The COVID-19 pandemic and physical activity

Preschool-aged children 24-hour movement behaviours before and during COVID-19

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected health, economies, and lifestyles, but little is known about its impact on children. We aimed to investigate changes in 24-hour (h) movement behaviours of pre-school children before and during COVID-19, and factors that influenced these. Children aged 3-6 years were recruited in Beijing in 2019, and their movement behaviours over 24 ​h assessed by questionnaire, as part of the International Study of Movement Behaviors in the Early Years (SUNRISE) study. We conducted the survey again during COVID-19, and compared the children's movement behaviours before and during COVID-19 and associated factors. Overall, 196 parents completed the survey at both time points. The percentage of children meeting movement guidelines decreased during the pandemic (p ​< ​0.01). Total physical activity decreased less among children getting good quality sleep or with more adults in the household (p ​< ​0.01). Children who were not cared for primarily by their mother had a greater decrease in moderate to vigorous intensity physical activity (p ​= ​0.02), but the decrease was smaller among children whose parents used the internet to support their physical activity and/or screen time (p ​< ​0.05). Children who used electronic screen devices in the 2 ​h before bedtime or whose parents reported body temperature in webchats had a greater increase in sedentary screen time (p ​< ​0.05). Children spending more time outdoors showed a smaller decrease in sleep (p ​< ​0.01). Overall, children's movement behaviours changed significantly during the pandemic.

Effects of high-intensity intermittent cross-training on maximal oxygen uptake

We investigated the effects of high-intensity intermittent cross-training (HIICT) on maximal oxygen uptake (V ˙ O2max). The HIICT consisted of alternating intermittent 20-s treadmill running (1st, 3rd, 5th, and 7th bouts) and 20-s bicycle exercise (2nd, 4th, and 6th bouts) with a 10-s rest period. Each intensity for running and bicycling of the HIICT corresponded to an oxygen demand of ∼160% and ∼170% of theV ˙ O2max, respectively. Fifteen healthy young males (aged [24 ​± ​1] yrs) were randomly assigned to training (TG, n ​= ​8) and non-training control (CG, n ​= ​7) groups. The TG completed this HIICT daily 4 days/week for 6 weeks. Significant group ​× ​time interactions were observed for both the running and bicyclingV ˙ O2max (p ​< ​0.001 each). After the training, theV ˙ O2max for both running ([57.4 ​± ​4.8] mL·kg-1·min-1) and bicycling ([50.6 ​± ​3.7] mL·kg-1·min-1) in the TG were significantly higher than those for running ([50.1 ​± ​3.1] mL·kg-1·min-1) and bicycling ([43.7 ​± ​3.6] mL·kg-1·min-1) in the CG, respectively (p ​< ​0.01 each). Post-hoc tests revealed a significant increase inV ˙ O2max for running and bicycling in the TG after the HIICT (p ​< ​0.001 each) but no significant difference in the CG. These results demonstrated that the newly developed HIICT increases theV ˙ O2max for both running and bicycling.

A longitudinal study to COVID-19 infection among university students: Physical fitness changes and psychological responses

Background

The impact of COVID-19 infection on physical and mental health of young adults remains unclear. This study aimed to investigate the changes in the physical fitness three months after recovering from acute COVID-19 infection, and examine if the infection could also influence the mental health of university students.

Methods

A total of 460 university students (mean age 18.9 ± 1.3 years, with 30 males and 27 females uninfected with COVID-19) volunteered for the study. Participants underwent a fitness test initially, followed by another physical fitness test and a mental health assessment three months after the infection of COVID-19. Physical fitness tests included body composition, flexibility, cardiorespiratory fitness, muscle strength, and muscular endurance. Mental health was assessed using the Depression-Anxiety-Stress Self-Assessment Scale (DASS-21), the Pittsburgh Sleep Quality Inventory (PSQI), and the Post-Traumatic Stress Disorder Self-Assessment Scale (PTSD).

