Effects of the COVID-19 Lockdown on Portuguese Children's Motor Competence

Background, rationale, and methodological overview of the REACT project-return-to-action on growth, motor development, and health after the COVID-19 pandemic in primary school children

OBJECTIVES

The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID-19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this introductory article, the first of the Journal's special issue dedicated to REACT, our goal was to present the project rationale, its methodology, training and certification of the team, statistical approach, quality control, governance, and study management.

METHODS

We sampled 1000 children (6-10 years of age) from 25 of the 32 primary schools in Matosinhos, northern Portugal. The protocol included a set of variables clustered around the child (growth, physical fitness, fundamental movement skills, and health behaviors), family (demographics, socioeconomic status, parental support for sports participation and physical activity), school (policies and practices for health behaviors, infrastructure for physical education and sports practices), and neighborhood and home environments (safety, sidewalks, sports facilities, as well as children electronic devices and play equipment at home). A set of standard protocols were implemented in REACT together with a rigorous system of training and certification of all members of the research team. This was complemented with a pilot study to assess, in loco, the quality of data acquisition, data entry, and control.

DISCUSSION

Results from REACT will provide school administrators and teachers with novel and far-reaching information related to children's growth and motor development as well as health behaviors after the COVID-19 pandemic. It will also provide city-hall education officials with insight regarding children's physical fitness, fundamental movement skills, and sports practices that will be of great importance in devising novel intervention programs to increase health-enhancing physical activity, and combat sedentariness and obesity. Finally, it will offer parents a wealth of information regarding their children's growth, motor development, and health.

The impact of the COVID-19 outbreak on physical fitness and academic performance of Chinese college students

BACKGROUND

Our study aimed to examine the effects of COVID-19 on the physical fitness and academic performance of Chinese college students.

PARTICIPANTS

The sample included physical fitness test data from 9,712 undergraduate students and academic performance data from 12,000 undergraduate students at a top university in China.

METHODS

Physical fitness was measured and evaluated according to the Chinese National Student Physical Fitness Standard. Data were analyzed using two-sample t-tests and Pearson product-moment correlations.

RESULTS

Total physical fitness test scores of college students decreased after the outbreak, but their mean body mass index (BMI) remained at normal levels. The mean academic performance of college students unexpectedly improved during the online learning period. The positive correlation between physical test scores and academic performance was significantly higher during COVID-19 than that before the outbreak.

CONCLUSIONS

Chinese college students with high physical fitness during COVID-19 were more likely to achieve good academic performance.

Move Well, Feel Good: Feasibility and acceptability of a school-based motor competence intervention to promote positive mental health

BACKGROUND

In response to the adverse impacts of the COVID-19 lockdown measures Move Well, Feel Good (MWFG) was developed as a school intervention using improvement of motor competence as a mechanism for promoting positive mental health. Study objectives were to evaluate the feasibility and acceptability of MWFG and to describe changes in child-level outcomes.

METHODS

Five northwest England primary schools were recruited. MWFG was delivered over 10-weeks through physical education (PE) lessons, which were supplemented by optional class-time, break-time, and home activities. The intervention focused on development of 9-10 year-old children's motor competence in locomotor, object control, and stability skills, and psychosocial skills. Feasibility was evaluated against nine pre-defined criteria using surveys, interviews (teachers), and focus groups (children). Pre- and post-intervention assessments of motor competence, mental health, prosocial behaviour, wellbeing, and 24-hour movement behaviours were also completed.

RESULTS

The five recruited schools represented 83% of the target number, 108 children consented (54% of target) with teachers recruited in all schools (100% of target). Intervention dose was reflected by 76% of the 45 scheduled PE lessons being delivered, and adherence was strong (>85% of children attending ≥75% of lessons). Positive indicators of acceptability were provided by 86% of children, 83% of PE teachers, and 90% of class teachers. Data collection methods were deemed acceptable by 91% of children and 80% of class teachers, and children spoke positively about participating in the data collection. Child-level outcome data collection was completed by 65%-97% of children, with a 3%-35% attrition rate at post-intervention, depending on measure. Favourable changes in motor competence (+13.7%), mental health difficulties (-8.8%), and prosocial behaviour (+7.6%) were observed.

CONCLUSIONS

MWFG is an acceptable and feasible motor competence intervention to promote positive mental health. Content and delivery modifications could inform progression to a pilot trial with a more robust design.

Effect of Motor Competence and Health-Related Fitness in the Prevention of Metabolic Syndrome Risk Factors

Purpose: In the last decades we have seen an increase in sedentary behaviors and a decrease in physical activity in children when compared to past generations. This lifestyle is commonly associated with the development of clustering risk factors that define metabolic syndrome (MetS). Knowing that motor competence (MC) development can influence lifelong physical activity habits, it is reasonable to assume that children's MC will directly link to clustered cardiometabolic health outcomes. The aim of this study was to analyze the role of MC in MetS risk factors. Methods: Seventy children with a mean age of 7.49 (SD = 1.28) years were evaluated on motor competence (MCA-Motor Competence Assessment instrument), cardiovascular fitness (PACER test), upper body strength (UBS; handgrip), and the components of MetS, hypertriglyceridemia, hypertension, abdominal obesity, low concentration of high-density lipoprotein cholesterol, and high fasting blood glucose. The composite value of MetS was calculated according to Burns et al. (2017). Multiple standard regressions were performed to explore the effect of different variables on MetS. Motor competence and health-related fitness (cardiovascular fitness and relative upper body strength) were used as independent variables (predictors) and MetS as dependent variable. Results: Overall, the results showed that motor competence (β = -.072; p < .05) is a significant predictor and this model explained 7,1% of the variance in MetS. Conclusion: Although more studies are needed, our results indicate that MC seems to have a positive role in children's health markers.

