COVID-19 lockdown: Impairments of objective measurements of selected physical activity, cardiorespiratory and sleep parameters in trained fitness coaches

Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience

BACKGROUND

For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown.

METHODS

This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences.

RESULTS

Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges.

CONCLUSIONS

Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.

A 6-month exercise intervention clinical trial in women: effects of physical activity on multi-omics biomarkers and health during the first wave of COVID-19 in Korea

BACKGROUND

Coronavirus disease 2019 (COVID-19) was first reported in December 2019 and the first case in Korea was confirmed on January 20, 2020. Due to the absence of therapeutic agents and vaccines, the Korean government implemented social distancing on February 29, 2020. This study aimed to examine the effect of physical activity (PA) on health through changes in multi-omics biomarkers with a 6-month of exercise intervention during the first wave of COVID-19 in Korea.

METHODS

Twenty-seven healthy middle-aged women were recruited and 14 subjects completed the exercise intervention. The mean age (± SD) was 46.3 (± 5.33) and the mean BMI (± SD) was 24.9 (± 3.88). A total of three blood and stool samples were collected at enrollment, after period 1, and after period 2 (3-month intervals). The amount of PA was measured with an accelerometer and by questionnaire. Clinical variables were used, including blood pressure, grip strength, flexibility, and blood glucose levels and lipid markers obtained from laboratory tests. The concentration of blood metabolites was measured by targeted metabolomics. Fecal microbiome data were obtained by 16 S rRNA gene amplicon sequencing.

RESULTS

During the second half period (period 2), Coronavirus disease 2019 occurred and spread out in Korea, and PA decreased compared with the first half period (period 1) (185.9 ± 168.73 min/week to 102.5 ± 82.30 min/week; p = 0.0101). Blood pressure, hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) decreased in period 1 (p < 0.05) and tended to increase again during period 2 (p < 0.05). Forty metabolites were changed significantly during period 1 (FDR p < 0.05), and we found that 6 of them were correlated with changes in blood pressure, HbA1c, and LDL-C via network analysis.

CONCLUSIONS

Our results may suggest that exercise improves health through changes in biomarkers at multi-omics levels. However, reduced PA due to COVID-19 can adversely affect health, emphasizing the necessity for sustained exercise and support for home-based fitness to maintain health.

TRIAL REGISTRATION

The trial is retrospectively registered on ClinicalTrials.gov (NCT05927675; June 30, 2023).

Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regions

BACKGROUND

Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection.

METHODS

Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively.

RESULTS

Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = -0.056 and -0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01).

CONCLUSIONS

Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.

Retrospective study of COVID-19 experiences in elite multinational aquatic athletes

This study assessed the experiences of elite aquatic athletes with coronavirus disease 2019 (COVID-19) during the first World Championship conducted without social distancing and an isolation "bubble". An online questionnaire was completed by 812 athletes (22.7 ± 5.9 years, 467 females) to provide data on demographics, sports activity, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates, symptoms, reinfection, vaccination status, and psychological aspects. The answers revealed that 49.4% of athletes had experienced SARS-CoV-2 infection. The infection rates varied significantly across different aquatic sports, with open water swimmers having the lowest (28%) and water polo players (67%) and artistic swimmers (61%) having the highest infection rates (p < 0.0001). The majority reported mild (51%) or moderate (27%) symptoms, while 16% remained asymptomatic. Reinfection occurred in 13%, and 10% of initial infections led to long COVID, with fatigue (65%) and shortness of breath (48%) being the most common long-term symptoms. Significantly, 92% of athletes received at least two vaccine doses and reported a positive vaccination experience (median score of 8 out of 10 for each shot). Mood changes and subjective performance drops significantly correlated with the overall experience scores (rho: 0.617, p < 0.0001, and rho: 0.466, p < 0.0001, respectively). In conclusion, most athletes experienced a benign disease course despite a relatively high infection rate. This study provides valuable insights into the COVID-19 experiences of elite aquatic athletes. The findings emphasize the importance of vaccination initiatives, monitoring psychological well-being and the need to fortify athletes' resilience in the face of future health challenges.

Effects of Taiwan's COVID-19 alert levels on the physical activity behaviors and psychological distress of community-dwelling older adults

BACKGROUND

The Taiwanese government implemented stringent preventative health measures to curb the spread of COVID-19. However, these measures negatively affected the physical activity behaviors and psychological distress of individuals. In this study, we investigated the effects of Taiwan's COVID-19 alert-based restrictions on the physical activity behaviors and psychological distress of community-dwelling older adults.