Results

Three months after acute COVID-19 infection, the physical performance of university students had decreased compared to pre-infection levels by approximate 3-15 % (p < 0.05). Regarding mental health, a notable difference was observed in sleep quality, with the positive group scoring 19 % higher than the negative group (p < .05, d = .44). Sex (β = .164, p < .05), previous infection (β = .277, p = .019) and anxiety (β = .373, p = .002) were predictive of PSQI scores, accounting for 37.5 % of the variance.

Conclusions

All participants experienced a decline in physical fitness compared to their pre-infection levels, regardless of infection status. Those who had been infected exhibited poorer sleep quality compared to their non-infected peers. Prior COVID-19 infection and higher anxiety levels may contribute to poorer sleep quality.

Recovery Strategies in Endurance Sports: A Survey in Coaches and Athletes

PURPOSE

This study explored endurance athletes' and coaches' views on recovery strategies, focusing on their use across competition levels, perceived importance and effectiveness, and common barriers.

METHODS

Endurance athletes (26.6% international, 35.7% national, 28.7% regional, and 9.1% other levels; mean experience 10.04 [7.84] y, n = 143) and coaches (mean experience 17.45 [12.44] y, n = 20) completed an online survey on frequency of usage, perceived importance, effectiveness, and common barriers of 25 recovery strategies. Data were coded and analyzed thematically. A Fisher exact test (P < .05) was conducted on 5-point Likert-scale responses.

RESULTS

Predominant strategies among athletes were hydration, hot showers, and carbohydrate (mean scores 4.62 [0.60], 4.32 [0.82], and 4.17 [0.87]). Only antioxidants showed significant variation in use across levels (P = .033). Coaches favored warm-down/cooling (4.56 [0.62]), hydration (4.41 [0.80]), and extra protein (4.12 [0.70]). Both groups ranked hydration as most important and effective. Athletes ranked extra protein and warm-down/cooling second and third, while coaches considered extra sleep/naps, warm-down/cooling, and extra protein equally important. Barriers of both populations included insufficient time (14.41%), limited knowledge (13.72%), lack of resources (12.63%), and skepticism regarding benefits and effectiveness (12.63%).

CONCLUSIONS

Athletes show no significant differences in recovery choices based on competitive level, except for antioxidants. Coaches and athletes have partially different views on effective recovery. Furthermore, a lack of time, as well as a lack of (shared) knowledge and education, hinders the effective implementation of recovery strategies for athletes.

Cross sectional associations of physical activity and sleep with mental health among Chinese university students

OBJECTIVE

This study aimed to examine the levels of physical activity (PA), sleep, and mental health (MH), specifically depression, anxiety, and stress, among Chinese university students. It also aimed to analyze the influencing factors of MH, providing a theoretical foundation for developing intervention programs to improve college students' mental health.

METHODS

A stratified, clustered, and phased sampling method was employed. In September 2022, a survey was conducted among 36,756 university students from 104 higher education institutions across 31 provinces, autonomous regions, and municipalities in China. The participants' PA behaviors, sleep patterns, depressive symptoms (use the CES-D), anxiety symptoms (use the GAD-7), smoking and drinking behaviors, and demographic information were assessed through an online questionnaire using Questionnaire Star software.

RESULTS

A total of 30,475 valid questionnaires were completed. The proportion of university students engaging in light-intensity PA was 77.6%. The prevalence of insufficient sleep was 39.5%, whereas the prevalence of poor sleep quality was 16.7%. The prevalence of depressive symptoms was 10%, and the prevalence of anxiety symptoms was 23.3%. Binary logistic regression analysis revealed that engaging in moderate to high-intensity PA and having sufficient and high-quality sleep were associated with a lower likelihood of depressive symptoms (OR = 0.207-0.800, P < 0.01), whereas appropriate sleep duration and higher sleep quality were associated with a lower likelihood of anxiety symptoms (OR = 0.134-0.827, P < 0.001).