Changes in Motor Competence of 4-8-Year-Old Children: A Longitudinal Study

OBJECTIVES

The development of children's motor competence (MC) from early to middle childhood can follow different courses. The purpose of this longitudinal study was to describe and quantify the prevalence of patterns of MC development from early to middle childhood and to identify undesirable patterns.

DESIGN

The study used a longitudinal design. Data were collected in three consecutive years, between February 2020 (T0) and May 2022 (T2).

METHODS

A total of 1128 typically developing Dutch children (50.2% male) between 4 and 6 years old at baseline (M = 5.35 ± 0.69 years) participated in this study. MC was measured with the Athletic Skills Track and converted into Motor Quotient (MQ) scores. To convert all individual MQ scores into meaningful patterns of MC development, changes in MQ categories were analyzed between the different timepoints.

RESULTS

A total of 11 different developmental patterns were found. When grouping the different patterns, five undesirable patterns were found with 18.2% of the children, showing an undesirable pattern of MC development between T0 and T2. The patterns of motor development of the other children showed a normal or fluctuating course.

CONCLUSIONS

There is a lot of variation in MC in early and middle childhood. A substantial percentage of young children showed undesirable MC developmental patterns emphasizing the need for early and targeted interventions.

I-MovE. An intervention to promote movement at childcare centers: Benefits for motor cognitive and socio-emotional development

The present contribution aimed to analyze the effects of a motor program intervention (i.e., I-MovE intervention) implemented indoors and outdoors at nursery school, on children's motor, socio-emotional, and cognitive skills. The study uses a non-randomized pre-post test design. Participants were children attending twenty nursery schools in the North of Italy. The intervention activities were adapted to age: Level 1 activities were addressed to children between 6 and 12 months, and Level 2 activities were addressed to children between 13 and 43 months. Within each level, one group of children developed the intervention indoors (IN-group; Level 1: n = 10; Level 2: n = 104) and another group developed the intervention outdoors (OUT-Group; Level 1: n = 12; Level 2: n = 66). Finally, one additional group was involved as the control group (CONT-Group; Level 1: n = 15; Level 2: n = 98). Children's motor, cognitive, and socio-emotional skills were assessed before and after the intervention by nursery school teachers. The main results showed that the motor intervention promoted children's motor skills development in both groups (i.e., groups implementing Levels 1 and 2 activities) and the cognitive and socio-emotional skills in the older group (i.e., group implementing Level 2 activities), especially the group that performed the intervention outdoors.

An Effective and Playful Way of Practicing Online Motor Proficiency in Preschool Children

The children's fairytale is a playful educational tool that can be modified in such a way to enhance motor proficiency. This study investigated the effect of an online exercise program with modified fairytales on children's motor proficiency during the kindergarten curriculum. Forty preschool children (20 girls and 20 boys; 5.13 ± 0.24 years old) were divided into two equal groups: an intervention (IG) group and a control group (CG). The IG followed a 3-month (3 times/week) online exercise intervention program (supervised by the class's kindergarten teacher) with modified children's fairytales, during the COVID-19 pandemic, with an aim to improve their motor proficiency. The CG did not attend any exercise intervention program. The Democritos Movement Screening Tool for Preschool Children (DEMOST-PRE), consisting of ten tests, was used to assess the children's motor proficiency. Τhe IG, after the end of the intervention program, significantly improved in the DEMOST-PRE total score (p < 0.001; mean change: 40.7%), while the CG did not significantly improve in the total score (p > 0.05). Furthermore, in the IG, a significant negative correlation between the pre-training DEMOST-PRE total score and the percentage change following the intervention (r = -0.64; p = 0.002) was observed. A modified exercise program using children's fairytales may be incorporated into the kindergarten curriculum as an effective educational tool for the improvement of motor proficiency.

The effects of the COVID-19 lockdowns on motor skill development of 6- and 7-year old children in the Netherlands: a longitudinal study

BACKGROUND

The closing of schools and sports clubs during the COVID-19 lockdown raised questions about the possible impact on children's motor skill development. Therefore, we compared motor skill development over a one-year period among four different cohorts of primary school children of which two experienced no lockdowns during the study period (control cohorts) and two cohorts experienced one or two lockdowns during the study period (lockdown cohorts).

METHODS

A total of 992 children from 9 primary schools in Amsterdam (the Netherlands) participated in this study (age 5 - 7; 47.5% boys, 52.5% girls). Their motor skill competence was assessed twice, first in grade 3 (T1) and thereafter in grade 4 (T2). Children in control group 1 and lockdown group 1 were assessed a third time after two years (T3). Motor skill competence was assessed using the 4-Skills Test, which includes 4 components of motor skill: jumping force (locomotion), jumping coordination (coordination), bouncing ball (object control) and standing still (stability). Mixed factorial ANOVA's were used to analyse our data.