METHODS

In this longitudinal study, 500 community-dwelling older adults were randomly sampled from a health promotion center in Taiwan. Telephone interviews were conducted between May 11, 2021, and August 17, 2021, which coincided with the Level 3 alert period when group physical activities were prohibited. Telephone interviews were again conducted between June 20, 2022, and July 4, 2022, after the alert level was reduced to Level 2 but group physical activities were prohibited period. Through the telephone interviews, data regarding the participants' physical activity behaviors (type and amount) and 5-item Brief Symptom Rating Scale (BSRS-5) scores were collected. Moreover, data regarding physical activity behaviors were collected from the records of our previous health promotion programs, which were conducted before the national alert period. The obtained data were analyzed.

RESULTS

The alert levels influenced physical activity behaviors. Because of strict regulations, physical activity amount decreased during the Level 3 alert period and did not recover rapidly during the Level 2 alert period. Instead of engaging in group exercises (e.g., calisthenics and qigong), the older adults chose to exercise alone (e.g., strolling, brisk walking, and biking). Our findings indicate that the COVID-19 alert level has a significant influence on the amount of physical activity for participants (p < 0.05, partial η2 = 0.256), with pairwise comparisons showing that the physical activity amount decreased significantly across the three time periods (p < 0.05). The psychological distress of the participants did not appear to change during the regulation period. Although the participants' overall BSRS-5 score was slightly lower during the Level 2 alert period compared to the Level 3 alert period, the difference was not statistically significant (p = 0.264, Cohen's d = 0.08) based on a paired t-test. However, the levels of anxiety (p = 0.003, Cohen's d = 0.23) and inferiority (p = 0.034, Cohen's d = 0.159) were considerably higher during the Level 2 alert period than during the Level 3 alert period.

CONCLUSIONS

Our findings indicate that Taiwan's COVID-19 alert levels influenced the physical activity behaviors and psychological distress of community-dwelling older adults. Time is required for older adults to regain their prior status after their physical activity behaviors and psychological distress were affected by national regulations.

Perceived Stress, Psychological Flexibility Profiles, and Mental Health During COVID-19: A Latent Profile Analysis

Purpose

Although the link between psychological flexibility and healthy functioning has been widely analyzed, the employed measurements often lacked accuracy. The current study introduced a person-centered approach that identified subgroups of college students across the dimensions of the Personalized Psychological Flexibility Index (PPFI) and explored how these subgroups relate to a risk factor (perceived stress) and mental health outcomes (depression, anxiety, negative affect, and positive affect) in the context of COVID-19.

Methods

A sample of 659 participants (M_age = 19. 99, SD = 1.27; 57.97% females) completed the questionnaires online. Latent profile analysis (LPA) was employed to determine the optimal number of subgroups or profiles. Then, multinomial logistic regression and analyses of variance were used to identify variables associated with profile membership.

Results

LPA identified three distinct profiles (active strategy, inconsistent strategy, and passive strategy). Furthermore, multinomial logistic regressions indicated that students with high perceived stress were more likely to be in the passive strategy group than the active strategy group (β = -0.104, OR = 0.901, p < 0.001) and the inconsistent strategy group (β = -0.087, OR = 0.917, p < 0.001). Additionally, analyses of variance revealed that the three profiles differed in depression (η² = 0.062, p < 0.001), anxiety (η² = 0.059, p < 0.001), negative affect (η² = 0.047, p < 0.001), and positive affect (η² = 0.048, p < 0.001).

Conclusion

The current study employed LPA based on the PPFI to identify and confirm three profiles of psychological flexibility. We found that perceived stress and mental health outcomes were associated with these three profiles. This study offers a new perspective on understanding psychological flexibility through a person-centered approach. Furthermore, interventions aimed at reducing college students' perceived stress during the COVID-19 crisis are critical for preventing the deterioration of psychological flexibility.

Effects of Covid-19 on the autonomic nervous system in elite athletes assessed by heart rate variability

Introduction

Covid-19 is a viral airway and systemic infection which can negatively affect the function of the autonomic nervous system. Cardiovascular autonomic function is essential for peak athletic performance. The aim of this study was to assess the effects of a Covid-19 disease on the autonomic nervous system of German elite athletes using heart rate variability (HRV).

Methods

60 elite athletes (aged 22.88 ± 4.71 years) were recruited, 30 of whom had undergone a Covid-19 disease. Heart rate (HR), blood pressure (BP) and heart rate variability (HRV) were measured during rest and during an orthostatic challenge.

