characteristics of French adults who self-reported having difficulties in continuing their exercise practices during the pandemic. Multivariate logistic regressions were used to test whether certain demographic, morphologic, behavioral (sleep, sedentary lifestyle, extent of household chores), and exercise-related variables were significant predictors of experiencing such difficulties, based on data from an online survey of insurance company members. Difficulties in PA practice were found in 57% of the population surveyed. Several factors were identified as predictors of experiencing difficulties, including a high BMI, the type and number of physical activities usually practiced before lockdown, as well as the number of times per week dedicated to PA. For the employed population, specific factors were additionally decisive: sex, time spent in front of screens, and sleeping. Our results will allow public health policy makers and stakeholders in PA and prevention to better target populations in difficulty during periods of disruption, such as that of the pandemic; thus, allowing them to propose structural or organizational solutions for the continuity of PA practice.

An Empirical Exploration of Volunteer Management Theory and Practice: Considerations for Sport Events in a “Post-COVID-19” World

The existing literature highlights some universal principles that are widely accepted as a good volunteer management practice, e. g., volunteer appreciation and recognition, provision of meaningful roles, effective communication, and the importance of relational connection, just to name a few. Yet, it can be argued that a gap exists in the relationship between volunteer management theory and practice in the context of large sport events. For example, published evidence shows that volunteer programs often lack effective planning and management to achieve successful program results. On one hand, this can be attributable to limited knowledge about volunteers' characteristics and motivations, their lived experiences, the processes of volunteering, and the actual volunteer management practices. On the other hand, a lack of the right mechanisms (e.g., political will, financial, and managerial resources) in place before and throughout the event lifespan intensifies this disconnect. The aim of this research, therefore, was to critically examine the reasons behind this theory-practice divide in volunteer–volunteer management relationship and its potential impact on volunteer experiences and volunteer program outcomes, particularly in the context of the COVID-19 pandemic and its implications for sport event organizers and volunteer managers in the UK. A mixed methods approach was adopted for this study: a survey conducted with volunteers (n = 101) combined with a series of interviews with volunteers (n = 8) and volunteer managers (n = 6). The study identified some potential challenges facing volunteer programs associated with large sport events post-pandemic, particularly in relation to volunteer recruitment, volunteer management, and safety concerns affecting volunteer confidence to re-engage in volunteering. These challenges carry with them certain resource implications that event organizers need to consider to effectively run volunteer programs and support volunteers in engagement and re-engagement following the pandemic, as well as to harness opportunities the pandemic has potentially created to successfully re-emerge from the shadow of COVID-19. The study provides specific recommendations to inform event planning and delivery to enhance volunteer experiences and, ultimately, outcomes of volunteer programs associated with large sport events.

Impact of COVID-19 on consumers' impulse buying behavior of fitness products: A moderated mediation model

During the COVID-19 pandemic, consumers are found to be more impulsive to purchase fitness products online. Accordingly, the purpose of this study was to investigate a moderated mediation model of consumers' perception of COVID-19 and impulse buying behavior through fear moderated by income. A total of 608 responses were collected from consumers in the United States, and this study employed partial least squares structural equation modeling (PLS-SEM) to examine the hypothesized relationships in the research model. The results showed that the perception of COVID-19 had a positive influence on fear, which in turn led to impulse buying behavior of fitness products. Moreover, consumers' income levels negatively moderated the positive relationship between fear and impulse buying behavior. The findings contribute to a better understanding of consumers' behavior and offer practical implications that enable marketers and retailers to predict consumers' behavior during the COVID-19 pandemic.

The differences of Slovenian and Italian daily practices experienced in the first wave of covid-19 pandemic

BACKGROUND

The COVID-19 pandemic situation with the lockdown of public life caused serious changes in people's everyday practices. The study evaluates the differences between Slovenia and Italy in health-related everyday practices induced by the restrictive measures during first wave of the COVID-19 pandemic.

METHODS

The cross-sectional cohort study examined changes through an online survey conducted in nine European countries from April 15-28, 2020. The survey included questions from a simple activity inventory questionnaire (SIMPAQ), the European Health Interview Survey, and some other questions. To compare difference in changes between European countries we examined Italy with severe and its neighbour country Slovenia with low incidence and victims of COVID-19 epidemic. 956 valid responses from Italy (N = 511; 50% males) and Slovenia (N = 445; 26% males) were investigated.