RESULTS

No significant differences in motor skill development over the study period between the lockdown groups and control groups (p > 0.05) were found, but a difference was found between the two lockdown groups: lockdown group 2 developed significantly better than lockdown group 1 (p = 0.008). While socioeconomic status was an effect modifier, sex and motor ability did not modify the effects of the lockdowns.

CONCLUSIONS

The COVID-19 lockdowns in the Netherlands did not negatively affect motor skill development of young children in our study. Due to the complexity of the factors related to the pandemic lockdowns and the dynamic systems involved in motor skill development of children, caution must be taken with drawing general conclusions. Therefore, children's motor skill development should be closely monitored in the upcoming years and attention should be paid to individual differences.

Physical activity and physical fitness among children and adolescents after the onset of the COVID-19 pandemic in the WHO European Region: a systematic review protocol

INTRODUCTION

The implementation of COVID-19 pandemic-related restrictions resulted in limitations for physical activity (PA) opportunities, which may have initiated a longer-term behavioural change. The protocol describes the methodology for a planned systematic review that aims to summarise changes in PA and physical fitness (PF) in children and adolescents in the WHO European Region after the onset of the COVID-19 pandemic.

METHODS AND ANALYSIS

The protocol adheres to the 'Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols' (PRISMA-P) statement. Using a peer-reviewed search strategy according to the evidence-based checklist 'Peer Review of Electronic Search Strategies' (PRESS), we will perform a systematic literature search in seven databases. Inclusion criteria are all primary studies that gathered data on children and adolescents ≤19 years living in the WHO European Region and made a comparison to pre-pandemic data. Primary outcomes are PA and PF. We will assess the risk of bias with the 'Risk of Bias Instrument for Non-Randomized Studies of Exposures' (ROBINS-E). The 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) approach will be used for the evaluation of the certainty of evidence. Also, subgroup analyses will be performed (eg, for gender, age, stringency of pandemic restrictions).

ETHICS AND DISSEMINATION

Ethical approval is not required, as primary data will not be collected in this study. The results will be presented in a peer-reviewed publication and at congresses relevant to the research field.

PROSPERO REGISTRATION NUMBER

CRD42023395871.

Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children's MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of 'Move Well Feel Good', a primary school physical activity intervention to improve children's MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8-9 years) participated in a series of co-creation workshops. Stakeholders' knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children's lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes.

Physical fitness in Austrian elementary school children prior to and post-COVID-19

Background

With the emergence of the COVID-19 pandemic, many countries implemented policies that included movement restrictions, social distancing and school closures in order to control the spread of the virus. Even though these actions may have been necessary to save lives, there have been some unintended consequences that could affect future public health.

Methods

The present study uses data from more than 24,500 Austrian elementary school children (51.2% male) that participated in a state-wide fitness evaluation program, which was initiated in the 2016/17 school year. In addition to body weight and height, data on cardiorespiratory endurance, muscular power, speed, agility, flexibility and object control were collected from three cohorts prior to the implementation of movement restrictions (school years: 2016/17, 2017/18, 2018/19) and one cohort in 2022, after the majority of COVID-19 policies had been lifted.

Results

Body mass index percentiles were significantly higher in children post-COVID-19 (p < 0.01). Further, cardiorespiratory endurance, agility and flexibility were significantly lower post-COVID-19 compared to the years preceding movement restrictions (p ≤ 0.01), while absolute muscular strength was higher in the year 2022 (p < 0.01).

Conclusion

Given the detrimental effects of COVID-19 policies on physical fitness in children, additional efforts are necessary that include versatile opportunities for physical activity and the promotion of physical fitness in order to modify the observed negative health trajectories and ensure future public health.

The mediational role of motivation in the model of motor development in childhood: A longitudinal study

The aim of this study was twofold: first, to examine the stability of the hypothesized conceptual model of motor development (without and with including various types of motivation) when children are followed up one-year later, and second to examine longitudinally whether changes in one model variable predict changes in other variables, according to the hypothesized pathways in the model. A sample of 361 Spanish students (50.7% girls, 8-11 years old) voluntarily participated in this study. In relation to the first aim, structural equation modeling revealed the expected positive relationship between the model variables in both measurement times. That is: actual motor competence (MC) predicted physical activity (PA) (p < .001), perceived MC mediated the relationship between actual MC and PA (p < .001), and autonomous motivation mediated the relationship between perceived MC and PA (p < .05). Moreover, the comparison of the invariance analysis showed non-practical differences between the unconstrained model and the constrained model, supporting the stability of the model over time. In relation to the second aim, the hypothesized model in Time 2 controlling for Time 1 values showed that changes in children's actual MC positively predicted changes in their perceived MC (p < .001), which in turn, predicted changes in their autonomous motivation (p < .001), and PA (p < .001) at Time 2. Based on these findings Physical Education teachers are recommended to foster children's actual and perceived MC as well as their autonomous motivation over time in order to promote PA strategies for lifelong health.

