Factors Protecting against a Decline in Physical Activity during the COVID-19 Pandemic

What explains adolescents' physical activity and sports participation during the COVID-19 pandemic? - an interpretable machine learning approach

Adolescents' physical activity (PA) and sports participation declined due to the COVID-19 pandemic. This study aimed to determine the critical socio-ecological factors for PA and sports participation using a machine learning approach. We did a cross-sectional secondary data analysis utilising the 2021 National Survey of Children's Health (NSCH) dataset (N=16,166; 49.0% female). We applied an interpretable machine learning approach (e.g. decision tree-based models) that examined the critical factors associated with PA and sports participation. The factors related to the intrapersonal, interpersonal, organisational, and community levels of the socio-ecological model. Out of the 25 factors examined, our findings unveiled the 11 critical factors associated with PA and the 10 critical factors associated with sports participation. Factors at the intrapersonal levels (e.g. age, screen time, and race) held greater importance to PA than those at the other three levels. While interpersonal factors (e.g. parent participation in children's events/activities, family's highest educational level, and family income level) were most important for sports participation. This study identified that the common critical factors of physical activity and sports participation during the COVID-19 pandemic mainly relied on intrapersonal and interpersonal levels. Unique factors were discussed.

The self-reported impacts of the COVID-19 pandemic on psychological health of U.S. Air Force cyber personnel

U.S. Air Force cyber personnel were faced with changes in their workplace, fitness routines, and personal lives during the COVID19 pandemic. Adjusting to COVID-19-related requirements likely increased the stress of already stressful jobs for military members and their families, which could have resounding impacts on emotional, social, and physical well-being. Therefore, it is important to evaluate psychological health outcomes and self-perceived impacts of the changes presented to cyber personnel because of the COVID-19 pandemic. An online occupational health assessment that included demographics, standardized measures of burnout, psychological distress, and work role strain; health behaviors; and perceived impacts of the COVID-19 pandemic was administered to 1488 cyber personnel. Thirty-two negative themes and 13 positive themes were created from qualitative coding for "How has the COVID-19 pandemic impacted you as an individual?" Of the themes created, 966 (68.5%) reported at least one negative impact and 440 (31.2%) reported at least one positive impact. Top-reported negative impacts were limited face-to-face interactions and loss of personal activities. Negative impacts were associated with negative psychological health outcomes (e.g., psychological distress, exhaustion, cynicism) and work role strain. Action-oriented recommendations are given in the event of another pandemic.

Trail use and recreational physical activity behavior of trail users and non-users during COVID-19 restrictions in Colorado Springs, Colorado

Physical activity (PA) is an important health behavior that was impacted for many by the public health response to the COVID-19 pandemic. In many places, indoor recreational facilities were required to close; however, many outdoor spaces like trails were available for recreational use. The purpose of this study was to examine the use of a mixed-use trail before, during, and after COVID-19 restrictions in a large Colorado city and explore if recreational PA behavior differed between trail users and non-users during those periods. Trail user counts on a mixed-use trail were extracted for 2019 and 2020 from continuous-count data. Trail use habits and recreational PA behavior from before, during, and after restrictions were collected via a retrospective internet survey (N=183). Minutes per week of walking, moderate-to-vigorous PA and total PA were calculated from survey responses. Trail use data were analyzed with a two-way ANOVA and PA data were analyzed with a two-way repeated measures ANOVA. Trail use (average count/day) during COVID-19 restrictions was greater than before by 178 users and after by 96 users. During restrictions, trail users reported 153.5 more minutes of total PA per week than non-users. These results suggest the importance of maintaining accessible outdoor infrastructure for promoting positive PA behaviors in general, and especially in a pandemic situation.

The relationship between self-determined motivation, emotional involvement, cognitive involvement and leisure-time physical activity among college students

Objective

Grounded in self-determination theory and the stimulus-organism-response framework, this study examines factors that affect college students' leisure-time physical activity by considering the basic psychological needs satisfaction (i.e., autonomy, competence, and relatedness), self-determined motivation, emotional and cognitive involvement.

Methods

The sample included 526 students (47.8 % male; 57.2 % female) from four universities in central China. A structural equation model was used to analyze associations among variables.

Results

The satisfaction of all three basic psychological needs had a significant positive impact on emotional involvement. Additionally, autonomy and competence need satisfaction had a significant positive impact on self-determined motivation and cognitive involvement. However, contrary to our expectation, there was no significant effect of relatedness need satisfaction on self-determined motivation and cognitive involvement. Furthermore, emotional involvement was found to have a significant effect on leisure-time physical activity intention for male students. Interestingly, the relationship between cognitive involvement and leisure-time physical activity intention is significant, but this effect was observed only among female students.

Conclusion

Pedagogical strategies and tactics better satisfied students' psychological needs, promote physical education classes emotional and cognitive involvement, therefore, achieve autonomous active lifestyle behaviors in leisure time.

Impact of the pandemic on leisure physical activity and alcohol consumption

BACKGROUND

The COVID-19 pandemic precipitated heightened morbidity and elevated mortality attributed to the SARS-CoV-2 infection. The pandemic also influenced health behaviors such as physical activity (PA) and alcohol consumption. The aim of this study was to examine changes in leisure PA and alcohol consumption in Sweden during the pandemic, and elucidate potential discrepancies in changes across demographic strata and socioeconomic status (SES).

METHODS

Data were retrieved from two waves of the longitudinal cohort study Life conditions, Stress and Health (LSH) (n = 2,523). Two measures of change were used; longitudinal change relative to baseline (2012-2015) and reported change compared to before the pandemic. For these two change measures, differences between sex, age group and SES were analyzed using multinomial logistic regression.

RESULTS

Regardless of the change measure, the proportion of individuals with diminished PA was notably higher among females compared to males. Furthermore, relative to baseline, females were less likely to have increased their PA, however according to the reported change they were more likely to have increased PA. Longitudinal change in PA compared to baseline followed a reversed age gradient, while, according to reported change, a decrease in PA during the pandemic was most prevalent in respondents 45 years of age at baseline (OR = 1.8, CI: 1.2-2.5) and respondents 50 years of age at baseline (OR = 1.7, CI: 1.2-2.4). High SES was associated with a greater variability in PA. Alcohol consumption was generally reduced during the pandemic. However, individuals aged 40 or 45 years at baseline were more likely than others to have initiated risky alcohol consumption.

CONCLUSIONS

Females exhibited a greater propensity to alter their PA levels during the pandemic, with the most profound decreases observed among individuals of working ages. Despite a general downturn in alcohol consumption, individuals aged 40 and 45 had a heightened likelihood of having initiated risky alcohol consumption compared to individuals in other age cohorts. In conclusion, societal restrictions during a pandemic render a dual impact on PA levels. While posing a risk for decreased PA among individuals in working ages, the restrictions also present a potential window of opportunity to increase PA, particularly among females.

