Physical Activity and Sedentary Behavior of Elderly Populations during Confinement: Results from the FRENCH COVID-19 ONAPS Survey

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study

AIMS

To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care.

DESIGN

A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service.

METHODS

Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper.

RESULTS

A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened.

CONCLUSIONS

COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition.

IMPACT

Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Neighbourhood Walkability and Physical Activity during the COVID-19 Pandemic

This study investigated whether living in a walkable neighbourhood could mitigate the adverse effects of the lockdown and closure of public open spaces during the COVID-19 pandemic on physical activity among adults in Bangkok, Thailand. We conducted a telephone survey with 579 respondents and collected information on their physical activity, access to green open spaces, neighbourhood walkability, and socioeconomic characteristics during the pandemic. Our study indicates that living in a walkable neighbourhood is associated with a higher likelihood of engaging in sufficient physical activity during the pandemic. Furthermore, we confirm the influence of socioeconomic factors and health behaviours on physical activity levels, aligning with previous research. Notably, our study highlights the significant association between access to green open spaces during lockdown and increased physical activity. These results underscore the importance of promoting walkable neighbourhoods and ensuring accessible green spaces to enhance physical activity and improve health outcomes during and beyond the pandemic.

Telecoaching as a new training method for elderly people: a systematic review

BACKGROUND

The numerous restrictive measures implemented during the recent COVID-19 pandemic have reduced the levels of physical activity (PA) carried out by elderly people and telecoaching (TC) could be a training method to maintain the recommended levels of PA. In fact, TC uses information and digital communications technologies, such as computers and mobile devices, to access training services remotely. Thus, this study aimed to systematically review the scientific literature to verify the application, efficacy, and safety of TC training programs.

METHODS

PubMed, Scopus, and Web of Sciences databases were used for this review, and randomized controlled trials analyzing TC training programs for elderly people were included. Only articles written in English and published in the last decade were considered.

RESULTS

3 articles were included in the qualitative synthesis including 194 elderly people. The sample size ranged from 12 to 117 and the TC training program from 8 to 12 weeks. The TC training programs were applied to elderly people with metabolic diseases and respiratory diseases. TC training program was effective in elderly people with metabolic diseases while the benefits for respiratory diseases have yet to be clarified.

CONCLUSION

TC seems to be a safe, effective, and injury-free training method, despite its limited application in elderly population. Future studies should better investigate this training method in elderly people in order to evaluate the effectiveness in a wider range of diseases.

Exploring Factors Associated with Physical Activity in the Elderly: A Cross-Sectional Study during the COVID-19 Pandemic

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

It's time to increase physical activity promotion among pregnant women in France

BACKGROUND

The lockdown linked to COVID-19 was shown to have negative effects on healthy behaviors in the general population, prompting the implementation of adapted public health measures. However, more vulnerable populations, such as pregnant women, were not specifically taken into account. At the time of writing this study, we know little about how the COVID-19 pandemic impacted the physical activity (PA) behavior of pregnant women in France. Given the many reports in the literature about women's low level of PA throughout pregnancy and the negative effects of the COVID-19 lockdown on behaviors in the general population; however, we might assume that their sedentary behaviors increased. The current study aimed to analyze the French recommendations and PA promotion among pregnant women.

MATERIALS AND METHODS

A literature search was done using PubMed for the key terms "physical activity/physical activity promotion," "pregnant women/pregnancy,", and "French population/France." All the relevant studies were included to support the argument for this narrative review.

RESULTS

Efforts to promote PA for pregnant women often seem ineffective and even unrealistic, and many women become overweight or obese during pregnancy. Health professionals need evidence-based guidelines and continuous training and skills development in order to convincingly encourage women to be more active during pregnancy and the postpartum period.

CONCLUSION

Health policies should strengthen PA promotion among pregnant women with detailed evidence-based guidelines on PA during postpartum.

Web-Based Physical Activity Interventions Are Feasible and Beneficial Solutions to Prevent Physical and Mental Health Declines in Community-Dwelling Older Adults During Isolation Periods

BACKGROUND

Periods of prolonged lockdown increase the risk of physical inactivity, which can contribute to physical decline among older adults. Online technology could be an innovative solution to promote physical activity (PA) habits in this context. The goal of this study was to examine and compare the acceptability, feasibility, and potential benefits of 2 modalities of web-based PA interventions in older adults during the coronavirus disease 2019 lockdown.

METHODS

Eighty-three nonphysically active community-dwelling older adults (aged 60 and older) were randomized to a 12-week web-based PA intervention delivered either in a live group (LG; n = 38) or a recorded group (RG; n = 45). Acceptability, feasibility as well as functional capacities, physical performance, quality of life, and PA level were assessed pre and postintervention.