RESULTS

During the survey, there was a 4.7-fold higher incidence and 12.1-fold more deaths (per 100,000) in Italy than in Slovenia. Barring periods and measures were similar, the latter more stringent in Italy. We found more changes in Italy than in Slovenia: physical inactivity increased (Italy: + 65% vs. Slovenia: + 21%; p < 0.001), walking time decreased (Italy: -68% vs. Slovenia: -4.4%; p < 0.001); physical work increased by 38% in Slovenia (p < 0.001), and recreation time decreased by 37% in Italy (p < 0.001). Italians reported a decrease in quality of general health, fitness level, psychological well-being, quality of life and care for own health (p < 0.001); Slovenians showed a decline in psychological well-being and quality of life (p < 0.001) but generally had a higher concern for their own health (p = 0.005). In pooled participants, changes in eating habits (meal size and consumption of unhealthy food), age and physical inactivity were positively correlated with increases in body mass, while changes in general well-being and concern for health were negatively correlated.

CONCLUSION

The study shows that the negative impact of COVID -19 measures is greater in Italy where the pandemic COVID -19 was more prevalent than in Slovenia with low prevalence. Additional consideration should be given to the negative impact of COVID-19 measures on some health-related lifestyle variables when implementing further measures to mitigate the COVID-19 pandemic.

Outpatient Cardiac Rehabilitation Closure and Home-Based Exercise Training During the First COVID-19 Lockdown in Austria: A Mixed-Methods Study

OBJECTIVE

To assess the impact of the closure of group-based cardiac rehabilitation (CR) training during the first COVID-19 lockdown in spring 2020 on patients' physical activity, cardiorespiratory fitness, and cardiovascular risk, and to describe the patient experience of lockdown and home-based exercise training during lockdown.

DESIGN

Mixed methods study. Prospectively collected post-lockdown measurements were compared to pre-lockdown medical record data. Quantitative measurements were supplemented with qualitative interviews about the patient experience during lockdown.

SETTING

Outpatient CR centre in Salzburg, Austria.

PARTICIPANTS

Twenty-seven patients [six female, mean (SD) age 69 (7.4) years] who attended weekly CR training sessions until the first COVID-19 lockdown in March 2020.

OUTCOME MEASURES

Quantitative: exercise capacity (maximal ergometer test, submaximal ergometer training), cardiovascular risk (Framingham risk score, blood pressure, body mass index, lipids). Qualitative: individual semi-structured interviews.

RESULTS

Exercise capacity had significantly reduced from pre- to post-lockdown: mean (SD) power (W) in maximal ergometry 165 (70) vs. 151 (70), p < 0.001; submaximal ergometer training 99 (40) vs. 97 (40), p = 0.038. There was no significant difference in Framingham risk score and other cardiovascular risk factors. Qualitative data showed that almost all patients had kept physically active during lockdown, but 17 (63%) said they had been unable to maintain their exercise levels, and 15 (56%) felt their cardiorespiratory fitness had deteriorated. Many patients missed the weekly CR training and the motivation and sense of community from training together with others. Several patients stated that without professional supervision they had felt less confident to carry out home-based exercise training at high intensity.

CONCLUSION

This study highlights the importance of group-based supervised exercise training for patients who engage well in such a setting, and the detrimental impact of disruption to this type of CR service on physical activity levels and exercise capacity. Additionally, learning from the COVID-19 pandemic may inform the development and implementation of remote CR modalities going forward.

Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic

The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.

