Physical Activity Levels and Related Energy Expenditure during COVID-19 Quarantine among the Sicilian Active Population: A Cross-Sectional Online Survey Study

The Impact of Quarantine on Physical Activity, Body Weight, and Eating Behaviors During the COVID-19 Pandemic in Saudi Arabia

Background Since February 2020, the number of coronavirus disease 2019 (COVID-19) cases in Saudi Arabia has been rising. The Saudi Arabian government implemented strict lockdown measures in March 2020 in an effort to stop the spread of the virus. Globally, changes in socioeconomic levels and health during quarantine have been reported. Additional detrimental effects of the stay-at-home mandate include less physical activity among adult populations, anxiety, stress, and emotional eating. This study aimed to assess the impact of quarantine during the COVID‑19 pandemic on physical activity practice and weight. Methodology This cross-sectional study was conducted using a newly developed validated online questionnaire survey. The data were collected during quarantine in June 2020, including each adult who lived in Saudi Arabia during the quarantine. The data were reviewed and analyzed using SPSS version 21 (IBM Corp., Armonk, NY, USA). Results A total of 4,970 eligible participants completed the study survey. About 78.1% of the study participants performed physical activity inside the house during the pandemic. Overall, 30.9% reported increased body weight during the lockdown, and the most reported cause of increased body weight was feeling bored and empty. Regarding factors associated with physical activity and weight changes, 82.2% of participants aged 25-30 years performed physical activity during the pandemic. Increased weight was significantly higher among participants aged more than 30 years. Conclusions This study shows an increased level of physical activity among the study participants during the COVID-19 pandemic, especially among younger, female, and unmarried participants. More than half of the participants reported weight change, either weight gain or weight loss. Weight gain was higher in older participants. Regarding eating habits, there was an increased tendency toward eating a healthy diet.

Telecoaching as a new training method for elderly people: a systematic review

BACKGROUND

The numerous restrictive measures implemented during the recent COVID-19 pandemic have reduced the levels of physical activity (PA) carried out by elderly people and telecoaching (TC) could be a training method to maintain the recommended levels of PA. In fact, TC uses information and digital communications technologies, such as computers and mobile devices, to access training services remotely. Thus, this study aimed to systematically review the scientific literature to verify the application, efficacy, and safety of TC training programs.

METHODS

PubMed, Scopus, and Web of Sciences databases were used for this review, and randomized controlled trials analyzing TC training programs for elderly people were included. Only articles written in English and published in the last decade were considered.

RESULTS

3 articles were included in the qualitative synthesis including 194 elderly people. The sample size ranged from 12 to 117 and the TC training program from 8 to 12 weeks. The TC training programs were applied to elderly people with metabolic diseases and respiratory diseases. TC training program was effective in elderly people with metabolic diseases while the benefits for respiratory diseases have yet to be clarified.

CONCLUSION

TC seems to be a safe, effective, and injury-free training method, despite its limited application in elderly population. Future studies should better investigate this training method in elderly people in order to evaluate the effectiveness in a wider range of diseases.

Assessment of lifestyle changes related to quarantine among Saudi population during the early COVID-19 pandemic: pre- and post-analysis

BACKGROUND

The escalating emergence of the COVID-19 pandemic interrupted human life due to the ever-increasing morbidity, containment measures, and the associated emotional distress. This study examined the influence of COVID-19-related measures on the lifestyle behaviors of adults living in the Kingdom of Saudi Arabia (KSA).

METHODS

The study recruited 638 participants through convenience sampling in Jeddah and Taif cities, Saudi Arabia. Demographic characteristics and COVID-19-related information were collected through an anonymous self-reported electronic questionnaire. Lifestyle behaviors were assessed before and during the quarantine using the Healthy Dietary Habits Index (HDHI)-A and the International Physical Activity Questionnaire (IPAQ-SF).

RESULTS

The study revealed significant changes in the dietary pattern: a reduction in fish intake and increased consumption of French fries and candies. Vegetables and fruit intake increased significantly. Sedentary time > 6 h per day increased from 36.7% pre to 60.8% during the pandemic. Healthy dietary index score and physical activity MET-minutes/week values were respectively 3.5% and 37.9% significantly higher before compared to the full quarantine period.

CONCLUSION

The pandemic detrimentally influenced eating habits and physical activity levels that led to weight gain, and hence higher vulnerability to COVID-19 infection and negative outcomes. This analysis provides public health agencies with data to tailor nutrition interventions that mitigate the observed adverse lifestyle behaviors.

Physical Activity in Patients with Neuromuscular Disease Three Years after COVID-19, a Longitudinal Survey: The After-Effects of the Quarantine and the Benefits of a Return to a Healthier Life-Style

BACKGROUND

Quarantine was one of the strategies adopted by governments against the spread of COVID-19. This restriction has caused an increase in sedentary behaviors and a decrease in the practice of physical activity (PA), with a consequent negative impact on lifestyle both in healthy people and in those who need constant practice of PA to combat diseases, such as patients suffering from neuromuscular diseases (NMDs). Hence, this study aimed to compare PA levels among patients with NMD during and after quarantine.

METHODS

An adapted version of the International Physical Activity Questionnaire Short-Form and the Short-Form Health Survey were administered during COVID-19 quarantine (T0) and after 3 years (T1) to 91 Italian patients with NMDs.

RESULTS

We found a significant increase in the total PA level at T1, with no significant changes in vigorous-intensity PA. Moreover, a significant decrease in the PA level was found among the patients with different NMDs. No significant changes in physical component scores and mental component scores were detected.

CONCLUSIONS

Our results suggest that it would be necessary to provide alternative indoor exercise settings to prevent the adoption of sedentary behaviors.

Assessment of lifestyle and coping strategies among asthmatic patients during the Covid-19 crisis

BACKGROUND

COVID-19 can cause an asthma attack by triggering asthma symptoms, such as wheezing, chest tightness, and difficulty breathing, which are distressing for patients and can cause anxiety. Additionally, it can progress to pneumonia or other severe lung diseases.

OBJECTIVES

Therefore, this study aimed to assess the coping strategies and lifestyle modifications among patients with asthma during the COVID-19 crisis.

METHODS

A descriptive comparative design was conducted on 300 adult patients with bronchial asthma at the Alexandria Main University Hospital's chest disease outpatient clinic. Three tools were used for data (including biosocio-demographic characteristics of patients with asthma, the effect of the COVID-19 crisis on the lifestyle of patients with asthma, and how patients with asthma cope with COVID-19) collection.

RESULTS

This study revealed that more than two-thirds of patients with asthma did not have COVID-19, while more than one-quarter had COVID-19. More than two-thirds had reasonable asthma control, and more than half had neutral coping with their asthma and the COVID-19 crisis. Half of the studied patients had coped neutrally with their asthma during the COVID-19 crisis, and more than half coped neutrally with the COVID-19 crisis.

CONCLUSION

These findings indicate that all stressors faced by patients with respiratory diseases during the COVID-19 crisis and psychological, social, and health support that should be provided to these patients during the pandemic require further investigation.

The impact of the COVID-19 pandemic on daily rhythms

OBJECTIVE

The COVID-19 pandemic has significantly impacted daily activity rhythms and life routines with people adjusting to new work schedules, exercise routines, and other everyday life activities. This study examines temporal changes in daily activity rhythms and routines during the COVID-19 pandemic, emphasizing disproportionate changes among working adult subgroups.

MATERIALS AND METHODS

In June 2021, we conducted a year-long study to collect high-resolution fitness tracker data and questionnaire responses from 128 working adults. Questionnaire data were analyzed to explore changes in exercise and work routines during the pandemic. We build temporal distributions of daily step counts to quantify their daily movement rhythms, then measure their consistency over time using the inverse of the Earth mover's distance. Linear mixed-effects models were employed to compare movement rhythm variability among subpopulations.

RESULTS

During the pandemic, our cohort exhibited a shift in exercise routines, with a decrease in nonwalking physical exercises, while walking remained unchanged. Migrants and those living alone had less consistent daily movement rhythms compared to others. Those preferring on-site work maintained more consistent daily movement rhythms. Men and migrants returned to work more quickly after pandemic restriction measures were eased.

DISCUSSION

Our findings quantitatively show the pandemic's unequal impact on different subpopulations. This study opens new research avenues to explore why certain groups return to on-site work, exercise levels, or daily movement rhythms more slowly compared to prepandemic times.