RESULTS

There were fewer dropouts in the LG than RG (LG: 16% vs RG: 46%). However, adherence rate (LG: 89%; RG: 81%), level of satisfaction (LG: 77% vs RG: 64%), and enjoyment (LG: 68% vs RG: 62%) were similar across groups, even if the participants found the intervention slightly difficult (LG: 58% vs RG: 63%). Both groups significantly improved on functional capacities, physical performance, and quality of life. Only the LG showed significant improvements in perceived health and PA level. The LG showed greater improvements in physical performance and quality of life than the RG.

CONCLUSION

Web-based PA interventions are feasible, acceptable, and beneficial for improving functional capacities and physical performance during periods of lockdown. However, the interactive web and live modalities appear to be more effective for promoting some of these outcomes than recorded and individual modalities.

Impacts of Remote Physical Exercises on Functional Status and Mobility among Community-Dwelling Pre-Disabled Seniors during the Covid-19 Lockdown

OBJECTIVES

To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown.

DESIGN

This is an interventional study conducted from May 2020 to May 2021.

SETTING

Community-dwelling older adults in 2 Canadian cities.

PARTICIPANTS

84 pre-disabled seniors.

INTERVENTION

12-week physical exercise programs (1 hour/ 3 times/ week) in kinesiologist-guided groups using Zoom or phone-supervised individual booklet-based home-program (n=44) vs. Control (usual life habits; n=40).

MEASUREMENTS

Functional status in daily activities (OARS scale); Daily level of aerobic (TAPA-1) and strengthening/flexibility (TAPA-2) physical activities; Basic mobility abilities (SPPB: balance, lower limbs strength, walking speed; Timed Up-and-Go) and Frailty (SOF index) were assessed at baseline and at 3, 6, 9 and 12-month follow-ups.

RESULTS

The participants' mean age was 78.5 ± 7.2 and 76.5 % were women. There was a group * time effect for the OARS scale (p=0.02), the TAPA-1 (p=0.06) and the TAPA-2 (p=0.007) scores. For these outcomes, scores significantly improved during the first 3 months of follow-up and then stabilised in the intervention group whereas they remained constant in the control group over time. There was an overall time effect for the SPPB (p=0.004), the 4-m walking speed (p=0.02) and for the SOF index (p=0.004), with no between-group differences. Finally, no effect was observed for the TUG.

CONCLUSION

Remote home-based physical exercise interventions and monitoring during the first Covid-19 lockdown seemed to have helped maintain seniors' level of physical activities without impacting on basic mobility abilities. Further studies are needed to identify parameters of remote exercise programs that can improve daily function and mobility in this population.

Changes in leisure activities of the elderly due to the COVID-19 in Korea

Recreational activities such as physical and social activities are key components of a healthy life for the elderly. Since the outbreak of Corona 19, leisure facilities such as indoor sports facilities, religious facilities, and cultural facilities have been closed, and group activities such as volunteer activities and clubs are also being held under control. These measures are expected to bring about many changes in the leisure activities of the elderly. In this study, an empirical analysis was made on how COVID-19 caused changes in leisure activities of the elderly using national statistical data. For the data analysis, raw data of the "2019 National Leisure Activities Survey" and "2020 National Leisure Activities Survey" conducted by the Ministry of Culture, Sports and Tourism were used, and data of a total of 5,069 elderly people were analyzed. As for the analysis method, the changes in leisure activities of the elderly before and after COVID-19 in terms of participation rate were compared and analyzed. In addition, the changes in leisure activities of the elderly in terms of the type of leisure activities were examined before and after COVID-19 as well. As a result of the analysis, the participation rate in sports activities, hobbies and entertainment activities, and leisure activities increased, while the participation rates in culture and art viewing and participation activities, sports viewing activities, tourism activities, and social activities decreased. In particular, it was found that the proportion of the elderly spending leisure time centered on active and social activities decreased, and the proportion of the elderly consuming leisure time centered on passive activities increased. As a result, it was found that the leisure activities of the elderly are changing passively due to COVID-19. Leisure support policies for active leisure activities of the elderly are likely to be necessary.

Rapidly adapting an effective health promoting intervention for older adults-choose to move-for virtual delivery during the COVID-19 pandemic

Background

The COVID-19 (COVID) pandemic shifted way of life for all Canadians. ‘Stay-at-home’ public health directives counter transmission of COVID but may cause, or exacerbate, older adults’ physical and social health challenges. To counter unintentional consequences of these directives, we rapidly adapted an effective health promoting intervention for older adults—Choose to Move (CTM)—to be delivered virtually throughout British Columbia (BC). Our specific objectives were to 1. describe factors that influence whether implementation of CTM virtually was acceptable, and feasible to deliver, and 2. assess whether virtual delivery retained fidelity to CTM’s core components.

