Change in Physical Activity During the Coronavirus Disease 2019 Lockdown in Norway: The Buffering Effect of Resilience on Mental Health

Varsity athletes' fitness perceptions, fitness-related self-conscious emotions and depression when sidelined from play

OBJECTIVE

Explore the association between varsity athletes' fitness perceptions and symptoms of depression while sidelined from sport for an extended period, and test whether fitness-related self-conscious emotions (i.e., shame, guilt, authentic pride, and hubristic pride) mediate this relationship.

PARTICIPANTS

Varsity athletes (N = 124) from a large university in Canada where sports had been restricted for the past year due to the pandemic.

METHOD

Participants completed a cross-sectional self-report survey. Regression analyses testing mediation (i.e., direct and indirect effects) were used to explore the main research aim.

RESULTS

Controlling for age and gender, separate models demonstrated significant indirect effects of fitness perceptions on depression symptoms through shame, guilt, and authentic pride, but not through hubristic pride.

CONCLUSION

Self-conscious emotions may be used as a tool to mitigate depression symptoms when varsity athletes are sidelined from sport for an extended period. Further research is needed to understand how self-conscious emotions develop when athletes are injured or retired.

Coronavirus-Related Stressors, Resilient Mindset, Loneliness, Depressive Symptoms in College Students: Testing a Moderated Mediation Model

The coronavirus (COVID-19) outbreak alarmingly threats the mental health and functioning of people globally. The present study aims to examine the moderated mediation role of resilient mindset and loneliness in the association of coronavirus stress and depressive symptoms. We recruited 394 undergraduate students from a state university in Türkiye, ranging in age between 18 and 47 years (M = 22.76, SD = 3.88; 65% female). The main results revealed that resilient mindset mediated the relationship between coronavirus-related stress and depressive symptoms. Moreover, loneliness moderated the mediating effect of resilient mindset in the coronavirus stress and depressive symptoms association. Taken together, these findings pointed out that the effects of the coronavirus stress on depressive symptoms can be captured better by underlying psychological mechanisms, namely resilient mindset and loneliness.

Association between individual resilience and depression or anxiety among general adult population during COVID-19: a systematic review

BACKGROUND

The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population.

METHODS

We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design.

RESULTS

A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety.

CONCLUSIONS

Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases.

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

BACKGROUND

Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020.

OBJECTIVE

Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries.

METHODS

Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses.

RESULTS

RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06).

CONCLUSIONS

We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.

Mental Health in the Post-Lockdown Scenario: A Scientometric Investigation of the Main Thematic Trends of Research

Since the outbreak of COVID-19, researchers and clinicians have published scientific articles on the SARS-CoV-2 virus and its medical, organizational, financial, and psychological implications. However, many effects have been observed in the post-lockdown scenario. In this study, we adopted a scientometric-bibliometric approach to drawing the state of the art regarding the emotional and psychological effects of the pandemic after the lockdown. In Scopus, we found 791 papers that were subsequently analyzed using CiteSpace. The document co-citation analysis (DCA) computation generated a network of eight major clusters, each representing a central area of investigation. Specifically, one major cluster-cluster no. 1-focuses on the long-term effects of the COVID-19 pandemic and individuals' ability to develop adaptive coping mechanisms and resilience. The results allow us to frame the fields covered by researchers more precisely and the areas that still need more investigation.

Assessment of Anxiety among People with Various Physical Activity Levels during Lockdown in Karachi, Pakistan