CONCLUSIONS

Considering the pandemic's unequal impact on subpopulations, organizations and policymakers should address diverse needs and offer tailored support during future crises.

Predictors of well-being, future anxiety, and multiple recurrent health complaints among university students during the COVID-19 pandemic: the role of socioeconomic determinants, sense of coherence, and digital health literacy. An Italian cross-sectional study

The pandemic deeply changed young adults' life. Lockdown period and the social restrictions dramatically affected university students' mental health. The aim of our cross-sectional study was to describe psychological well-being, future anxiety (FA), and health complaints (HCs) in a sample of 3,001 students of the University of Florence in the middle of the first two pandemic waves. We assessed the role of subjective social status, chronic diseases, sense of coherence (SoC), and digital health literacy (DHL) as predictors of psychological well-being, FA, and HCs. Students expressed high levels of FA and reported being disturbed by not being able to achieve their desired future goals. About 40% reported a low or a very low well-being and 19.1% experienced two or more subjective health complaints more than once a week. The likelihood of having a better mental health status significantly increased with increasing SoC and among males. Subjective Social Status proved to be a predictor for FA. Enhancing SoC could improve the health status of the university students during the pandemic and beyond.

Physical activity and sedentary time distribution among adult residents during COVID-19 circuit breaker movement restrictions in Singapore: a public health perspective

Introduction

Social lockdowns and quarantines have been enforced in various populations to mitigate the spread of coronavirus disease 2019 (COVID-19) in the community. This study investigated the impact of COVID-19 lockdown, known as circuit breaker movement restrictions (CBMR), on physical activity (PA) and sedentary time (ST) distribution patterns among Singapore residents aged 21-65 years.

Methods

This was a cross-sectional retrospective study that utilised a 44-item questionnaire that included sections to determine PA and ST distribution patterns before and during CBMR. It also included information on sleep duration, PA preference and routine, awareness of local initiatives and perceptions on barriers towards PA during the CBMR period.

Results

There was an overall decrease in PA and a significant increase in physical inactivity and ST during the CBMR period. A greater proportion of participants reported sleeping for longer hours, suggesting positive adaptations in sleep habits during CBMR. Majority were unaware of online exercise initiatives and programmes offered during the CBMR period, and >50% of the respondents never used an online resource for exercise. Singapore residents seemed to prefer outdoor and facility-based venues for exercise and PA, and closure of facilities was the primary barrier for PA during the CBMR period.

Conclusion

Reduced PA and increased ST during CBMR reflect negative lifestyle adaptations and may have adverse public health implications. Increased sleep duration suggests successful coping, which may consequently lead to physical and mental health benefits. While Singapore adult residents may be flexible with certain aspects of being physically active, they seemed less adaptive to changes in type of exercise, facility and environment.

Changes in health behaviours during the COVID-19 pandemic and effect on weight and obesity among older people in England

During COVID-19 lockdown, negative changes in health behaviours have been reported in European older adults. However, less is known about the consequences of these changes on weight gain and obesity, especially in older adults living in England. This study explored the association of health behaviour changes with weight and obesity in English older adults aged 50 years and older, during lockdowns in 2020. We included 4182 participants of the English Longitudinal Study of Ageing COVID-19 sub-study in June/July and Nov/Dec 2020 who also had pre-pandemic data. Perceived changes in health behaviours were regressed on weight and obesity, adjusted for pre-pandemic weight or obesity, and several covariates. Results suggested that less exercise, more sedentariness, eating more and alcohol drinking were associated with a significant increase in weight at both timepoints. Meanwhile, less sedentariness and eating less significantly reduced weight in Nov/Dec 2020. A higher risk of obesity at both timepoints was found in adults sitting, eating, or sleeping more than usual. To conclude, during UK lockdown, older people who engaged in risky health behaviours were at higher risks of weight gain and obesity both in the short run and long term. Considering potential health risks associated with obesity and disruptions in routine lifestyle in the older population even after the pandemic, improved weight management interventions are necessary nationwide.

Relation between Photogrammetry and Spinal Mouse for Sagittal Imbalance Assessment in Adolescents with Thoracic Kyphosis

The evaluation of postural alignment in childhood and adolescence is fundamental for sports, health, and daily life activities. Spinal Mouse (SM) and photogrammetry (PG) are two of the most debated tools in postural evaluation because choosing the proper instrument is also important to avoid false or misleading data. This research aims to find out the best linear regression models that could relate the analytic kyphosis measurements of the SM with one or more PG parameters of body posture in adolescents with kyphotic posture. Thirty-four adolescents with structural and non-structural kyphosis were analyzed (13.1 ± 1.8 years; 1.59 ± 0.13 m; 47.0 ± 12.2 kg) using SM and PG on the sagittal plane in a standing and forward-bending position, allowing us to measure body vertical inclination, trunk flexion, and sacral inclination and hip position during bending. The stepwise backward procedure was assessed to estimate the variability of the grade of inclination of the spine and thoracic spine curvature with fixed upper and lower limits, evaluated with SM during flexion. In both models, the PG angle between the horizontal line and a line connecting the sacral endplate-C7 spinous process and the PG hip position were the best regressors (adjusted-R² SM bend = 0.804, p < 0.001; adjusted-R² SM fixed bending = 0.488, p < 0.001). Several Spinal Mouse and photogrammetry parameters showed significant correlations, especially when the Spinal Mouse measurements were taken when the adolescents were in the forward-bending position. Physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.

Mental health in relation to changes in sleep, exercise, alcohol and diet during the COVID-19 pandemic: examination of four UK cohort studies

BACKGROUND

Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health.

METHODS

We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis.

RESULTS

Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2-26.2) before lockdown, 25.5% (20.0-30.3) in May and 28.2% (21.2-35.2) in September.

CONCLUSIONS

Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

Discrepancies Between Self-reported and Objectively Measured Smartphone Screen Time: Before and During Lockdown

Screen time shows higher health risks compared to other types of sedentary behaviors. A lockdown may simultaneously increase screen time, reduce physical activity (PA), and change time perception. Our goal was to compare self-reported against objectively measured smartphone screen time (SST) in a sample of active and inactive Portuguese adults before and during a social lockdown. This study was a cross-sectional analysis with 211 Portuguese adults (57.8% males), aged 25.2 ± 8.5 years, from two cohorts, one before the social lockdown and the other during the lockdown. SST was self-reported (SR-SST) and objectively measured using a smartphone (OM-SST). PA was self-reported. Linear regressions were performed to determine the association between SR-SST and OM-SST. A Bland and Altman analysis was used to assess agreement. Independent T-tests were performed for comparisons between cohorts and paired sample T-tests for comparisons within each cohort. The cohort assessed during the lockdown showed a higher SST than the cohort assessed before the lockdown (OM-SST; p < 0.001 and SR-SST; p = 0.009). Before the lockdown, there was no difference between SR-SST and OM-SST (p = 0.100). However, during the social lockdown, although the agreement between SR-SST and OM-SST was good (ICC = 0.72), participants systematically underestimated their SST by ~ 71 min/day (p < 0.001), and this underestimation was higher in inactive participants (~ 85 min/day) than in active individuals (~ 49 min/day). The general population needs to be aware of the benefits of limiting screen time, especially during periods of societal modifications, such as a generalized lockdown. There was a tendency to underestimate SST, meaning a lack of awareness of the actual time spent in this potentially deleterious behavior. This underestimation was more pronounced during the lockdown period and for the inactive participants, thus posing a greater health risk. The findings from this investigation entail relevant information for policy makers to delineate strategies for reducing population screen time from a preventive health perspective.

"Stay at Home" during the COVID-19 Pandemic: Effects on Physical Activity and Sedentary Behavior in an Italian Academic Community

This study investigates changes in physical activity (PA) and sedentary behavior in an Italian university community during Phase 1 of SARS-CoV-2 lockdown (“stay at home” government decree, from March 8th to May 4th, 2020) compared to their habits prior to the COVID-19 pandemic. We also examine differences according to gender, university position, BMI categories, and sport participation. A total of 2596 people (median age 24, IQR 11 years; 70.8% women) filled out a survey after eight weeks of statutory confinement at home. The International Physical Activity Questionnaire measured PA and sedentary behavior in a typical week before and during lockdown. Physically inactive people passed from 10.9% to 35.0% before−during the lockdown. The total amount of PA decreased (median 2307 vs. 1367 MET-min/week; p < 0.001), while sedentary behavior increased (median 349 vs. 440 min/day; p < 0.001) between before and during the lockdown. The following categories showed a higher reduction in the total amount of PA: men when compared to women; people with normal weight when compared to pre-obese/obese people; and people who played sports when compared to those who did not play sports. There is a need to propose PA/exercise programs to counteract physical inactivity and sedentarism during a social emergency, with special attention to people who showed higher PA reduction.