Methods

We conducted a 3-month rapid adaptation feasibility study to evaluate the implementation of CTM, virtually. Our evaluation targeted two levels of implementation within a larger socioeconomic continuum: 1. the prevention delivery system, and 2. older adult participants. We implemented 33 programs via Zoom during BC’s 1st wave acute and transition stages of COVID (April–October 2020). We conducted semi-structured 30-45 min telephone focus groups with 9 activity coaches (who delivered CTM), and semi-structured 30-45 min telephone interviews with 30 older adult participants, at 0- and 3-months. We used deductive framework analysis for all qualitative data to identify themes.

Results

Activity coaches and older adults identified three key factors that influenced acceptability (a safe and supportive space to socially connect, the technological gateway, and the role of the central support unit) and two key factors that influenced feasibility (a virtual challenge worth taking on and CTM flexibility) of delivering CTM virtually. Activity coaches also reported adapting CTM during implementation; adaptations comprised two broad categories (time allocation and physical activity levels).

Conclusion

It was feasible and acceptable to deliver CTM virtually. Programs such as CTM have potential to mitigate the unintended consequences of public health orders during COVID associated with reduced physical activity, social isolation, and loneliness. Adaptation and implementation strategies must be informed by community delivery partners and older adults themselves. Pragmatic, virtual health promoting interventions that can be adapted as contexts rapidly shift may forevermore be an essential part of our changing world.

Covid-19 and the impact on the physical activity level of elderly people: A systematic review

INTRODUCTION

Social isolation and lifestyle changes provoked by the COVID-19 pandemic have negatively affected the level of physical activity of the elderly people.

OBJECTIVE

To evaluate the available evidence related to the level of physical activity (PA) of elderly people during the COVID-19 pandemic.

METHODS

This is a systematic review, registered on PROSPERO (CRD42021241116), which included cross-sectional and cohort studies. Embase, Pubmed, Cochrane, Web of Science and Scopus databases were used to search for the studies. Finally, the New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies.

RESULTS

25 studies were found, being 14 cross-sectional and 11 cohort studies. The studies showed that the elderly population was highly affected in relation to the level of physical activity and lifestyle during restrictions, quarantine and lockdowns caused by the COVID-19. There was a significant reduction in physical activity levels, leading to declines in physical fitness and increased sedentary lifestyle, factors directly related to the increase in frailty in this population.

CONCLUSION

The level of physical activity in the elderly population decreased during the quarantine period of COVID-19 worldwide. Strategies to maintain physical condition must be encouraged with physical exercises that meets the needs of the elderly in the current pandemic scenario, in order to maintain and improve the health of this population.

Assessing Physical Performance in Older Adults during Isolation or Lockdown Periods: Web-Based Video Conferencing as a Solution

During the COVID-19 pandemic, face-to-face assessments were limited. Fortunately, older adults have access to web-technology (60%). Thus, we aimed to explore if assessing physical performance remotely is as reliable and valid as in person. At the end of the first lockdown, 15 older adults agreed to perform two similar evaluations in remote and face-to-face conditions. Functional capacities [5-repetitions Sit-to-Stand (STS); unipodal balance, 4-m walking speed (normal (NWS); fast (FWS)), 3-m Timed-Up and Go (normal (nTUG); fast (fTUG))] and muscle power and endurance were assessed. Fast walking speed was moderately reliable. Unipodal balance, NWS and nTUG were highly reliable (ICC>0.7). fTUG, STS, muscle endurance and power were extremely reliable (ICC>0.9). For absolute reliability, SEM varied from 15.54 to 5.14%. Finally, the MDC varied from 43.07 to 14.21%. Assessing functional capacities and muscle function remotely is as reliable and valid as a face-to-face assessment and should be considered as a clinical practice.

Feasibility and Acceptability of Remote Physical Exercise Programs to Prevent Mobility Loss in Pre-Disabled Older Adults during Isolation Periods Such as the COVID-19 Pandemic

This study aimed to assess the feasibility and acceptability of remote physical exercise (PE) to prevent mobility loss among pre-disabled older adults during the COVID-19 lockdowns. Participants followed a 12-week PE remote program in Zoom© supervised groups (Web-Ex group, n=11) or phone-supervised individual booklet-based home-program (Booklet group, n=33). The total rate of adherence was 82.5% in the Web-Ex group and 85.8% in the Booklet group. The level of satisfaction was « a lot » for 60% of the participants in the Web-ex group and for 37.9% of those included in the Booklet group. Respectively 10% and 31% of the participants rated the difficulty as « low » in the web-ex and Booklet groups. Remote physical exercise using a web technology or booklets at home with regular and personalized follow-up during the lockdown was feasible and acceptable among pre-disabled seniors.