Results

At rest and after orthostatic stress blood pressure and the root mean square of successive differences (RMSDD) were significantly lower in Covid-19 athletes (COV) than in control athletes (CON) (p = 0.002 and p = 0.004, respectively); heart rate was significantly higher (p = 0.001). COV showed a significantly greater reduction in blood pressure and elevation of heart rate than CON, but the change in RMSSD did not differ significantly during the orthostatic challenge.

Conclusion

These results show a change in cardiac parasympathetic activity and cardiovascular autonomic function in German elite athletes after Covid-19. These findings further the understanding of effects of the Covid-19 disease on the cardiovascular physiology in athletes. Heart rate variability may be a helpful tool in the return-to-play assessment of elite athletes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11332-023-01067-7.

Association between sleep quality and psychological symptoms: A cross-sectional survey of Chinese university students performed during the COVID-19 pandemic

Background

Since the start of the coronavirus 2019 pandemic, people have faced many challenges, including in relation to sleep quality and psychological health. This study aims to analyze the association between sleep quality and psychological symptoms among university students in China, and to provide reference data to facilitate the development of interventions to improve the physical and mental health of university students.

Methods

A stratified cluster sampling method was used to investigate the sleep quality and psychological symptoms of 6,363 university students in China. The Chi-square test was used to analyze differences in sleep quality among groups. Logistic regression analysis was used to analyze the association between sleep quality and psychological symptoms.

Results

The proportions of Chinese university students with good, medium, and poor sleep quality were 25.73, 10.99, and 63.28%, respectively. The overall rate of psychological symptoms was 16.5%. Logistic regression analysis showed that, in general, university students with poor sleep quality had a higher risk of psychological symptoms than those with good sleep quality (OR = 1.53, 95%CI: 1.28, 1.84, p < 0.01). Compared with university students with good sleep quality, those with poor sleep quality were more likely to experience emotional symptoms (OR = 1.62, 95%CI: 1.36, 1.94), behavioral symptoms (OR = 1.55, 95% CI: 1.3, 1.84), and difficulties with social adaptation (OR = 1.84, 95% CI: 1.51, 2.25) (all p < 0.01).

Conclusion

There was an association between sleep quality and psychological symptoms among Chinese university students. University students with poor sleep quality have a higher risk of psychological symptoms. Measures should be taken to improve the sleep quality of university students and reduce the incidence of psychological symptoms. This study provides reference data for government and education departments that could inform public health policies.

Home-based exercise alters pulmonary function and cellular stress markers in overweight middle-aged men during covid-19 Home quarantine

BACKGROUND

This study aimed to investigate the effects of a combined home-based exercise program on potential indicators of severe coronavirus disease 2019 (COVID-19) in overweight middle-aged men during home quarantine caused by COVID-19.

METHODS

Forty men (aged 45-64 years) were assigned to the exercise (EXE, n = 20) or control (CON, n = 20) groups. A 6-week combined program was carried out three days/week, starting at 20 min per session at 50% maximal heart rate (HRmax) and advancing to 45 min at 70% HRmax. Pulmonary functional and cellular stress biomarkers were measured before and after the training program. Analysis of the covariance (ANCOVA) was used for comparison between the two groups considering the baseline values.

RESULTS

Thirty-six participants (EXE, n = 17; CON, n = 19) completed the research protocol. The EXE group showed post-training improvements in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, Vital capacity (VC), and Forced expiratory flow at 25-75% (FEF25-75) compared to the CON group (P < 0. 05). Further, the plasma levels of fibrinogen, Interleukin (IL)-6, Interleukin (IL)-1β, D-dimer, and angiotensin (Ang II) decreased in the EXE group compared to the CON group (P < 0. 05). After six weeks of the training program, leukocyte counts increased in the EXE group compared to the CON group (P < 0. 05). There was a significant positive correlation between body mass index (BMI) with cardiovascular and inflammatory biomarkers other than white blood cells (WBC) in the EXE group (P < 0.05).

CONCLUSIONS

The findings suggest that combined home-based exercise during home quarantine improves risk factors for severe COVID-19 in overweight middle-aged men. These improvements were further correlated with changes in BMI. Future research is required to confirm the findings of this study.

Sleep duration during the COVID-19 pandemic in Bangladesh: A GIS-based large sample survey study

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7-9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30-60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18-25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18-25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors.