Fear of COVID-19 influences physical activity practice: a study in a Brazilian sample

The suspension of social activities combined with health insecurity, uncertainty and fear of COVID-19 may influence physical activity practice. We aimed to investigate the relationship between the fear of COVID-19 and anxiety on physical activity patterns during the pandemic period. This cross-sectional study was performed in a sample of 520 Brazilian participants recruited by online sampling and snowball method. We assessed demographic variables, health perceptions, anxiety, fear of COVID-19 and physical activity characteristics. Both fear scores and anxiety were higher in woman (p < 0.0001). We observed a remarkable reduction in the frequency and intensity of physical activity and a modification in the exercise practice environment (from gym or sports centers to home-based physical activity) (p < 0.05). Sedentary (sitting) behavior increased during pandemic both in the weekdays and in the weekend (p < 0.0001). Participants who have never been infected were more prone of being classified in higher levels for physical activity (OR: 1.916, CI = 1.043-3.521) versus those who were previously infected (p = 0.05). Participants with a low or moderate level of physical activity before the pandemic presented lower chances of being classified as high physical activity level during the pandemic in comparison to those with high level before pandemic (p < 0.001). The Fear of Covid-19 score was negatively associated with the physical activity level (the higher the fear, the lower the level of physical activity); that is, for every increase in scale score, the odds of vigorous physical activity decreased 3%. In conclusion, fear of COVID-19 and previous contact with the virus negatively influenced physical activity practice.

Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017-2021: focusing on the comparisons before and during the COVID-19 pandemic

Objectives

We investigated recent trends in health behaviors and mental health conditions among Korean adolescents from 2017 to 2021 and compared the changes before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Data analysis was conducted on 289,415 adolescents participating in the Korea Youth Risk Behavior Web-Based Survey, an annual cross-sectional study from 2017 to 2021. All analysis was conducted using sex stratification, and the annual percentage change (APC) was calculated.

Results

Alcohol consumption and smoking decreased in the first year of the COVID-19 pandemic compared with before, except for girls from the low-income level. The prevalence of inadequate physical activity for both boys and girls increased in 2020 compared with the pre-COVID-19 period and decreased again by 2021. The prevalence of obesity in both sexes increased regardless of the period (boys, APC = 8.2%, 95% confidence intervals (CI), 6.4-10.1; girls, APC = 3.3%, 95% CI, 1.8-4.8). The prevalence of stress, depression, and suicidal ideation, plans, and attempts for both sexes decreased in 2020 compared to the pre-COVID-19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. No significant APC changes were observed in the prevalence of mental health.

Conclusions

These findings demonstrate the trends and APCs in health behaviors and mental health conditions among Korean adolescents over the last 5 years. We must pay attention to the heterogeneous and multifaceted features of the COVID-19 pandemic.

Investigation of musculoskeletal disorders, physical activity level, sleep quality, and fatigue in health professionals with and without a history of COVID-19

BACKGROUND

Healthcare workers belong to an occupational group that is at high risk during the coronavirus 2019 (COVID-19) pandemic. The increased workload of healthcare workers and the accompanying psychosocial stress caused by the pandemic can affect musculoskeletal system disorders, physical activity status, sleep quality, and fatigue in this group.

OBJECTIVE

To investigate musculoskeletal system disorders, physical activity level, sleep quality, and fatigue in healthcare workers healthcare workers with and without a COVID-19.

METHODS

A total of 200 healthcare professionals aged 18-65 years with and without a history of COVID-19 were in the study. Data were collected between January and March 2021. A "Preliminary Evaluation Form", "Extended version of the Nordic Musculoskeletal System Questionnaire (NMQ-E)", "the International Physical Activity Questionnaire-Short Form (IPAQ-SF)" and "the Pittsburgh Sleep Quality Index (PSQI) were used for data collection".

RESULTS

It was determined that musculoskeletal system disorders did not differ significantly between healthcare workers with and without a COVID-19 history (p > 0.05). It was found that the number of people with problems in the low-back region was higher in those with a COVID-19 history (p = 0.002). In the sleep duration component, the scores of those who did not have a COVID-19 history were found to be significantly higher than those who did (p = 0.10). In other comparisons, it was determined that there was no significant difference.

CONCLUSIONS

It was found that the number of people with problems in the low-back region was higher in those with a COVID-19 history. Those without a COVID-19 history had higher scores in sleep duration parameter.

The longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in older adults

Background: Older adults are at a greater risk for contracting and experiencing severe illness from COVID-19 and may be further affected by pandemic-related precautions (e.g., social distancing and isolation in quarantine). However, the longitudinal impact of the COVID-19 pandemic on older adults is unclear. The current study examines changes in health behaviors, psychosocial factors, and cognitive functioning in a large sample of older adults using a pre-pandemic baseline and longitudinal follow-up throughout 9 months of the COVID-19 pandemic. Methods: One hundred and eighty-nine older adults (ages 65-89) were recruited from a multisite clinical trial to complete additional virtual assessments during the COVID-19 pandemic. Mixed effects models evaluated changes in health behaviors, psychosocial factors, and cognitive functioning during the pandemic compared to a pre-pandemic baseline and over the course of the pandemic (i.e., comparing the first and last COVID-19 timepoints). Results: Compared to their pre-pandemic baseline, during the pandemic, older adults reported worsened sleep quality, perceived physical health and functioning, mental health, slight increases in depression and apathy symptoms, reduced social engagement/perceived social support, but demonstrated better performance on objective cognitive tasks of attention and working memory. Throughout the course of the pandemic, these older adults reported continued worsening of perceived physical health and function, fewer depression symptoms, and they demonstrated improved cognitive performance. It is important to note that changes on self-report mood measures and cognitive performance were relatively small regarding clinical significance. Education largely served as a protective factor, such that greater years of education was generally associated with better outcomes across domains. Conclusions: The present study provides insights into the longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in a population disproportionately affected by the virus. Replicating this study design in a demographically representative older adult sample is warranted to further inform intervention strategies targeting older adults negatively impacted by the COVID-19 pandemic.

The Coronavirus pandemic and closed fitness clubs negatively affected members exercise habits

Introduction

Due to the Coronavirus pandemic, politicians enacted directions to reduce social interactions, including lockdown of fitness clubs. We aimed to investigate how this changed exercise habits of Norwegian gym members.

Method

Based on survey data, men and women (≥18 years, n = 233, data collection from Aug. 2020 to Jan. 2021) were recruited to this study by an email-invitation from their fitness club chain or by Facebook advertisement. The participants reported on background variables (e.g., age, gender, total household income, occupation, and education), and exercise habits pre- and during social lockdown. Data were analyzed using independent or student t-test, chi-squared test, or McNemar's test, as appropriate.

Results

Home-based exercise (18.0 vs. 72.5%, p = <0.001), walking (49.8 vs. 65.2%, p = <0.001), and cycling (16.7 vs. 24.5%, p = 0.004) was more common during than pre-lockdown. Also, men (4.33 to 3.68 days/week, p =0.013) and women (4.20 to 3.79 days/week, p = 0.001) reported a lower exercise frequency, and a shorter duration. Exercise frequency was lower in those with a BMI ≥25 than in those with BMI <25 (3.95 vs. 4.48 days/week, p = <0.007) pre-lockdown. High exercise attendees (≥3 sessions/week, 66.5%) reported a smaller decrease in exercise frequency (mean change: 0.06 vs. 1.24 days/week, p = <0.001) and duration (>60 min. per session: 33.0 vs. 3.8%, p = <0.001) than low exercise attendees during lockdown.

Discussion

Home-based exercise, walking, and cycling were most frequently reported during lockdown. Participants reported a small decrease in exercise duration and frequency compared with pre-lockdown. Closure of fitness clubs impacted low attendees more than high attendees.

Onset of the COVID-19 pandemic reduced active time in patients with implanted cardiac devices

BACKGROUND

Physical inactivity and sedentary behavior are modifiable risk factors for chronic disease and all-cause mortality that may have been negatively impacted by the COVID-19 shutdowns.