COVID-19 Pandemic as an Equalizer of the Health Returns of Educational Attainment for Black and White Americans

BACKGROUND

COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies conducted before the COVID-19 pandemic demonstrated diminished returns of educational attainment for Black individuals compared to White individuals.

OBJECTIVES

The study has three objectives: First, to test the association between educational attainment and cigarette smoking, e-cigarette vaping, presence of chronic medical conditions (CMC), self-rated health (SRH), depressive symptoms, and obesity; second, to explore racial differences in these associations in the USA during the COVID-19 pandemic; and third, to compare the interaction of race and return of educational attainment pre- and post-COVID-19 pandemic.

METHODS

This study utilized data from the Health Information National Trends Survey (HINTS) 2020. Total sample included 1313 adult American; among them, 77.4% (n = 1017) were non-Hispanic White, and 22.6% (n = 296) were non-Hispanic Black. Educational attainment was the independent variable operationalized as years of education. The main outcomes were cigarette smoking, e-cigarette vaping, CMC, SRH, depressive symptoms, and obesity. Age, gender, and baseline physical health were covariates. Race/ethnicity was an effect modifier.

RESULTS

Educational attainment was significantly associated with lower CMC, SRH, depressive symptoms, obesity, cigarette smoking, and e-cigarette vaping. Educational attainment did not show a significant interaction with race on any of our outcomes, suggesting that the health returns of education is similar between non-Hispanic White and non-Hispanic Black individuals.

CONCLUSION

COVID-19 may have operated as an equalizer of the returns of educational attainment. This observation may be because White may have more to lose; Black communities may be more resilient or have economic and social policies that buffered unemployment and poverty regardless of historical anti-Black oppression.

Effects of the COVID-19 associated United Kingdom lockdown on physical activity in older adults at high risk of cardiovascular disease: a mixed methods perspective from the MedEx-UK multicenter trial

Introduction

Physical inactivity and sedentary behaviour are linked to increased risk of cardiovascular disease, infections and dementia, as well as placing a significant economic burden on healthcare systems. The implementation of COVID-19 pandemic lockdown measures aimed at reducing virus transmission posed challenges to the opportunity to be physically active. This study investigates how the first UK COVID-19 lockdown affected objectively measured physical activity in older adults at higher risk of cardiovascular disease.

Methods

We studied 48 individuals aged 55-74 years (81.3% female) with self-reported PA levels < 90 min/week and a QRISK2 score ≥ 10 (indicative of a ≥ 10% risk of a major cardiovascular event in the next 10 years) without mild cognitive impairment or dementia. Physical activity data was collected using objective wrist-based activity monitors and analysed across three time periods, usual activity (pre-pandemic), the precautionary phase when the UK began advising on limiting social contact and finally during the first UK lockdown period was collected (27 January 2020 and 07 June 2020). Data was analysed using linear mixed effects model was used to investigate PA levels over the measured 12-week period. Effects of BMI, age, deprivation score and baseline PA levels on PA across the three measurement periods were also examined. Focus-group and individual interviews were conducted, and data were thematically analysed.

Results

Average daily step count (-34% lower, p < 0.001) and active energy expenditure (-26% lower, p < 0.001) were significantly lower during the precautionary period compared with the usual activity period. Physical activity remained low during the UK lockdown period. Participants with a lower BMI engaged in significantly more (+45% higher daily steps p < 0.001) physical activity and those over 70 years old were more physically active than those under 70 years across the 12-week period (+23% higher daily steps p < 0.007). The risk of COVID-19 infection and restrictions because of lockdown measures meant some individuals had to find alternative methods to staying physical active. Participants described a lack of access to facilities and concerns over health related to COVID-19 as barriers to engaging in physical activity during lockdown. For some, this resulted in a shift towards less structured activities such as gardening or going for a walk.

Discussion

The data presented shows that lockdown measures during the COVID-19 pandemic significantly reduced physical activity among older individuals at risk of cardiovascular disease, particularly those with a higher body mass index. To support this population group in staying active during future lockdowns, a multifaceted strategy is needed, emphasizing psychosocial benefits and home-based physical activity. The MedEx-UK study was pre-registered with ClinicalTrials.gov (NCT03673722).

Factors that contributed to Ontario adults' mental health during the first 16 months of the COVID-19 pandemic: a decision tree analysis

The COVID-19 pandemic has negatively impacted the mental health of individuals globally. However, less is known about the characteristics that contributed to some people having mental health problems during the pandemic, while others did not. Mental health problems can be understood on a continuum, ranging from acute (e.g., depression following a stressful event) to severe (e.g., chronic conditions that disrupt everyday functioning). Therefore, the purpose of this article was to generate profiles of adults who were more or less at risk for the development of mental health problems, in general, during the first 16-months of the COVID-19 pandemic in Ontario, Canada. Data were collected via online surveys at two time points: April-July 2020 and July-August 2021; 2,188 adults (Mage = 43.15 years; SD = 8.82) participated. Surveys included a demographic questionnaire and four previously validated tools to measure participants' mental health, subjective wellbeing, physical activity and sedentary behaviour, and sleep. A decision tree was generated at each time point for those with mental health problems, and those with no mental health problems. Results showed that subjective wellbeing was the biggest contributor to mental health status. Characteristics associated with no mental health problems among adults included having good wellbeing, being a good sleeper (quantity, quality, and patterns of sleep), and being over the age of 42. Characteristics associated with mental health problems included having poor wellbeing and being a poor sleeper. Findings revealed that specific characteristics interacted to contribute to adults' mental health status during the first 16 months of the COVID-19 pandemic. Given that wellbeing was the biggest contributor to mental health, researchers should focus on targeting adults' wellbeing to improve their mental health during future health crises.

Impact of leisure satisfaction on perceived risk of infectious disease during the COVID-19 pandemic: evidence from new worker classes

Introduction

This study examines how job market changes affect individuals' leisure choices and satisfaction, focusing on worker classes that have undergone daily life changes (e.g., economic and social activities) due to the coronavirus disease-2019 (COVID-19) pandemic.

Methods

A population-based cross-sectional study design was employed. South Korean workers aged 20-59 years answered an online survey administered from September 14 to October 4, 2021. Ultimately, 764 responses were used in the analysis. The measures used in this study consisted of factors affecting infectious disease risk perception and leisure satisfaction among the six new worker classes that emerged during the pandemic, according to socio-demographic status.

