Cardiorespiratory fitness in adolescents before and after the COVID-19 confinement: a prospective cohort study

Comparison between grip strength and relative grip strength in their relationship with allostatic load among adolescents

PURPOSE

To assess the associations of muscle strength, measure by grip strength and relative grip strength (grip strength divided by body weight), on the allostatic load (AL) index in adolescent boys and girls.

METHODS

A total of 1,323 students were recruited (boys = 776, girls = 547). Data on general demographic characteristics, anthropometric indicators, grip strength, blood pressure, pulse rate, and biological samples were collected. A 20-indicator-based AL index (using the AL1, AL2, and AL3 calculation methods) was used as the dependent variable. Multiple linear regression models were used to evaluate the association between grip strength, relative grip strength, and AL. All analyses were stratified by sex.

RESULTS

The mean age of the participants was 14.17 ± 1.45 years. Overall, the linear regression model adjusting for demografic characteristics showed that greater grip strength was associated with higher AL1 scores (R2 = 10.1%, β = 0.096, P < 0.001). Then, we further adjusted for body weight, and negative associations were observed between grip strength and AL1 (R2 = 35.3%, β = -0.027, P = 0.030). However, after sex stratification, this association was not statistically significant in girls. Moreover, relative grip strength was negatively associated with AL1 (R2 = 14.8%, β = -8.529, P < 0.001) after adjusting for demographic characteristics in the total sample. Specifically, relative grip strength was more strongly associated with the AL1 burden in boys than in girls. Finally, sensitivity analyses of AL2 and AL3 yielded similar results.

CONCLUSION

We observed that compared with grip strength, relative grip strength might be a useful indicator for the identification of AL burden in adolescents. The results suggest that strengthening relative handgrip strength in adolescents might help reduce the AL burden, especially in boys.

A Novel Summer Camp Integrating Physical, Psychological, and Educational Health in Youth: The THINK Program

Numerous youth summer programs focus upon physical fitness, nutritional health, psychological well-being, or education. Few, however, have integrated all of these elements into a single program. The Translational Health in Nutrition and Kinesiology (THINK) program provides an integrative nutrition and exercise science curriculum that is interfaced with social emotional learning (SEL) and STEM education to enhance healthy behaviors in youth. The purpose of this study was to determine whether the THINK program could improve physical fitness, nutrition habits, SEL, and STEM education in a 6-week summer program covering a 3-year period. Participants from South Miami were enrolled in THINK (n = 108, 58 males, 50 females, 12.03 + 0.56 years). Physical fitness assessments, the Positive Youth Development Inventory (PYDI), the Students' Attitude Towards STEM Survey, and the Adolescent Food Habits Checklist (ADFH) were recorded at baseline and post-testing. Means and standard error values were evaluated for all dependent variables. Paired samples t-tests (SPSS version 27) were used to determine changes. Improvements in cardiorespiratory fitness (p < 0.001), power (p < 0.006), flexibility (p < 0.001), agility (p < 0.001), muscular endurance (p < 0.001), lean body mass (p < 0.001), ADFH (p < 0.001), and PYDI (p = 0.038) were found. An integrative summer fitness program can result in improvements in physical fitness, nutrition habits, and SEL in as little as six weeks.

Analysis of Changes in Physical Fitness in Children and Adolescents (11-15 Years) From Kraków (Poland) During COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed a threat to society worldwide. The aim of the study was to analyze changes in the physical fitness of 11- to 15-year-olds during the COVID-19 pandemic.

METHODS

Cross-sectional research was conducted in randomly selected schools in Kraków (Poland) during the years 2020 and 2022. The study group included 1635 adolescents aged 11-15 years. The results of fitness tests such as flexibility, standing broad jump, handgrip strength, overhead medicine ball throw, shuttle run (10 × 5 m), and 30-second sit-ups were analyzed. Body height and weight measurements were also taken. The standing broad jump and handgrip strength were normalized. A statistical analysis was performed to compare the differences between groups using 2-way analysis of variance with the Tukey HSD post hoc test or Kruskal-Wallis test.

RESULTS

The test results revealed a deterioration decrease in sit-ups, standing broad jump, shuttle run, and normalized standing broad jump in both sexes. Furthermore, the test results among girls showed a decrease in overhead medicine ball throw and flexibility. An increase in test results of both sexes was noticed in handgrip strength of the right and left hand. Among boys in 2022, the results were better in the flexibility test and overhead medicine ball throw compared with their peers from 2020.

CONCLUSION

This study indicates a decrease in overall physical fitness in adolescents. The observed results may be associated with a decrease in physical activity, changes in nutrition, and restrictions imposed during the COVID-19 pandemic.

Assessing the Impact of COVID-19 on Amateur Runners' Performance: An Analysis through Monitoring Devices

This retrospective study aimed to analyze the return to running of non-professional runners after experiencing asymptomatic or mild COVID-19. Participants aged 18-55 years who maintained a training load of ≥10 km/week for at least three months prior to diagnosis and utilized Garmin/Polar apps were included. From these devices, parameters such as pace, distance, total running time, cadence, and heart rate were collected at three intervals: pre-COVID, immediately post-COVID, and three months after diagnosis. The Wilcoxon signed rank test was used for analysis (significance was set at ≤0.05). Twenty-one participants (57.1% male; mean age 35.0 ± 9.8 years) were included. The results revealed a significant decrease in running duration and distance two weeks after diagnosis, without significant changes in other parameters. Three months after infection, no differences were observed compared to pre-infection data, indicating a return to the pre-disease training load. These findings underscore the transient impact of COVID-19 on training performance among non-professional runners with mild or asymptomatic symptoms, highlighting the importance of tailored strategies for resuming running after infection.

Back to 'normal'? BMI, physical fitness and health-related quality of life of children from North East England before, during and after the COVID-19 lockdowns

We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown remained 12 and 18 months later. Twenty-metre shuttle run test (20mSRT), handgrip strength, standing broad jump, sit-and-reach, height, body mass, and health-related quality of life (Kidscreen27 questionnaire) were measured in 90 children (8-9 years) during October 2019 ("T0"), November 2020 ("T1"), November 2021 ("T2") and June 2022 ("T3"). Mixed-effects models showed age- and sex-normalised BMI increased from T0 (mean: 0.71) to T1 (0.97), remaining elevated at T2 (0.95) and T3 (0.89). Decreases in 20mSRT performance were observed from T0 (22.0) to T1 (19.3), then increased at T2 (23.5) and T3 (28.3). Standing broad jump and handgrip strength increased over time. The proportion of children with overweight/obesity increased from T0 (32%) to T3 (48%). Health-related quality of life decreased for "Physical Wellbeing" yet increased for "Autonomy & Parents". Our findings highlight that lockdowns may have had lasting implications for children's health, and the urgent need to reduce overweight and obesity in North East England. Improving health and fitness behaviours to maximise long-term health outcomes and build resilience to future emergencies and disruptions to health behaviours is also paramount.

Increased Resting and Peak Exercise Systolic Blood Pressure in Children Throughout the COVID-19 Pandemic

The COVID-19 pandemic created significant disruptions to daily life. Lockdown effects resulted in decreased exercise capacity and increased blood pressure in adults and adolescents in the first year of the pandemic. We examined changes in exercise capacity (peak workload, ventilatory anaerobic threshold-VAT, and VO2 peak), resting BP, and peak exercise BP in children before the COVID-19 pandemic and throughout five 6-month intervals of the pandemic. 951 maximal cardiopulmonary exercise tests completed by healthy children aged ≤ 18 years were analyzed retrospectively. BP was auscultated. Tests were divided into pre-pandemic and six-month intervals starting from the declaration of the pandemic (Interval 1: March 11 2020-August 2020, Interval 2: September 2020-February 2021, Interval 3: March-August 2021, Interval 4: September 2021-February 2022, Interval 5: March-August 2022). Peak workload, VAT, and VO2 peak were unchanged from pre-pandemic baseline until Interval 3, when they were significantly decreased. Exercise capacity then returned to values unchanged from baseline. Peak exercise systolic BP was significantly higher than baseline in Intervals 2, 4, and 5. Resting systolic BP was significantly higher than baseline in Interval 5. There was no significant difference in age, sex, BMI, or peak exercise heart rate between intervals. Peak exercise BP was elevated above pre-pandemic baseline when exercise capacity was unchanged. The decrease in exercise capacity subsequently resolved, but the increase in post-exercise BP remained in Intervals 4 and 5. An increase in peak exercise BP preceded a small but significant increase in resting systolic BP.

Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

Face masks were recognized as one of the most effective ways to prevent the spread of the COVID-19 virus in adults. These benefits were extended to children and adolescents. However, the fear of negative consequences from wearing a face mask during physical exercise led to cancellations of physical education lessons. This further decreased the amount of physical activity available to children and adolescents during the pandemic. However, there is little published data on the potential adverse effects of wearing the most effective and partially mandatory FFP2/N95 face masks during PE or physical activity (PA) in this age. Even though the pandemic has been declared as passed by the WHO, the rise of a new pandemic and thus the use of face masks for limiting its spread is inevitable, so we need to be better prepared for alternative options to lockdown and limitation of PA in such a scenario. Twenty healthy children aged 8-10 years performed two identical cardiopulmonary exercise tests as an incremental step test on a treadmill within an interval of 2 weeks, one time without wearing a protective mask and one time wearing an FFP2 mask. The cardiopulmonary exercise parameter and especially the end-expiratory gas exchange for oxygen and carbon dioxide (petO2 and petCO2) were documented for each step, at rest and 1 min after reaching physical exhaustion. Twelve boys (mean age 8.5 ± 1.4 years) and 8 girls (mean age 8.8 ± 1.4 years) showed no adverse events until maximal exertion. The mean parameters measured at peak exercise did not differ significantly between both examinations (mean peak VO2 = 42.7 ± 9.5 vs 47.8 ± 12.9 ml/min/kg, p = 0.097, mean O2pulse 7.84 ± 1.9 ml/min vs. 6.89 ± 1.8, p = 0.064, mean VE/VCO2slope 33.4 ± 5.9 vs. 34.0 ± 5.3, p = 0.689). The only significant difference was the respiratory exchange rate (RER, 1.01 ± 0.08 vs 0.95 ± 0.08, p = 0.004). The measured respiratory gases (end-tidal O2 and CO2) decreased and respectively increased significantly in almost every step when wearing an FFP2 mask. However, these levels were well below hypercapnia and above hypoxia.

CONCLUSION

 In this study, no significant differences in the cardiorespiratory function at peak exercise could be discerned when wearing an FFP2/N95 face mask. While the end-tidal values for CO2 increased significantly and the end-tidal values for O2 decreased significantly, these values did never reach levels of hypercapnia or hypoxia. Furthermore, the children terminated the exercise at a lower RER and heart rate (HR) suggesting a subconscious awareness of the higher strain. Since the detrimental effects of limiting sports during the pandemic are well documented, stopping PE lessons altogether because of the minor physiological effects of wearing these masks instead of simply stopping pushing children to perform at their best seems premature and should be reconsidered in the future.

WHAT IS KNOWN

• Wearing a face mask has an influence on psychological, social, and physiological functions in adults. • Because of the observed effects of wearing face masks in adults, physical activity in children was limited during the pandemic.

WHAT IS NEW

• Wearing an FFP2/N95 mask during physical activity did not lead to hypercapnia or hypoxia in children in this study. • Even though end-tidal CO2 values were significantly higher and end-tidal O2 values significantly lower when wearing an FFP2/N95 face mask, no pathological values were reached.

Healthy fitness zone prevalence and age-specific fitness profile of young people in seven European countries in 2022: The EUFITMOS project

BACKGROUND

Physical fitness is a health marker in youth and is associated with current and future health.

OBJECTIVE

Present the healthy fitness zone (HFZ) prevalence and age-specific fitness profile of young people from seven European countries.

METHODS

This study used data from the European Fitness Monitoring System project. The sample comprised 4965 (51.4% boys) youths aged 9 to 18 years. Fitness data were collected by physical education teachers using field-based tests. Raw data from the fitness tests were used to calculate the prevalence and 95% confidence intervals (CI) of participants in the HFZ.

RESULTS

The overall prevalence of boys and girls in the HFZ for all tests was 16.6% (95% CI = 14.7, 18.1) and 14.9% (95% CI = 13.2, 16.6), respectively. Boys have a mainly positive HFZ profiles, except for the 9-year-olds in the sit and reach (z-score difference = -1.20) and the 20 m run for boys 13-18-year-olds (z-score difference range: -0.09 to -0.01). Girls have worse HFZ profiles than boys, being out of the HFZ in several tests. Furthermore, a decreasing trend in z-score difference from the HFZ with age was observed in VO2 peak for boys and girls and sit and reach for girls. Notwithstanding, several country-related, sex and age differences were observed.

CONCLUSIONS

Boys presented mostly healthy age-specific fitness profiles in several fitness tests and ages. These differences should be considered when promoting youth's health through physical activity and fitness, as different fitness levels may require different approaches to implementing health-enhancing physical activity policies.

Regional differences of physical fitness and overweight and obesity prevalence among college students before and after COVID-19 pandemic since the "double first-class" initiative in China

Introduction

Physical fitness has been widely recognized as a powerful marker of health in children and adolescents, and it negatively affected by the COVID-19 pandemic. The construction of world-class universities and first-class disciplines, known as the "Double First-Class" Initiative (DFC), is a major commitment made by the Chinese government to adapt to changes in the educational environment, both domestically and internationally, in order to promote the development and practice of international higher education. The aim of the study was to look deep into the regional differences of physical fitness and overweight and obesity prevalence among college students before and after the COVID-19 pandemic since the DFC.

Methods

The original physical fitness parameters of students from 10 DFC universities and colleges in Central South China were downloaded from the official website of Chinese National Student Physical Fitness Database (CNSPFD) and then divided into 3 groups based on the pandemic periods: pre-pandemic (2019), the first year after pandemic outbreak (2020), and the second year after pandemic outbreak (2021). All the data were stored in Excel 2010, analyzed by SPSS 17.0, and plotted with ArcGIS 10.4.

Results

The total "fail" percentage (from 9.19% in 2019 to 12.94% in 2021) and the prevalence of overweight and obesity in boys (from 22.53 to 29.25% in 2021) exhibited a continuous increase year by year, and among all the physical fitness indicators the score of strength in boys and endurance quality in all individuals were the lowest in overweight and obesity groups. Students with 'fail' rate developed from northern and northeastern province to southern areas from 2019 to 2021. For grade 2019th, overweight and obesity students who also failed the test had covered nationwide and the most affected areas including northeast, east, as well as central north in senior year. The distribution of overall fitness assessments in Hubei province was in accordance with the national data, and the overall scoring growths in both class of 2021st and 2022nd were measured with a negative increase (p < 0.01).

Conclusion

The government and related functional departments should take into consideration the student regional sources, especially in western and northeast regions of China, and school polices and physical education (PE) teachers should pay more attention to put training efforts on endurance for all adolescents and strength for boys and the group of overweight and obesity who also failed in the standard test, when designing specific interventions to promote physical health and counteract the negative effects of COVID-19 pandemic in college students.

Physical fitness among children with diverse weight status during and after the COVID-19 pandemic: a population-wide, cohort study based on the Slovenian physical fitness surveillance system (SLOfit)

Background

COVID-19 public health crisis has exerted immediate negative impacts on children's physical fitness, but the longer-term effects are not clear, and the impact on children with excess weight is yet unknown. We examined changes in multiple components of physical fitness in response to COVID-19 imposed restrictions, but also a year after the restrictions were terminated, and compared these trends in groups of boys and girls with normal weight, overweight, or obesity before the pandemic.

Methods

Information was gathered through Slovenia's national fitness surveillance system, and included 41,330 children (19,890 girls), aged 5-17, who had their fitness levels measured yearly from 2019 to 2022. Multilevel linear mixed models, fitted separately for boys and girls, were used to model the individual-level trends over time in centile score for each fitness test across 3 weight groups.