Actual and Perceived Motor Competence in Chilean Schoolchildren before and after COVID-19 Lockdowns: A Cohort Comparison

(1) Background: the measures applied in Chile to reduce COVID-19 infections have been very strict, mainly for children who have experienced lockdowns and school closures for almost two years. Emerging evidence indicates that lockdowns have had several negative effects on children; therefore, the present study seeks to analyze the secular effects of COVID-19 lockdowns on Chilean students’ actual motor competence (AMC) and perceived motor competence (PMC). (2) Methods: using a sequential cohort design, data from 523 fifth-grade students at nine elementary schools (46.8% girls, age M = 11.11, SD = 0.66) were assessed in 2018–19 (pre-lockdown) (n = 265) and 2022 (post-lockdown) (n = 258). (3) Results: in the domain of object control (AMC and PMC), no significant differences were found (AMC p = 0.559; PMC p = 0.682). In the self-movement domain of AMC and PMC, the significant differences found presented a small effect size (AMC p = 0.044, ηp2 = 0.01; PMC p = 0.001, ηp2 = 0.03). (4) Conclusions: although the differences encountered were not drastic, self-movement skills tended to be greatly affected by the lockdowns resulting from the COVID-19 pandemic. These findings broaden information on the negative consequences of the pandemic on students in aspects related to an active and healthy life.

Children's Physical Activity During the COVID-19 Lockdown: A Cross Cultural Comparison Between Portugal, Brazil and Italy

The COVID-19 pandemic forced governments to implement measures that disrupted the daily routines of many families worldwide. We studied how the COVID-19 lockdown affected children's routines in Portugal (PT), Brazil (BR), and Italy (IT) to determine if children's age and country impacted their physical activity (PA) and sedentary time. We launched an anonymous online survey to assess how 3-12 years old children adjusted their daily routines to this situation. Parents reported the times each child was engaged in different activities throughout the day, and we used these data to calculate separately overall sedentary and physical activity time. We conducted separate analyses of variance for age and country on the percentage of time spent in the different activities. Results, based on the data from 3045 children in these three countries (PT n = 2044; BR n = 836; IT n = 165), showed that, during lockdown, most children spent most of their awake daily hours in sedentary activities. There was a clear age effect on the way their routines were organized. Percentages of time spent in intellectual activity, playful screen activity, and overall sedentary time were greater in the older age groups, whereas percentages of time spent in play (with and without PA) and in overall PA were greater in the younger groups. We found a main effect of country for all variables except play without PA. The country effect was mainly due to the difference between the routines in BR when compared to PT and IT. Values of playful screen time and overall sedentary activity were higher in BR than in the two European countries. Conversely, values for play with PA, PA, and overall PA (except in the older group) were lower in BR. Patterns of time spent in these activities were similar in IT and PT, but PA and overall PA times were higher in the two younger age groups in IT. In summary, percentage of PA time of confined children was low and decreased with age across all three countries and was particularly low for children in BR relative to those in PT and IT.

Association between decreased grip strength in preschool children and the COVID-19 pandemic: an observational study from 2015 to 2021

Background

Coronavirus disease 2019 (COVID-19) has reduced people’s physical activity. It is essential to accumulate knowledge regarding the influence of COVID-19 on the stimulation of physical fitness and physical functions. Several studies have reported the effects of COVID-19 on physical fitness; however, there are very few reports regarding preschoolers. This study aimed to compare the physical fitness of preschoolers before and during the COVID-19 pandemic to clarify the effects of curtailment of outings implemented to control the pandemic on physical fitness among preschoolers.

Methods

The subjects were 593 Japanese preschool children enrolled at a kindergarten during 2015–2019 and in 2021 who received a physical fitness test. Children enrolled in 2020 who did not receive a physical fitness test because of the COVID-19 pandemic were excluded. The physical fitness test included grip strength, standing long jump, and a 25-m run. The relationship between physical fitness level and survey year was analyzed using a general linear model, with grip strength and standing long jump as dependent variables, year of study as the independent variable, and sex and age in months as adjusted variables. Kruskal–Wallis test was used to analyze data for the 25-m run. Multiple comparisons were used to compare fitness levels between 2021 (during the COVID-19 pandemic) with levels in previous years.

Results

Significant relationships were found between survey year and each of grip strength (p < 0.001), standing long jump (p < 0.05), and 25-m run (p < 0.001) among the overall subjects. Grip strength was significantly lower in 2021 compared with the 2016–2019 period. Similarly, sub-stratification analysis by sex showed that grip strength was lower in 2021 than in previous survey years, in both sexes. However, there was no difference in standing long jump or 25-m run times between before and during the pandemic among the overall subjects or according to sex.

Conclusions

These findings indicate that the COVID-19 pandemic has had a negative effect on the development of muscle strength in preschoolers, and suggest the need to develop strategies that could promote the development of muscle strength of preschool children when limitations are placed on activity during prolonged infectious disease pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40101-023-00321-8.

The Impact of COVID-19 Pandemic and Social Distancing on Motor Function and Growth of Children with Congenital Zika Syndrome: A Prospective Cohort Study

This article describes the impact of social distancing during the COVID-19 pandemic on the motor function and growth of children with congenital Zika syndrome (CZS). Children's motor function, weight, height and joint range of movement (ROM) were evaluated before the onset of the pandemic and soon after their return to face-to-face activities at a rehabilitation center. Fifty-two children (Mean 46.07 months, SD 3.76 months) were assessed. Results showed a reduction in proportion of children with adequate body mass index (p = .04), an increase in proportion with adequate height (p < 0.001), deterioration in gross motor function in children with severe motor impairment (p < .01), and a reduction in the maximum ROM for shoulder (p < .01) and wrist flexion (p = .046), elbow (p = .01), knee (p = .03) and ankle extension (p < .01), and an increase in hip flexion (p = .04). The social distancing period appears to have contributed to important losses in motor function and joint mobility of children with CZS; however, this period of time appeared to have less impact on their growth.