Results

The results showed that among male participants, social, emotional, physical, environmental, and educational factors of leisure satisfaction were more strongly affected, with higher social, physical, and interpersonal relationships being factors in the perception of infectious disease risk. Among female participants, the interpersonal relationship factor of perceived risk was significantly affected by the social, emotional, and educational factors of leisure satisfaction. Interpersonal relationships, affected leisure satisfaction among members of Classes 1-3, who experienced no change in pay. However, for the members of Class6 who experienced a decrease in pay, the economic factor negatively affected leisure satisfaction and played a pivotal role in our findings.

Conclusion

This study verified the risk factors that inhibit leisure satisfaction among new worker classes that emerged during the COVID-19 pandemic. Furthermore, the psychological health of people suffering pandemic-related financial constraints was affected, as they experienced a lower quality of life owing to reduced leisure activities and satisfaction.

Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW)

Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.

The influence of home isolation during COVID-19 on the physical fitness development of college students: a study utilizing repeated measures analysis of variance

BACKGROUND

Research on the impact of COVID-19-induced home isolation on the physical fitness of college students is limited. This study aims to compare and analyze the physical fitness test scores of college students in two groups: those who experienced home isolation and those who did not, over three consecutive years after enrolment, to investigate the effects of home isolation on the physical fitness development of Chinese college students.

METHODS

This comparative study included two longitudinal surveys conducted among medical college students. The participants were divided into an experimental group and a control group. The physical fitness indicators measured included body mass index (BMI), vital capacity (VC), 50-metre run, sit-and-reach, standing long jump, 1000/800-metre runs (males/females), pull-ups (males) and sit-ups (females). Repeated measures analysis of variance (ANOVA) was employed, and the Greenhouse-Geisser correction was applied when Mauchly's assumption of sphericity was violated. Pairwise comparisons were conducted using the Bonferroni method.

RESULTS

A total of 6580 students participated in the study, with 3360 students (1490 males, 1870 females) enrolled in 2019 as the experimental group and 3220 students (1326 males, 1894 females) enrolled in 2017 as the control group. All participants completed the physical fitness tests for three consecutive years. The results showed that the experimental group exhibited decreased performance in the 1000-metre and 800-metre runs, and improved performance in the sit-and-reach test. After the end of home isolation, there was an improvement in the performance of the 1000-metre run and 800-metre run, while no significant differences were observed in the trends of the other tested indicators.

CONCLUSION

The findings of this study indicate that the home isolation environment during COVID-19 had a significant impact on the physical fitness of college students, specifically in terms of endurance and flexibility qualities, as well as male BMI. To better prepare for future public health emergencies and mitigate the effects of isolation, teaching students endurance exercises that can be performed at home should be prioritized. Furthermore, physical education programs should be improved to enhance student flexibility.

Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents

OBJECTIVES

We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP).

METHODS

We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences.

RESULTS

Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent's physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father's education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother's education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05).

CONCLUSIONS

Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.

Physical Activity and Social Interaction among Rural Older Adults in Saskatchewan during COVID-19

Physical activity and social interaction among rural older adults are important, particularly during the COVID-19 pandemic when restrictions on physical gatherings were placed. The purpose of this qualitative study was to gain a deeper understanding of rural older adults' experience with physical activity and social interaction during the COVID-19 pandemic. An interpretative phenomenological approach was used to explore the experience of 10 older adults, 67-82 years of age, from rural communities throughout Saskatchewan. Findings revealed that many rural older adults acknowledged the health benefits of physical and social activities and experienced loneliness when COVID-19 restrictions were placed, even when living with a partner. For some, the restrictions placed on physical and social activity provided a welcome break from daily responsibilities. Rural communities, often at a disadvantage, were also perceived by participants as being protected against COVID-19. The resilience demonstrated among rural participants to persevere and adapt to their changing environment during the pandemic was evident in the findings.

Contextual disruption and exercise: mapping changes to exercise routines and engagement during the COVID-19 pandemic

OBJECTIVE

This study examines the impact of COVID-19 restrictions on exercise routines and engagement in moderate-vigorous physical activity (MVPA).

DESIGN

Individuals (N = 397) who reported meeting recommended guidelines for MVPA prior to COVID-19 completed an online questionnaire during the United States' COVID-19 lockdowns in April/May 2020.

MAIN OUTCOME MEASURES

Participants reported their MVPA currently and before COVID-19, and answered questions about five contextual cues (e.g. time of day, interaction partners, type of workout, surrounding events, location of exercise) that characterized their exercise routines currently and before COVID-19.

RESULTS

Contextual cues were perceived as highly disrupted and less consistent during COVID-19 (vs. before) and these changes were associated with greater declines in MVPA. For each cue, distinct effects predicting MVPA declines also emerged for perceived disruption due to COVID-19 restrictions, perceived importance of cue in getting one to exercise, and cue consistency over time.

CONCLUSION

Building on prior research, COVID-19 restrictions affected the context in which people exercised, and changes in these contextual cues were related to declines in MVPA. Re-establishing consistency in certain cues (e.g. time of day) after a disruption may help to forestall declines in MVPA compared to others (e.g. type of workout).

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.

Comparative research on the development of college students' physical fitness based on online physical education during the COVID-19 pandemic

BACKGROUND

There are few studies that focus on the impact of online physical education teaching on college students during the coronavirus disease 2019 (COVID-19) pandemic. This research focuses on the impact of online physical education among medical school students in China by comparing physical fitness test results for three consecutive years from 2019 to 2021.

METHOD

This study is a longitudinal survey. The subjects of the experiments were students enrolled in a medical school who completed a physical fitness test for three consecutive years from 2019 to 2021. The student subjects were divided into two groups, namely, male and female. The test indices included body mass index (BMI), vital capacity (VC), 50-metre run, sit-and-reach, standing long jump, pull-up (male), 1000-metre run (male), sit-ups (female) and 800-metre run (female). Repeated measures ANOVA method was used in physical fitness test indices at three consecutive time points ranging from 2019 to 2021. The Greenhouse-Geisser correction was applied when Mauchly's hypothesis test did not meet the assumption of sphericity, and the Bonferroni method was used for pairwise comparisons.

RESULTS

A total of 3360 students (1490 males and 1870 females) completed physical fitness tests in three consecutive years from 2019 to 2021. The proportion of overweight and obesity in male students was significantly higher than that in female students (28.0% vs. 12.7%). For all subjects, in 2020, the BMI and VC indexes improved, while the 800-/1000-metre running indexes declined. In 2021, all indexes except sit-and-reach increased.

CONCLUSION

The pairwise comparisons of physical fitness test results from 2019 to 2021 show that online physical education is effective in improving all items except long-distance running. Future research needs to involve a larger and geographically more dispersed sample to further analyse the effectiveness of online physical education.