The impact of COVID-19 quarantine on lifestyle indicators in the United Arab Emirates

Introduction

COVID-19 is a virus that has spread rapidly and brought economic and social crises all around the world. The current study aimed to investigate the impact of COVID-19 quarantine on dietary habits, physical activity, food purchasing, smoking, and sleeping patterns in the United Arab Emirates.

Methods

A cross-sectional study was conducted using an online questionnaire between November 1st, 2020 and the end of January 2021. Citizens and residents of the UAE aged ≥ 18 years old were asked to complete an anonymous electronic questionnaire created via Google Forms and distributed on various platforms, such as WhatsApp, Twitter, and email. A total of 1682 subjects participated in the study.

Results

The results included that during the COVID-19 lockdown, more participants (44.4%) reported an increase in weight. This gain seems to be linked to increased food consumption [(Adjusted Odd Ratio) AOR = 1.68, 95% (Confidence Interval) CI = 1.12, 2.54, p = 0.022], decreased physical activity (AOR = 2.25, 95% CI = 1.58, 3.21, p < 0.001), and increased smoking (AOR = 1.90, 95% CI = 1.04, 3.50, p = 0.038). The groups that were most likely to gain weight included those who consumed more cereals (AOR = 1.67, 95% CI = 1.08, 2.57, p = 0.011), had an increased desire for sweets (AOR = 2.19, 95% CI = 1.50, 3.19, p < 0.001), and an increased desire for food (hunger) (AOR = 2.19, 95% CI = 1.53, 3.14, p < 0.001). In contrast, those who exercised more were more likely to lose weight (AOR = 0.61, 95% CI = 0.44, 0.86, p < 0.001) as well as those who slept over 9 h a day (AOR = 1.90, 95% CI = 0.45, 0.88, p = 0.006).

Discussion

Overall, it is essential to promote healthy habits and methods of healthy diet maintenance during stressful and unusual times when people might find it difficult to put effort into their health.

Fear of COVID-19 and Anxiety: Serial Mediation by Trust in the Government and Hope

Purpose

How to reduce the damage of COVID-19 pandemic to people's mental health is a current research hotspot. The present study examined the mediating role of trust in the government and hope in the relationship between fear of COVID-19 and anxiety.

Participants and Methods

In this cross-sectional study, a total of 1053 Chinese subjects (20.24±3.97 years old, 85.3% female) were investigated by using the Fear of COVID-19 Scale, Anxiety Scale, Trust in the Government Measure Scale and Herth Hope Scale, which was conducted by an online survey using snowball sampling technique. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating effects of trust in the government and hope in the relationship between fear of COVID-19 and anxiety.

Results

The fear of COVID-19 could positively predict anxiety level (β=0.36, p<0.001). Results of the mediation analyses demonstrated that trust in the government (β=-0.16, p<0.001) and hope (β=-0.28, p<0.001) mediated the relationship between fear of COVID-19 and anxiety level respectively. Moreover, fear of COVID-19 could also indirectly predict anxiety level through the chain-mediated role of the trust in the government and the hope (β=0.28, p<0.001).

Conclusion

Our findings shed light on a correlation between fear of COVID-19 and anxiety. This study emphasizes the value of trust in the government and hope in maintaining mental health when individuals face public stress events from both external and internal perspectives.

Can melatonin reduce the severity of post-COVID-19 syndrome?

This short review aimed at (i) providing an update on the health benefits associated with melatonin supplementation, while (ii) considering future potential research directions concerning melatonin supplementation use relative to Coronavirus disease of 2019 (COVID-19). A narrative review of the literature was undertaken to ascertain the effect of exogenous melatonin administration on humans. Night-time melatonin administration has a positive impact on human physiology and mental health. Indeed, melatonin (i) modulates the circadian components of the sleep-wake cycle; (ii) improves sleep efficiency and mood status; (iii) improves insulin sensitivity; and (iv) reduces inflammatory markers and oxidative stress. Melatonin has also remarkable neuroprotective and cardioprotective effects and may therefore prevent deterioration caused by COVID-19. We suggest that melatonin could be used as a potential therapy in the post-COVID-19 syndrome, and therefore call for action the research community to investigate on the potential use of exogenous melatonin to enhance the quality of life in patients with post-COVID-19 syndrome. See also Figure 1(Fig. 1).

The Role of Self-Esteem in the Relationship Between Psychological Capital and Anxiety of Left-Behind Experience College Students During COVID-19 Pandemic: An Online Study

Background

There is growing evidence that the COVID-19 pandemic has had a dramatic impact on public mental health. However, less attention has been paid to left-behind experience college students (LBEs). This online study aimed to investigate the relationship between psychological capital (PsyCap) and anxiety among LBEs during COVID-19 pandemic, and further analyze the mediation role of self-esteem between them.