Physical Activity Behaviors and Physical Work Capacity in University Students during the COVID-19 Pandemic

Objective. The COVID-19 pandemic led to restricted access to sports and recreation facilities, resulting in a general decrease in physical activity. Many studies present the results of on-line questionnaires conducted during the pandemic, but there are few reports of objectively measured indicators of physical condition. Thus, the objective of this study was to assess the changes in physical work capacity, body composition, and physical activity behaviors in university students during 14 weeks of lockdown. Material and Methods. Twenty students of Tourism and Recreation (13 female and 7 male) participated in the study. The first examination was conducted in November 2020, and the second in March 2021. Body composition was assessed with a Tanita 418 MA device. The students performed the PWC 170 cycling test and completed the International Physical Activity Questionnaire (short version) on-line. Results. Neither physical work capacity nor body composition parameters changed substantially during the analyzed period. In the female students, vigorous physical activity decreased significantly, but no substantial changes occurred in weekly metabolic equivalent of task. In male students, walking days and metabolic equivalent of task decreased, but the changes were not significant. Conclusions. Fourteen weeks of COVID-19 lockdown had little effect on the body composition, physical work capacity level, and physical activity habits of Tourism and Recreation students. Studies with larger groups of participants should verify the current conclusions, and care should be taken when extrapolating to other populations.

The (In)Accessibility of YouTube Fitness Videos for Disabled Individuals Before and During the COVID-19 Pandemic: A Preliminary Application of a Text Analytics Approach

Background

People with disabilities face barriers to in-person physical activity (PA), including a lack of adaptive equipment and knowledgeable instructors. Given this and the increased need for digital resources due to widespread COVID-19 lockdowns, it is necessary to assess the accessibility of digital fitness resources for people with disabilities. To investigate whether YouTube fitness content creators have made videos accessible to people with disabilities would be informative about access to PA during COVID-19 and could also provide insight into the feasibility of individuals who are disabled relying on YouTube for PA in a post–COVID-19 world.

Objective

This study aims to ascertain if disability-friendly PA videos on YouTube are accessible through searching general fitness terms and whether a change in the availability of accessible fitness resources for people with disabilities occurred on YouTube between before and during the COVID-19 pandemic on “Hospital/Medical Institutions,” “Individual(s),” and “Other(s)” channels. Secondary aims are to investigate if different categories of YouTube channels produce more accessible fitness content and highlight any disparities in disability-friendly PA content on YouTube.

Methods

A cross-sectional text analysis of exercise-related YouTube videos was conducted. The authors used Python (version 3.0) to access the YouTube database via its data application programming interface. Terms pertaining to PA that were searched on YouTube were at-home exercise, exercise at home, exercise no equipment, home exercise, home-based exercise, no equipment workout, and workout no equipment. Various elements (eg, view count and content generation) of the videos published between January 1 and June 30, 2019 (n=700), were compared to the elements of videos published between January 1 and June 30, 2020 (n=700). To capture a broad idea of disability-friendly videos on YouTube, videos were labeled “accessible” if they were found in the first 100 video results and if their title, description, or tags contained the following terms: para, paralympic, adaptive, adapted, disabled, disability, differently abled, disability-friendly, wheelchair accessible, and inclusive. Each video and channel were categorized as “Hospitals/Medical Institutions,” “Individuals,” or “Other(s).”

Results

The analysis revealed a statistically significant increase in viewership of fitness content on YouTube (P=.001) and in fitness content generated by Hospitals/Medical Institutions (P=.004). Accessible terms applicable to people with disabilities had minimal appearances in 2019 (21 videos) and 2020 (19 videos). None of the top viewed fitness videos that populated on YouTube from 2019 or 2020 were accessible.

Conclusions

The proportion of accessible disability-friendly videos remains diminutive relative to the prevalence of disability in the general population, revealing that disability-friendly videos are seldom findable on YouTube. Thus, the need for disability-friendly fitness content to be easily searched and found remains urgent if access to digital fitness resources is to improve.

Factors That Shape Women's Physical Activity: Development of the Reasons to Participate in Physical Activity Scale (RPPAS)

(1) Background: Obesity could deepen women's susceptibility to COVID-19 infections and deaths. While physical activity has the potential to improve women's physical and psychological resilience to the pandemic, there is a dearth of research on factors that motivate women's participation in physical activity. Thus, to bridge the research gap, this study aims to identify factors that motivate women's participation in physical activity. (2) Methods: An online survey on motivations for physical activity was developed and distributed to the participants. A total of 108 women offered complete answers (N = 108, 18-33 years old, Mage = 20.34 ± 2.42 years). Participants selected factors that promote their physical activity from a list of 34 factors from the Reasons to Participate in Physical Activity Scale (RPPAS) developed in this study. (3) Results: Exploratory factor analysis revealed that factors that motivate women's participation in physical activity are: enjoyment and gratification, consideration for other activities (i.e., exergaming), health benefits, networking opportunities, and appearance and performance. Multiple linear regression analyses indicate that only consideration for appearance and performance was significantly associated with participants' physical activity levels after controlling for compounding factors. (4) Conclusions: The findings of this study underscore the importance of appearance and performance in shaping women's participation in physical activity. Furthermore, the results also emphasize the need for a nuanced understanding of factors that influence women's physical activity levels. Future research could investigate how to leverage these motivators in tailored health interventions that aim to improve women's physical activity.