Variation in leisure sport conflicts and coping strategies depending on participation type and proximity during the COVID-19 pandemic

Introduction

New conflict types have arisen in leisure sports activities due to social regulations designed to address COVID-19. We analyze the differences in conflict-inducing factors and coping strategies across various types of leisure sports and levels of spatial proximity.

Methods

Korean adults aged between 20 and 60 years, who had participated in leisure sports activities since the COVID-19 outbreak in January 2020, were surveyed, and 508 responses were collected for analysis. The differences in leisure sports conflicts and coping strategies across the types of leisure sports participation and spatial proximity were tested.

Results

The results show that conflict due to prejudice was higher in typical indoor sports activities, such as Pilates, yoga, and gym workouts, whereas conflict due to competition or not observing etiquette was higher in indoor golf. Second, conflict due to prior expectations and prejudice was high in outdoor sports activities, such as jogging and hiking. Finally, all participants showed avoidance behavior, but it was observed more frequently in outdoor sports than indoor sports.

Discussion

The study reveals how much leisure conflict is induced by various types of leisure sports participation, particularly during outdoor activities, which usually feature a relatively low density of participants. It underscores the necessity of developing structural approaches to resolving leisure conflicts in dangerous spaces or requiring intensive management and creating new leisure sports activities.

Prevalence and change in social inequalities in physical activity before and during the COVID-19 pandemic in Sweden

BACKGROUND

Physical activity is crucial for our wellbeing. Since the COVID-19 pandemic emerged, physical activity behaviour has changed globally, and social inequalities that already exist in physical activity have increased. However, there is limited knowledge of how these inequalities have evolved in Sweden. Thus, the aim of this study was to assess the prevalence of physical activity, and the socioeconomic inequalities in physical activity before and during the COVID-19 pandemic.

METHODS

This study analysed data from the national 'Health on Equal Terms' survey which was conducted on participants between 16 and 84, through a repeated cross-sectional design in 2018 (pre-pandemic) and 2021 (during the pandemic). The socioeconomic variables included gender, age, education, occupation, income, and place of birth. For both years, the prevalence of low physical activity, the absolute risk differences, the slope index of inequality, and the slope index difference for each of the variables were calculated.

RESULTS

The level of physical activity increased for the total population studied. However, the social inequalities that existed in 2018 increased over time and across age, education, occupation, income, and place of birth, but not with regard to gender.

CONCLUSIONS

Even though the Swedish population increased their levels of physical activity during the COVID-19 pandemic, the social inequalities that already existed in physical activity increased. Interventions to increase the level of physical activity among the young, people with low socioeconomic status, and those born outside Sweden are needed to reduce these social inequalities, and to improve the Swedish population's wellbeing.

Understanding physical activity declines during COVID-19: The affective repercussions of disruption to exercise routines

Recent research has examined psychological factors that forestalled declines in physical activity (PA) during the early stages of the COVID-19 pandemic. Surprisingly, there has been limited evidence of an association between intrinsic motivation (IM) and PA. We reasoned that IM may have not predicted PA because COVID-19 restrictions limited opportunities to engage in exercise in ways that produced positive affective experiences (i.e., inherent rewards). Using data from a cross-sectional survey (N = 373 participants), we tested a moderated mediation model that predicted perceived changes to affective experiences during exercise would mediate the association between disruption to one's exercise routine and self-reported declines in PA, and that effects would be moderated by IM. Evidence of moderated mediation was found, suggesting that disruptions to exercise routines were associated with fewer positive affective experiences during exercise that predicted declines in PA engagement, especially for people who typically exercised for intrinsic reasons.

Relationship of Social Connectedness With Decreasing Physical Activity During the COVID-19 Pandemic Among Older Women Participating in the Women's Health Initiative Study

BACKGROUND

Aging is generally accompanied by decreasing physical activity (PA), which is associated with a decline in many health parameters, leading to recommendations for older adults to increase or at least maintain PA.

METHODS

We determined relationships between social connectedness and decreasing or increasing PA levels during the coronavirus disease 2019 pandemic among 41 443 participants of the Women's Health Initiative Extension Study. Outcomes of logistic regression models were decreasing PA activity (reference: maintaining or increasing) and increasing PA activity (reference: maintaining or decreasing). The main predictor was social connectedness as a combined variable: not living alone (reference: living alone) and communicating with others outside the home more than once/week (reference: once/week or less). We adjusted for age, race, ethnicity, body mass index, physical function level, and education.

RESULTS

Compared with participants who were not socially connected, socially connected participants had lower odds of decreasing PA (adjusted odds ratio 0.91, 95% confidence interval 0.87-0.95). Odds of increasing PA (vs decreasing or maintaining PA) were not significantly different among socially connected and not socially connected participants. Associations between social connectedness and decreasing PA did not significantly differ by age (<85 vs ≥85 years), race/ethnicity (non-Hispanic White vs other races/ethnicity), education (college vs 75).

CONCLUSION

Social connectedness was associated with lower odds of decreasing PA among older women during the pandemic. These findings could inform the development of future interventions to help older women avoid decreasing PA.

Influence of social distancing on physical activity among the middle-aged to older population: Evidence from the nationally representative survey in China

Background

Group-based physical activity is an important positive factor assisting the middle-aged to older population to be regularly physically active, especially inside a society with a large population and highly sociable environment. However, when group-based physical activity is restricted during a public health crisis such as the infectious disease pandemic, the influence of social distancing on physical activity among this vulnerable group needs to be recognized.

Objectives

This study aimed to investigate the influence of social distancing on physical activity among the middle-aged to older Chinese population at the national level.

Methods

Data from a nationally representative social follow-up survey (China Family Panel Studies, CFPS) for 2018 and 2020 were used. Physical activity level in year 2018 was set as the baseline to be compared with that for each individual in 2020, when China implemented social distancing during the COVID-19. Chinese population with an age greater than 45 years were included, and three levels of physical activity were established. Logistic models were developed to identify sociodemographic characteristic that may be associated with a higher probability of worse PA behaviors during the social distancing.

Results

Over 46% respondents could be described as being Physically Inactivity during 2018 and this proportion increased to 67.2% in 2020. Respondents who live in the Northeast or rural regions, having a spouse, being employed, having a low level of education, and being of low-income level showed a higher decrease in physical activity compared to other groups. However, individuals living with chronic diseases emerge as being more likely to maintain positive habits with respect to physical activity in this context.

Conclusion

Social distancing during the COVID-19 pandemic has significantly influenced the extent of physical activity among middle-aged to older Chinese residents. This is especially true in respect to middle-aged and elderly people who are at increased risk of chronic diseases. Given this, there is a clear need to consider effective modalities for physical activity in the context of social distancing based on home quarantine and city lockdown. Furthermore, specific health-related strategies need to be considered in relation to different regions and populations.