METHODS

Accelerometry data was retrospectively collected from 332 permanent pacemaker (PPM) and 244 implantable cardiac defibrillation (ICD) patients for 6 time points: March 15-May 15, 2020 (pandemic period), January 1-March 14, 2020, October 1-December 31, 2019, March 15-May 15, 2019, January 1-March 14, 2019, and October 1-December 31, 2018. Paired t-tests, with Bonferroni correction, were used to compare time periods.

RESULTS

Activity significantly decreased during the pandemic period compared to one year prior by an average of 0.53 ± 1.18h/day (P < 0.001) for PPM patients and 0.51 ± 1.2h/day (P < 0.001) for ICD patients. Stratification of subjects by active time (< 2 versus ≥ 2h/day) showed patients with < 2h, particularly those with ICDs, had modestly greater activity reductions with the pandemic onset. Logistical regression analyses suggest a trend toward a greater reduction in active time at the onset of the pandemic and an increased risk of hospital or emergency department (ED) admission for PPM patients, but not ICD patients.

CONCLUSION

The onset of the pandemic in the United States was associated with a significant drop in PPM and ICD patient active hours that was modestly more pronounced in less active patients and cannot be explained by one year of aging or seasonal variation. If sustained, these populations may experience excess cardiovascular morbidity.

Evaluation of Health Promoting Lifestyle Habits During Pandemic Period: A cross-sectional study

Objective: The COVID-19 pandemic imposed lifestyle changes. The aim of this study was to evaluate the health-promoting lifestyle habits of individuals who applied to a primary care center during the pandemic period. Methods: This descriptive and cross-sectional study was conducted with the voluntary participation of 524 individuals. The data was collected through a research questionnaire form and the Health Promoting Lifestyle Scale (HPLS). Results: Women accounted for 58.2% (n=305) of all participants, 45.2% of them (n=237) had chronic disease and 32.1% (n=168) were smoking. Mean age was 41.26±14.28 (min:18, max:75) years old. Among these participants, %53.2 had equal income to their expenses (n=279), 52.3% experienced sleep pattern changes (n=274), 35.7% had COVID-19 disease and 66.6% vaccinated for COVID-19. The mean HPLS score was 162.75±8.10 points. Interpersonal relationships, stress management and total HPLS scores were higher in women (p

Effects of quarantine on Physical Activity prevalence in Italian Adults: a pilot study

Background

COVID-19 is a respiratory disease that caused a global pandemic status in March 2020. Due to its fast diffusion, many governments adopted forced solutions including social restrictions, which could negatively affect citizens' habits as physical activity. Our study aimed to investigate how and why the physical activity prevalence varied from the period before the quarantine up to the period after it, and understand what citizens thought of physical inactivity COVID-19 related to and whether they were satisfied with physical activity promotion during the lockdown.

Methods

A new questionnaire was created and administered online. A sample of 749 interviews (female = 552 (73.7%), male = 197 (26.3%)) was collected and analysed.

Results

The prevalence of people who were older than 50 years reduced both during and after the lockdown (P < 0.05) and the most common reason for which they have quitted physical activity practice was related to psychological problems (lockdown = 64.57%; post-lockdown = 62.17%). In addition, youngers seemed to be more sensitive than elders to unhealthy consequences generated by forced isolation (P < 0.05), and they believed that children/adolescents and older adults practised an insufficient amount of physical activity and/or sport, which could negatively impact public health.

Conclusions

Although many strategies were implemented during the lockdown to promote regular physical activity practice, several results suggested that quarantine negatively affected citizens' habits. The future government should focus on adequate measures to improve health behaviours.

Structure of the training program during the COVID-19 confinement in spanish professional football, a coach survey

OBJECTIVES

To describe and analyze the training programs carried out during the COVID-19 forced confinement in men´s professional football in Spain.

METHODS

Observational Study based on a telematic ad-hoc questionnaire developed to meet the objective of the study. The sample consisted of thirty-six coaches representing thirty-six professional men's soccer teams in the Spanish first and second division.

RESULTS

Training programs developed during confinement prioritized conditioning and functional emphasis, in addition to general and nonspecific resistance training, due to contextual limitations.

CONCLUSION

The structure of training during the COVID-19 confinement was limited by contextual circumstances. This study has made possible to record the training and strategies used in professional football during a confinement due to a worldwide state of alarm, with the aim of resuming competitive activity in the best possible conditions.

Physical activity before and during the COVID-19 pandemic in Vojvodina, Serbia

Background

The physical activity (PA) of the youth and adult population underwent changes during the last 2 years due to the coronavirus (COVID-19) pandemic, and all for the purpose of maintaining the health of the population. The purpose of this study was to estimate the levels of PA in the youth population and the adult population (young and old) during the COVID-19 pandemic in the territory of Vojvodina, Serbia, and to determine the differences between them, as well as to compare these results with the results before the pandemic.

Methods

A total of 1,117 subjects (age 36.27 ± 15.08 years) from the territory of Vojvodina, Serbia, participated in the study. Subjects were recruited and assigned to one of the three groups according to their age: youth group (N = 395; age 18-24 years), young adults group (N = 347; from 25 to 44 years), and old adults group (N = 375; age 45-65 years). All participants in this study completed the International Physical Activity Questionnaire Short-Form between July and November 2021, during the fourth wave of the COVID-19 pandemic in Vojvodina, Serbia. The Kruskal-Wallis test and Dunn multiple comparison post-hoc method were used for statistical analyses.

Results

The youth showed the highest result in total weekly energy expenditure (3,893.72 ± 2,010.01 MET-min/week) compared to young adults (2,528.20 ± 1,804.11 MET-min/week) and old adults (2,369.07 ± 2,084.95 MET-min/week) during the COVID-19 pandemic in Vojvodina, Serbia. In addition, adults (young and old) spent more time sitting than youth during the same period. Furthermore, the youth achieved greater results in levels of PA during the COVID-19 pandemic compared to the situation before the COVID-19 pandemic. However, adult populations achieved lower results during the COVID-19 pandemic than before the COVID-19 pandemic.

Conclusion

During the COVID-19 pandemic, the youth from Vojovida, Serbia, achieved greater results in PA levels than the adult populations. Based on that, we recommend that it is necessary to take steps toward increasing PA in the adult population, especially old adults.

Physical Culture and Sports as an Educational Basis of Students' Healthy Physical Activities during and Post-Lockdown COVID-19 Restrictions

(1) Background: The SARS-CoV-2 virus manifests itself in many aspects of everyday life, among which one of the most frequently accentuated are changes in physical activity from the perspective of lockdown mobility limitations. The aim of this study was to assess the level of physical activity in groups of students with different levels of educational engagement in physical activity while taking into account the realities of remote and traditional education. (2) Methods: The study was conducted among 200 students of 3 majors with varying degrees of curriculum related to physical activity, including students of physical education (n-73), tourism and recreation (n-65) and students of a non-physical education major (n-62). The survey technique used was the short version of the International Physical Activity Questionnaire (IPAQ). (3) Results: PE students are the most engaged in physical activity compared to other study groups. This pattern is particularly true for high physical activity. An interesting observation is that, in the post-lockdown period, there was no statistically significant difference between the physical activity levels of PE students and TR students. Meanwhile, such a difference in favor of PE students was evident during the lockdown period. (4) Conclusions: Educational links to physical activity appear to be an important factor in stimulating this activity during times of epidemiological emergency.

Changes in Physical Fitness among Elementary and Middle School Students in Korea before and after COVID-19

The present study aimed to analyze changes in health-related physical fitness among Korean elementary and middle school students before (2019) and after (2021) the COVID-19 pandemic. Data collection was completed by requesting the physical activity promotion system (PAPS) data from elementary and middle school students. This information is obtained annually by the Goyang Office of Education in Gyeonggi-do, Korea. The collected data were measured in 2019 and 2021. Data were collected from 17,000 children in the fifth and sixth grades of elementary school and about 24,000 boys and girls in the first, second, and third grades of middle school. Chi-square analyses were used to examine data from each school's health-related physical fitness examinations. Our results indicated that physical fitness levels were significantly lower in 2021 than in 2019 across the following six areas: cardiorespiratory endurance, power, muscular strength, flexibility, obesity, and overall health-related physical fitness (p < 0.05). In addition, the ratio of students with excellent physical fitness (PAPS Grades 1 and 2) significantly decreased from 2019 to 2021, while the ratio of students with poor physical fitness (PAPS Grades 3, 4, and 5) increased (p < 0.05). In addition, there were some differences according to grade and gender. Discussions regarding the impact of decreases in physical activity on physical fitness, interpretations of physical fitness in the context of a pandemic, and practical measures that can be implemented to improve health and fitness among children and adolescents in such situations remain essential.