Background  The purpose of this study is to make it easier to counsel the general public on how to promote their psychological health and better lifestyle by boosting their physical activity in the event of more devastating future waves of coronavirus disease 2019. Coronavirus disease is a viral infection first reported in Wuhan, China, which led to a worldwide pandemic and lockdown. In addition to physical health, the uncertainty of situation and fear of infection have further affected the mental health of the individuals. Lockdown has also halted the physical activity of people further adding into the stress and anxiety. Methods  A sample size of 376 was required, but a convenient sampling technique collected 400 responses due to overwhelming Participation. A well-structured questionnaire was used for data collection, which contained sections such as a demographics section. We used the International Physical Activity Questionnaire scale to measure various physical activity levels and the generalized anxiety disorder scale to measure anxiety levels, because of their considerate validity and feasibility. Later both of our variables were compared to find out the correlation of anxiety levels with different physical activity levels. Results  Mean Anxiety and its prevalence rates in the sample were 7.32 ± 5.767 and 33%. On performing Pearson correlation, increasing age was found to be a risk factor for Anxiety. One-way analysis of variance showed a significant difference between Physical Activity and Anxiety. In the post-hoc Tukey test, a considerable difference in anxiety level was found between people with no physical activity and vigorous physical activity. Conclusion  During the lockdown period, the mean anxiety was found to be 7.0 ± 5.56 with prevalence rate of 33% among the people with no, low, moderate or vigorous physically active levels was found to be associated with better perceived mental health status which suggests the need to promote physically active style to cope with anxiety and awareness sessions to be conducted especially among those who could not maintain a physically active lifestyle. Also, among the general population e-Health programs could provide an appropriate way to promote a physically active lifestyle.

How digital health technologies promote healthy life in the Post-COVID-19 Era: evidences from national survey on Chinese adolescents and youngsters

The rapid development of intelligent technologies coupled with the stay-at-home trends in the Post-COVID-19 Era has significantly changed youth's health behavior as well as reshaped their lifestyles. Digital health technologies (DHTs) have been more and more used for health management among youngsters. However, little was known about the use of DHTs among youths and its consequences on their health, especially in developing countries like China. Inspired by behavior intervention technology (BIT) model, this study examined the underlying mechanisms of use and social interactions of DHTs on Chinese adolescents' and youngsters' healthy lifestyles and mental health, using a representatively national survey among high school and freshman students in China (N = 2,297). It found that use of DHTs had a significantly positive effect on Chinese youths' healthy lifestyles and mental health, with behavioral regulation as a mediator. However, social interactions of DHTs were negatively associated with their mental health. The findings contribute to a better guidance on health promotion, as well as the enhanced design of DHTs' products.

The safe pilot study: A prospective naturalistic study with repeated measures design to test protective factors against violence in and after discharge from forensic facilities

Assessing violence risk amongst forensic patients is a vital legal and clinical task. The field of violence risk assessment has developed considerably over the past two decades but remains primarily risk focused. Despite this, growing attention to and work on protective factors or strengths has occurred. In this prospective naturalistic study with repeated observer-rated measures of 27 forensic patients, we tested the role of three potentially important but understudied dynamic protective factors: hope, insight, and resilience, along with a history of criminality, in terms of their impact on violence. Main effects models indicated that higher hopelessness and past criminal convictions were predictive of violence acts; higher resilience was associated with lower violence. In interaction models, hopelessness remained predictive. Importantly, there were significant interactions between resilience and past criminal convictions, with higher levels of resilience leading to lower violence, most amongst those with criminal convictions, and between resilience and hopelessness related emotional distress, in that higher resilience at high levels of patient acknowledged emotional distress due to hopelessness led to lower violence. Findings indicate the importance of focusing on strengths or protective factors in the assessment of risk and treatment planning for forensic patients. Despite the small sample, the repeated measures design was feasible and informative.

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.

The corona blues according to daily life changes by COVID-19: A partial least squares regression model

This study identifies determinants of the variation in depression resulting from COVID-19, specifies in detail the changes to daily life, and then compares the determinants' magnitude. The determinants were combined into three groups: first, the unpredictability of the disease and side effects by its response measures (specifically, restrictions on the freedom of movement and strain on social relationships); second, (mis)information through social media, public authorities, and mass media; and third, income reductions and other sociodemographic factors. Daily life changes were divided into four categories: travel/mobility, time at home (alone and with family), domestic activities (remote work, online shopping, food deliveries, reading, and online networking), and conflicts (with family and neighbors). We measured the total 29 predictors using data from the 2020 Seoul Survey, which is based on face-to-face interviews with a probability sample of adult residents. We made our estimations using partial least squares regression, which can analyze all original variables regardless of collinearity. The regression model found that major stressors include declines in out-of-home offline networking and the rise of domestic activities-and subsequent conflicts with family-restrictions on mobility (specifically, those of leisure travel), and income reductions. In contrast, changes to working and shopping (to remote work and online shopping) rather than leisure increased uses of private transportation modes. Moreover, we found influences of all forms of communications and media to be insignificant. We shall also provide a discussion on policy and academic implications of the findings.