Living Situation and Physical Activity in the COVID-19 Pandemic Among American Private University Students

Many university students experienced changes during the COVID-19 pandemic, including potential changes in physical activity (PA) levels and living situation. As PA behaviors in young adulthood help establish life-long habits and future health outcomes, the purpose of this study was to investigate overall change in PA, as well as change in PA due to living situation, among private university students during the COVID-19 pandemic. Private university students (n = 109) between 18 and 25 years of age completed an online survey that included the International Physical Activity Questionnaire - Short Form. T-tests examined changes in overall time spent in PA from before to during the COVID-19 pandemic, and the differences in MET-minute distributions between groups. Students performed significantly less activity during the COVID-19 pandemic than before (t(108) = 3.51, p = .001, d = 0.493), with 70.6% of all students meeting exercise recommendations before the pandemic and 51.4% after. Students living with vs. without a parent/guardian attained similar PA levels (t(107) = -.114, p = .910) before the pandemic (73.1% vs. 69.9%, respectively), but students living with a parent/guardian engaged in significantly less PA (t(107) = 2.04, p = .044, d = 0.475) than those living without a parent/guardian during the pandemic (37.5% vs. 57.1%, respectively). The declines in PA suggest the need for targeted interventions and education among private university students. In order to maximize the health benefits of PA, it is crucial that activity engagement return to at least pre-COVID-19 levels.

Effects of Vibration Resistance Exercises on EMG and Skeletal Muscle Hemodynamics

Objectives: Past studies show that vibration can stimulate muscle activity and improve muscle performance. However, further verification is needed on the effects of different vibration frequencies combined with different muscle strength exercise intensities on EMG activity and skeletal muscle hemodynamics. Methods: We recruited 27 male college athletes for 40%, 60%, and 80% maximum voluntary contraction (MVC) tests at the vibration frequencies of 0 Hz, 10 Hz, 20 Hz, and 30 Hz. We collected EMG activity signals using wireless EMGs and skeletal muscle hemodynamic parameters using a near-infrared spectrometer. Results: At an 80% MVC intensity of the rectus femoris, the mean, peak, and area of EMG at 30 Hz were significantly increased, compared with those at 0 Hz. At a 40% MVC intensity with vibration frequencies of 10 Hz, 20 Hz, and 30 Hz, the HHb of skeletal muscles was significantly increased, while the O2Hb and TSI were significantly decreased, compared with those at 0 Hz. Conclusions: We conclude that high frequency and strongly vibrated muscle strength exercise can improve EMG activity, while vibration and low-intensity muscle strength exercise could increase the oxygen consumption of skeletal muscles.

Thinking inside the box: The future of young children's physical activity and the home environment

Parrish et al.'s (2021) investigation of caregiver perceptions of preschoolers' physical activity (PA) within the home environment posits important opportunities for public policy to consider space and available opportunities for PA for preschoolers. This study uncovered qualitative themes on preschoolers' PA in the home, referencing the use of indoor and outdoor spaces, adaptations within the home, interplay between space and caregiving, and variability in child's PA. This work sparks a discussion into the current understanding of the home environment for preschooler PA and future research directions. We propose three main areas to bring forward physical activity and public health research, including 1) role of policies and community (e.g., societal norms) on the home environment and child physical activity, 2) reimagination of the home environment beyond the physical components as a complex system, and 3) advanced measurement of child physical activity using modern technology. Merging these new opportunities with past efforts may help design and facilitate healthier PA and movement patterns for preschoolers now and into the future.

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.

Effects of one-year once-weekly high-intensity interval training on body adiposity and liver fat in adults with central obesity: Study protocol for a randomized controlled trial

Objective

This study aims to examine the effects of one-year, once-weekly high-intensity interval training (HIIT) on body adiposity and liver fat in adults with central obesity.

Methods

One-hundred and twenty adults aged 18–60 years with central obesity (body mass index ≥25, waist circumference ≥90 cm for men and ≥80 cm for women). This is an assessor-blinded randomized controlled trial. Participants will be randomly assigned to the HIIT group or the usual care control group. Each HIIT session will consist of 4 × 4-min bouts at 85%–95% maximal heart rate, interspersed with 3-min bouts at 50%–70% maximal heart rate. The HIIT group will complete one session per week for 12 months, whereas the usual care control group will receive health education. The primary outcomes of this study are total body adiposity and intrahepatic triglyceride content. The secondary outcomes include abdominal visceral adipose tissue, subcutaneous adipose tissue, body mass index, waist circumference, hip circumference, cardiorespiratory fitness, lean body mass, bone mineral density, blood pressure, fasting blood glucose, insulin, triglycerides, glycated hemoglobin, cholesterol profile, liver function enzymes, medications, adherence to exercise, adverse events, quality of life, and mental health. Outcome measure will be conducted at baseline, 12 months (post-intervention), and 24 months (one-year follow-up).

Impact of the project

This study will explore the benefits of long-term once-weekly HIIT with a follow-up period to assess its effectiveness, adherence, and sustainability. We expect this intervention will enhance the practical suitability of HIIT in inactive adults with central obesity, and provide insights on low-frequency HIIT as a novel exercise option for the management of patients with central obesity and liver fat.

Trial registration

ClinicalTrials.gov (NCT03912272) registered on 11 April 2019.

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

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

Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.

Variability in Physical Inactivity Responses of University Students during COVID-19 Pandemic: A Monitoring of Daily Step Counts Using a Smartphone Application

This study investigated the changes in physical inactivity of university students during the COVID-19 pandemic, with reference to their academic calendar. We used the daily step counts recorded by a smartphone application (iPhone Health App) from April 2020 to January 2021 (287 days) for 603 participants. The data for 287 days were divided into five periods based on their academic calendar. The median value of daily step counts across each period was calculated. A k-means clustering analysis was performed to classify the 603 participants into subgroups to demonstrate the variability in the physical inactivity responses. The median daily step counts, with a 7-day moving average, dramatically decreased from 5000 to 2000 steps/day in early April. It remained at a lower level (less than 2000 steps/day) during the first semester, then increased to more than 5000 steps/day at the start of summer vacation. The clustering analysis demonstrated the variability in physical inactivity responses. The inactive students did not recover daily step counts throughout the year. Consequently, promoting physical activity is recommended for inactive university students over the course of the whole semester.

