Is It Important to Perform Physical Activity During Coronavirus Pandemic (COVID-19)? Driving Action for a Correct Exercise Plan

Physical fitness trend after COVID-19 restrictions in Italian school-aged children: a cross-sectional study

BACKGROUND

Physical fitness (PF) is a marker of health in children. Muscular strength and speed-agility PF components play a crucial role in musculoskeletal development and bone health. The outbreaks of COVID-19 pandemic changed the daily and sports activities in younger increasing sedentary habits with a detrimental effect on PF. We aimed to investigate the impact of COVID-19 restrictions on PF in Italian school-aged children.

METHODS

We recruited 286 elementary school children, and they were tested through an internationally validated battery test, which evaluate muscular strength and speed-agility (as a multifactorial performance) prior (2018) and after the outbreak of COVID-19 pandemic (2021).

RESULTS

Our results showed a reduction in the lower limb strength (SBJ in boys mean difference (MD) -0.42 m; SBJ in girls MD=-0.20 m; P<0.05) and in the speed-agility ability (10x5 m in boys MD=14.1 s; 10x5 m in girls MD=11.2 s; P<0.05), while the upper limb strength remained steady before and after the restrictions. Specifically, for boys of all ages there was a reduction in lower limb strength and in speed-agility but not in upper limb strength. For girls of all ages there was not a recurrent trend, while for 6-8 girls there was a reduction only speed-agility, for 9-11 girls there was a reduction in lower limb and speed-agility.

CONCLUSIONS

Our results could be useful to help teachers and sport specialists to evaluate and improve strength and speed-agility in children. We encourage trainers and sport specialists to implement programs to help children to become more active and healthier during their lifespan.

Effects of an Online Supervised Exercise Training in Children with Obesity during the COVID-19 Pandemic

COVID-19 restrictions have dramatically reduced the active lifestyle and physical activity (PA) levels in the whole population, a situation that can contribute to weight gain and to develop obesity. To improve physical fitness (PF) in children with obesity during COVID-19 restrictions, sport specialists started to deliver physical training through tele-exercise. For these reasons, the aim of this study was to evaluate the effects of a 12-week online supervised training program in children with obesity on different PF components and PA levels. We enrolled a total of 40 Caucasian children (9 F/31 M; aged 11 ± 1.9 years) with obesity. The data collection consisted of a series of anthropometric measures, the PAQ-C questionnaire, and PF tests, valid and reliable tools to assess PF in children. We used a Wilcoxon’s t-test and a Student’s t-test, as appropriate, to assess the differences before and after the training protocol. A total of 37 patients completed the training protocol and were considered in the analysis. Our results show an improvement in all the PF tests, a reduction in the BMI z-score, the waist circumference, and in the waist-to-height ratio, and an increased PA level. In conclusion, the results of our study show that an online supervised training program is effective to promote PA, improving PF and reducing the BMI z-score in children with obesity.

Effects of the lockdown period on the mental health of elite athletes during the COVID-19 pandemic: a narrative review

Purpose

This review aimed to assess the effects of COVID-19 pandemic lockdown on mental health to elite athletes. The emotional background influenced their sport career and was examined by questionnaires.

Methods

We included original studies that investigated psychological outcomes in elite athletes during COVID-19 lockdown. Sixteen original studies (n = 4475 participants) were analyzed.

Results

The findings showed that COVID-19 has an impact on elite athletes’ mental health and was linked with stress, anxiety and psychological distress. The magnitude of the impact was associated with athletes’ mood state profile, personality and resilience capacity.

Conclusion

The lockdown period impacted also elite athletes’ mental health and training routines with augmented anxiety but with fewer consequences than the general population thanks to adequate emotion regulation and coping strategies.

Satisfaction with the walking-related environment during COVID-19 in South Korea

This study aimed to examine the satisfaction level differences between urban and rural areas with regard to their walking environment during the COVID-19 pandemic in South Korea. This online cross-sectional research was conducted using a mobile health application. Overall, 1,032 local residents who participated in the mobile healthcare program of a public health center were classified as being from either urban (n = 481, 46.6%) or rural areas (n = 551, 53.4%) for the purpose of this study. The Walkability Checklist, which includes sociodemographic information, was employed using a Chi-square test and a multivariate logistic regression to investigate whether or not the participants were satisfied with the environmental factors associated with walking. It was found that both urban and rural areas were more likely to be unsatisfied with walking comfort (adjusted OR: 24.472, 95% CI: 14.937-40.096). Regarding the walking comfort aspects of the walking environment, urban residents chose poor landscape ("needed more grass, flowers, or trees"; aOR: 13.561, 95% CI: 3.619-50.823) as their primary dissatisfaction, and rural residents chose messy streets ("dirty, lots of litter or trash"; aOR: 29.045, 95% CI: 6.202-136.015). Compared with urban residents, rural residents were more discontented with the walking environment. Thus, to promote walking activities at the community level, it is necessary to focus on walking comfort, and implement efforts related to environmental beautification.