CONCLUSION

The intensity of PA among university students is predominantly light, and the reported rate of insufficient sleep is relatively high. Moderate to high-intensity PA and sufficient high-quality sleep may alleviate MH issues among college students, with an interaction effect observed among PA, sleep, and depression symptoms. Future studies should further explore targeted interventions combining PA and sleep behaviors to enhance the MH of university students.

A scoping review of COVID-19 economic response policies in the MENA countries: lessons learned for Iran for future pandemics

BACKGROUND

Given the significant impact of the COVID-19 pandemic, it is imperative to examine the economic response policies implemented by governments. This study aims to review evidence from the Middle East and North Africa (MENA) region, including Iran, on COVID-19 economic response policies designed to protect households, vulnerable groups, and businesses.

METHODS

Utilizing Arksey and O'Malley's scoping review methodology, electronic search engines and databases were systematically searched to identify published studies within the timeframe of December 31, 2019, to 2022. Additionally, a gray literature search for relevant policy documents and reports was conducted. The following six-step approach was employed: (1) defining the review questions, (2) identifying relevant studies through database searches, (3) screening studies for inclusion, (4) extracting and charting data, (5) analyzing and presenting results, and (6) providing guidance and suggestions. Narrative synthesis was utilized for data analysis.

RESULTS

After a rigorous screening process, 53 studies were selected from a pool of 3392 search results. The findings are categorized into three primary groups: Households, vulnerable groups, and economic businesses. The majority of MENA countries implemented economic and social measures to support these groups, including stimulus packages, tax deferrals and exemptions, wage subsidies, and debt obligation deferments. The size of stimulus packages in MENA countries varied significantly, ranging from 0 to 14% of real Gross Domestic Product (GDP). The average stimulus package size in MENA countries was 3.67%, notably lower than the global average of 11%. Among the 64 selected countries, the average government support as a share of GDP was 6.3%, with Ecuador at the lowest (0.05%) and Germany at the highest (23%). In Iran, government financial support contributed approximately 7% to the Gross National Product.

CONCLUSION

MENA countries, including Iran, implemented diverse economic strategies and policies in response to the critical circumstances of the COVID-19 pandemic, tailored to their specific conditions. Assessing the effectiveness of these policies and the extent of the pandemic's long-term economic, health, and lifestyle impacts requires a more extended timeframe.

The 100-Days: Physical Exercise and Challenges to Assess, Maintain and Improve Physical Fitness During Lockdown

The COVID-19 pandemic reduced physical activity and increased sedentary behavior, raising health risks. To combat this, a 100-day training program was designed to maintain and improve fitness during lockdown. This program, which included a challenge with physical assessments and online sessions, aimed to enhance fitness and motivation.

METHODS

Twenty participants (mean age 45.2 ± 12.7 years) with good baseline fitness completed strength, endurance, coordination, and flexibility exercises over 100 days, with monthly challenges. Fitness was assessed at baseline (T0), mid-program (T1), and completion (T2).

RESULTS

Males initially showed higher BMI and mild cardiovascular risks. Flexibility improved for both genders, with females increasing from 12.5 ± 4.51 cm to 14.8 ± 6.65 cm and males from 4.4 ± 6.33 cm to 8.8 ± 10.69 cm. Males' vertical jump height increased from 20.7 ± 13.05 cm to 28.2 ± 10.49 cm. In the challenge, push-up repetitions rose for both genders, achieving excellent scores (>24 reps for females, >25 for males). Males advanced in the repeated crunch test, while females consistently excelled in the repeated squat. Weight and BMI reductions were also observed, particularly in overweight males.

CONCLUSIONS

The 100-day training program, combined with the challenge, effectively sustained physical fitness and motivation among participants during pandemic-related restrictions. Notable strength and endurance improvements were observed across both genders, reinforcing the potential of interactive, remote training programs to promote physical health in periods of limited activity.