Findings

Overall fitness levels decreased markedly across all weight categories between 2019 and 2020, with the largest decreases in Total Fitness Index observed in children with normal weight and overweight (-8.4 and -7.7 centiles for boys and -8.3 and -8.8 for girls, respectively, p < 0.001). While there was some recovery in the overall fitness level between 2020 and 2022, it remained much lower in 2022 compared to 2019 across most groups, apart from boys with obesity. Fitness components that had the largest impact on general fitness trends were cardiorespiratory fitness, lower body power, body core, and upper body strength.

Interpretation

A severe decline in fitness that has not come close to returning to pre-pandemic levels in most population groups of youth begs for urgent population-wide initiatives that will provide additional opportunities for physical activity to youth. Among vulnerable groups, girls with overweight and obesity deserve a special focus of these policies.

Funding

Horizon 2020 (Grant no. 774548), Slovenian National Research Agency (Grant no. P5-0142), Croatian Science Foundation (Grant no. DOK-2020-01-3728).

COVID-19 lockdown effects on the anthropometrics, aerobic capacity, muscle function and metabolic control in children and adolescents with overweight and obesity

OBJECTIVE

The lockdown due to a novel coronavirus (COVID-19) pandemic negatively impacted the daily physical activity levels and sedentary behavior of children and adolescents. The purpose of this study was to determine the effects of lockdown on the anthropometric measurements, aerobic capacity, muscle function, lipid profile and glycemic control in overweight and obese children and adolescents.

METHODS

104 children and adolescents with overweight and obesity were divided in a non-lockdown group (NL) (n = 48) and a lockdown group (L) (n = 56). Both NL and L groups were evaluated on three consecutive days, day one: anthropometric measurements; day two: aerobic capacity and muscle function and day three: lipid profile and glycemic control. Data are presented as mean ± standard deviation (SD) and median plus interquartile range (IQR) according to their assumption of normality.

RESULTS

The L group increased the body weight (81.62 ± 22.04 kg vs 74.04 ± 24.46 kg; p = 0.05), body mass index (32.54 ± 5,49 kg/m2 vs 30.48 ± 6.88 kg/m2; p = 0.04), body mass index by z-score (3.10 ± 0.60 SD vs 2.67 ± 0.85 SD; p = 0.0015), triglycerides [141.00 mg/dl IQR (106.00- 190.00 mg/dl) vs 103.00 mg/dl IQR (78.50- 141.50 mg/dl); p = 0.001], fasting insulin [31.00 mU/L IQR (25.01- 47-17 mU/L vs 21.82 mU/L IQR (16.88 - 33.10 mU/L; p = 0.001)] and HOMA index [6.96 IQR (6.90 - 11.17) vs 4.61 IQR (3.96 - 7.50; p = 0.001)] compared with NL group.

CONCLUSIONS

The lockdown due COVID-19 pandemic had a negative impact on the anthropometric measurements, lipid profile, and glycemic control of overweight and obese children and adolescents.

Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C in our hospital in the 12 months preceding the date of observation were considered for inclusion in the study. Pre-existing cardio-respiratory diseases and/or the lack of collaboration were the exclusion criteria. At enrolment, each subject passed a cardiological examination, rest ECG, echocardiogram, 24 h Holter-ECG, blood tests, and a CPET complete of spirometry. A total of 20 patients met the inclusion criteria (11.76 ± 3.29 years, 13 male). In contrast to the normality of all second-level investigations, CPET showed lower-than-expected peakVO₂ and peak-oxygen-pulse values (50% of cases) and higher-than-expected VE/VCO_2-slope values (95% of cases). A statistically significant inverse correlation was observed between P-reactive-protein values at admission and peakVO₂/kg values (p = 0.034), uric acid values at admission, and peakVO₂ (p = 0.011) or peak-oxygen-pulse expressed as a percentage of predicted (p = 0.021), NT-proBNP values at admission and peakVO₂ expressed as a percentage of predicted (p = 0.046). After MIS-C (4-12 months) relevant anomalies can be observed at CPET, which can be a valuable tool in the follow-up after this condition.

Physical fitness before and during the COVID-19 pandemic: Results of annual national physical fitness surveillance among 16,647,699 Japanese children and adolescents between 2013 and 2021

BACKGROUND

Limited nationally representative evidence is available on temporal trends in physical fitness (PF) for children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. The primary aim was to examine the temporal trends in PF for Japanese children and adolescents before and during the COVID-19 pandemic. The secondary aim was to estimate the concurrent trends in body size (measured as body mass and height) and movement behaviors (exercise, screen, and sleep time).

METHODS

Census PF data for children in Grade 5 (aged 10-11 years) and adolescents in Grade 8 (aged 13-14 years) were obtained for the years 2013-2021 from the National Survey of Physical Fitness, Athletic Performance, and Exercise Habits in Japan (n = 16,647,699). PF and body size were objectively measured, and movement behaviors were self-reported. Using sample-weighted linear regression, temporal trends in mean PF were calculated before the pandemic (2013-2019) and during the pandemic (2019-2021) with adjustments for age, sex, body size, and exercise time.

RESULTS

When adjusted for age, sex, body size, and exercise time, there were significant declines in PF during the pandemic, with the largest declines observed in 20-m shuttle run (standardized (Cohen's) effect size (ES) = -0.109 per annum (p.a.)) and sit-ups performance (ES = -0.133 p.a.). The magnitude of the declines in 20-m shuttle run and sit-ups performances were 18- and 15-fold larger, respectively, than the improvements seen before the pandemic (2013-2019), after adjusting for age, sex, body size, and exercise time. During the pandemic, both body mass and screen time significantly increased, and exercise time decreased.

CONCLUSION

Declines in 20-m shuttle run and sit-ups performances suggest corresponding declines in population health during the COVID-19 pandemic.

Changes in Physical Fitness Parameters in a Portuguese Sample of Adolescents during the COVID-19 Pandemic: A One-Year Longitudinal Study

Due to a worldwide response to the COVID-19 pandemic, many changes were imposed on individuals' daily lives, including those related to the physical activity of children and adolescents. The present study aims to comprehend the impact of early COVID-19 pandemic restrictions on Portuguese adolescents' physical fitness parameters during two school years. A total of 640 students from the 5th to the 12th grades participated in the longitudinal study. Data on body composition, aerobic fitness, speed, agility, lower and upper body strength, and flexibility were collected at three moments: 1. before the COVID-19 pandemic (December 2019); 2. after the COVID-19 lockdown when the schools reopened delivering in-person classes (October 2020), and 3. two months after the in-person classes started (December 2020). To analyze the overall changes between the three moments and between two age groups, we conducted repeated measure ANOVAs. The main findings indicate that participants' body composition (i.e., waist circumference) and aerobic fitness (i.e., maximal oxygen uptake) deteriorated after the first lockdown but improved two months after the in-person classes started. However, the same did not happen to neuromuscular fitness (i.e., horizontal Jumps and Sit and Reach). These findings suggest that the COVID-19 lockdown may have negatively impacted adolescents' physical fitness, particularly older adolescents. Altogether, data reinforce the importance of in-person classes and school context in promoting adolescents' physical health.

[Assessment of the effect of the COVID-19 health crisis on the aerobic capacities of healthy patients. Analysis of the effort tests of the patients of the sports medicine services of the Angers UHC and the Cholet HC between May 2018 and May 2021]

Objectives

To measure the impact of the health crisis related to SARS-CoV-2 on the aerobic capacities of healthy patients based on the measurement of VO_2max and VO₂ at the first ventilatory threshold (AT). To measure the impact of the introduction of the antibacterial filter on the ventilatory parameter measuring device.