Methods

A total of 9990 students were chosen using the stratified cluster sampling method. Three self-reported questionnaires were used to assess the PsyCap, self-esteem, and anxiety, respectively. All the statistical analyses were conducted using SPSS 23.0 and R, and to further investigate the mediation effect of self-esteem in the association of PsyCap with anxiety, AMOS 23.0 was used to build a structural equation model.

Results

PsyCap, self-esteem, and anxiety were significantly correlated among LBEs during the COVID-19 pandemic. PsyCap affects anxiety directly (β = -0.22, SE = 0.051, 95% CI: -0.27, -0.17, P < 0.05). In addition, self-esteem partially mediated the relationship between PsyCap and anxiety (mediating effect value = -0.16, 95% CI: -0.20, -0.13, P < 0.05).

Conclusion

During the pandemic of COVID-19, left-behind experience had a negative influence on the PsyCap and self-esteem of college students. In addition, for LBEs, self-esteem plays an important mediating role between PsyCap and anxiety. Therefore, from the perspective of PsyCap and self-esteem, schools should translate them into practical educational strategies to enhance the mental health and mitigate the anxiety levels of LBEs.

Effects of COVID-19 related physical inactivity on motor skills in children with intellectual disability

BACKGROUND

Children with intellectual disabilities (ID) may show declines in motor skills during the Covid-19 restrictions. This study compared the effects of physical inactivity due to COVID-19 on the motor skills of active and inactive children with ID.

METHOD

In this prospective cohort study, 30 boys with ID were divided into two groups based on study inclusion criteria (mean age 10.86 ± 1.81 active, 10.20 ± 1.42 inactive). The BESS test, the Y test, the Timed Up and Go (TUG) test, and the Bruininks-Oseretsky test-short form were used.

RESULTS

Results showed a significant difference between active and inactive groups in the total score of gross motor skills (P = 0.001), fine motor skills (P = 0.002), motor skills (P = 0.001), postural control (P = 0.01), and dynamic balance (P = 0.01).

CONCLUSIONS

The results showed a significant difference between active and inactive children with ID in terms of gross and fine motor skills after a one-year movement restriction. Therefore, considering the tendency to be sedentary among these people and the subsequent complications caused by this inactivity, including obesity and chronic diseases, it is suggested that parents and educators design practical and numerous exercises and encourage them to be more active and participate in physical activity programs.

Synchronous online lecturing or blended flipped classroom with jigsaw: an educational intervention during the Covid-19 pandemic

BACKGROUND

The Covid-19 pandemic has changed the education system throughout the world. This study aimed to compare synchronous online lecturing with blended flipped classroom plus jigsaw in terms of their effects on the students' learning, communication skills and critical thinking disposition.

METHODS

This is an educational intervention conducted at the Nursing and Midwifery School of Shiraz University of Medical Sciences. Two incoming students of nursing and midwifery were selected by complete enumeration. Then synchronous online lecturing was given to one group (n = 40) and blended flipped classroom and jigsaw to the other (n = 44). After that, given the prevailing conditions, both methods were performed fully online. Then Participants completed an online questionnaire. A researcher-made learning questionnaire, the Interpersonal Communication Skills Questionnaire developed by Fetro, and Ricketts' Critical Thinking Disposition Inventory were used to assess the study variables.

RESULTS

The mean learning scores in the blended group were slightly higher but this difference was not significant (P = 0.767). In the blended group, the mean scores of communication skills were significantly higher after the intervention in all the dimensions, except for empathy & intimacy and listening skills. In the online lecture group, there was no significant difference between before and after the intervention. Communication skills (P < 0.001) scored significantly higher in the blended group after the intervention than that in the synchronous online lecturing group in all the dimensions except for empathy & intimacy. In the online lecture group, there was no significant difference in critical thinking disposition between before and after the intervention. In the blended group, the overall score of critical thinking disposition and its dimensions was significantly higher after the intervention (P < 0.001), except for the perfection dimension. There was no significant difference between the two groups in terms of the mean total score of critical thinking disposition and its dimensions before and after the intervention.

CONCLUSION

Given the global circumstances, the blended method was more effective in promoting learning outcomes and communication skills than synchronous online lectures. Furthermore, it seems that this new approach could improve critical thinking.