COVID-19 Impacts on Physical Activity Among Community-Dwelling Older Adults With Memory Problems: The Moderating Role of Walkable Neighborhood Destinations

BACKGROUND AND OBJECTIVES

The number of people with memory problems who desire or are forced to age in place has been growing rapidly. Coronavirus disease 2019 (COVID-19) has brought significant challenges to the ability of those with memory problems to stay active and age in place. This study investigated the roles of neighborhood environments in helping community-dwelling people with memory problems maintain physical activity during the COVID-19 pandemic.

RESEARCH DESIGN AND METHODS

We used retrospective online survey data from 75 caregivers who responded on behalf of their care recipients with memory problems living in Texas communities. We used difference-in-difference (DID) estimations based on zero-inflated negative binomial regression models to examine the changes in recreational walking and moderate-to-strenuous exercise before and during the COVID-19 pandemic and whether such changes vary by diversity of walkable neighborhood destinations.

RESULTS

In the total sample, there was a significant reduction in both recreational walking (Δ change = -45.16 min/week, p < .001) and exercise (Δ change = -36.28 min/week, p = .03) after the COVID-19 outbreak. The pandemic's impact on exercise varied by diversity of neighborhood destinations (DID = 0.81, p = .03). Those living in neighborhoods with diverse walkable destinations experienced less decline in physical activity compared to those living in areas with limited destinations.

DISCUSSION AND IMPLICATIONS

These findings suggest that the impact of the COVID-19 pandemic on physical activity among people with memory problems may be partially explained by neighborhood land-use characteristics. Destination-rich, mixed-use neighborhood environments can help people with memory problems stay active even during pandemics such as COVID-19 in the United States and potentially elsewhere.

Navigating Physical Activity Promotion and Policy in the Post-COVID-19-Pandemic Era

BACKGROUND

There is limited evidence on the priorities and opportunities associated with promoting population physical activity (PA) participation for the post-COVID-19-pandemic future.

PURPOSE

This study assessed government-led PA promotion efforts before and during the COVID-19 pandemic, along with post-COVID-19-pandemic priorities and recommendations.

METHODS

Two separate cross-sectional surveys conducted in 2023. Survey 1 was targeted at the Global Observatory for Physical Activity (GoPA!) Country Contacts. Survey 2 also included key international informants representing influential stakeholders in PA policy implementation.

RESULTS

There were 68 respondents to Survey 1, collectively representing 61 countries. An additional 37 people, including representatives from 14 key international stakeholders responded to Survey 2. Eighty-two percent of countries had national PA policies. COVID-19 widely disrupted PA policy implementation. Less than 40% of countries integrated PA into their COVID-19 response plan and more than 75% reported policies that restricted PA participation. Although most respondents indicated that government PA priorities did not change due to the COVID-19 pandemic, one in five countries reported that cross-sectoral partnership had become more important during this period. Less than a third of postpandemic governments reported as highly engaged despite the widespread proliferation of PA policies and plans prior to the pandemic. There were variations according to country, region, and income.

CONCLUSIONS

Elevating PA promotion on the public health agenda is crucial for the post-COVID-19-pandemic era. At a policy level, it is critical to focus on adequate resourcing, cross-sectoral partnerships, integrated interventions, and inequities in participation. These factors have become increasingly important in the postpandemic PA policy landscape.

Neuro-inflammatory pathways in COVID-19-induced central nervous system injury: Implications for prevention and treatment strategies

This review explores the neuroinflammatory pathways underlying COVID-19-induced central nervous system (CNS) injury, with a focus on mechanisms of brain damage and strategies for prevention. A comprehensive literature review was conducted to summarize current knowledge on the pathways by which SARS-CoV-2 reaches the brain, the neuroinflammatory responses triggered by viral infection, neurological symptoms and long COVID. Results: We discuss the mechanisms of neuroinflammation in COVID-19, including blood-brain barrier disruption, cytokine storm, microglial activation, and peripheral immune cell infiltration. Additionally, we highlight potential strategies for preventing CNS injury, including pharmacological interventions, immunomodulatory therapies, and lifestyle modifications. Conclusively, Understanding the neuroinflammatory pathways in COVID-19-induced CNS injury is crucial for developing effective prevention and treatment strategies to protect brain health during and after viral infection.