The impact of COVID-19 pandemic on lifestyle among the Saudi population

Background

During COVID-19, major change occurred in the governmental regulations to combat the pandemic. Lifestyle factors are changeable habits and routine behaviors with an impact on physical and mental health. With the pandemic, sudden and radical changes occurred in the lifestyle of people worldwide. The main purpose of the study is to assess the impact of COVID-19 on lifestyle factors including (dietary habits, physical activity, sleeping patterns, smoking, and alcohol use) among the Saudi population.

Design and methods

This is a cross-sectional study on a convenient sample of adults residing in Saudi Arabia. An online survey was distributed via social media channels. Descriptive statistics were used to analyze the distribution of demographic variables using Chi-square χ2 tests for categorical variables and t-test for continuous variables. Bowker test, and McNemar's Test were performed to evaluate the effects of lockdown on lifestyle factors.

Results

A total of 1051 participants were included in the study. There was a slight decrease in the overall diet score during the pandemic (14.98%) compared to before the pandemic (15.05%) (p-value = 0.02), indicating poorer dietary intake during the lockdown. Approximately one-fourth of the participants (26.1%) reported following specific eating habits or a restricted diet during the pandemic (p-value = 0.0001). There was increased consumption of most components of dietary intake categories, during the lockdown. An increase in physical activities for three or more times was reported. A higher proportion of respondents reported sleeping nine or more hours a day during the lockdown (10.8%). Similarly, a higher percentage of individuals reported smoking daily during the lockdown (12.2%). As of overall health status, higher percentage of respondents reported poor health status during lockdown (6.1%).

Conclusion

This study revealed major changes in lifestyle factors, negative shifts were revealed in dietary habits and smoking patterns. Positive changes were shown in physical activity, drinking water, and sleeping patterns. Our findings suggest that COVID-19 played a major role in changing lifestyle factors among adults in Saudi Arabia. Healthcare providers and public health officials are encouraged to increase awareness of healthy lifestyle factors that strengthen the immune system to combat COVID-19. The Saudi population needs increased awareness programs about healthy lifestyles to be prepared during pandemics.

Does Change in Physical Activity During the Initial Phase of the COVID-19 Pandemic Predict Psychological Symptoms in Physically Active Adults? A Six-Month Longitudinal Study

Objectives: The current study aimed to investigate if change in physical activity during the initial phase of the COVID-19 pandemic predicted severity of anxiety and depression symptoms 6 months later in physically active adults. Methods: A total of 855 respondents (32.6% women) completed the Hospital Anxiety and Depression Scale (HADS) at two time points and reported change in physical activity habits in the first 3 months of the COVID-19 lockdown in Norway. Results: Women had higher prevalence rates than men for both anxiety and depression symptoms in the Unchanged, Increased and Decreased physical activity (PA) subgroups. Women and men who reported Increased PA at baseline were associated with increased risk for anxiety symptoms at time 2. Increased PA was associated with higher risk for depression at time 2 for women, but not for men. Conclusion: The results indicate that the COVID-19 pandemic is associated with deterioration in mental health also for physically active adults.

Hope and Resilience Related to Fear of COVID-19 in Young People

In the face of the psychological crisis of fear caused by the COVID-19 pandemic, it is relevant to know the positive impact of hope and resilience during this context. The purpose of this study was to determine the correlation between hope and resilience with fear of COVID-19 in young people. The design was non-experimental, cross-sectional, and correlational. The sample consisted of 192 young people living in Metropolitan Lima, Peru. We used the Hope-Despair Questionnaire, the Resilience Scale, and the COVID-19 Fear Questionnaire. The results show that there is a significant correlation between hope, resilience, and fear of COVID-19 in young people. On the other hand, a significant difference was found in resilience according to gender. Likewise, it was found that the variables hope and resilience explain 81% (R2 adjusted) of the fear of COVID-19 (F test = 21.53; p < 0.01). Hope and resilience are protective factors that have a positive impact when facing the fear of COVID-19. Thus, policies, programs, and public health strategies related to positive mental health should be promoted, with emphasis on hope and resilience.