Perceiving reduced physical activity during COVID-19 lockdown is related to lower quality of life: a cross-sectional study with young adults

Physical activity and social participation are positively related to mental health and represent resources that strengthen individuals’ resilience. However, the measures aiming to contain the coronavirus disease 2019 (COVID-19) pandemic included restrictions regarding these health resources. For many people, stay-at-home orders had a negative effect on mental health and health-related behaviors such as physical activity. Young adults seem to be a particularly vulnerable group. The study aimed to examine the relationship between changes in physical activity and perceived quality of life in young adults during lockdown conditions. We conducted an online survey during the second lockdown in Germany and assessed perceived changes in physical activity, social activities, quality of life (QoL), the perceived burden of changes in social activities, and current QoL in 212 young adults (63.7% women, mean age = 23.46, standard deviation = 3.63). Young adults that maintained or increased their physical activity level under lockdown conditions, rated their current QoL higher and perceived a less negative change of their QoL during lockdown compared to those with decreased physical activity. Furthermore, those who rated that their physical activity levels did not change or increased, perceived the reduction of their social activities as less burdening. The results indicate that physical activity is a beneficial health resource during lockdown conditions. This highlights the importance of gaining knowledge regarding the antecedents of reducing physical activity and developing strategies that support young adults to be physically active in challenging times such as the pandemic (e.g. ehealth/mhealth approaches).

Relationships among changes in walking and sedentary behaviors, individual attributes, changes in work situation, and anxiety during the COVID-19 pandemic in Japan

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Females, younger people, those living in the highest-density tended to be inactive.

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Inactivity was related to standby/work-from-home for higher socioeconomic people.

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Inactivity was related to decreased amount of work for lower socioeconomic people.

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Decreased physical activity was related to strong anxiety during the pandemic.

Studies from many countries, including Japan, have reported decreased physical activity during the coronavirus disease 2019 (COVID-19) pandemic. However, the individual attributes as related to changes in physical activity during the pandemic in Japan have been scarcely investigated. The present study explored the relationships among individual attributes including demographic, socioeconomic, and geographic characteristics, work situation changes, perception of anxiety, and changes in walking and sedentary behaviors, during the pandemic in Japan. To obtain data indicating individual circumstances during the first wave of the pandemic in Japan, we conducted a nationwide online survey from May 19 to May 23, 2020 (n = 1,200). To observe changes in walking behavior objectively and retrospectively, we collected data on the number of daily steps as measured by the iPhone’s Health application. Path analysis was employed to examine relationships between individual attributes and changes in walking and sedentary behaviors. Decreased physical activity, especially, decreased walking behavior among younger individuals and those living in highest-density neighborhoods were identified. There was increased sedentary behavior among females. Moreover, individuals with higher socioeconomic status (SES) tended to become inactive due to work-from-home/standby-at-home and individuals with lower SES tended to become inactive due to decreased amount of work. Decreased walking behavior and increased sedentary behavior were associated with a perception of strong anxiety related to the pandemic. Our findings would be helpful in considering measures to counteract health risks during the pandemic by taking into account individual backgrounds.

Exercising under COVID-2x: Conceptualizing Future Green Spaces in Australia’s Neighborhoods

The COVID-19 pandemic has proven to be a social and economic disruptor on a global scale, severely curtailing people’s ability to travel and engage in many recreation activities. Periodic lockdown and stay-at-home orders have exacerbated the situation. In this social climate, urban green spaces have attained a high significance for the maintenance of the physical and mental health of the population. Given the presence of similar coronaviruses in animal populations, it can be predicted that future epidemics and even pandemics will occur. Urban planning needs to incorporate the lessons learnt during COVID-19 in order to future-proof our communities. This paper reviews the role that urban green spaces played during the COVID-19 pandemic. Based on these observations, the paper discusses a range of options for the provision of pandemic-sensitive spaces for physical exercise and mental recreation. Design concepts for long-term planning adjustments as well as for future ad-hoc solutions are provided. These include the provision of social distancing ‘pods’ embedded in design and landscaping of permanent parks, the design of ad-hoc, socially distanced ‘parklets’ on a quietened street and a rethink of the design of curb-to-boundary setbacks (nature strip) in residential streets.

Lifestyle Behaviors and Quality of Life Among Older Adults After the First Wave of the COVID-19 Pandemic in Hubei China

Background: Older adult quality of life (QoL) is facing huge challenges during the COVID-19 pandemic. New normal lifestyle behaviors, including getting adequate physical activity (PA), consuming sufficient fruits and vegetables (FV) and enacting individual preventive behaviors (frequent hand washing, facemask wearing, and social distancing), as a significant determinant for QoL, have not been adequately addressed in older adults during the pandemic. This study aimed to investigate the characteristics of QoL in Chinese older adults after the first wave of the COVID-19 pandemic in Hubei China. The objective of the study was to examine any associations of lifestyle behaviors with QoL, and to identify the moderating role of socioeconomic indicators in the associations identified. Methods: A cross-sectional study was conducted in Hubei, China, from June 15, 2020, to July 10, 2020. Five hundred sixteen older adults completed an online survey (mean age = 67.6 ± 6.6; 57.9% women). The questionnaire consisted of demographic information, covariates (chronic diseases and infected cases of acquaintances), lifestyle behaviors [PA stage, FV intake (FVI) stage and three preventive behaviors], and QoL. T-tests, ANOVA tests, multiple linear regression models with simple slope analyses were used to test the hypotheses. Results: QoL significantly differed in relation to economic situation, chronic diseases, marital status, education, living situation, age group, and professional status. Participants' economic situation (βaverage vs. below average = 0.17, p < 0.01; βabove average vs. below average = 0.15, p < 0.01), chronic diseases (βyes vs. no = 0.19, p < 0.001), FVI stage (β = 0.21, p < 0.001), and preventive behaviors (β = 0.10, p < 0.05) indicated a significant association with QoL. Education level and economic situation significantly interacted with preventive behaviors on QoL, respectively (βpreventive behaviors × educational level = -1.3, p < 0.01; βpreventive behaviors × economic situation = -0.97, p < 0.05). Conclusions: Findings emphasize the importance of enhancing FVI and preventive behaviors on QoL improvement in older adults during the COVID-19 pandemic. Older adults who are in a lower economic situation with lower education levels should be given priority when implementing interventions to improve preventive behaviors and QoL in older adults.

Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase-specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health-promoting behaviors.

Moving Forward: Understanding Correlates of Physical Activity and Sedentary Behaviour during COVID-19-An Integrative Review and Socioecological Approach

Population-level physical activity (PA) and sedentary time/behaviour estimates represent a significant public health issue exacerbated by restrictions enforced to control COVID-19. This integrative review interrogated available literature to explore the pandemic's impact on correlates of such behaviours in adults (≥18 years). Five electronic databases were systematically searched in January 2021. Data extracted from 64 articles were assessed for risk-of-bias using the Mixed Methods Assessment Tool, with correlates identified, coded, and themed via thematic analysis. A socioecological model of during-pandemic PA was conceptualized and mapped to the Capability, Opportunity, Motivation, and Behaviour (COM-B) model of behaviour change mechanisms, which illustrates influences over five levels: Individual (biological)-general health; Individual (psychological)-mental health, cognition, motivation, and behaviour; Social-domestic situation, sociodemographic factors, support, and lifestyle choices; Environmental-resources and area of residence; and Policy-COVID-19-related rules. For sedentary time/behaviour, individual level factors, namely general and mental health, may be important correlates. Neither age or sex were clearly correlated with either behaviour. As we transition into a new normal, understanding which behaviour mechanisms could effectively challenge physical inactivity is essential. Targeting capability on a psychological level may facilitate PA and limit sedentary time/behaviour, whereas, on a physical level, maximizing PA opportunities could be crucial.