Materials and methods

Based on a multicentre (Angers and Cholet), observational and retrospective study, we want to analyze the effect of containment measures and the cessation of sports competitions on the measurement of VO_2max in healthy patients. For each patient, will be collected: the gross value of the max VO₂ and indexed to the weight of the patient, as well as its percentage with respect to the expected theoretical value, the value of the VO2 at the aerobic threshold indexed to the wieght of the patient and the usual cardiorespiratory parameters (HR max, RR max, VE max, RER max). Two samples will be analyzed: patients with only one EFX ("unpaired" sample) and patients with multiple successive EFX over three years ("matched" sample). The impact of the antibacterial filter, used in one of the Sports Medicine departments, will be studied as a secondary issue. Statistical analyses were performed with the IBM SPSS 26 software. For all statistical tests, a p value of 0.05 was used in bilateral testing as the significance criterion.

Results

There is a significant difference in the value of VO_2max and AT in both the "unpaired" (VO_2max: 36.72 vs. 35.08 mL/kg/min, P = 0.014-AT: 21.03 vs. 19.25 mL/kg/min, P < 0.001) and "matched" groups (VO_2max: 2.76 vs. 2.64 L/min, P = 0.037-AT: 1.55 vs. 1.38 L/min, P = 0.001), more pronounced in patients over 60 years of age. The impact of the antibacterial filter does not show any particular impact within the "independent" sample. Within the "matched" sample, the significant age difference is not conclusive, but the exclusion of patients over the age of 60 makes the results meaningless.

Effect of smoking on coronavirus disease susceptibility: A case-control study

INTRODUCTION

Tobacco use has changed since the onset of the coronavirus disease (COVID-19) pandemic. The effect of smoking on COVID-19 susceptibility has not yet been determined. In this study, we aimed to assess the association between smoking and COVID-19 susceptibility.

METHODS

This retrospective case-control study was conducted at the quarantine center of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, between April and June 2020. A total of 142 adults participated in the study, 73 of whom tested positive for COVID-19 and were matched for both sex and age with participants in the control group. Telephone interviews were conducted to assess the risk factors associated with that exposure.

RESULTS

Different variables are investigated for their impact on COVID-19 infection susceptibility. The current study's findings indicated that smokers comprised only 27.5% (n=39) of the participants. There was no association between the COVID-19 swab results and smoking status (χ²=1.857; p=0.395). Furthermore, there was no significant association between any of the smoking parameters and susceptibility to COVID-19, except for the smoking period (t= -2.105, p=0.041). The odds of having a positive swab result among cigarette smokers were lower than those among pipe, waterpipe, and electronic cigarette smokers (OR=0.600; p=0.394). An association was also observed between COVID-19-positive swab results and contact with an individual with COVID-19 or respiratory disease (χ²=79.270 and χ²=18.929, respectively, p≤0.001).

CONCLUSIONS

This study revealed no association between smoking status and COVID-19 swab test results. Further research with a bigger sample size is suggested to confirm the relationship between smoking and COVID-19 susceptibility.

Secular trends of cardiorespiratory fitness in children and adolescents over a 35-year period: Chronicle of a predicted foretold

Background

In the context of concerns regarding the cardiorespiratory fitness (CRF) of youth populations, the aims of this study were: (1) to update reference values for the VO₂max for school-aged Canadians and (2) to document secular trends in CRF after a 35-year interval.

Methods

Between September 2014 and April 2017, the CRF of 3725 students (53.2% boys; 6.0 to 17.9 yrs) was determined using the 20-m shuttle run test. The sample was collected in 36 different schools from six cities of Québec (Canada).

Results

Median values of VO₂max decreased with age in both sexes (p ≤ 0.05). By the age of 10, more than 20% of boys showed VO₂max values below the recommended value (42 ml·kg^-1·min^-1). At the age of 17, that proportion reached 56.8%. A similar proportion of 12 yrs girls (20%) were under the recommended minimal value (37 ml·kg^-1·min^-1) and that value reached 69.9% at the age of 17. Compared to 1982, the VO₂max at age 17 has declined by 18% for boys and 12% for girls. The situation is worse in terms of functional capacity (number of stages completed) with an overall decrease of more than 30%.

Conclusion

This study demonstrates that, compared to data obtained using the same methodology 35 years ago, the CRF and functional capacity of children and adolescents has declined to levels that should raise concerns from a public health perspective. Thus, the development of strategies to promote a physically active lifestyle in youth is more relevant than ever.

Molero H, Moreno Morales N, Jiménez Marfil S, López Mariscal S, Jurado Lavanant A, Márquez García FJ, Caro Muñoz Ó, García García JA, Hinojosa Montañes JM, García-Revillo Muñoz JJ, Diéguez Gisbert MJ, Mosquera Gamero AM, Martínez Gómez D, Smith Palacios E, Troyano Ruiz J, Álamo Mendoza JM, Porras García ME. Valoración del nivel de actividad física y aptitud física en una muestra de universitarios

El tránsito de la educación secundaria a la enseñanza universitaria se ha convertido en un momento crítico para el estilo de vida de los jóvenes, especialmente para la práctica de actividad física. Por ello, el principal objetivo del presente estudio fue valorar los niveles de actividad física en universitarios, mediante la correlación entre los resultados del IPAQ-SF y las distintas variables de condición física (Eurofit). La muestra estuvo conformada por 194 estudiantes del Grado de Educación Primaria, con una edad media de 21,37 ± 2,66 años. Los principales resultados obtenidos reflejan la relación directa entre la práctica de actividad física en general, y la actividad física vigorosa en particular y una óptima aptitud física de los estudiantes universitarios, vinculada sobre todo con el componente fuerza. En cuanto a la comparación entre los universitarios del curso prepandémico (18/19) y el curso pospandémico (21/22), el aumento de la actividad física tras la pandemia no reportó diferencias sustanciales en los componentes de la condición física. A modo de conclusión, estos resultados deben conducirnos a una reflexión sobre la influencia de un estilo de vida activo en la aptitud física, la cual tiene repercusión en el estado de salud general y la calidad de vida.

Physical Activity and Physical Fitness in Adolescents after the COVID-19 Lockdown and One Year Afterward

The purpose of this study was to analyze the changes in physical activity and physical fitness between the beginning of the first academic year after a confinement (November 2020) and the beginning of the second academic year after a confinement ("new normality": November 2021) in a cohort of adolescents. Moreover, the evolution of physical fitness after controlling for physical activity was examined. A total of 687 students (M = 15.35, SD = 1.677) from a high school located in a rural town in northern Spain gave information on their physical activity (PA) levels in two different periods. Linear mixed models were used to examine these changes. The results indicated that vigorous physical activity (VPA) and the metabolic equivalent of task (MET) significantly increased between the two periods. A growth tendency of several components of fitness (upper body power, strength endurance, cardiovascular fitness, flexibility, and eye-hand coordination) was also observed. Finally, the results indicated that belonging to a sports club and getting involved in more VPA better explained the development in cardiovascular and muscle fitness between the two time points. Thus, the results of this study highlighted the relevance of membership in a sports club and vigorous PA in order to mitigate the potential negative effect of social distancing measures on physical fitness.

Sex-Related Differences in the Relationship between Sugar-Sweetened Beverage Consumption and Cardiorespiratory Fitness: Results from Chinese Cross-Sectional Study on Children

Sugar-sweetened beverage (SSB) consumption continues to increase among children, with adverse health effects, and China is no exception. Our study investigates the association between SSB consumption and cardiopulmonary fitness. We used stratified whole group sampling to investigate and test SSB consumption and cardiopulmonary fitness in 21,055 children aged 13−15 years in China. A chi-square test and one-way ANOVA were used to compare different categories of SSB consumption. General linear regression analysis and logistic regression analysis were used to analyze the relationship between different SSB consumption and cardiopulmonary fitness in Chinese children. Our research results show the proportions of Chinese children with SSB consumption ≤ 1 time/week, 2−4 times/week, and ≥5 times/week were 33.3%, 52.8%, and 13.9%, respectively. VO2max in children consuming ≥ 5 times/week was lower than those consuming 2−4 times/week and ≤2 times/week of SSB by 0.15 and 0.301 mL·kg−1·min−1, with statistically significant differences (F-value 18.807, p < 0.001). After relevant confounders were adjusted, children in the SSB consumption ≥ 5 times/week group had a higher risk of developing poorer cardiopulmonary fitness than those in the SSB consumption ≤ 1 time/week group (OR: 1.336, 95% CI: 1.181, 1.511) (p < 0.001). In conclusion, the consumption of SSBs among children aged 13−15 in China is higher than the recommended intake by the World Health Organization, and boys are higher than girls. In addition, after adjusting for relevant confounders, the association between SSB consumption and an increased risk of poor cardiorespiratory fitness remained. The relationship between SSB consumption and cardiopulmonary fitness was higher in girls compared with boys.