A New Developmental Approach for Judo Focusing on Health, Physical, Motor, and Educational Attributes

Judo is currently the most practiced combat sport in the world. There is no doubt of its importance for children, adolescents, adults, and seniors. However, due to its inherent complexity, coaches tend to place greater or lesser emphasis only on one of its multiple domains during the judoka formative years. The present study presents a novel developmental approach signaling Judo as an excellent way for physical, motor, educational, and health development across the lifespan. In this study, we consulted 23 Judo coaches, aiming to clarify the relevance and adequacy of the domains (Competitive, Health, Technical-Tactical, and Philosophical-Educational) and phases of the proposed model. Our findings showed that the model contents-physical, motor, educational, and health-are entwined with its four domains, which were considered of utmost importance by experts in the development of judokas. We, therefore, contend that our model is essential to better understand the growth and development of young judokas. Also, it may be a useful tool for Motor Development experts.

COVID-19 Lockdown: Impact on Oral Health-Related Behaviors and Practices of Portuguese and Spanish Children

This study aimed to assess and compare the impact of COVID-19 pandemic lockdowns on the oral health attitudes, dietary habits and access to dental care of Portuguese and Spanish children. A cross-sectional observational study involving caregivers of 3−17-year-old children who had cohabited during a COVID-19 pandemic lockdown in Spain and Portugal was conducted. Caregivers completed an online anonymous questionnaire. Aiming groups comparison, chi-square test was used for qualitative variables. 770 surveys were obtained. Significant changes in the children’s routine were higher in Portugal (p < 0.001). Both countries showed a large percentage of children who had between 2−3 snacks between meals (p < 0.001) and a higher consumption of snacks was particularly noticed among Spanish children with untreated dental caries during the lockdown (p = 0.003). Most caregivers reported children’s oral hygiene habits did not suffer noteworthy alterations (p = 0.417), although parental supervision of toothbrushing was associated with dental attendance during the lockdown. The majority of the sample had no dental attendance during confinement. Confinement appears to have not markedly affected the oral health status and habits of the majority of these children, although an important impact of some demographic and behavioral factors upon dietary and oral care/habits was detected.

Youth physical activity and the COVID-19 pandemic: A systematic review

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Numerous studies examined youth physical activity (PA) during the COVID-19 pandemic.

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Overall decreases in youth PA were seen during the first 1.5 years of the pandemic.

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There were differences in PA by sub-populations (e.g., age, sex/gender)

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There were also differences in PA by location/type (e.g., outdoor, play)

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Programming and policy should focus on evolving PA promotion for youth.

The purpose of the systematic review was to identify, evaluate, and synthesize evidence from available published literature examining the impact of the coronavirus disease 2019 (COVID-19) pandemic on youth physical activity (PA). A systematic review of the literature was conducted for years 2020–2021. Published articles were searched in eight databases. Inclusion criteria included: availability of full-text, written in English language, and reported quantitative or qualitative results of original or secondary data on PA and COVID-19 related factors among youth (ages 5–17 years). A standard quality assessment tool assessed risk of bias and quality of included articles. The search retrieved 2,899 articles with 51 articles ultimately meeting inclusion criteria. The majority of articles (65 %) investigated change in PA from before to during the pandemic. Most evidence indicated an overall decrease in youth PA levels during the pandemic with differences observed among sub-populations (e.g., age, sex or gender), type, and location. Findings suggest pandemic-related closures hindered PA participation due to a high reliance on school- and sport-based PA. Programmatic strategies (e.g., activity breaks, active curriculum, free online activities/lessons) should include aligning intervention measures and geared towards evolving and ongoing PA promotion based on the latest findings.

Implications for balance in 11- and 12-year-old children in northern Spain during SARS-CoV-2 lockdown

Introduction

The home lockdown due to the appearance of SARS-CoV-2 in Spanish society led to changes in certain habits in children and adolescents. These habits were related to the practice of physical activity and the implications of higher rates of sedentary activities. This lockdown lasted from March to June 2020. The aim of this study was to determine the implication that lockdown in Spain due to the SARS-CoV-2 virus outbreak had on balance in 11-12 year-old schoolchildren.

Materials and methods

In total, 50 Spanish children aged 11-12 years (M = 11.40, SD = 0.50) participated, 33 (66%) boys and 17 (34%) girls. The Movement Assessment Battery for Children 2 (Movement ABC-2) and an ad hoc questionnaire for sociodemographic data and other relevant information were used for the three data collections.

Results

There are significant differences (p < 0.05) in the results for balance variables measured by static balance tests on supports in the total sample, in boys and girls. There are also significant differences in the total sample as well as in the boys in the heel-toe backward walking test. In addition, there are significant differences in mean, scalar and percentile dimension scores for balance between before and after lockdown in both boys and girls. No significant differences were found in the total sample or by gender in measurements related to the zigzag jumping test with dominant as well as non-dominant leg in girls (p = 0.317).

Conclusion

As a consequence of SARS-CoV-2 confinement, there was a worsening of balance values in children aged 11-12 years.