Time trends of physical activity for leisure and transportation in the Brazilian adult population: results from Vigitel, 2010-2019

This time-series study examined a 10-year historical series of the physical activity prevalence for leisure and transportation in the Brazilian adult population. Information from 512,969 adults interviewed from the Vigitel between 2010 and 2019 was analyzed. Individuals who reported practicing at least 150 minutes/week of moderate-intensity physical activity or at least 75 minutes/week of vigorous-intensity physical activity were considered active during leisure time. Individuals who reported walking or cycling to/from work, course, or school at least 30 minutes/day, equivalent to at least 150 minutes/week of moderate-intensity physical activity, were considered active during transportation. The prevalence of physical activity for leisure and transportation was calculated annually and stratified by sex, age group, schooling, and race/skin color. The segmented regression model was applied to analyze the time series. Annual percent change and average annual percent change were calculated. Over time, the prevalence of physical activity for leisure increased, and the prevalence of physical activity for transportation decreased. The highest prevalence of physical activity for leisure was observed among males, young individuals, and those with high education. Older adults, those with high education, and white people presented the lowest prevalence of active transport. Policymakers should propose strategies that encourage and facilitate physical activity for leisure in women, individuals aged ≥ 35 years, and those with less education (< 12 years), and physical activity for transportation among older adults (≥ 60 years), those with high education (≥ 12 years), and white people.

Injury rates following the COVID-19 lockdown: A case study from an UEFA futsal champions league finalist

Introduction

Recently, a pandemic disease (i.e., COVID-19) arose complicated conditions for players, clubs, and sports competitions. Most European countries postponed or canceled their respective leagues as players were forced into a long-term lockdown. This case study presents and compares the absolute and relative non-contact lower-limb injury rates and characteristics before and after the lockdown from a Finalist of the UEFA Futsal Champion League.

Material and methods

Thirteen elite futsal players (age: 27 ± 2.8 years old; body mass: 76 ± 5.4 kg; height: 1.79 ± 0.1 m; body fat: 9 ± 1.6%) participated in this study. Injury severity, location, type, and mechanism were recorded. Data from the 6 weeks pre- and post-lockdown were collected, and injury rates were expressed per 1,000 training and match hours.

Results

Chi-Square tests revealed a significant difference (p = 0.039) in the distribution of the number of injuries between the two moments. No overuse and non-contact injuries were observed during the 6 weeks before the lockdown. Nevertheless, 38% (i.e., 5) of the players suffered minimal severity (i.e., ≤ 3 days of court absence) overuse injuries in the hip/groin and thigh muscles post-home-confinement.

Conclusions

Elite male futsal players sustained a substantially higher number of lower-body non-contact injuries after the lockdown. Practitioners should implement a thorough analysis of players’ neuromuscular qualities and fatigue to identify individual training and recovery needs and, thus, prescribe more tailored injury-reduction programs.

Working from home during the COVID-19 pandemic, its effects on health, and recommendations: The pandemic and beyond

PURPOSE

We provide an overview of how to work from home during the coronavirus disease 2019 (COVID-19) pandemic and what measures should be taken to minimize the negative effects of working from during this time.

CONCLUSIONS

The COVID-19 pandemic has forced an adaptation process for the whole world and working life. One of the most adaptation measures is working from home. Working from home comes with challenges and concerns but it also has favorable aspects.

PRACTICE IMPLICATIONS

It is crucial to develop and implement best practices for working from home to maintain a good level of productivity, achieve the right level of work and life balance and maintain a good level of physical and mental health.