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.

Changes in Workers’ Physical Activity and Sedentary Behavior during the COVID-19 Pandemic

Background: COVID-19 has changed the world and strongly affected the health of the people and the quality of their life. These changes might impact employees’ physical activity (PA) and sedentary behavior (SB). This study aimed to summarize the literature focusing on the COVID-19-caused changes in physical activity and sedentary behavior among the adult working population. Methods: Literature searches were conducted in June 2021 using multiple electronic databases. The following keywords and synonyms were used during the searching process: physical activity, sedentary behavior, COVID-19, employee. After the data cleaning process (duplicates, inclusion criteria), the title and the abstract of all manuscripts from the searches were screened independently by two reviewers. Results: Thirty-nine manuscripts were selected as a result of the searching process. Of these, 5 were SB related, 15 were PA related and 19 addressed both PA and SB. There were longitudinal (10), cross-sectional (28) and a case study (1) in the selected manuscripts. The majority of studies were conducted in the USA (6) and Europe (18), and four studies examined the PA and/or SB in multiple countries. The majority (34 studies) of the studies used subjective, self-reported, but mostly before-validated questionnaires. Objective measures were less common and used only 12.8% of the examined studies. Moreover, 76.4% of the studies described an overall decrease in the amount of PA during the COVID-19 pandemic. In three cases, researchers observed an increase in PA among the workers. Five studies reported no significant changes in the amount of PA during the pandemic. As far as SB is concerned, 18 out of 24 of the studies reported an overall increase in the amount of SB between the two periods. Four manuscripts reported no significant change in the amount of SB, and there was only one manuscript in the examined studies that reported an overall decrease in the SB time before and during the COVID-19 pandemic. Discussion: There is no doubt that the COVID-19 pandemic, including lockdown and work from home (WFH) policies, impaired the PA and SB level of the populations. This period has delivered an important message for the adult working population as well. They should be as active as possible and avoid high levels of SB and uninterrupted sitting time. Therefore, organizations, policies and public health bodies should motivate workers, especially office workers, to be more active and interventions must be developed to mitigate the negative effects of the COVID-19 on PA and SB.

Impact of COVID-19 Stay-at-Home Orders on Health Behaviors and Anxiety in Black and White Americans

Background

In the United States (US), the incidence and severity of COVID-19 infections, hospitalizations, and deaths are higher in Black compared to White residents. Systemic inequities and differences in health behaviors may contribute to disparities in COVID-19 health outcomes. The aim of this study was to examine the impact of COVID-19 stay-at-home orders on changes in health behaviors and anxiety in Black and White adults residing in the US.

Methods

Beginning April 2020, the Pennington Biomedical Research Center COVID-19 Health Behaviors Study collected information on changes to employment, income, diet, physical activity, anxiety, and sleep patterns through a global online survey.

Results

Of 4542 survey respondents in the US, 7% identified as Black and 93% as White. Prior to the COVID-19 stay-at-home orders, a greater proportion of Blacks compared to Whites reported earning < US$50,000 per year (p < 0.0001). A greater proportion of Blacks reported being laid off, working fewer hours, and working from home following COVID-19 stay-at-home orders (p < 0.0001 for all). In the overall sample, eating behaviors improved, physical activity decreased, sleep time prolonged, and anxiety heightened following COVID-19 stay-at-home orders (p < 0.01 for all), which were universal between Black and White respondents (p ≥ 0.315 for all).

Conclusions

This study highlights the disproportionate changes to employment and income in Blacks, with no differential impact on health behaviors and anxiety compared to Whites due to COVID-19 stay-at-home orders. As the COVID-19 pandemic continues, disproportionate changes to employment and income status may widen among Blacks and Whites, which may influence health behaviors and anxiety.

Changes in Training, Lifestyle, Psychological and Demographic Factors, and Associations With Running-Related Injuries During COVID-19

The primary purpose of this study was to examine how the type and magnitude of changes in running behavior, as a consequence of COVID-19 pandemic restrictions, influence running-related injuries. Secondarily, we aimed to examine how lifestyle and psychosocial well-being measures may influence running behavior change. An online survey was advertised to individuals over the age of 18 that currently run or have previously participated in running for exercise. The survey questions examined injury history and new injuries sustained during COVID-19 restrictions, as well as changes related to training behavior changes, training environment changes, social behaviors, and psychosocial well-being. Changes reflected differences in running behaviors prior to COVID-19 restrictions (1 month prior to COVID-19 restrictions being imposed) and during COVID-19 restrictions (May 5 to June 10, 2020). A total of 1,035 runners were included in the analysis. Current injuries sustained during COVID-19 occurred in 9.5% of the runners. Injured runners made a greater number of total changes (p = 0.031) as well as training-related (p = 0.042) and environment-related (p = 0.017) changes compared with uninjured runners. A significant relationship was found between injury and those that reported less time to exercise to changes in work environment (p = 0017). This study highlights the multi-dimensional nature of running-related injuries and the need to consider the interaction of multiple changes in running behavior, rather than isolating single factors. Greater understanding of the underlying causes of running-related injuries can help reduce the risk of future injury.

Household chaos, maternal stress, and maternal health behaviors in the United States during the COVID-19 outbreak

Objectives:

Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physical activity and sleep, potentially via higher stress. The purpose of this study is to evaluate the relationships among household chaos, maternal stress, and maternal physical activity and sleep, and identify barriers to home organization during the COVID-19 outbreak.

Methods:

A cross-sectional study using an online survey of 1721 mothers of preschoolers (ages = 3.0–5.9 years) in the United States was conducted in May 2020 during COVID-19 stay-at-home orders and early reopening. Mothers reported demographic characteristics, household chaos, stress, physical activity and sleep, and barriers to home organization during the outbreak. Mediation models were conducted among household chaos, stress, and physical activity and sleep with adjustment for covariates.