Exploring the Link Between Physical Activity, Sports Participation, and Loneliness in Adolescents Before and Into the COVID-19 Pandemic: The HUNT Study, Norway

BACKGROUND

The COVID-19 pandemic's effects on adolescents' physical activity, sports involvement, and feelings of loneliness remain inadequately understood. This study aimed to explore the shifts in leisure-time physical activity, sports participation, and loneliness among adolescents before and during the pandemic, positing that the pandemic has led to decreased physical activity and sports engagement, as well as heightened loneliness, where more active adolescents experience lower loneliness levels. This study included a prior four-year follow-up cohort from the same region two decades earlier to explore the existence of typical longitudinal aging effects in a cohort not affected by the pandemic.

METHODS

Prospective and longitudinal data from two cohorts of the Young-HUNT Study two decades apart involving adolescents aged 13-19 years were utilized. The controls were as follows: Cohort 1 from the Young-HUNT1 (YH1) Survey included 2399 adolescents with follow-up in the Young-HUNT2 (YH2) Survey four years later. Cohort 2 included the Young-HUNT4 (YH4) Survey (2017-2019) of 8066 adolescents, with a subset of 1565 participants followed up in the Young-HUNT COVID Survey (YHC) (2021) after exposure to the COVID-19 pandemic and associated restrictions. Changes over time were assessed using McNemar's tests and dependent sample T-tests, while multinomial logistic regression modeled within-individual changes in loneliness, adjusting for age, gender, and other factors.

RESULTS

The findings revealed a significant decline in physical activity and sports participation in both cohorts from early to late adolescence. Additionally, there was a considerable increase in reported loneliness, more after exposure to the pandemic and especially among girls, but without any difference in historical initial levels (between cohorts). Inactive adolescents faced a greater risk of increased loneliness, while those participating in sports had a lower risk of loneliness. Physically inactive boys had a higher risk of loneliness compared with physically active boys at both time points in Cohort 2, which was higher than in the control Cohort 1. There was no historical difference between initial assessments.

CONCLUSION

Adolescents experienced a significant decrease in physical activity and sports participation, along with increased loneliness, from early to late adolescence. Given the protective benefits of physical activity against loneliness and the negative longitudinal trends observed, public health initiatives should focus on increasing physical activity and reducing sports drop-out rates among adolescents to combat rising loneliness.

Metacognition-Associated Factors in Physical and Occupational Therapy Students: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Supporting the mental well-being of students through their educational journey is of vital importance. The objective of this study was to investigate the relationship between metacognition, personality traits, and various factors affecting mental health in a cohort of physical therapy (PT) and occupational therapy (OT) students.

METHODS

This cross-sectional observational study involved a self-administered questionnaire (distributed in October to November 2020) that gathered demographic information and included six scales measuring personality characteristics, health literacy, self-management skills, exercise habits (benefits and barriers), cognitive thinking, and cognitive deliberateness and impulsivity.

RESULTS

A cohort of 195 PT and OT students participated in the study. The findings revealed significant associations between metacognition and personality, particularly the association between low cognitive self-confidence and high emotional instability. This link suggests that students who struggle with cognitive self-confidence may also experience greater emotional instability, highlighting a need for targeted mental health support. Additionally, health literacy was negatively correlated with anxiety, while metacognition was positively correlated with perceived exercise benefits.

CONCLUSIONS

This study highlights the importance of individualized metacognitive approaches to support students' mental well-being. Interventions should focus on strengthening cognitive self-confidence through methods such as resilience training, cognitive restructuring, and mindfulness practices to help manage emotional instability. Furthermore, promoting physical activity, particularly among female students, and incorporating gender-specific strategies could enhance mental health outcomes.