The Effects of Physical Exercise on Mental Health: From Cognitive Improvements to Risk of Addiction

(1) Background: we aimed to investigate the effects of physical activity on cognitive functions and deficits of healthy population and other needy groups. Secondly, we investigated the relation between healthy habits and psychopathological risks. Finally, we investigated the impact of COVID-19 pandemic on exercise addiction and possible associated disorders. (2) Methods: From April 2021 to October 2021, we conducted a review aimed at identifying the effects of physical exercise on mental health, from cognitive improvements to risk of addiction; we searched for relevant studies on PubMed, Web of Science, EMBASE, PsycINFO and CINHAL. (3) Results: For the first purpose, results indicated multiple effects such as better precision and response speed in information processing tasks on healthy populations; improvement of executive functions, cognitive flexibility and school performance in children; improvement of attention and executive functions and less hyperactivity and impulsiveness on children with attention deficit hyperactivity disorder (ADHD); improvement of executive and global functions on adults; improvement of overall cognitive functioning on patients with schizophrenic spectrum disorder or bipolar disorder. Data also demonstrated that exercise addiction seems to be related to low levels of education, low self-esteem, eating disorders and body dysmorphisms. Eventually, it was found that people with lower traits and intolerance of uncertainty show a strong association between COVID-19 anxiety and compulsive exercise and eating disorder. (4) Conclusions: these findings underline on one side the beneficial effects of physical activity on cognitive function in healthy individuals in a preventive and curative key, while on the other side the importance of an adequate evaluation of psychological distress and personality characteristics associated with exercise addiction.

Prospective changes in physical activity, sedentary time and sleep during the COVID-19 pandemic in a US-based cohort study

OBJECTIVES

Assess differences in movement behaviours within the 24-hour cycle, including light intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time and sleep, before and during the COVID-19 pandemic and assess these differences stratified by several relevant factors in a subcohort of the Cancer Prevention Study-3.

DESIGN AND SETTING

US-based longitudinal cohort study (2018-August 2020).

PARTICIPANTS

N=1992 participants, of which 1304 (65.5%) are women, and 1512 (75.9%) are non-Latino white, with a mean age 57.0 (9.8) years.

MEASURES

Age, sex, race/ethnicity, education; self-reported LPA, MVPA, sedentary time and sleep duration collected before and during the pandemic; pandemic-related changes in work, childcare and living arrangement; COVID-19 health history.

RESULTS

Compared to 2018, participants spent an additional 104 min/day sedentary, 61 fewer min/day in LPA and 43 fewer min/day in MVPA during the pandemic. Time spent sleeping was similar at the two time points. Differences in movement behaviours were more pronounced among men, those with a higher level of education, and those who were more active before the pandemic.

CONCLUSIONS

From 2018 to Summer 2020, during the COVID-19 pandemic, US adults have made significant shifts in daily time spent in LPA, MVPA and sedentary. There is an urgent need to promote more physical activity and less sedentary time during this public health crisis to avoid sustaining these patterns long-term.

Finnish late adolescents' physical activity during COVID-19 spring 2020 lockdown

Background

Physical activity (PA) is recognised as one of the leading and effective strategies to prevent non-communicable diseases that boosts the immune system to fight against diseases. Closures of schools, sport clubs and facilities because of COVID-19 reduced the opportunities to participate in PA. We aimed to examine physical activity levels of late adolescents, the contexts to be physical active and its changes during the spring 2020 lockdown.

Methods

A national representative sample of late adolescents in general upper secondary school (n = 2408, females = 64%, mean age = 17.2y, SD = 0.63) completed self-report online surveys on PA behaviours between March and June 2020. Multinominal logistic regression analyses were performed to identify correlates with PA, and decision tree analyses to ascertain the perceived changes on PA during lockdown based on sport club aspirations and levels of PA.

Results

Among the late adolescents, the distribution of PA frequency was 23% (0-2 days/week), 35% (3-4 days/week), 30% (5–6 days/week) and 12% (7 days/week), and differences between males and females were not statistically significant. Participation in both indoor and outdoor PA were 50 times more likely to report daily PA (OR = 54.28, CI = 15.16–194.37) than non-participation. A quarter of late adolescents were not part of a sports club, yet their PA levels increased. Although sports club members generally perceived they did less PA during lockdown, over a third of sport club members with competitive aspirations reported daily PA.