The role of school physical education on adolescents' fitness levels during the pandemic period from COVID-19: An observational study of the Italian scientific high school-section sport and physical activity

Objectives

In Italy, in 2013, a new school curriculum with a sport character was established in high schools, called Sports High School (SHS). The aims of this study were: (1) to assess the fitness levels of SHS students who, respecting all the safety rules to limit the spread of COVID-19, practiced physical education (PE) at school with continuity for almost all of 2021, and to compare them with Traditional High School (THS) students; (2) to evaluate as the SHS may have influenced the fitness levels in adolescents.

Methods

This is a case-control study in which thirty participants were enrolled (SHS: n = 15; THS: n = 15). To assess the fitness levels, the following tests were administered: the Static Baropodometric and Stabilometric Analyses, the Counter Movement Jump (CMJ), and the Handgrip test. All these tests were administered when the non-pharmaceutical interventions (NPIs) for COVID-19 allowed the resumption of PE lessons (T0) and 2 months after their resumption (T1).

Results

Unpaired t-test between SHS (T0) vs. THS (T0) showed significant differences between: Handgrip test Dx and Handgrip test Sx (both p < 0.001), Surface Sx foot and Surface Dx foot (both p < 0.05), and CMJ (p < 0.001). These results were also confirmed in T1. The performance analysis between T0 and T1 of both SHS and THS showed improvements in SHS: Handgrip test Dx (p < 0.05; d = 0.57), Handgrip test Sx (p < 0.01; d = 0.87), and CMJ (p < 0.05; d = 0.59). Pearson's analysis of the results of the tests showed significant strong correlations between: Handgrip test Dx and Handgrip test Sx (R = 0.959; p < 0.001), Handgrip test Dx and CMJ (R = 0.881; p < 0.001), Handgrip test Sx and CMJ (R = 0.893; p < 0.001). The same analysis showed significant but moderate correlations between: Surface foot Sx and CMJ (R = 0.489; p < 0.01), Surface foot Sx and y-mean (R = 0.485; p < 0.01), Surface foot Dx and CMJ (R = 0.444; p < 0.05).

Conclusions

This study is in agreement with the literature showing that the quarantine period and the NPIs for COVID-19 caused a decrease in fitness levels in adolescents. Our results showed that students of SHS recorded higher strength performance both in the Handgrip test and in the CMJ.

Bibliometric analysis of the top-50 cited articles on COVID-19 and physical activity

Background

Since the 2019 novel coronavirus (COVID-19) pneumonia outbreak in late 2019, an endless stream of research has emerged surrounding physical activity. This study analyzes the 50 most influential articles on COVID-19 and physical activity over the past 2 years to describe the research landscape and hotspots from bibliometric citation analysis.

Methods

The top-50 cited articles were extracted from the Web of Science Core Collection database, and bibliometric citation analysis was performed by Excel 2019 and VOSviewer software.

Results

The top-50 articles were cited 160.48 ± 106.90 (range: 70-587). Most of the articles were from the United States (14), followed by Italy (11) and England (9). The International Journal of Environmental Research and Public Health (n = 10) is the journal with the top-50 cited articles. The collaboration between authors was mainly among three teams, including Smith L, Musumeci G, and Napoli C. The hotspot of research around COVID-19 and physical activity focused on lifestyle change (sedentary behavior, sitting time), mental health (depressive, anxiety, loneliness), the credibility of physical activity assessment tools (reliability, validity), and physical activity of different populations (gender, youth, children).

Conclusions

Based on a bibliometric analysis of high-impact articles on COVID-19 and physical activity highlights physical activity as an essential lifestyle change and developments and hotspots in this field. These data will provide insights for future researchers regarding the direction of physical activity research in the COVID-19 pandemic.

Effects of the COVID-19 Pandemic on the Perception of Inclusion in School Education and Physical Activity Among Polish Students

The coronavirus disease-2019 (COVID-19) pandemic impacted the lives of children and adolescents, leading to many changes in their routines, especially in education. Face-to-face physical education (PE) classes during COVID-19 were affected in organization, possibly conditioning students' participation, motivation, and learning. In the extreme conditions of the coronavirus, it may be assumed that daily physical activity became much less than before, partly because students are learning outside the school environment and PE lessons taught using remote forms do not fulfill their purpose. The aim of the study was to assess the pupil's perception of inclusion in school education during the remote learning caused by the COVID-19 pandemic and to compare the results with the control group. Moreover, the physical activity of respondents during social isolation due to the coronavirus was examined. The sample consisted of 111 pupils of both genders, aged 14–21 years. The Perceptions of Inclusion Questionnaire (PIQ) was used to measure the perception of inclusion in school education. The structure of the participants' physical activity was examined using the International Physical Activity Questionnaire-Long Form (IPAQ-LF) for adolescents. It was observed that the pupils' gender did not differentiate their perception of inclusion in school education. It was proved that respondents participating in research during the COVID-19 pandemic obtained statistically significantly lower results in the case of “emotional wellbeing in school” (p &lt; 0.001; η2 = 0.07) but a higher mean was observed in relation to “social relationships with other pupils” (p = 0.04; η2 = 0.02) than the control group. Girls achieved a higher mean in the case of walk Metabolic Equivalent of Task (MET) (p = 0.02; η2 = 0.06) than boys. In addition, it was observed that the recommendation of vigorous physical activities was achieved by 37.78% of boys and 34.85% of girls. In turn, 69.70% of female pupils and 77.78% of male respondents met the recommendations for medium physical activities. It was also noted that 87.88% of girls and 86.67% of boys participating in the research achieved the recommendation for total physical activities. The analysis showed negligible and low positive correlations between examined variables.

Physical activity and sitting time changes in response to the COVID-19 lockdown in England

To reduce the spread of the novel coronavirus disease 2019 (COVID-19), national governments implemented measures to limit contact between citizens. This study evaluated changes in physical activity and sitting in response to the first COVID-19 lockdown in England and factors associated with these changes. A cross-sectional online survey-based study collected data from 818 adults between 29 April and 13 May 2020. Participants self-reported demographic information, physical activity and sitting for a ‘typical’ week before and during lockdown. Participants were grouped into low, moderate and high physical activity, and low and high (≥8 hours/day) sitting. Paired samples t-tests compared physical activity (MET-min/week) before and during lockdown. Pearson’s Chi-squared evaluated the proportion of participants in the physical activity and sitting categories. Logistic regression explored associations of demographic and behavioural factors with physical activity and sitting during lockdown. Walking and total physical activity significantly increased during lockdown by 241 (95% confidence interval [CI]: 176, 304) MET-min/week and 302 (CI: 155, 457) MET-min/week, respectively (P < 0.001). There was a 4% decrease in participants engaging in low physical activity and a 4% increase in those engaging in high physical activity from before to during lockdown (P < 0.001). The proportion engaging in high sitting increased from 29% to 41% during lockdown (P < 0.001). Lower education level (odds ratio [OR] = 1.65, P = 0.045) and higher BMI (OR = 1.05, P = 0.020) were associated with increased odds of low physical activity during lockdown, whereas non-White ethnicity (OR = 0.24, P = 0.001) was associated with reduced odds. Younger age was associated with increased odds of high sitting (OR = 2.28, P = 0.008). These findings suggest that physical activity and sitting both increased during lockdown. Demographic and behavioural factors associated with low physical activity and high sitting have been identified that could inform intervention strategies during situations of home confinement.