The COVID-19 Conundrum: Keeping safe while becoming inactive. A rapid review of physical activity, sedentary behaviour, and exercise in adults by gender and age

Background

Coronavirus (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally restricted the factors that encourage regular and frequent PA; opportunity, capability and motivation. However, the effects of these restrictions are likely to have differed by gender and age and different intensities of PA. This rapid review builds on previous evidence by synthesising the global impact of COVID-19 on adult PA through specific intensities and types of PA and evaluating this by gender and age.

Methods

A rapid systematic search of seven electronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, Academic Search Complete, APA PsycInfo, and APA PsycArticles) was performed from December 2019 to January 2021. Studies investigating adult change in PA, exercise or sedentary behaviour due to COVID-19 were included.

Results

From an initial database search identifying 3,863 articles, 66 remained for synthesis after applying eligibility criteria. Results demonstrate decreases among all intensities and types of PA—walking (6 out of 7 papers), moderate-only (5 out of 6 papers), vigorous-only (5 out of 6 papers) and MVPA (4 out of 5 papers); as well as overall PA (14–72% participants reported a decrease). Reflecting that COVID-19 responses were designed to have universal effects, they also achieved whole-society decreases in PA behaviour, accented in older age groups.

Conclusion

There is a universal need to address the low levels of PA post-COVID-19. The consequences of decreased PA across all intensities has powerful, potentially recoverable, impacts. Universal declines have implications for public health officials and PA advocates for post-COVID-19 initiatives to promote PA.

The Importance of Physical Activity to Augment Mood during COVID-19 Lockdown

The purpose of this study was to assess the effect of COVID-19 lockdown on mood and objective physical activity. A sample of 78 college students in Spain completed an assessment of mood using the valid Profile of Mood State (POMS) questionnaire and had their physical activity tracked objectively using a validated wrist-worn accelerometer (Xiaomi Mi Band 2) for one week before being under COVID-19 lockdown (T1) and for one week during COVID-19 lockdown (T2). Paired samples t-tests revealed significantly greater (p = 0.027) POMS Total Mood Disturbance (TMD) Score T2 (mean ± SD) (22.6 ± 28.0) compared to T1 (17.7 ± 22.6) (lower score represents better mood) and significantly lower (p ≤ 0.001) POMS Vigor Score T2 (14.1 ± 5.0) compared to T1 (18.2 ± 4.5) (lower vigor score represents lower mental and physical energy levels). Additionally, Total Objective Steps was significantly less (p ≤ 0.001) lT2 (15,841.9 ± 17,253.2 steps) compared to T1 (64,607.0 ± 50,525.2 steps). Regression analyses demonstrated significant negative relationships of Total Objective Steps and POMS Depression (p = 0.014, Beta = -0.277, t = -2.511), POMS Anger (p = 0.040, Beta = -0.233, t = -2.091), and POMS TMD (p = 0.007, Beta = -0.302, t = -2.754) T2. The regressions also revealed a significant positive relationship (p = 0.012, Beta = 0.283, t = 2.57) of Total Objective Steps and POMS Vigor T2. These data suggest that being in a lockdown due to a pandemic may have negative physical and mental health-related consequences and that engaging in physical activity may reduce these deleterious mental health-related consequences during lockdowns and quarantines.

Moderate-to-vigorous intensity physical activity among adolescents in the USA during the COVID-19 pandemic

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The study examined adolescents’ physical activity during the COVID-19 pandemic.

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Median moderate-to-vigorous physical activity was 2 h per week.

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8.9% met physical activity guidelines during the pandemic compared to 16.1% before.

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Poor mental health, worry, and stress were associated with lower physical activity.

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Higher coping and social support were associated with higher physical activity.