Reduction in physical activity during Covid-19 lockdowns predicts individual differences in cognitive performance several months after the end of the safety measures

Prior studies suggest that the reductions in physical activity during Covid-19-related lockdowns impacted physical and mental health. Whether reductions in physical activity that occurred during lockdowns also relate to cognitive functions such as memory and attention is less explored. Here, we investigated whether changes in physical activity (PA) that occurred during and following Covid-19-related lockdowns could predict a variety of measures of cognitive performance in 318 young adults. Participants were assessed on their engagement in PA before, during, and after lockdowns. They also completed tests of cognitive control, working memory, and short-term memory following lockdown(s). As expected, engagement in PA decreased during lockdown and returned to near baseline levels thereafter. Decreases in PA during lockdown predicted individual differences in cognitive performance following lockdown. Greater reductions in PA during lockdown were associated with lower scores on the go/no-go task, a measure of cognitive control ability, and the n-back task, a measure of working memory performance. Larger post-lockdown increases in PA were associated with higher scores on the same tasks. Individual differences in pandemic-related stress and insomnia also predicted cognitive outcomes. These findings suggest that reductions of PA can predict cognitive performance, and underscore the importance of maintaining PA for cognitive health, especially in situations such as lockdowns.

Physiological Profile Assessment and Self-Measurement of Healthy Students through Remote Protocol during COVID-19 Lockdown

Background: The COVID-19 pandemic has led to reduced physical activity and increased sedentary behaviors, negatively impacting mental and physical health. Engaging in physical activity at home during quarantine became essential to counteracting these adverse effects. To develop appropriate physical activity programs, assessing individuals' fitness levels and the impact of inactivity is crucial. This study aims to compare motor abilities-including flexibility, balance, reaction time, cardiovascular endurance, and lower and upper limb strength-assessed both in-person and remotely, to determine the accuracy and repeatability of self-administered tests. Methods: A total of 35 young subjects (age 24.2 ± 1.97 years, BMI 22.4 ± 2.61 kg/m2) participated in this study. Each participant underwent a battery of motor ability tests designed to assess various fitness components. The tests were administered twice for each subject: once in a laboratory setting and once remotely at home. The sequence of tests was randomly assigned to ensure unbiased results. Both the in-person and remote assessments were used to evaluate the accuracy and reliability of self-administered tests. Results: The comparison of test results between the laboratory and remote settings revealed percentage differences ranging from 5% to 10%. This variation is considered an acceptable margin of error, suggesting that the tests conducted remotely were relatively accurate when compared to those performed in a controlled laboratory environment. Conclusions: The findings indicate that remote fitness testing is a promising method for evaluating motor abilities. With an acceptable margin of error, remote assessments can be effectively used to personalize training programs based on individuals' physiological characteristics. This approach may be particularly beneficial during times of limited access to fitness facilities, such as during quarantine, or for individuals seeking more flexible fitness evaluation methods.

Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study

PURPOSE

To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR).

MATERIALS AND METHODS

This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis.

RESULTS

At start, service-users were sedentary for 12.6 ± 0.7 h · day-1 and accumulated most PA at a light-intensity (133.52 ± 28.57 min · day-1) - neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR.

CONCLUSIONS

Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies.

Effects of COVID-19 on the cardiovascular system: A mendelian randomization study

Infections with the coronavirus disease 2019 (COVID-19) and disorders of the heart and blood vessels are causally related. To ascertain the causal relationship between COVID-19 and cardiovascular disease (CVD), we carried out a Mendelian randomization (MR) study through a method known as inverse variance weighting (IVW). When analyzing multiple SNPs, MR can meta-aggregate the effects of multiple loci by using IVW meta-pooling method. The weighted median (WM) is the median of the distribution function obtained by ranking all individual SNP effect values according to their weights. WM yields robust estimates when at least 50% of the information originates from valid instrumental variables (IVs). Directed gene pleiotropy in the included IVs is permitted because MR-Egger does not require a regression straight line through the origin. For MR estimation, IVW, WM and MR-Egger were employed. Sensitivity analysis was conducted using funnel plots, Cochran's Q test, MR-Egger intercept test, MR-PRESSO, and leave-one-out analysis. SNPs related to exposure to COVID-19 and CVD were compiled. CVD for COVID-19 infection, COVID-19 laboratory/self-reported negative, and other very severe respiratory diagnosis and population were randomly assigned using MR. The COVID-19 laboratory/self-reported negative results and other very severe respiratory confirmed cases versus MR analysis of CVD in the population (p ​> ​0.05); COVID-19 infection to CVD (p ​= ​0.033, OR ​= ​1.001, 95%CI: 1.000-1.001); and the MR-Egger results indicated that COVID-19 infection was associated with CVD risk. This MR study provides preliminary evidence for the validity of the causal link between COVID-19 infection and CVD.