Physical Functions among Children before and during the COVID-19 Pandemic: A Prospective Longitudinal Observational Study (Stage 1)

One major impact of the COVID-19 pandemic on children's lifestyles is the lack of exercise owing to activity restrictions. However, information regarding the way in which physical functions among children decline under these circumstances remains scarce. In this study, we compared the physical functions and life habits among children before and during the COVID-19 pandemic in Japan. The participants involved 40 children aged between 9-15 years (23 girls and 17 boys) who were examined medically both before and during the pandemic. The compared variables included muscle strength, static and dynamic balance functions, gait speed, body fat percentage, screen and sleep times, quality of life, and physical activity time. During the pandemic, compared to before the pandemic, children had lower levels of dynamic balance functions (p = 0.039), increased body fat percentages (p < 0.0001), longer screen time per day (p = 0.002), and shorter sleep time per day (p < 0.0001). Between the two periods, there were no significant differences in muscle strength, static balance functions, gait speed, quality of life, and physical activity time. The activity restrictions imposed as a result of the COVID-19 pandemic negatively affect dynamic balance functions, body-fat levels, and life habits among children.

The Developmental Trajectory of Motor Competence of Children That Lived the COVID-19 Confinement Period: A Four-Year Follow-Up Study in Portuguese Children

Children’s motor competence (MC) was negatively affected by the COVID-19 pandemic; however, possible chronic effects have not been studied. Therefore, the aim of this study was to examine the possible impact of the forced lack of physical activity (PA) during the COVID-19 lockdown on children’s MC two years later. The motor competence of sixty-seven healthy children (7.4−12.2 years old) was assessed using the Motor Competence Assessment (MCA). All participants completed the MCA tests at two different moments (before and after the COVID-19 lockdown), four years apart. The mean values after the COVID-19 lockdown for all participants on the subscales and on the Total MCA are lower, but no significant changes were found when controlling for gender and age (p > 0.05 in all analyses). However, a significant decrease was found in the Locomotor subscale in boys (p = 0.003). After dividing the participants into three age groups, the youngest also suffered a decrease in the Locomotor subscale (p < 0.001) and their Total MCA (p = 0.04). In addition, those participants who had a higher MC at baseline decreased their scores for the Locomotor (p < 0.001) and Manipulative (p < 0.001) subscales, and for the Total MCA (p < 0.001). In conclusion, the younger children and the more motor proficient did not fully recover from the negative effects of the pandemic lockdown after two years.

Changes in Physical Fitness during the COVID-19 Pandemic in German Children

With the beginning of the COVID-19 pandemic in December 2019, each country has developed strategies to try to control the virus. The restrictions and subsequent consequences also limited the possibilities and structures for being physically active. Therefore, the aim of this study was to examine changes in physical fitness in a cohort that was investigated over an extended period. Physical fitness testing was conducted with the IPPTP-R in a primary school from a small rural community annually since 2012. Mean values of test items were calculated for each cohort. We conducted an ANCOVA to examine the differences between cohorts PreCOVID and 2020 as the first year of the COVID-19 pandemic, and between PreCOVID and 2021 as the second year of the COVID-19 pandemic. Overall, no evidence for a negative effect of the COVID-19 pandemic on physical fitness in children between the ages of 7 and 9 years was found. In strength tests, performances increased when comparing the PreCOVID cohort and COVID-19 cohorts (Push-Ups: p < 0.001, ηp2 = 0.032; p = 0.017, ηp2 = 0.006). No evidence for a change was found for endurance (6-min Run: p = 0.341, ηp2 = 0.001; p = 0.267, ηp2 = 0.001. The rural community maintained physical fitness despite restrictions and limitations through the environmental circumstances. Considering this, it is a positive example of how adequate long-term efforts promoting physical fitness make an impact and an active friendly environment helps to overcome COVID-19 pandemics limiting the structures for being physically active.

Online physically active academic lessons in COVID-19 times: A pilot study

Schools play an important role in promoting physical activity among students. This paper studies the perception of educators, students, and parents about the use of online physically active academic lessons during COVID-19 in the north of Chile. Starting the first week of November 2020, and for a period of five weeks, 323 students, alongside 11 educators, practiced a geometry-based dance routine online. The qualitative analysis results reveal a positive perception of the experience and an increase in physical activity without reducing the amount of time spent on academic activities. There were also improvements in learning, social relationships, and enjoyment.

The Impact of the COVID-19 Pandemic on the Physical Fitness of Primary School Students in China Based on the Bronfenbrenner Ecological Theory

After the outbreak of the COVID-19 pandemic, nation lockdown became an effective way to isolate the spread of the virus. Schools were postponed, students had to stay at home and opportunities for physical activity amongst school children were severely affected. This research sought to determine the impact of the pandemic on the physical fitness of primary school students. In total, 1,235 students from grades one to five in a primary school in Beijing took part in this research. Using the Chinese National Student Physical Fitness Standard as a guide, the students were subjected to BMI, vital capacity, 50 m sprint, sit and reach, timed rope-skipping, timed sit-ups, and 50m × 8 shuttle run measurements. These tests were administered once before and once after the lockdown period. The results showed that the overall physical fitness of the participants was better after the lockdown [p = 0.000, r = -0.14, 95% CI (-0.219, -0.061)]. Specifically, vital capacity, sit and reach, timed rope-skipping and timed sit-ups had improved after the lockdown. Meanwhile, 50m × 8 shuttle run dropped slightly but not significantly whereas 50 m sprint dropped sharply after the lockdown. The proportion of overweight and obese students increased, but the difference before and after the lockdown was small. It appeared that during the pandemic, through the intervention of many comprehensive factors, home-based fitness was normalized and promoted the healthy development of students.