Relationship between the number of steps taken during lockdown caused by the COVID-19 pandemic and low back pain

Introduction: In 2020, the whole world was overwhelmed by the SARS-CoV-2 coronavirus threat. In order to prevent the spread of the virus, national governments introduced restrictions of movement in public space, closing schools, universities, many companies switched to remote working. In addition to the obvious benefits of the above changes, numerous side effects can be observed. One of them is pain in the locomotive organs caused by the sedentary lifestyle. Objective: The main objective of the study was to assess the relationship between physical activity during quarantine, caused by the COVID-19 pandemic, and the occurrence of spinal pain. Material and methods: The study was attended by 55 people (29 women and 26 men) who attended physiotherapeutic consultations due to low back pain. For comparison purposes, they were divided into two groups: Group 1 (n=24) includes active persons, Group 2 (n=31) includes inactive persons. The survey was conducted in June 2020. The study used the reading of pedometers from mobile phones and the Rolland-Morris Questionnaire, Laitinen’s Pain Scale and author’s own questionnaire. The respondents were asked to share the pedometer results from given weeks before, during and after restriction causes by the COVID-19. Results: Physically active persons (those performing health training) performed more steps before introducing restrictions (p<0.001). After the introduction of restrictions, all-day activity decreased significantly in both groups. The evaluation of pain characteristics revealed significant differences (between groups) in two categories – pain intensity and physical activity limitation. Group 2 individuals also reported greater functional limitations. Conclusion: In physically inactive people, the intensity of low back pain was much higher. This proves the relationship between activity levels and pain.

Change of Residents’ Attitudes and Behaviors toward Urban Green Space Pre- and Post- COVID-19 Pandemic

The COVID-19 pandemic has changed and influenced people’s attitudes and behaviors toward visiting green spaces. This paper aims to explore the association between residents’ health and urban green spaces (UGS) through an in-depth study of changes in residents’ use of UGS under the influence of the COVID-19 pandemic. The Wuhan East Lake Greenway Park was selected as the location for the field survey and in-depth interviews. At the same time, an online survey was also conducted (total number = 302) regarding participants’ physical and mental health and their attitude and behavior toward the UGS. A paired sample t-test and binary logistic regression were performed to investigate the association between participants’ health and UGS during COVID-19. The results show that: (1) the COVID-19 pandemic has primarily changed the leisure patterns of parks, with potential impacts on the physical and mental health of participants; (2) the purpose, frequency, timing, and preferred areas of participants’ park visits have changed to varying degrees after the pandemic, highlighting the important role and benefits of UGSs; (3) the physical and mental health of participants and urban development issues reflected by UGS use are prominent. This study reveals that awareness of the construction and protection of UGSs is an important prerequisite for ensuring the health of urban residents.

The Impact of the Different Stages of COVID-19, Time of the Week and Exercise Frequency on Mental Distress in Men and Women

The COVID-19 pandemic produced life disturbances and loss of routine which affected diet and sleep quality as well as physical exercise frequency. Interestingly, mental distress was higher even in those who exercised. The purpose of this study was to assess exercise frequency in relation to different levels of mental distress severity in men and women while accounting for working days and weekends. A de-identified secondary data set was analyzed. Regression analyses produced models of the different stages of COVID-19 in relation to physical exercise frequency and mental distress levels. Margin analysis generated predictive models that could be used prophylactically to customize physical exercise frequencies in men and women to reduce their risk of mental distress during future pandemics. Mental distress during the lockdown and after ease of restrictions was associated with different physical exercise frequencies, with a noticeable difference between men and women. During a pandemic, sedentary men are more likely to be mentally distressed during working days. Nevertheless, moderately active, but not very active women, may be less distressed during pandemic weekends. These findings may provide a framework to optimize mental health during different stages of a pandemic by customizing physical exercise frequencies based on gender and time of the week.

Association between Self-Classification of COVID-19 Risk Levels and Adverse Lifestyle Changes among Physically Active Older Adults Following the Coronavirus Outbreak

The COVID-19 pandemic has imposed barriers to a healthy lifestyle, especially for older adults who are considered to be at a high-risk of infection. This study examined the associations between negative changes and the self-classification to COVID-19 risk level among physically active older adults who are members of a nationwide health club chain. A cross-sectional digital survey was sent to 19,160 older adults (age ≥ 65). The data collected included information on the subjects’ self-classification to the COVID-19 high-risk group (HRG) and changes in physical activity (PA), body weight, and smoking habits since the outbreak. Logistic regression models were used to investigate the associations between the dependent variables of ‘experienced a negative change’ and the independent variables. Of the 1670 survey respondents, 78.3% classified themselves as COVID-19 HRG. Over half of the respondents reported a reduction in PA hours, 26.6% reported weight gain, and 17.7% of smokers increased their amount of smoking. A self-classification to the HRG was associated with 1.46 (95%CI 1.10−1.93, p < 0.009) and 1.67 (95%CI 1.21−2.31, p < 0.002) greater odds for reduced hours of exercise and weight gain compared to the not high-risk group, respectively. Decision makers should consider how policies may cause barriers to a healthy lifestyle and develop risk communication strategies to encourage positive health-related behaviors, even during a pandemic.

Capturing the Features of Physical Activity in Old Adults during the COVID-19 Pandemic: Results of an Italian Survey

The restriction measures adopted to control the COVID-19 pandemic had significant consequences on individuals’ lifestyles. This study is aimed at assessing the amount and type of habitual physical activity (PA) in older adults during the advanced phase of the pandemic and their possible relationships with sociodemographic aspects. A questionnaire that included sociodemographic characteristics and the Physical Activity Scale for the Elderly (PASE) was administered online to elderly subjects living in the Apulia region, South Italy. A sample of 939 participants (57.1% F; mean age 75.9 ± 6.3) was obtained. In total, 68.8% of female respondents reported a decrease in PA during the pandemic, while 55.1% of men maintained their previous levels (<0.001). The total PASE score did not differ between gender groups (median value 91.7 in males vs. 90.0 in females; p = 0.067). However, differences were registered in leisure activities, particularly regarding walking (23.8 ± 14.8 in males vs. 20.2 ± 14.6 in females; p = 0.001). Higher PA levels were related with lower age (OR 0.253; 95% CI 0.192−0.333; p = 0.001). Since inactivity can affect elderly health and wellbeing, and considering the impact of the COVID-19 lockdown on this habit, health promotion strategies to counteract the negative effects of the pandemic should include interventions aimed at increasing PA in this sub-group of the population, especially among women and elderly subjects.

The Influence of Obesity on Nutrition and Physical Activity during COVID-19 Pandemic: A Case-Control Study

Obesity is one of the important risk factors for a severe course of COVID-19. Maintaining a healthy body weight through diet and physical activity is a reasonable approach to preventing a SARS-CoV-2 infection or in alleviating its course. The goal of the study was to determine the influence of obesity on nutrition and physical activity during the COVID-19 pandemic. A total of 964 respondents, including 227 individuals with a body mass index (BMI) ≥30 kg/m2 were evaluated in this study. In the case of 482 respondents, including 105 individuals (21.8%) with BMI ≥ 30 kg/m2, the data were collected during the pandemic period from 1 June to 31 August 2020. The remaining 482 individuals were the “pre-pandemic” group, selected via propensity score matching (PSM) out of the 723 National Health Program study participants whose data was collected in 2017−2019. The evaluated dietary health factors were quantitatively similar in patients with BMI of either <30 kg/m2 or ≥30 kg/m2 and showed no significant changes during the pandemic. The diets of those who suffered from obesity prior to the pandemic showed the evaluated unhealthy nutritional factors to be less pronounced in comparison with those of individuals with BMI < 30 kg/m2. During the pandemic, the BMI ≥ 30 kg/m2 group showed a significant increase in the overall calorie intake (by 319 kcal; p = 0.001) and an increased consumption of total carbohydrates 299.3 ± 83.8 vs. 252.0 ± 101.5; p = 0.000), sucrose (51.7 ± 30.0 vs. 71.6 ± 49.9; p = 0.000), plant protein (26.3 ± 12.1 vs. 29.3 ± 8.3; p = 0.040), total fat (73.1 ± 42.6 vs. 84.9 ± 29.6; p = 0.011) and saturated fatty acids (29.5 ± 16.4 vs. 34.3 ± 13.9; p = 0.014) in comparison with the pre-pandemic period. The energy and nutritional value of the diets of BMI < 30 kg/m2 individuals did not change between the pre-pandemic and pandemic period. Before the pandemic, the level of leisure physical activity of the BMI ≥ 30 kg/m2 group was significantly lower than of those with BMI < 30 kg/m2. Such differences were not observed in the levels of physical activity at work or school. The pandemic did not alter the amount of physical activity either during leisure time or at work/school in individuals with BMI ≥ 30 kg/m2. However, respondents without obesity exercised significantly less during the pandemic than before. In conclusion, the pandemic altered the diets and levels of physical activity in the Polish population, with dietary changes observed in individuals with BMI ≥ 30 kg/m2 and changes in physical activity observed in those with BMI < 30 kg/m2.