Changes in Physical Fitness among Elementary and Middle School Students in Korea before and after COVID-19

The present study aimed to analyze changes in health-related physical fitness among Korean elementary and middle school students before (2019) and after (2021) the COVID-19 pandemic. Data collection was completed by requesting the physical activity promotion system (PAPS) data from elementary and middle school students. This information is obtained annually by the Goyang Office of Education in Gyeonggi-do, Korea. The collected data were measured in 2019 and 2021. Data were collected from 17,000 children in the fifth and sixth grades of elementary school and about 24,000 boys and girls in the first, second, and third grades of middle school. Chi-square analyses were used to examine data from each school's health-related physical fitness examinations. Our results indicated that physical fitness levels were significantly lower in 2021 than in 2019 across the following six areas: cardiorespiratory endurance, power, muscular strength, flexibility, obesity, and overall health-related physical fitness (p < 0.05). In addition, the ratio of students with excellent physical fitness (PAPS Grades 1 and 2) significantly decreased from 2019 to 2021, while the ratio of students with poor physical fitness (PAPS Grades 3, 4, and 5) increased (p < 0.05). In addition, there were some differences according to grade and gender. Discussions regarding the impact of decreases in physical activity on physical fitness, interpretations of physical fitness in the context of a pandemic, and practical measures that can be implemented to improve health and fitness among children and adolescents in such situations remain essential.

Changes in Physical Health-Related Indexes of Chinese College Students before and after COVID-19 Lockdown

The outbreak of the COVID-19 pandemic has caused negative impacts on people's lifestyles, as well as considerable indirect social impacts, which has even overshadowed the direct impact of virus infection itself. This study is aimed at examining the changes in physical health-related indexes of Chinese college students before and after the COVID-19 lockdown. The data of this study are from the National Physical Health Testing Program, covering 43 college students (male: 22) from a class of a Chinese university. Paired t-tests were performed on the physical health test data separately collected in November 2019 before the COVID-19 pandemic and October 2020 after the COVID-19 lockdown was lifted. As shown by the test results, compared to the prelockdown data, college students had an increased body mass index (BMI) (0.43 (SD 0.94) P = 0.004), decreased vital capacity (VC) (-128.98 (SD 310.13) ml P = 0.009), and lowered performance in the 800/1000 m endurance (-6.21 (SD 8.81) points P < 0.001) and standing long jump tests (-2.44 (SD 7.37) points P = 0.036) after the lockdown, and the differences in these regards all were significant. In addition, for the students in the overweight/obese group, their pre- and postlockdown physical fitness test results were found to have no statistically significant difference (P > 0.05), but the students in the control group showed a significantly increased BMI, as well as significantly decreased vital capacity and performance in the 800/1000 m endurance and standing long jump tests (P < 0.05). The findings of this study are expected to help government departments and policymakers better understand the impacts of school closures and online learning on the physical health of adolescents, while providing a basis for the formulation of measures that are aimed at reversing adolescents' physical health decline.

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.

Estimated Oxygen Consumption with the Abbreviated Method and Its Association with Vaccination and PCR Tests for COVID-19 from Socio-Demographic, Anthropometric, Lifestyle, and Morbidity Outcomes in Chilean Adults

COVID-19 causes cardiovascular and lung problems that can be aggravated by confinement, but the practice of physical activity (PA) could lessen these effects. The objective of this study was to evaluate the association of maximum oxygen consumption (V˙O2max) with vaccination and PCR tests in apparently healthy Chilean adults. An observational and cross-sectional study was performed, in which 557 people from south-central Chile participated, who answered an online questionnaire on the control of COVID-19, demographic data, lifestyles, and diagnosis of non-communicable diseases. V˙O2max was estimated with an abbreviated method. With respect to the unvaccinated, those who received the first (OR:0.52 [CI:0.29;0.95], p = 0.019) and second vaccine (OR:0.33 [CI:0.18;0.59], p = 0.0001) were less likely to have an increased V˙O2max. The first vaccine was inversely associated with V˙O2max (mL/kg/min) (β:−1.68 [CI:−3.06; −0.3], p = 0.017), adjusted for BMI (β:−1.37 [CI:−2.71; −0.03], p = 0.044) and by demographic variables (β:−1.82 [CI:−3.18; −0.46], p = 0.009); similarly occur for the second vaccine (β: between −2.54 and −3.44, p < 0.001) on models with and without adjustment. Having taken a PCR test was not significantly associated with V˙O2max (mL/kg/min). It is concluded that vaccination significantly decreased V˙O2max, although it did not indicate cause and effect. There is little evidence of this interaction, although the results suggest an association, since V˙ O2max could prevent and attenuate the contagion symptoms and effects.

Consequences of the SARS-CoV-2 Infection on Anaerobic Performances in Young Elite Soccer Players

The COVID-19 pandemic required local confinement measures reducing sport practice with possible consequences on the athletes’ performances. Furthermore, anaerobic detraining was underestimated and poorly known in adolescents. This article aimed to assess the effects of SARS-CoV-2 infection and 1-month COVID-19 confinement on jump testing in young elite soccer players despite a 1-month multimodal training program followed by a 1-month soccer retraining period. Thirty-one elite soccer players aged 14 were included; 16 were infected by the SARS-CoV-2 and compared with 15 non-infected elite soccer players before and after 1 month of COVID-19 confinement, and after 1 month of a soccer retraining period. Squat jumps (SJ), countermovement jumps with (CMJs) and without arm swinging (CMJ) and multiple consecutive jumps (stiffness) were used to explore the anaerobic performances. Analysis of variance for repeated measures was used to compare the positive and negative SARS-CoV-2 groups, taking into account the confinement period (low training) and the retraining soccer period. The jump tests were not altered in the positive SARS-CoV-2 group compared to the negative SARS-CoV-2 group after confinement (SJ: 31.6 ± 5.6 vs. 32.7 ± 3.7; CMJ: 34.1 ± 6.9 vs. 34.2 ± 2.6; CMJs: 38.6 ± 6.8 vs. 40.3 ± 3.9; stiffness: 28.5 ± 4.3 vs. 29.1 ± 3.7) and at 1 month of this period (SJ: 33.8 ± 5.5 vs. 36.2 ± 4.6; CMJ: 34.7 ± 5.5 vs. 36.4 ± 3.5; CMJs: 40.4 ± 6.7 vs. 42.7 ± 5.5; stiffness: 32.6 ± 4.7 vs. 34.0 ± 4.3). The SARS-CoV-2 infection had no consequence on anaerobic performances assessed by jump tests in adolescent soccer players. The adolescents’ growth could explain the absence of alteration of jump performances during the COVID-19 confinement. These results can be useful to manage the recovery of the anaerobic fitness after SARS-CoV-2 infection occurring in adolescent athletes.

Puberal and Adolescent Horse Riders' Fitness during the COVID-19 Pandemic: The Effects of Training Restrictions on Health-Related and Functional Motor Abilities

The aim of the study was to analyse the fitness level of young horse riders before and after 12 weeks of training restrictions instituted due to the COVID-19 emergency. Anthropometrical measure assessment and an eight-items fitness test battery were administered to 61 puberal and adolescent female amateur horse riders. Subjects were evaluated within 3 weeks before (pre-tests) the period of training restrictions and on the first day of normal training after it (post-tests). Post-test results showed significant increases in body weight (Z: −1.732; p value: 0.001; ES: −0.157) and BMI (F: 9.918; p value: 0.003; ES: 0.146), whilst the performance in hand grip and abdominal strength, hip mobility, and 10 × 5 m Shuttle and Cooper 12 min tests’ outcomes significantly decreased (F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001, respectively). Correlation analysis revealed that riders’ experience was significantly correlated with hand grip (p < 0.01), leg strength (p < 0.01), hip mobility (p < 0.05), and 5 × 10 m Shuttle (p < 0.01) and the Cooper 12 min (p < 0.01) test results. It could be suggested that equestrian activities could produce a higher fitness level in puberal and adolescent riders, whilst home-based, unsupervised, and unattentively planned training during the twelve weeks of training restrictions might be insufficient to maintain it.