Fundamental movement skills in preschoolers before and during the COVID-19 pandemic in Japan: a serial cross-sectional study

Background

Physical inactivity during the coronavirus disease 2019 (COVID-19) pandemic may have hindered the development of fundamental movement skills in preschoolers. This serial cross-sectional study compared fundamental movement skills by age group before and during the COVID-19 pandemic (2019–2020), among Japanese preschoolers aged 3–5 years.

Methods

Of the 22 preschools within Unnan City, Shimane Prefecture, Japan, 21 (95.5%) and 17 (77.3%) participated in the 2019 and 2020 surveys, respectively. We analyzed 608 and 517 preschoolers in both surveys. Fundamental movement skills were objectively assessed with a 25 m run, standing long jump, and softball throw, based on the Japanese physical activity guidelines for preschoolers. Mann–Whitney U tests were used to compare the fundamental movement skills data between periods.

Results

For the 25 m run, participants aged 5 years were faster before than during the pandemic (p = 0.018), while participants aged 3 and 4 years showed no significant differences. Participants aged 3–5 years showed no significant differences before and during the pandemic for the standing long jump (p ≥ 0.072). For the softball throw, all grades scored higher before than during the pandemic (p < 0.001).

Conclusions

These findings suggest that the COVID-19 pandemic impeded the development of fundamental motor skills, especially for object control skills. This highlights the need for interventions aimed at developing fundamental motor skills in preschoolers during and after the pandemic.

Supplementary information

The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00049.

Variation and Predictors of Gross Motor Coordination Development in Azorean Children: A Quantile Regression Approach

We investigated the development of gross motor coordination (GMC) as well as its predictors in school-aged Azorean children. The sample included 181 children (90 girls), followed consecutively for 4 years from 6 to 9 years of age. GMC was assessed with the Körperkoordinationstest für Kinder, and predictors included body mass index, standing long jump, 50-yard dash, and shuttle run. The changes in GMC and the effects of predictors were analyzed with mean-modeling as well as quantile regression. In the latter, we considered the following three quantiles (Q): Q20, Q50, and Q80 as markers of low, median, and high GMC levels, respectively. All analyses were conducted using R software and alpha was set at 5%. The GMC changes were curvilinear in both models, but the quantile approach showed a more encompassing picture of the changes across the three quantiles in both boys and girls with different rates of change. Further, the predictors had different effect sizes across the quantiles in both sexes, but in the mean-model their effects were constant. In conclusion, quantile regression provides more detailed information and permits a more thorough understanding of changes in GMC over time and the influence of putative predictors.

The Impact of COVID-19-Related Mitigation Measures on the Health and Fitness Status of Primary School Children in Austria: A Longitudinal Study with Data from 708 Children Measured before and during the Ongoing COVID-19 Pandemic

The COVID-19-related closing of schools and sport facilities resulted in major changes to daily routines worldwide. It was the aim of this study to investigate the impact of COVID-19-related mitigation measures on the health and fitness status of primary school children in Austria. Seven hundred and eight primary school children (7–10 years old) participated in the longitudinal study. Data on height, weight, waist circumference, and fitness were collected before (September 2019) and during the course of the COVID-19 pandemic (June 20, September 20, March 21, June 21). A significant increase in EQUI BMI_AUT (η_p² = 0.087) and significant changes (η_p² = 0.355) in waist circumference were found. Cardiorespiratory endurance (η_p² = 0.440) and action speed (η_p² = 0.221) decreased dramatically following lockdowns/school closures. In contrast, muscle strength showed no significant changes. The COVID-19-related mitigation measures intended to contain a communicable disease resulted in an acceleration of the pre-existing pandemic of overweight and obesity. The adverse combination of increasing BMI and the loss of physical fitness is likely to result in long-term negative effects on the health status of growing and developing individuals. Health professionals should therefore not only support further longitudinal observations of this “non-communicable disease” but also support intervention programs to reverse this worrying side-effect of COVID-19-associated containment policies.

Children Are Back to School, but Is Play Still in Lockdown? Play Experiences, Social Interactions, and Children's Quality of Life in Primary Education in the COVID-19 Pandemic in 2020

The right to play is crucial for the overall development of children. Several studies highlight the need to have time and space to play, especially at school where children spend much of their time. Unfortunately, in formal education the obsession with academic achievements sidelines and ignores the importance of play. The neglection of play had already reached a critical stage before the pandemic, so data are needed to realize how the right to play in school is presently affected. This paper aims to understand children’s play experience in primary education during the pandemic. It investigates what activities children participated in and what materials were used, and provides insight into the social interactions between peers. Furthermore, children’s quality of life is explored. A group of 370 Portuguese children answered a questionnaire on play and social interactions, alongside with Peds 4.0^TM on health-related quality of life (HRQOL). The results showed that recess still emerges as a significant element of children’s daily lives, but COVID-19 has brought limitations on play experiences and peer-interaction. It might also have impacted HRQOL, especially in emotional functioning. Since play, health and well-being are closely connected, play opportunities at school are crucial in helping children to thrive in the pandemic, and should be invested in.