Conclusions

Overall, most late adolescents reported their PA levels decreased during lockdown. Findings from this study continue to demonstrate factors associated with PA in the context of the COVID-19 lockdown.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12263-w.

Associations between individual and environmental determinants and physical activity levels of an active population during the Spanish lockdown

Restrictions during the COVID-19 pandemic are likely to decrease physical activity (PA) levels. The purpose of the study was to explore the associations between age, gender, and exercise facilities-type membership and physical activity levels during COVID-19 lockdown among users of exercise facilities from Spain. Participants were recruited among the members of 84 exercise facilities across Spain. Data was collected through an online questionnaire between 5th and 20th of April 2020 during the COVID-19 lockdown. A total of 7062 participants met inclusion criteria and responded correctly to the International Physical Activity Questionnaire. Lower levels of total PA were found in women compared with men (β = -26, 95%CI: -40 to -13), and among older adults (β = -48, 95%CI: -10 to -85) compared with younger ones. Moreover, users of private facilities showed higher levels of PA (β = 40, 95%CI: 13 to 66) than those from low-cost and public facilities (reference). Lastly, women from private facilities showed greater levels of PA (β = 63, 95%CI: 29 to 96) than low cost and public's users, an increase higher than what was found in men (β = 7, 95%CI: -38 to 52). Therefore, gender, age and the type of exercise facility's subscription had a relevant influence on PA levels during COVID-19 lockdown in an active population. These findings are useful for public health recommendations, in order to identify subpopulations of previously active people at risk of being physically inactive during and after this pandemic.

Behavioral and Mental Responses towards the COVID-19 Pandemic among Chinese Older Adults: A Cross-Sectional Study

The novel COVID-19 pandemic spread quickly and continuously influenced global societies. As a vulnerable population that accounted for the highest percentage of deaths from the pandemic, older adults have experienced huge life-altering challenges and increased risks of mental problems during the pandemic. Empirical evidence is needed to develop effective strategies to promote preventive measures and mitigate the adverse psychological impacts of the COVID-19 pandemic. This study aimed to investigate the behavioral responses (i.e., preventive behaviors, physical activity, fruit and vegetable consumption) and mental responses (i.e., depression and loneliness) towards the COVID-19 pandemic among Chinese older adults. A further aim was to identify the associations among demographics, behavioral responses, and mental responses. Using a convenience sampling approach, 516 older adults were randomly recruited from five cities of Hubei province in China. Results of the cross-sectional survey showed that 11.7% of participants did not adhere to the WHO recommended preventive measures, while 37.6% and 8.3% of participants decreased physical activity and fruit–vegetable consumption respectively. For mental responses, 30.8% and 69.2% of participants indicated significantly depressive symptoms and severe loneliness, respectively. Participants’ behavioral and mental responses differed significantly in several demographics, such as age group, living situation, marital status, education levels, household income, medical conditions, and perceived health status. Demographic correlates and behavioral responses could significantly predicate the mental response with small-to-moderate effect sizes. This is the first study to investigate the characteristics of behavioral and mental responses of Chinese older adults during the COVID-19 pandemic. Research findings may give new insights into future developments of effective interventions and policies to promote health among older adults in the fight against the pandemic.

The health-related quality of life of patients with musculoskeletal disorders after the COVID-19 pandemic

Purpose

To verify changes in the health-related quality of life (HRQOL) of patients with musculoskeletal disorders after the coronavirus disease 2019 (COVID-19) pandemic and to assess the relationship between the patients’ change in several activities of daily living and in the HRQOL to discover factors related to the deterioration in HRQOL.

Methods

A multi-centre cross-sectional questionnaire survey was administered between November 1, 2020, and December 31, 2020, in Japan. The participants included those who visited the orthopaedics clinic within the survey period and had experienced the first and second waves of COVID-19 in Japan and the first stay-at-home order issued by the government. Patients’ HRQOL at the two different time points (pre-outbreak and post-second wave of COVID-19) was assessed with the EuroQoL-5 dimensions 5-level (EQ-5D).