Change in BMI and Fitness among Primary School Children in Austria: A 24-Month Follow-Up Study of 303 Children Measured before and during the Ongoing COVID-19 Pandemic

The ongoing COVID-19 pandemic not only impacted the health of school children directly through SARS-CoV-2 infections, but the associated closures of schools and sports facilities also resulted in long-term negative side effects. The aim of this study was to investigate the effects of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. A total of 303 primary school children participated in the longitudinal study. Data on height, weight, and fitness were collected before the COVID-19 pandemic (September 2019) and at one-year intervals (September 2020 and September 2021) during the course of the pandemic. In the first year, from September 2019 to September 2020, there were alarming increases in body mass index (BMI) standard deviation scores (SDSs) (from 0.32 to 0.49) and dramatic decreases in both cardiorespiratory endurance (CRE) (from 0.49 to −0.43) and action speed (from −0.31 to −0.64). In the second year (September 2020 to September 2021), the BMI scores stabilized, and improvements in CRE were observed, especially in the subgroup of children who were members of sports clubs. In the future, more initiatives and projects, in addition to sports club activities, should be started and expanded, particularly in schools, to specifically counteract the observed health damage and, thus, have a positive effect on the development of all children, especially those without sports club membership.

Impact of the COVID-19 pandemic on perceived cardiorespiratory fitness in athlete patients

INTRODUCTION

Cardiorespiratory fitness (CRF), as one of the most potent prognostic factors in medicine, is followed longitudinally to guide clinical management. Coronavirus disease 2019 (COVID-19) pandemic-related changes in lifestyle stand to influence CRF.

OBJECTIVE

To assess the influence of the pandemic on perceived CRF in athlete patients and evaluate how perceived CRF change was related to demographics, pre-pandemic measured CRF, and current physical activity (PA).

DESIGN

Prospective cohort study, utilizing electronic survey.

SETTING

Tertiary care sports cardiology clinical practice.

PARTICIPANTS

Adult athlete patients without COVID-19 with pre-pandemic measured CRF using cardiopulmonary exercise testing.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Perceived change in CRF since pandemic onset; association between perceived CRF change and demographics, PA, health status, and pre-pandemic measured CRF assessed via analysis of variance (ANOVA).

RESULTS

Among 62 participants (male: 71%, 50.1 ± 12.1 years old), 40% (25/62) reported no change and 32% (20/62) reported an increase in perceived CRF since pandemic onset. Among the 27% (17/62) who reported a decrease in perceived CRF, in most (12/17), this was characterized as only mild. Demographics and pre-pandemic measured CRF did not differ across groups of perceived CRF change. Participants with a moderate or greater decrease in perceived CRF regarded their overall health (via Euro Quality of Life Visual Analogue Scale) as worse than other groups (ANOVA, p = .001). Although total PA was similar across groups, those who had improvement in perceived CRF reported higher levels of moderate intensity PA (ANOVA, p = .008).

CONCLUSIONS

The majority of participants perceived that they had maintained or improved CRF over the pandemic. Findings from this study suggest that a reduction in perceived CRF from pre-pandemic values in athletic patients in clinical practice may not result from population-wide pandemic changes in lifestyle. Worse health status and lower levels of moderate intensity PA were associated with perceived reduction in CRF over the pandemic in athlete patients.

Comparison of Physical Fitness Profiles Obtained before and during COVID-19 Pandemic in Two Independent Large Samples of Children and Adolescents: DAFIS Project

COVID-19 pandemic restrictions might have negatively affected the health-related physical fitness of children and adolescents. The aim of this study was to contrast the body composition and physical fitness data of two independent samples of children and adolescents obtained from an online database (DAFIS project) before (n = 15,287) and during (n = 2101) the first academic year of the COVID-19 pandemic. The results revealed higher values for the body mass index (p = 0.002), waist circumference (p < 0.001), and waist to hip and waist to height ratios (p < 0.001) during than before the pandemic, particularly in the case of boys. On the other hand, lower muscular fitness was observed for girls during the pandemic. Quantitative and qualitative analysis did not detect relevant changes in cardiorespiratory fitness in children or adolescents (p > 0.05). Our data suggested that pandemic constraints might have affected body composition and muscular fitness of children and adolescents. These results might be of interest for designing specific interventions oriented toward counteracting the negative effects of pandemic restrictions on health-related physical fitness.

The effects of living and learning conditions on the health-related quality of life of children and adolescents during the COVID-19 lockdown in the French Grand Est region

INTRODUCTION

COVID-19 lockdown measures resulted in children and adolescents staying and learning at home. This study investigated health-related quality of life (HRQoL) and its associated factors among youth during the first lockdown.

METHODS

A cross-sectional study was conducted among 8- to 18-year-olds from the French Grand Est region. Sociodemographic data and information on living and learning conditions were collected using an online survey. HRQoL was assessed using the KIDSCREEN-27. Multiple regression analysis was performed to explore factors related to low HRQoL in each dimension.

RESULTS

In total, 471 children from 341 households were included. Difficulties isolating at home were associated with low HRQoL in the psychological well-being (OR = 2.2, 95% CI: 1.2-4.0) and parent relations and autonomy (OR = 2.1, 95% CI: 1.2-3.8) dimensions. Conflicts with dwelling occupants were related to increased ORs in the psychological well-being (OR = 2.9, 95% CI: 1.9-4.6), parent relations and autonomy (OR = 2.2, 95% CI: 1.4-3.4) and school environment (OR = 2.4, 95% CI: 1.5-3.7) dimensions. Living in an apartment (OR = 1.8, 95% CI: 1.1-3.1), never leaving home (OR = 2.6, 95% CI: 1.2-5.9), having indoor noise at home (OR = 2.3, 95% CI: 1.2-4.6), and having a parent with high anxiety (OR = 1.8, 95% CI: 1.1-3.1) were associated with low HRQoL in the social support and peers dimension. Children working less than 1 h/day on schoolwork had an increased OR of 3.5 (95% CI: 1.4-9.0) in the school environment dimension.

CONCLUSION

Living and learning conditions were associated with low HRQoL among children and adolescents during the COVID-19 lockdown. Prevention and intervention programs are needed to support youth by facilitating their interactions and improving their coping and to prepare for future waves.

The Impact of COVID-19-Related Mitigation Measures on the Health and Fitness Status of Primary School Children in Austria: A Longitudinal Study with Data from 708 Children Measured before and during the Ongoing COVID-19 Pandemic

The COVID-19-related closing of schools and sport facilities resulted in major changes to daily routines worldwide. It was the aim of this study to investigate the impact of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. Seven hundred and eight primary school children (7–10 years old) participated in the longitudinal study. Data on height, weight, waist circumference, and fitness were collected before (September 2019) and during the course of the COVID-19 pandemic (June 20, September 20, March 21, June 21). A significant increase in EQUI BMI_AUT (η_p² = 0.087) and significant changes (η_p² = 0.355) in waist circumference were found. Cardiorespiratory endurance (η_p² = 0.440) and action speed (η_p² = 0.221) decreased dramatically following lockdowns/school closures. In contrast, muscle strength showed no significant changes. The COVID-19-related mitigation measures intended to contain a communicable disease resulted in an acceleration of the pre-existing pandemic of overweight and obesity. The adverse combination of increasing BMI and the loss of physical fitness is likely to result in long-term negative effects on the health status of growing and developing individuals. Health professionals should therefore not only support further longitudinal observations of this “non-communicable disease” but also support intervention programs to reverse this worrying side-effect of COVID-19-associated containment policies.