Physical Activity of Children and Adolescents during the COVID-19 Pandemic-A Scoping Review

To counteract the COVIC-19 pandemic, many governments have introduced social distancing measures. While these restrictions helped contain the virus, it had adverse effects on individuals’ mental and physical health—especially children. The aim of the present study is to review the evidence on the effects of COVID-19 restrictions on children’s physical activity and their determinants. A scoping review was conducted in the databases PubMed, Web of Science, SportDiscus, and BISp-Surf. Inclusion criteria were empirical and peer-reviewed studies, youth samples, investigation of COVID-19 restrictions, and investigating changes and/or determinants of physical activity before and during the COVID-19 pandemic. Risk of bias was assessed using the checklist by Downs and Black. The search resulted in 1672 studies, of which 84 studies were included in the analysis. The results highlighted a decrease in physical activity during the pandemic, ranging between −10.8 min/day and −91 min/day. If an increase was detected, it related to unstructured and outdoor activities. The main determinants of children’s physical activity during the pandemic were age, gender, socioeconomic background, and the outdoor environment. The results imply that governments need to consider the negative effects that restrictive measures have on children’s physical activity and act to ensure high levels of physical activity.

Effect of the COVID-19 Emergency on Physical Function among School-Aged Children

In April 2020, the Japanese government declared a state of emergency due to the novel coronavirus disease (COVID-19). Schools were closed and a stay-at-home order was issued in April and May 2020. This before-and-after study aimed to measure the effects of these COVID-19-related restrictions on physical function among Japanese children. The study included children aged 6–7 years, enrolled before and after the emergency declaration. Their body fat percentage, single-leg standing time, Gait Deviation Index score, and history of falls were compared. There were 56 and 54 children in the before and after groups, respectively. Children in the after group had a higher body fat percentage (p = 0.037), shorter single-leg standing time (p = 0.003), and a larger number of falls per month (p < 0.001) than those in the before group. In the logistic regression analysis, children in the after group had a significantly shorter single-leg standing time (odds ratio (OR): 0.985, 95% confidence interval (CI): 0.972−0.997, p = 0.013), a greater number of falls per month (OR: 1.899, 95% CI: 1.123−3.210, p = 0.017), and a higher body fat percentage (OR: 1.111, 95% CI: 1.016−1.215, p = 0.020) than those in the before group. The COVID-19 emergency restrictions had a negative effect on children’s physical function, especially on balance.

Decline in Motor Function during the COVID-19 Pandemic Restrictions and Its Recovery in a Child with Cerebral Palsy: A Case Report

Children with cerebral palsy (CP) experience various restrictions owing to their underdeveloped mobility. Home confinement due to the coronavirus disease 2019 pandemic may further increase these restrictions. We report the case of a 7-year-old boy with CP (Gross Motor Function Classification System level IV) whose motor function declined during the period when physical therapy was discontinued due to lockdown, approximately four months. At the end of the home confinement, the patient's ability to maintain a sitting posture and weight-bearing capacity of the lower extremities decreased. His Gross Motor Function Measure total score also decreased from 34.5% to 31.9%. After resuming physical therapy, the patient recovered the function status seen before the discontinuation of physical therapy, but this took almost twice as long as the confinement period. We reaffirm that frequent physical therapy is crucial for maintaining motor function in non-ambulatory children with CP. As a countermeasure for the future, urgent efforts are needed for the development of telerehabilitation.

Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period

During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in such patients at the pED. All imaging studies performed in patients with trauma at the pED of a tertiary children's Hospital during the first wave of the COVID-19 pandemic (between March and May 2020) were reviewed, in comparison with a control time interval (March to May 2019). In the pre-COVID control era, 669 imaging studies documented bone fractures in 145/568 children (25.5%). In the COVID-era, 79/177 (44.6%) pediatric patients showed bone fractures on 193 imaging studies. Comparative analysis shows a 71% decrease in imaging studies, and the proportion of negative imaging studies (with no evidence of bone fractures) dropped in 2020 by 19% compared to the 2019 control era (p < 0.001). The sharp decrease of negative studies suggests that the rate of appropriateness was higher during COVID-era, suggesting some attitude toward defensive medicine in the previous control year, as a result of some degree of imaging inappropriateness. The impact of a pandemic on emergency medicine may offer a unique opportunity to revisit diagnostic and therapeutic protocols in pediatrics.

Changes in Motor Competence after a Brief Physical Education Intervention Program in 4 and 5-Year-Old Preschool Children

Low motor competence (MC) can cause low participation in physical activities in preschool children, and together with a high caloric intake, it can lead to obesity. Interventions on motor skills are effective in the short term to improve MC, therefore the objectives of this study were (1) to investigate the effect of a short six-week program on levels of motor competence in preschool children, and (2) to examine the effects of gender-based intervention. A total of 156 preschool children (5.20 ± 0.54 years old) from Lugo (Spain) participated. A quasi-experimental pre-post-test design was used with a control group of 76 students. The Movement Assessment Battery for Children-2nd Edition (MABC-2) was used to collect the data. Significant differences between the control and experimental groups were found after the intervention program in aiming and catching (p < 0.001), balance (p < 0.001), the total score of eight tests (p < 0.001), and total percentile score (p < 0.001). The results regarding gender in the experimental group showed a reduction in differences with respect to the initial results except in aiming and catching, where scores were higher in boys. The data suggest that the application of specific intervention programs in MC could positively influence the improvement of MC in preschool children, thus reducing differences between genders.