Results

The survey was completed by 1254 patients (average age: 52.5 ± 21.9 years; 644 women). Among them, 431 patients (34.3%) reported a decrease in the EQ-5D index after the pandemic. The largest decrease was in the pain domain followed by the mobility domain. Multivariate logistic regression analysis revealed that the patients with decreased regular exercise habits were significantly related to deterioration in HRQOL compared with those with stable regular exercise (adjusted odds ratio = 1.76, p < 0.001) independently from age, sex, and change of symptoms.

Conclusions

Up to 35% of patients with musculoskeletal disorders reported deterioration of HRQOL after the COVID-19 pandemic. Pain and mobility rather than anxiety were the two leading factors of the HRQOL decrease. The decrease in regular exercise was related to the HRQOL decrease.

Physical exercise for the management of systemic autoimmune myopathies: recent findings, and future perspectives

PURPOSE OF REVIEW

The aim of this review is to present the main pieces of evidence, recent literature and to present future perspectives on the use of exercise/physical training in the treatment and improvement of the quality of life of patients with systemic autoimmune myopathies.

RECENT FINDINGS

In the last decades, knowledge about the relevance of physical exercise training in preventing and treating chronic diseases and improving quality of life has grown. Following the global trend exemplified by the expression 'exercise is medicine', the importance of exercise/physical training has also grown in myopathies. However, the science of exercise has a lot to collaborate on and improve patients' quality of life with myopathies by appropriating new technological tools, including accessible and low-cost devices and smartphone apps.

SUMMARY

Physical exercise, as already consolidated in the literature, is an effective, well tolerated, and low-cost strategy for patients with myopathies. The use of wearable devices, smartphone apps, and online training prescriptions must accompany the global scenario, bringing new research fields and expanding the options for access to training for the individualized basis, and prescribed by qualified professionals.

Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020

BACKGROUND

The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo.

METHODS

A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male).

RESULTS

The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52-0.80]) or insufficiently active [aPR: 0.39 (0.18-0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35-0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40-0.79)].

CONCLUSIONS

A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

The Association of Cardiometabolic Disease with Psychological Factors in Colombian People during the COVID-19 Pandemic: A Cross-Sectional Study

During the COVID-19 pandemic, psychological disorders have been documented in the population, and their exacerbation in vulnerable populations such as those with Cardiometabolic Diseases (CD) might challenge health systems. This study determined psychological factors associated with CD in Colombian adults during the COVID-19 pandemic. For this purpose, 284 persons were evaluated, 142 without CD and 142 with CD. Sociodemographic data were collected, and the International Physical Activity Questionnaire (IPAQ), the SF-12v2, the Pittsburgh Sleep Quality Index (PSQI) and the Zung Self-Rating Depression Scale (ZSDS), which were integrated into an online form, were used. Through a simple and multiple logistic regression model, it was shown that CD was associated with low sleeping quality (LSQ) (OR = 3.51) and with depressive symptoms (DS) (OR = 1.98). In addition, in the group with CD, the presence of DS was related to BMI (OR = 2.45), and LSQ was related to living with persons at risk for COVID-19 (OR = 3.64) and BMI (OR = 5.88). In conclusion, this study showed that people with CD have a higher chance of presenting DS and LSQ. Furthermore, living with people at risk for COVID-19 was related to the presence of LSQ.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Changes in Alienation in Physical Education Classes, School Happiness, and Expectations of a Future Healthy Life after the COVID-19 Pandemic in Korean Adolescents

This study aims to investigate the changes in the structural relationship between alienation in physical education (PE) classes, school happiness, and future healthy life expectations in Korean adolescents after the COVID-19 pandemic. The data were collected from Korean adolescents using different scales. The collected data were analyzed using frequency analysis, reliability analysis, validity analysis, independent t test, and path analysis. The key results were: First, there were partial changes in each of the parameters since the outbreak of COVID-19. Second, before the pandemic, alienation in PE classes negatively affected school happiness, and school happiness positively affected expectations of a future healthy life; however, alienation in PE classes did not affect the expectations of a future healthy life, showing a complete mediating effect. Third, during the pandemic, alienation in PE classes negatively affected school happiness, and school happiness positively affected the expectations of a future healthy life; alienation in PE classes negatively affected the expectations of a future healthy life, showing a partial mediating effect. These findings emphasize the importance and potential of school education, especially PE, in promoting happiness and healthy lives in adolescents. We expect these findings to have practical implications for future research by presenting theoretical and empirical data.