Changes in children's physical fitness, BMI and health-related quality of life after the first 2020 COVID-19 lockdown in England: A longitudinal study

We aimed to assess one-year changes in physical fitness, health-related quality of life (HRQoL) and body mass index (BMI), encompassing the 2020 COVID-19 UK lockdowns. Data were collected (October 2019, November 2020) from 178 8-10-year-olds in Newcastle-upon-Tyne, England, 85% from England's most deprived quintile. Twenty-metre shuttle run test performance (20mSRT), handgrip strength (HGS), standing broad jump (SBJ), sit-and-reach, height, body mass, HRQoL (Kidscreen-27 questionnaire) and sports club participation were measured. BMI z-scores and overweight/obesity were calculated (≥85th centile). Paired t-tests and linear regression assessed change, adjusting for baseline BMI. Significant (p<0.001) changes were observed: increases in mean BMI (+1.5kg·m^-2), overweight/obesity (33% to 47%), SBJ (+6.8cm) and HGS (+1.5kg); decreases in 20mSRT performance (-3 shuttles), sit-and-reach (-1.8cm). More children at follow-up were categorized "very low" for 20mSRT performance (35% baseline v 51%). Increased BMI z-score was associated with decreased "Physical Wellbeing" HRQoL. Follow-up sports club participation was associated with better 20mSRT performance (p=0.032), and "Autonomy & Parents" (p=0.011), "Social Support & Peers" (p=0.038) HRQoL. Children's 20mSRT performance and BMI changed adversely over one year; national lockdowns potentially made negative contributions. Physical fitness, physical activity and sports programmes should be part of children's physical and mental recovery from the pandemic.

Changes in Physical Fitness during COVID-19 Pandemic Lockdown among Adolescents: A Longitudinal Study

The negative impact of COVID-19 on physical activity has been improved, while the research on changes in physical fitness that may be caused by physical inactivity is still scarce. This study aims to explore the impact of the COVID-19 pandemic lockdown on physical fitness, and the impact of initial physical fitness indicators on their changes during the lockdown in adolescents. A longitudinal study including 265 adolescents aged 14.1 ± 0.4 years old was conducted in China. Physical fitness measurement at baseline and follow-up were respectively measured before (November 2019) and after the lockdown (July 2020). Several physical fitness indicators including aerobic fitness (i.e., 800-m or 1000-m run) and explosive force (i.e., 50-m sprint) deteriorated during the lockdown. Whereas the performances of vital capacity, flexibility (i.e., sit and reach), and muscular strength (i.e., pull-ups) were significantly improved during the lockdown. Furthermore, the reduction in physical fitness for adolescents with higher physical fitness before the lockdown was greater than that for others. These findings may contribute to the development of targeted intervention strategies for physical fitness promotion during the lockdown caused by the public health emergency.

The Influence of Physical Activity on COVID-19 Prevention Among Quarantined Individuals: A Case–Control Study

Background

Patients and Methods

Results

Conclusion

COVID-19 school and kindergarten closure relates to children's social relationships: a longitudinal study in Japan

The COVID-19 pandemic has led children to experience school closures. Although increasing evidence suggests that such intense social quarantine influences children’s social relationships with others, longitudinal studies are limited. Using longitudinal data collected during (T1) and after (T2) intensive school closure and home confinement, this study investigated the impacts of social quarantine on children’s social relationships. Japanese parents of children aged 0–9 years (n = 425) completed an online questionnaire that examined children’s socio-emotional behavior and perceived proximity to parents or others. The results demonstrated that social quarantine was not significantly related to children’s socio-emotional behavior across all age groups. However, changes in children’s perceived proximity varied depending on certain age-related factors: elementary schoolers’ perceived closeness to parents significantly decreased after the reopening of schools, whereas that to others, such as peers, increased. Such effects were not observed in infants and preschoolers. The follow-up survey 9-month after the reopening of schools (T3; n = 130) did not detect significant differences in both children’s socio-emotional behavior and perceived proximity from that after the intense quarantine. These findings suggest that school closure and home confinement may have influenced children’s social development differently across their age, and its effects were larger in perceived closeness rather than social behavior.

The impact of COVID-19 on physical activity behaviour in Italian primary school children: a comparison before and during pandemic considering gender differences

BACKGROUND

The World Health Organization stated an average of 60 min of Moderate to Vigorous Physical Activity (MVPA) that children should accumulate every day. Nevertheless physical inactivity is growing and, due to restrictions imposed during pandemic, PA levels of children might be more negatively affected. The study aimed to analyse the impact of COVID-19 on the PA of an Italian sample of primary school children by comparing it before and during COVID-19 considering gender differences.

METHODS

A pre-post analysis (October 2019-January 2021) was conducted using a randomized sample (N = 77) from the I-MOVE study settled in an Italian primary school. Both objective (Actigraph accelerometers) and self-reported (PAQ-c questionnaires) assessments of PA were performed. Changes were compared using T-Student and Chi-Square test. Gender differences were calculated using Anova.

RESULTS

Weekly and daily minutes time spent in MVPA significantly decreased respectively by - 30.59 ± 120.87 and - 15.32 ± 16.21 from before to during pandemic while the weekly time spent in sedentary behaviour increased (+ 1196.01 ± 381.49). PAQ-c scores followed the same negative trend (- 0.87 ± 0.72). Boys seem to have suffered more than girls from the imposed restrictions.

CONCLUSION

These findings outline the need for strategies to promote PA and reduce sedentary behaviours in children to prevent COVID-19 restriction long-term effects.

Recreational runners who recovered from COVID-19 show different running kinetics and muscle activities compared with healthy controls

BACKGROUND

Social isolation through quarantine represents an effective means to prevent COVID-19 infection. A negative side-effect of quarantine is low physical activity.

RESEARCH QUESTION

What are the differences of running kinetics and muscle activities of recreational runners with a history of COVID-19 versus healthy controls?

METHODS

Forty men and women aged 20-30 years participated in this study and were divided into two experimental groups. Group 1 (age: 24.1 ± 2.9) consisted of participants with a history of COVID-19 (COVID group) and group 2 (age: 24.2 ± 2.7) of healthy age and sex-matched controls (controls). Both groups were tested for their running kinetics using a force plate and electromyographic activities (i.e., tibialis anterior [TA], gastrocnemius medialis [Gas-M], biceps femoris [BF], semitendinosus [ST], vastus lateralis [VL], vastus medialis [VM], rectus femoris [RF], gluteus medius [Glut-M]).

RESULTS

Results demonstrated higher peak vertical (p = 0.029; d=0.788) and medial (p = 0.004; d=1.119) ground reaction forces (GRFs) during push-off in COVID individuals compared with controls. Moreover, higher peak lateral GRFs were found during heel contact (p = 0.001; d=1.536) in the COVID group. COVID-19 individuals showed a shorter time-to-reach the peak vertical (p = 0.001; d=3.779) and posterior GRFs (p = 0.005; d=1.099) during heel contact. Moreover, the COVID group showed higher Gas-M (p = 0.007; d=1.109) and lower VM activity (p = 0.026; d=0.811) at heel contact.

SIGNIFICANCE

Different running kinetics and muscle activities were found in COVID-19 individuals versus healthy controls. Therefore, practitioners and therapists are advised to implement balance and/or strength training to improve lower limbs alignment and mediolateral control during dynamic movements in runners who recovered from COVID-19.