Adapted physical activity in subjects and athletes recovering from covid-19: a position statement of the Società Italiana Scienze Motorie e Sportive

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic illness that is impacting the cardiovascular, pulmonary, musculoskeletal, and cognitive function of a large spectrum of the worldwide population. The available pharmacological countermeasures of these long-term effects of COVID-19 are minimal, while myriads of non-specific non-pharmacological treatments are emerging in the literature. In this complicated scenario, particular emphasis should be dedicated to specific exercise interventions tailored for subjects and athletes recovering from COVID-19. Specific guidelines on adapted physical activity in this critical population are unavailable so far, therefore, in this position statement of the Società Italiana di Scienze Motorie e Sportive (SISMeS) the members of the steering committee of the research group Attività Motoria Adattata, Alimentazione, Salute e Fitness have indicated the adapted physical activity approaches to counteract the long-term effects of the COVID-19, both in good health people and athletes.

Physical Activity and Diet in a Global Pandemic: An Investigation of the Impact of COVID-19 on Factors Relevant for Musculoskeletal Health at Two Different Stages of the Lifecourse

Background

Physical activity, nutrition and other lifestyle factors play important roles in maintaining musculoskeletal health. The coronavirus disease (COVID-19) originated in late 2019, spread globally to be declared a pandemic by the World Health Organisation in March 2020, and led to widespread behaviour change. The aim of this study was to use two existing cohorts, the Hertfordshire Cohort Study (HCS) and Health and Employment After Fifty Study (HEAF), to understand how wave one of the COVID-19 pandemic impacted lifestyle factors associated with musculoskeletal health in the UK.

Methods

125 eligible participants, 65 males and 60 females (drawn from the HCS study, median (IQR) age 84.3 (82.4-86.6) years, all Caucasian, and community dwelling) were contacted by telephone and asked to complete a questionnaire administered by a trained researcher. Data collection occurred over the period July 2020 to February 2021. 2469 participants, 1086 men and 1383 women (drawn from the HEAF study, median age 65.7 (62.0-69.3) years, mostly Caucasian and community dwelling) completed an online questionnaire in March 2021.

Results

In HCS, 47% respondents reported being less physically active than before the pandemic (and only 5% more so), 27% said they consumed less alcohol compared to pre-pandemic times (and only 3% more so), and 18% reported eating less than before, although quality of diet was generally unchanged over this timeframe surveyed. In HEAF, 44% participants said they were less active than before the pandemic, while 17% reported being more active. The majority of participants reported no changes in alcohol consumption and diet; however, 19% said they drank more than before (32% of which was above recommended levels), 16% said their diet was less healthy, and 19% reported eating more than before.

Conclusion

We have reported the experience of the first wave of the COVID-19 pandemic among participants of two Caucasian community dwelling UK cohorts, highlighting the impact of the pandemic on lifestyle factors associated with musculoskeletal health. Changed physical activity levels were reported in a high proportion of respondents in both studies; an investigation of reversibility of these changes is required.

Initial Psychometric Evidence of Physical Inactivity Perceived Experience Scale (Pipes): COVID-19 Pandemic as a Pilot Study

Aims

Our study aimed to develop a two-factor self-administered orthogonal questionnaire to assess the experience of perceived physical inactivity, to test its psychometric properties, to confirm its relationships with fear of COVID-19, and finally, with perceived stress during the pandemic.

Methods

A total of 481 Tunisian subjects collected in several cities, aged from 16 to 67 years with a mean age = 32.48 ± 9.46, and of both sexes participate in our study with (male: 51.8%) and (female: 48.2%), divided according to the level of study into three categories. All subjects voluntarily answered the PIPES questionnaire, the IPAQ scale, the COVID-19 fear scale and the PSS-10 test.

Results

The results of the exploratory and confirmatory factor analysis supported the robustness of the tool measure. In addition, examination of configurational, metric, scalar, and strict invariance supported the equivalence of the structure by gender and educational level. Concurrent validity was established by the positive association of a negative perception of physical inactivity with scores measured by the IPAQ scale and a negative association with scores of COVID-19 fear and perceived stress. Whereas, a positive perception of physical inactivity from the COVID-19 scale was negatively associated with the IPAQ and positively associated with fear of COVID-19 and perceived stress.

Conclusion

The PIPES-10 scale can be used to measure the perception of physical inactivity in different situations.

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

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

University Students Adjusting to COVID-19 Stressors: Exploratory and Confirmatory Factor Analyses of the COVID-19 Stressors Questionnaire

The psychological effects of COVID-19 have been documented in the past year, but scarce literature exists on the nature of COVID-19 stressors. Using a random split sample of 1199 young adult university students, results of exploratory factor analyses (EFA) identified a four-factor structure in the COVID-19 Stressors Questionnaire (C19SQ), which were labeled Resource Constraints, Social Restrictions, Future Uncertainty, and Health Concerns. This model was supported by a confirmatory factor analysis (CFA) when run on the other split sample of 1139 university students. Higher levels of COVID-19 stress were positively associated with anxiety and depressive symptoms and negatively associated with sleep duration, sleep quality, and the number of exercise days. COVID-19 stress also uniquely predicted poor university adjustment. This study demonstrated the link between COVID-19 stressors and mental and physical health symptoms, thus providing support for conceptualizing the psychological impact of the pandemic as adjustment problems for some individuals.

Changes in Spanish lifestyle and dietary habits during the COVID-19 lockdown

PURPOSE

The COVID-2019 pandemic forced many governments to declare the "to stay at home" which encouraged social distancing and isolation among citizens. The aim of this study was to assess the dietary and lifestyle habit changes that occurred during home confinement in Spain.

METHODS

An European online survey was launched in April 2020. This included 70 questions on sociodemographic characteristics, lifestyle, dietary habits, including key Mediterranean diet (MedDiet) foods. A total of 945 Spanish adults from 1268 European that completed the online survey were included in the analysis.

RESULTS

Most of the Spanish participants adopted healthier dietary habits during home lockdown, which was translated to a higher MedDiet adherence. However, a negative impact on physical activity levels, sleep quality or smoking rates was observed. Low MedDiet adherence was associated with a higher risk of weight gain (OR = 1.53, CI 1.1-2.1; p = 0.016), while no snacking between meals reduced the risk by 80% (OR = 0.20, CI 0.09-0.45, p < 0.001) and eating more quantity, considering portion size, increased body weight gain risk almost sixfold more.

CONCLUSION

To conclude, although dietary habits were improved during home lockdown, certain unhealthy behaviours (e.g. increased snacking between meals, increased food intake, and an increase in sedentary behaviour) were increased.

Exercise frequency during the COVID-19 pandemic: A longitudinal probability survey of the US population

Regular physical activity is important for general health and reduces the risk for COVID-19 infections and for severe outcomes among infected people. However, measures to mitigate COVID-19 likely decrease population physical activity. This study aimed to examine 1) changes in exercise frequency in a representative sample of US adults during the pandemic (04/01/2020-07/21/2021), and 2) how sociodemographic characteristics, pre-COVID health-related behaviors and outcomes, and state-level stringency of COVID-19 containment measures predict exercise frequency. Self-reported exercise frequency and its individual-level predictors were determined based on 151,155 observations from 6,540 adult participants (aged ≥ 18 years) in all US states from the Understanding America Study. State-level stringency of COVID-19 control measures was examined from the Oxford COVID-19 Government Response Tracker. Exercise frequency varied significantly over 28 survey waves across 475 days of follow-up (F 1,473 = 185.5, p < 0.001, η2 = 0.28, 95% CI = 0.23-1.00), where exercise frequency decreased between April 2020 and January 2021, and then increased from January 2021 to July 2021. Those who were younger, living alone, non-White, had no college degree, lower household income, low pre-pandemic physical activity levels, obesity, diabetes, kidney disease and hypertension had lower exercise frequency. State-level stringency of COVID-19 control measures was inversely associated with exercise frequency (B = 0.002, SE = 0.001, p < 0.01) between April and December 2020 when the overall stringency level was relatively high; but the association was non-significant (B = 0.001, SE = 0.001, p > 0.05) between January and July 2021, during which the stringency index sharply declined to a low level. This longitudinal probability survey of the US population revealed significant fluctuations in exercise during COVID-19. Low exercise levels are concerning and deserve public health attention. Health inequalities from physical inactivity are likely to exacerbate because of COVID-19. Physical activity promotion in safe environments is urgently warranted, especially in at-risk population subgroups.

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review

INTRODUCTION

The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples' lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic.