Results:

About half of mothers were middle income (48.2%), employed full-time prior to the outbreak (59.1%), and met the physical activity (47.7%), and sleep guideline (49.7%, 7–9 h/day). Household chaos and stress were both negatively related to physical activity and sleep. For every 1 unit increase in mother’s current stress, mothers were 11% (95% confidence interval = 6% to 16%) less likely to meet the physical activity guideline and 19% (95% confidence interval = 14% to 23%) less likely to meet the sleep guideline. Household chaos was positively related to stress. Stress partially mediated the relationship between household chaos and physical activity and sleep. Virus concerns, occupational changes (i.e. teleworking), and lack of childcare were barriers to home organization.

Conclusion:

During the COVID-19 outbreak, many mothers had poor sleep and physical activity, which was associated with household chaos and stress. Opportunities to promote order at the individual, household, and community level may result in beneficial mental and physical health in mothers of young children during the COVID-19 outbreak and beyond.

A Pandemic within the Pandemic? Physical Activity Levels Substantially Decreased in Countries Affected by COVID-19

Governments have restricted public life during the COVID-19 pandemic, inter alia closing sports facilities and gyms. As regular exercise is essential for health, this study examined the effect of pandemic-related confinements on physical activity (PA) levels. A multinational survey was performed in 14 countries. Times spent in moderate-to-vigorous physical activity (MVPA) as well as in vigorous physical activity only (VPA) were assessed using the Nordic Physical Activity Questionnaire (short form). Data were obtained for leisure and occupational PA pre- and during restrictions. Compliance with PA guidelines was calculated based on the recommendations of the World Health Organization (WHO). In total, n = 13,503 respondents (39 ± 15 years, 59% females) were surveyed. Compared to pre-restrictions, overall self-reported PA declined by 41% (MVPA) and 42.2% (VPA). Reductions were higher for occupational vs. leisure time, young and old vs. middle-aged persons, previously more active vs. less active individuals, but similar between men and women. Compared to pre-pandemic, compliance with WHO guidelines decreased from 80.9% (95% CI: 80.3–81.7) to 62.5% (95% CI: 61.6–63.3). Results suggest PA levels have substantially decreased globally during the COVID-19 pandemic. Key stakeholders should consider strategies to mitigate loss in PA in order to preserve health during the pandemic.

Longitudinal Weight Gain and Related Risk Behaviors during the COVID-19 Pandemic in Adults in the US

Cross-sectional analyses have shown increased obesogenic behaviors and a potential for weight gain during COVID-19 related peak-lockdown (March-May 2020), but longitudinal data are lacking. This study assessed longitudinal changes in body weight and lifestyle behaviors in the US adults during the pandemic.

METHODS

We used Qualtrics survey to collect self-reported data on body weight, dietary, physical activity, and psychological variables (n = 727) during the peak-lockdown (April/May) and at post-lockdown (September/October). Peak-lockdown weight data were categorized based on the magnitude of weight gained, maintained, or lost, and behavioral differences were examined between categories at two time points.

RESULTS

Body weight increased (+0.62 kg; p < 0.05) at the post-lockdown period. The body mass index also increased (26.38 ± 5.98 kg/m2 vs. 26.12 ± 5.81 kg/m2; p < 0.01) at the post-lockdown period vs. peak-lockdown period. Close to 40% of participants reported gaining either 1-4 lbs or >5 lbs of body weight during the peak-lockdown, while 18.2% lost weight. Weight-gainers engaged in riskier dietary behaviors such as frequent ultra-processed food intake (p < 0.01) and snacking (p < 0.001), were less active, and reported high stress and less craving control during peak-lockdown. Of those gaining >5 lbs, 33% continued to gain weight after the lockdown eased, while 28% maintain higher body weight. In weight-gainers, takeout meal frequency increased, and high ultra-processed food intake and stress, and low craving control continued to persist after the lockdown eased.

CONCLUSION

We show that the COVID-19 lockdown periods disrupted weight management among many Americans and that associated health effects are likely to persist.

The Development Strategy of Home-Based Exercise in China Based on the SWOT-AHP Model

In view of the increasing importance of sports to people and the impact of COVID-19 on people’s lives, home-based exercise has become a popular choice for people to keep fit due to its unique advantages and its popularity is expected to keep growing in the future. Therefore, it is necessary to determine the development direction of home-based exercise and put in the corresponding efforts. However, there is currently a lack of research on all aspects of home-based exercise. The purpose of this research was to investigate the effective sustainable development strategy of home-based exercise in China through a SWOT (Strengths, Weaknesses, Opportunities and Threats) and AHP (Analytic Hierarchy Process) hybrid model. Thirteen factors corresponding to the SWOT analysis were identified through a literature review and expert opinions. The results show that in China the advantages and potential outweigh the weaknesses and threats of home-based exercise. Home-based exercise should grasp the external development opportunities and choose the SO development strategic type that combines internal strengths and external opportunities. As the core for the development of home-based exercise, this strategy should be given priority. To sum up, home-based exercise is believed to have a bright future.

The Physical Fitness Level of College Students Before and After Web-Based Physical Education During the COVID-19 Pandemic

Background: The COVID-19 pandemic has been an emergency worldwide. Web-based physical education is a choice for college students to keep on their study. The aim of this study was to compare the data of physical fitness of college students before and after web-based physical education. Methods: All the students of 2018 and 2019 in Wuhan University of Technology who had taken the web-based physical education class in 2020 were included in this study. The records of annual physical fitness tests of all the subjects in 2019 and 2020 which were carried out in September were reviewed, including weight, height, body mass index (BMI), vital capacity (VC), 50-m dash, sit-and-reach, standing long jump, male-specific pull-ups and 1,000-m race, and female-specific sit-ups and 800-m race. Results: There were 24,112 male and 9,690 female records of physical fitness tests included in our study. The results of 11,219 male and 4,651 female students who completed both physical fitness tests in 2019 and 2020 were employed for Wilcoxon signed-rank test. Declined performance was observed on male 50-m dash by 0.1 s, male 1,000-m race by 14 s, and female 800-m race by 11 s. Notably, the percentage of male obesity, based on BMI, rose from 10.6 to 15.2% and 17.1 to 21.8% for male overweight; correspondingly, the percentage of male normal weight declined from 55.9 to 51.9% and 16.4 to 11.1% for male thinness. The trend of increasing BMI in males should be paid attention to. Improved results on vital capacity, sit-and-reach, standing long jump for both males and females, female 50-m dash, female sit-ups, and male pull-ups were observed in 2020. All the results of physical fitness tests were significantly different between 2019 and 2020 (p < 0.01) by Wilcoxon signed-rank test. Conclusions: The changes of physical fitness tests before and after web-based physical education suggested that the focus should be placed on improvement for running tests through appropriate alternatives, such as fast running in place and shuttle run. In addition, the simple, convenient, and practical sport that require available equipment and little field should be considered for web-based physical education.