Knowledge and Lifestyle Behaviors Related to COVID-19 Pandemic in People over 65 Years Old from Southern Italy

BACKGROUND

Control measures adopted during the COVID-19 pandemic had a considerable impact on human daily life and lifestyles. Adherence to the recommended measures is influenced by knowledge and attitudes towards the disease. This cross-sectional study aimed to assess the level of knowledge regarding COVID-19, the related control measures, and lifestyle behaviors adopted during the pandemic in a sample of elderly Italian people.

METHODS

A web-based questionnaire investigating socio-demographic characteristics, knowledge of COVID-19, the related preventive measures, and lifestyle changes that occurred during the pandemic, were distributed to ≥65 years old people living in South Italy.

RESULTS

A satisfactory level of knowledge about COVID-19 and the related control measures has been found in the enrolled sample. However, a decrease in physical activity, as well as worsening sleeping and dietary habits, were found in roughly 60% of participants. Females were impacted greater by these lifestyle changes.

CONCLUSIONS

Participants in this study showed a good level of knowledge regarding COVID-19 and its prevention. Nevertheless, they reported an increase in unhealthy habits that may have important health consequences in the long term and should be addressed by public health interventions targeted at older people.

Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being: A Pandemic Case Study

Societal crises and personal challenges are often followed by substantial changes in physical activity. Is there a link between such changes and psychological well-being? Seeking to answer this question, we conducted a correlational study on a representative sample in Sweden during the first year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased their physical activity compared to their self-reported activity level prior to the pandemic, whereas 32% had increased it. The results showed a positive and robust association between changes in daily activity level and corresponding changes in psychological well-being. Specifically, individuals who had reduced their physical activity over the last year reported lower life satisfaction than before, and individuals who had increased their physical activity reported higher life satisfaction than before. The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data, meaning that individuals who reported increasing inactivity per day also reported a greater decline in life satisfaction. Additional analyses showed that the association between daily activity level and life satisfaction was somewhat stronger for men than for women, but there was no difference when comparing individual versus organized activities. The current study was based on a cross-sectional design, measuring self-reported change over time. Recent work from other research teams have used longitudinal data and experience-sampling in different settings, finding similar results. We conclude that there is good reason to recommend physical exercise as a coping strategy in difficult times.

Associations of physical activity and sedentary behaviors with child mental well-being during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic resulted in public health and policy measures to reduce in-person contact and the transmission of the virus. These measures impacted daily life and mental well-being (MWB). The aims of this study were to explore the MWB impacts of COVID-19 on children and assess the associations among perceived changes in physical activity (PA) and sedentary behaviors (SB), with perceived MWB changes, using a mixed-methods approach.

METHODS

A convergent parallel mixed-methods design consisting of an online survey with a convenience sample and interviews was conducted from May through July 2020 with parents/caregivers of kindergarten through 5th graders in the St. Louis region. Survey domains assessed included child MWB, PA, and SB. Interviews were recorded, transcribed, and qualitatively analyzed using a code book developed to elicit themes. Survey data was analyzed with chi-squared tests and logistic regressions. The dependent variable was perceived change in child MWB due to the impact of COVID-19. Independent variables included perceived changes in PA, SB, and child concerns about COVID-19.

RESULTS

Sample size consisted of 144 surveys and 16 interviews. Most parents reported a perceived decrease in child MWB (74%), a decrease in child PA (61%), and an increase in child SB (91%). Discontentment with stay-at-home orders and concern about COVID-19 were associated with a perceived decrease in MWB. Children whose PA decreased were 53% less likely to have the same or better MWB (OR 0.47) and children whose outside PA decreased were 72% less likely to have the same or better MWB (OR 0.28). Common qualitative themes included difficulty in adjusting to COVID-19 restrictions due to school closures and lack of socializing, child concerns about family getting sick, and PA benefits for improving MWB.

CONCLUSIONS

Based on parent perceptions, MWB decreased with COVID-19. Maintained or increased child PA improved the chances MWB would remain the same or improve. Parent interviews provide context to these findings by showing how COVID-19 impacted MWB and the associations between PA and MWB. Understanding protective factors for child MWB during COVID-19 is important to offset negative long-term health outcomes from this ongoing pandemic.