METHODS

In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being).

RESULTS

Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes.

CONCLUSION

Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.

Systematic review of the effects of pandemic confinements on body weight and their determinants

Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in grey sources from their inception until 1 July 2020 with an update in PubMed and Scopus on 1 February 2021. In total, 2361 unique records were retrieved, of which forty-one studies were identified eligible: one case–control study, fourteen cohort and twenty-six cross-sectional studies (469, 362 total participants). The participants ranged in age from 6 to 86 years. The proportion of female participants ranged from 37 % to 100 %. Pandemic confinements were associated with weight gain in 7·2–72·4 % of participants and weight loss in 11·1–32·0 % of participants. Weight gain ranged from 0·6 (sd 1·3) to 3·0 (sd 2·4) kg, and weight loss ranged from 2·0 (sd 1·4) to 2·9 (sd 1·5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lockdown. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Impact of Dutch COVID-19 restrictive policy measures on physical activity behavior and identification of correlates of physical activity changes: a cohort study

Background

Identification of characteristics of individuals that are related to decreases in physical activity (PA) levels during lockdown is needed to develop targeted-interventions. This study aims to evaluate changes in domain-specific (i.e. leisure time, transportation, occupational, and household) and total PA due to the Dutch COVID-19 lockdown, which started on March 15 2020. Furthermore, we aim to identify demographic, health-related, and psychological correlates of these changes.

Methods

Individuals who participated in the Nijmegen Exercise Study during 2017-2019 were invited to this study, which was conducted between April 16 and May 12 2020. Participant characteristics (i.e. age, sex, body mass index (BMI), marital status, education, household composition, and occupation status), living environment (i.e. housing type and degree of urbanization), psychological characteristics (i.e. resilience, outcome expectations, vitality, and mental health), and medical history were collected via an online questionnaire. Short Questionnaire to Assess Health-enhancing physical activity was used to assess PA behavior before and during lockdown. Wilcoxon signed-rank test was used to compare PA levels, in metabolic equivalent of task (MET)-minutes per week (min/wk), before and during lockdown. Multivariable linear regression analyses were performed to examine correlates of PA changes.

Results

4033 participants (57% male; 59 ± 13 years) were included. PA decreased significantly during lockdown with mean ± SD changes of 393 ± 2735 MET-min/wk for total, 133 ± 785 MET-min/wk for transportation, 137 ± 1469 MET-min/wk for occupation, and 136 ± 1942 MET-min/wk for leisure time PA. Household PA did not change significantly. Unemployment, COVID-19-related occupational changes, higher BMI, and living in an apartment or semi-detached/terraced house were significantly related to larger decreases in total and domain-specific PA. Higher vitality was related to smaller decreases in total and domain-specific PA. Higher age was significantly associated with a larger decrease in leisure time PA. Lower education was associated with smaller decreases in transportation and occupational PA compared to higher education.

Conclusion

PA levels significantly reduced during lockdown compared to before lockdown. Declines were observed during transportation and occupation, but were not compensated by an increase in leisure time PA. We identified subgroups that were more susceptible to reductions in domain-specific or total PA levels and should therefore be encouraged to increase their PA levels during lockdown.

Cardiopulmonary Exercise Performance in the Pediatric and Young Adult Population Before and During the COVID-19 Pandemic

Physical activity (PA) decreased and sedentary behavior (SB) increased in the pediatric population during the Coronavirus Disease 2019 (COVID-19) pandemic. We examined the effects of PA and SB on cardiopulmonary exercise performance in children, adolescents and young adults both with and without underling cardiac disease, and hypothesized that there will be a change in aerobic and physical working capacity during the pandemic. This was a single-center retrospective longitudinal cohort study in patients age 6-22 years who underwent serial maximal cardiopulmonary exercise stress testing before and during the COVID-19 pandemic. Metabolic variables were obtained; PA and SB data were extracted from clinic notes. A total of 122 patients (60% male) underwent serial exercise testing with a median age of 14 years at the first CPET. Predicted peak aerobic capacity significantly decreased among both females and males during the pandemic, even after adjusting for changes in somatic growth. There was no significant change in physical working capacity during the pandemic. Patients who were more aerobically fit experienced a greater decrease in aerobic capacity during the pandemic compared to those less fit. In conclusion, cardiopulmonary exercise performance, notably aerobic activity, decreased during the COVID-19 pandemic in children, adolescents and young adults compared to pre-pandemic values. This decline was most notable in those with the highest pre-pandemic aerobic capacity values and was independent of somatic growth or changes in BMI. This study has public health implications and demonstrates the importance of PA on overall cardiovascular health.

The Effects of a Five-Month Lockdown Due to COVID-19 on Physical Fitness Parameters in Adolescent Students: A Comparison between Cohorts

Background: This study examined the effects of a five-month lockdown due to COVID-19 pandemic on physical fitness parameters in urban adolescent male and female students. Methods: Two hundred and ninety-three male and female students (age: 15.8 ± 0.3 years) who attended the fourth grade of the same high school during the years 2016–2017 (first control group), 2018–2019 (second control group) and 2020–2021 (lockdown group) took part in the present study. Results: The percentage of overweight and obese students, according to body mass index, increased in males from 16.0% (2016–2017) and 14.6% (2018–2019), to 36.7% in 2020–2021 (p < 0.01), and in females from 8.6% (2016–2017) and 7.0% (2016–2017), to 25.6% in 2020–2021 (p < 0.01). Lower body fitness, as assessed by jumping, sprinting and agility tests, was impaired for both males and females after the lockdown compared with the 2016–2017 and 2018–2019 cohorts (vertical jumps: 10.4–15.1%; p < 0.01; d = 0.58–1.01, 30 m sprint: 3.7–4.9%; p < 0.01; d = 0.62–0.74; 505 agility test: from 6.1% to 9.4%; p < 0.01; d = 0.80–1.04). However, flexibility and performance in upper-body fitness tests (handgrip maximum isometric strength and medicine ball throws with different loads) was significantly reduced only in males after the lockdown (p < 0.05 to 0.01). Conclusions: These results suggest that a five-month lockdown negative influenced the physical fitness of adolescent students. Notably, greater reductions were observed in upper body strength, power and flexibility in males than in females. These results highlight the need to maintain strength, power and body mass during long periods of inactivity in adolescent populations.

Physical Activity and Sports Practice in Children and Adolescents at the Time of the COVID-19 Pandemic: Hypothetical Future Scenarios and Preventive Practical Applications

As a logical and direct consequence of the closure of schools and sports facilities, an expected reduction in the practice of physical activity (PA) and sports has been detected in both children and adolescents all over the world. Hence, we analysed the short-term and long-term consequences of the lack/low level of PA and sports activity in this population, which we referred to as primary and secondary risks, respectively, the latter of which have to be considered in hypothetical future scenarios.

Changes in the behavioural determinants of health during the COVID-19 pandemic: gender, socioeconomic and ethnic inequalities in five British cohort studies

BACKGROUND

The COVID-19 pandemic is expected to have far-reaching consequences on population health. We investigated whether these consequences included changes in health-impacting behaviours which are important drivers of health inequalities.

METHODS

Using data from five representative British cohorts (born 2000-2002, 1989-1990, 1970, 1958 and 1946), we investigated sleep, physical activity (exercise), diet and alcohol intake (N=14 297). We investigated change in each behaviour (pre/during the May 2020 lockdown), and differences by age/cohort, gender, ethnicity and socioeconomic position (childhood social class, education attainment and adult financial difficulties). Logistic regression models were used, accounting for study design and non-response weights, and meta-analysis used to pool and test cohort differences in association.

RESULTS

Change occurred in both directions-shifts from the middle part of the distribution to both declines and increases in sleep, exercise and alcohol use. Older cohorts were less likely to report changes in behaviours while the youngest reported more frequent increases in sleep, exercise, and fruit and vegetable intake, yet lower alcohol consumption. Widening inequalities in sleep during lockdown were more frequent among women, socioeconomically disadvantaged groups and ethnic minorities. For other outcomes, inequalities were largely unchanged, yet ethnic minorities were at higher risk of undertaking less exercise and consuming lower amounts of fruit and vegetables.

CONCLUSIONS

Our findings provide new evidence on the multiple changes to behavioural outcomes linked to lockdown, and the differential impacts across generation, gender, socioeconomic circumstances across life, and ethnicity. Lockdown appeared to widen some (but not all) forms of health inequality.