This study aimed to evaluate adolescents’ moderate-to-vigorous intensity physical activity (MVPA) during the COVID-19 pandemic with regards to sociodemographic characteristics and determine mental health and resiliency factors associated with MVPA among a diverse national sample of adolescents ages 10–14 years. Data were collected during the pandemic in May 2020 from the Adolescent Brain Cognitive Development Study (ABCD, N = 5,153), a national prospective cohort study in the U.S. MVPA was quantified as the product of reported duration and frequency (hours per week), which was further summarized as the proportion meeting age-appropriate 2018 Physical Activity Guidelines for Americans. A similar estimate was generated using MVPA data collected prior to the pandemic. Mental health and resiliency measures were collected during the pandemic. Regression models examined associations between mental health or resiliency measures and MVPA during the pandemic. Median MVPA was 2 h per week (IQR 0, 6). Overall, the percentage of the cohort meeting MVPA guidelines decreased from 16.1% (pre-pandemic) to 8.9% (during the pandemic). Racial/ethnic minority adolescents and adolescents from lower socioeconomic backgrounds were significantly less likely to meet MVPA guidelines during the pandemic. Poorer mental health, COVID-related worry, and stress were associated with lower MVPA, while more social support and coping behaviors were associated with higher MVPA during the pandemic. In this large, national sample of adolescents, the proportion of those meeting MVPA Guidelines was lower during the COVID-19 pandemic, with significant disparities by race/ethnicity and socioeconomic status. Interventions to promote social support and coping behaviors may improve MVPA levels among adolescents during the pandemic.

Physical activity, well-being, and priorities of older women during the COVID-19 pandemic: a survey of Women's Health Initiative Strong and Healthy (WHISH) intervention participants

Sheltering-in-place, social distancing, and other strategies to minimize COVID-19 transmission may impact physical activity (PA) and well-being in older adults. To assess self-reported PA changes, well-being, and priorities of older women across the USA early in the COVID-19 pandemic. In May 2020, a 10-question survey was emailed to 5,822 women, aged over 70 years, who had been assigned to the Women’s Health Initiative (WHI) Strong and Healthy (WHISH) trial PA intervention and had provided email addresses. The survey assessed general and physical well-being, current priorities, and PA levels before and during the COVID-19 pandemic. Demographic and physical function data were collected previously. Descriptive analyses characterized participants’ priorities and PA changes from before the pandemic to the time of data collection during the pandemic. Differences in PA change by age, physical function, and geographic region were assessed by Kruskal-Wallis and post hoc Dunn tests. Among 2,876 survey respondents, 89% perceived their general well-being as good, very good, or excellent, despite 90% reporting at least moderate (to extreme) concern about the pandemic, with 18.2% reporting increased PA levels, 27.1% reporting no changes, and 54.7% reporting decreased PA levels. Top priorities “in the midst of the COVID-19 outbreak” were staying in touch with family/friends (21%) and taking care of one’s body (20%). Among priorities related to physical well-being, staying active was selected most frequently (33%). Support for maintaining PA in older populations should be a priority during a pandemic and similarly disruptive events.

Prospective COVID-19 related changes in physical activity and sedentary time and associations with symptoms of depression and anxiety

PROBLEM

The COVID-19 pandemic is associated with psychological distress. Decreased moderate-vigorous physical activity (MVPA) and increased sedentary time may be exacerbating pandemic-related symptoms of anxiety and depression, but existing studies exploring these associations are almost entirely cross-sectional.

METHODS

Reported data from 2018 and Summer 2020 were used to create change categories based on compliance with MVPA guidelines and relative sedentary time. Participants completed the Patient Health Questionnaire-4 (PHQ-4) in Summer 2020. Associations among changes in MVPA and sedentary time (separately and jointly) with psychological distress (total PHQ-4 score) were examined with ordinal logistic regression and associations with depressive or anxiety symptoms were examined with logistic regression.