The Role of Crowd Support on Home Advantage during COVID-19 Restrictions on Italian Football Competitions. Comparison between 2018–19 and 2020–21 Seasons of the Italian Serie A and Serie B Championships

The home advantage (HA) affects football competitions, especially due to the presence of crowd support. Even though several studies demonstrated that HA (which is influenced by the crowd) decreased in recent years, the empty stadia caused by COVID-19 restrictions offered unique situations to explore and quantify HA. For this reason, we aimed to assess HA in two seasons of the major Italian Championships. We conducted an observational study with the data from the last three seasons of the Italian football championship A–B series, analyzing a total of 2.964 individual game scores. To quantify the HA, the number of points won at home was calculated as a percentage of the total number of points won, home and away. In every season and for every team classification, HA was found (scored points > 50% in home matches). We reported a difference in HA median score for Serie B. Additionally, a difference was found in Serie A for middle-ranking HA median scores in the two seasons compared (p-value = 0.017), which was similarly found in Serie B (p-value = 0.009). The number of penalties was lower in the season with a crowd compared to one without a crowd (p = 0.001). The HA did not disappear in empty stadiums, so there must be other contributing factors. Additionally, we found that the referees were biased by the presence of the crowd in favor of the home teams, and this result could be considered by the football association during referees’ training and formation.

Provision of pulmonary rehabilitation in Latin America 18 months after the COVID-19 pandemic: A survey of the Latin American Thoracic Association

Introduction

The Coronavirus disease (COVID-19) pandemic has significantly altered the provision of rehabilitation services, especially pulmonary rehabilitation (PR). Our objective was to assess the provision of PR services in Latin America 18 months after the COVID-19 pandemic was declared.

Methods

A cross-sectional study that included professionals dedicated to PR in centres in Latin America was applied. Responses to an online questionnaire were collected from May to September 2021. The following data were included for the analysis: demographic data, evaluation strategies, program structure, PR intervention in post-COVID-19 patients, and perception of strategies therapies for the care of post-COVID-19 patients. The questionnaire was distributed in Spanish and Portuguese languages.

Results

Responses were received from 196 PR centres. Exercise tolerance was predominantly measured with the six-minute walk test. Less than 50% of the institutions evaluate quality of life, physical qualities, symptoms, and lung function. Most of the programmes have physiotherapists (90.8%), as well as pulmonologists (60%), and psychologists (35%), among other professionals.

Conclusion

PR services in Latin America have adapted in their way to the requirements of the pandemic, and most continued to provide face-to-face services. It was identified that the application of the programs is heterogeneous both in evaluations and interventions.

Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review

The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks.

Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era

The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.

"CoVidentary": An online exercise training program to reduce sedentary behaviours in children with type 1 diabetes during the COVID-19 pandemic

AIM

We explored the physical activity (PA) level and the variation in glycaemic control in children with type 1 diabetes (T1D) before and during the lockdown. Then, we proposed an online training program supported by sport-science specialists.

METHODS

Parents of children with T1D (<18 years) filled out an online survey. Anthropometric characteristics, PA, play, sport and sedentary time and the medical related outcomes were recorded. An adapted online program "Covidentary" was proposed through full-training (FT) and active breaks (AB) modality.

RESULTS

280 youth (11.8 ± 3.3 years) were included in the analysis. We reported a decline in sport (-2.1 ± 2.1 h/week) and outdoor-plays (-73.9 ± 93.6 min/day). Moreover, we found an increase in sedentary time (+144.7 ± 147.8 min/day), in mean glycaemic values (+25.4 ± 33.4 mg/dL) and insulin delivery (71.8% of patients). 37% of invited patients attended the training program, 46% took part in AB and 54% in FT. The AB was carried out for 90% of the total duration, while the FT for 31%. Both types of training were perceived as moderate intensity effort.

CONCLUSION

A decline of participation in sport activities and a subsequent increase of sedentary time influence the management of T1D of children, increasing the risk of acute/long-term complications. Online exercise program may contrast the pandemic's sedentary lifestyle.

Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity (0-30; 31-90; 91-150; 151-300; and >300 min/week) and into active (≥150 min) or inactive (<150 min). Increased sweets consumption was the most commonly reported change to eating habits (42.5%), followed by an increase in the consumption of vegetables (26.6%), fruits (25.9%), and fried foods (17.9%). Physical activity practice was related to lower consumption of fried foods (OR = 0.60; p < 0.001) and sweets (OR = 0.53; p < 0.001). A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet (p < 0.001). Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic.

Impact of COVID-19 Pandemic on University Students' Physical Activity Levels: An Early Systematic Review

Purpose: This systematic review aimed to analyze the impact that the COVID-19 lockdown had on the amount of physical activity performed by university students. Materials and Methods: A systematic electronic search for studies providing information regarding physical activity levels pre and during COVID-19 pandemic in university students was performed up to 20th October 2020 in the databases Cochrane Library, PubMed, SPORTDiscus, and Web of Science. The risk of bias of external validity quality of included studies was assessed by means of those the Newcastle-Ottawa Scale (NOS). The quality of the evidence for main outcomes was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results and Conclusions: A total of 10 studies were selected. Physical activity levels were assessed by means of questionnaires (10 studies) and accelerometer (1 study). Risk of bias was regarded as low and high in six and four investigations, respectively. The quality of evidence was downgraded to low. A significant reduction of physical activity levels were observed in 9 studies. Compared to pre-lockdown values, five studies showed a reduction of light/mild physical activity (walking) between 32.5 and 365.5%, while seven studies revealed a reduction of high/vigorous physical activity between 2.9 and 52.8%. Walking, moderate, vigorous, and total physical activity levels have been reduced during the COVID-19 pandemic confinements in university students of different countries. Despite of the reductions, those who met the current minimum PA recommendations before the lockdown generally met the recommendations also during the confinements.