Change in physical fitness due to the COVID-19 pandemic lockdown in French adolescents: a comparison between two independent large samples from Diagnoform battery

Numerous studies reported a significant decline in physical activity level in adolescents as a result of the COVID-19 lockdown. Physical fitness is recognized as a powerful marker of health in youth. The aim of this study was to evaluate the impact of the COVID-19 pandemic lockdown on health-related physical fitness in French adolescents. Two cross-sectional studies were performed comparing two different groups of French adolescents, before (sample 1) and after the first lockdown (sample 2). A total of 1231 adolescents (aged to 16.5 ± 1.5 years) participated in the two cross-sectional studies. Complete data for physical fitness and anthropometrics data were obtained. Adolescents from sample 2 showed lower physical fitness levels compared to adolescents from sample 1. Regarding physical fitness for boys and girls, physical fitness levels were significantly lower in both sex between adolescents from the sample 1 and adolescents from the sample 2, except for cardiorespiratory fitness and flexibility for boys and girls, respectively. The physical fitness global score was also significantly lower between adolescents from the sample 1 and 2 for boys (-9.8%, p < 0.01) and girls (-16.2%; p < 0.01), respectively. Overall, the higher difference was found for performance in the speed body displacement test (-30%). A difference of 12.8% and 25% was observed for boys and girls, respectively.   Conclusion: COVID-19 pandemic lockdown had a negative impact on physical fitness in French youth. This study highlights the need to develop, in a near future, prevention programmes in order to improve the physical fitness in youth. What is Known: • COVID-19 pandemic deeply impacted lifestyle habits. A worrying decrease of physical activity, associated to a dramatic increase of time spent in sedentary behaviors was found in many coutries. What is New: • Our study bring first data on the health-related physical fitness consequences due to lockdown in French adolescents. Our study demonstrate the negative impact of COVID-19 pandemic lockdown on health-related physical fitness in French adolescents.

Needs assessment for physical activity information during COVID-19 among a nationally representative sample of parents and children ages 6-17 in the United States: a cross-sectional study

Background

The COVID-19 pandemic presented novel barriers to youth physical activity engagement. Identifying what resources parents and children are interested in receiving can support efforts to mitigate the negative impact of the pandemic on youth physical activity behavior. This study aimed to identify physical activity-related information needs during the COVID-19 pandemic among a nationally representative sample of American parents of children 6–10 years-old and parent-child dyads of children 11–17 years-old.

Methods

A cross-sectional survey was conducted by a market research company in October–November 2020. Parents and children were asked about their interest in specific types of information about helping their family and themselves, respectively, be active (Yes/No). Weighted percentages were calculated for reported information needs and compared using two-sample test of proportions.

Results

Final analytic sample was 1000 parents (55.4% female; 74.7% White; 74.0% non-Hispanic); 500 children 11–17 years-old (52.1% male; 77.6% White). Over 40% of participants were interested in information about being active during COVID-19. Parents were more likely to be interested in information if they always (versus never) worked from home [53.3% (95% CI: 43.3–63.0%) versus 22.0% (95% CI: 14.9–31.3%), p < 0.001]; had children attending school remotely versus in-person [47.3% (95% CI:40.2–54.5%) versus 27.5% (95% CI: 19.6–37.1%), p < 0.001]; and lived in a big city versus a rural area [66.5% (95% CI:54.5–76.7%) versus 34.1% (95% CI: 22.8–47.6%), p < 0.001]. Children most interested were those who did not have resources for online activity engagement and those worried about their safety or getting infected with COVID-19. Children were also more likely to be interested if their parents worked full-time versus not working [48.6% (95% CI:41.7–55.6%) versus 31.5% (95% CI: 24.1–39.9%), p < 0.001], and lived in a big city versus a rural area [57.2% (95% CI:45.3–68.3%) versus 27.8% (95% CI:17.8–40.7%), p < 0.001].

Conclusions

Families are interested in physical activity resources, particularly those whose daily routines and opportunities for physical activity may have been most significantly impacted by the pandemic. This includes parents who always worked from home or whose children attended school remotely. Identifying felt needs is an important step in developing tailored interventions that aim to effectively and sustainably support families in promoting physical activity.

Adverse Collateral Effects of COVID-19 Public Health Restrictions on Physical Fitness and Cognitive Performance in Primary School Children

The aim of the present study was to evaluate whether the COVID-19-related confinement and social restrictions affected the levels of physical fitness and academic achievement in primary school French children. A total of 206 primary school children (106 before confinements and 100 after restrictions) completed a test battery evaluating their anthropometric characteristics, body compositions, activity preferences, cognitive performances and physical fitness. The performance of the Standing Long Jump was better at T0 (169.9 ± 142.5 cm) compared to T1 (135.2 ± 31.4 cm) (p = 0.0367), and the Medicine Ball Throw performance declined from T0 to T1 (297.3 ± 81.1 cm vs. 249 ± 52 cm; p < 0.0001). Motor skills (26.9 ± 6.2 s vs. 30.9 ± 5.4 s; p < 0.0001), the shuttle-run test (stages completed), Maximal Aerobic Speed, and the estimated VO_2max were lower at T1 compared to T0 (p < 0.0001). Executive functioning was found to be greater at T0 compared to T1 (p < 0.0001). Explicit liking or wanting for sedentary or physical activities did not change between T0 and T1. Both overall physical fitness and cognitive performance drastically declined among primary school French children with the COVID-19-related public health restrictions, which reinforces the need to urgently develop preventive strategies in anticipation of further mitigation measures.

Training for Marathons during a Marathon Pandemic: Effect of the COVID-19 Pandemic on Fitness among High-Level Nonelite Runners

Background

The COVID-19 pandemic has had a profound effect on all aspects of life, including physical fitness and well-being of the general population. In the present study, we assessed the effect of the pandemic on the subjective and objective fitness of high-level nonelite runners.

Methods

The MASTERS Athletic Study is an ongoing survey of training and health habits of high-level nonelite runners, the majority of whom compete in marathons and other extreme endurance events. We invited participants to a web-based questionnaire regarding training and fitness during the COVID-19 pandemic. Comparisons were made between subjective and objective fitness as well as well as the relationship of prepandemic training volume and history of COVID-19 on change in fitness during the pandemic, using Mann–Whitney rank-sum tests and chi-square tests for nonparametric and categorical variables, respectively.

Results

A total of 189 runners completed the survey, of whom 26 (13.8%) reported prior diagnosis with COVID-19. In terms of the subjective sense of fitness compared to before the pandemic, 49 (25.9%) reported they were less fit, 55 (29.1%) reported they were more fit, and 85 (45.0%) reported their fitness was unchanged. These assessments correlated well with objective measurement of training volume in MET-min/week. Runners with improved fitness at present had a lower calculated training volume before the pandemic versus those who reported unchanged or worsened fitness. There was no relationship between the report of prior COVID-19 and either subjective or objective measures of fitness.

Conclusion

The COVID-19 pandemic has had a variable effect on the fitness of high-level nonelite runners. We found an inverse relationship between baseline training volume and the likelihood of runners reporting improved fitness and no relationship between a history of COVID-19 and change in fitness through the pandemic. Understanding the effect of the COVID-19 pandemic on athletic fitness will help guide strategies to maintain physical health and wellness through future public health crises.

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups.

The impact of COVID-19 on Physical Activity of Czech children

INTRODUCTION

The pandemic of coronavirus disease (COVID-19) and related restrictions (closed schools and sports centers, social isolation, masks) may have a negative impact on children's health. The purpose of this study was to evaluate the level of physical activity (PA) of Czech children during COVID-19 in autumn 2020.

METHODS

Ninety-eight Czech children (mean age = 10.1 ± 1.47 years) completed the standardized Physical Activity Questionnaire for Older Czech Children (PAQ-C/cz) during COVID lockdown. Data were compared with previously published norms. Thirty-five children also reported daily number of steps measured by accelerometers.

RESULTS

Total PAQ-C score was 0.38 lower during COVID compared to Pre-COVID [t(302) = 5.118., p < .001]. The male PAQ-C total score was 0.37 lower [t(146) = 3.21., p = .002)] and the female total score was 0.39 lower [t(154) = 3.97., p < .001] during COVID compared to Pre-COVID. Specifically, responses of PA during spare time, before-school, physical education (PE), and recess were significantly lower during COVID. The average number of steps was 7.767 steps/day (boys = 9.255; girls = 6.982).

CONCLUSION

COVID lockdown resulted in significant reduction of PA in Czech children. Strategies to promote adequate PA of children during the pandemic need to be determined.

Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone

BACKGROUND

The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone.

METHOD

A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool.

RESULTS

The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12-14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating.

CONCLUSION

The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.