RESULTS

Among 2,240 participants (65% women, mean age 57.5 years), 67% increased sedentary time and 21% became inactive between the two time points. After multivariate adjustment, participants who became (OR = 1.71, 95% CI: 1.05-2.78) or remained inactive (OR = 2.07, 1.34-3.22) were more likely to experience depressive symptoms compared to those who remained active. Participants who increased sedentary time were also more likely to experience depressive symptoms compared to those who maintained sedentary time (OR = 1.78, 1.13-2.81). Jointly, those who increased sedentary time while remaining (OR = 3.67, 1.83-7.38) or becoming inactive (OR = 3.02, 1.44-6.34) were much more likely to have depressive symptoms compared to the joint referent (remained active/maintained sedentary time). Associations with anxiety symptoms were not statistically significant.

CONCLUSIONS

These findings support the value of promoting MVPA and limiting sedentary time during stressful events associated with psychological distress, like the COVID-19 pandemic.

A Rapid Review on the Influence of COVID-19 Lockdown and Quarantine Measures on Modifiable Cardiovascular Risk Factors in the General Population

Preceding coronavirus outbreaks resulted in social isolation, which in turn is associated with cardiovascular consequences. Whether the current COVID-19 pandemic negatively impacts cardiovascular health is unclear. The aim of the rapid review was to investigate, whether COVID-19 lockdown influences modifiable cardiovascular risk factors (i.e., physical inactivity, sedentary behaviour, smoking, alcohol use, unhealthy diet, obesity, bad blood lipids, and hypertension) in the general population. Medline and EMBASE were searched until March 2021. Title, abstracts, and full texts were screened by one reviewer and 20% by a second reviewer. Only studies using probability sampling were included in order to ensure the representativeness of the target population. Data extraction and critical appraisal were done by one reviewer and double-checked by another reviewer. We identified 32 studies that fulfilled our inclusion criteria. Findings show that physical activity decreased, and sedentary behaviour increased among all age groups during the COVID-19 lockdown. Among adults, alcohol consumption increased, dietary quality worsened, and the amount of food intake increased. Some adults reported weight gain. Studies on children and adolescents were sparse. This rapid review found a high number of epidemiological studies on the impact of COVID-19 lockdown measures on modifiable cardiovascular risk factors, but only a few used probability sampling methods.

Consumer-Based Activity Trackers as a Tool for Physical Activity Monitoring in Epidemiological Studies During the COVID-19 Pandemic: Development and Usability Study

BACKGROUND

Consumer-based physical activity trackers have increased in popularity. The widespread use of these devices and the long-term nature of the recorded data provides a valuable source of physical activity data for epidemiological research. The challenges include the large heterogeneity between activity tracker models in terms of available data types, the accuracy of recorded data, and how this data can be shared between different providers and third-party systems.

OBJECTIVE

The aim of this study is to develop a system to record data on physical activity from different providers of consumer-based activity trackers and to examine its usability as a tool for physical activity monitoring in epidemiological research. The longitudinal nature of the data and the concurrent pandemic outbreak allowed us to show how the system can be used for surveillance of physical activity levels before, during, and after a COVID-19 lockdown.

METHODS

We developed a system (mSpider) for automatic recording of data on physical activity from participants wearing activity trackers from Apple, Fitbit, Garmin, Oura, Polar, Samsung, and Withings, as well as trackers storing data in Google Fit and Apple Health. To test the system throughout development, we recruited 35 volunteers to wear a provided activity tracker from early 2019 and onward. In addition, we recruited 113 participants with privately owned activity trackers worn before, during, and after the COVID-19 lockdown in Norway. We examined monthly changes in the number of steps, minutes of moderate-to-vigorous physical activity, and activity energy expenditure between 2019 and 2020 using bar plots and two-sided paired sample t tests and Wilcoxon signed-rank tests.

RESULTS

Compared to March 2019, there was a significant reduction in mean step count and mean activity energy expenditure during the March 2020 lockdown period. The reduction in steps and activity energy expenditure was temporary, and the following monthly comparisons showed no significant change between 2019 and 2020. A small significant increase in moderate-to-vigorous physical activity was observed for several monthly comparisons after the lockdown period and when comparing March-December 2019 with March-December 2020.

CONCLUSIONS

mSpider is a working prototype currently able to record physical activity data from providers of consumer-based activity trackers. The system was successfully used to examine changes in physical activity levels during the COVID-19 period.