Effect of COVID-19 pandemic on bioimpedance health indicators in young adults

OBJECTIVES

Herein, we investigate the relationships between the COVID-19 pandemic and overcoming the virus, and its effects on body composition parameters in young adults from Slovakia.

METHODS

We assessed 773 adults aged 18 to 30 years in pandemic-status sub-groups. Individual lifestyles and overcoming the COVID-19 effects were evaluated by a detailed questionnaire, and body composition parameters were analyzed using the InBody 770 bioimpedance analyzer.

RESULTS

Statistically significant lower values were observed in the male group during the pandemic for the following parameters; proteins and minerals, fat free mass (FFM), skeletal muscle mass (SMM), lean body mass (LBM) and its values in the right and left arm and trunk, total body water (TBW) and its values in the right and left arm and trunk, body cell mass (BCM), basal metabolic rate (BMR) and phase angle (PA). The regression analysis confirmed the negative pandemic effect and the negative impact of COVID-19 on men in the following parameters: proteins (p = .027 for pandemic and p = .005 for COVID-19), FFM (p = .023 for pandemic and p = .005 for COVID-19), LBM (p = .022 for pandemic and p = .004 for COVID-19), SMM (p = .028 for pandemic and p = .005 for COVID-19), TBW (p = .020 for pandemic and p = .004 for COVID-19), BMR (p = .024 for pandemic and p = .005 for COVID-19) and PA (p = .009 for pandemic). Physical activity was a further significant predictor in men for all the above parameters.

CONCLUSIONS

We observed significantly lower body composition parameters associated with fat free mass in young adult men during the pandemic than before it. However, future research is warranted to determine if these effects have long-term significance.

Sociodemographic Factors Related to Perceived Physical Activity on Chilean Adults after COVID-19 Pandemic

The current study aimed to examine the relationship between sociodemographic variables (i.e., sex, age, marital status, educational level, socioeconomic status, and working mode) and physical activity levels declared by Chilean adults. The sample comprised 483 Chilean adults, 159 men (32.9%) and 324 women (67.1%) aged from 18 to 69 years old (36.5 ± 12.0). The participants completed an ad hoc sociodemographic online survey between December 2022 and March 2023 that included questions about characteristics of participants such as sex, age, educational level, household income, marital status, and working mode. Vigorous, moderate, and walking activities were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), a self-administered questionnaire. Men declared significantly higher vigorous and moderated physical activity than women. People aged 18 to 25, single or unmarried, and with the lowest household income, showed significantly higher scores in vigorous physical activity than those aged 26 to 45, cohabiting with a partner or married, and middle household income, respectively. Regarding working mode, people working at their job site said walking more than people not working, working in a hybrid mode, and working online. Our findings suggest that promoting strategies that increase physical activity during the pandemic is necessary to avoid health problems.

A Qualitative Description of Graduate Students' Perceived Decline in Physical Activity from Undergraduate School

Many university students, especially graduate students, are experiencing poor physical and psychological health. Thus, universities are initiating programs like Exercise is Medicine-On Campus (EIM-OC) to promote positive physical activity behavior to improve physical and mental health for primarily undergraduate university students. However, the influences on physical activity when transitioning from an undergraduate to a graduate student are unknown. To explore perceptions of if and how the physical activity levels of graduate students changed from their time as undergraduate students while considering environmental and lifestyle factors. METHODS: Using a qualitative, phenomenological research design, a convenience sample of current graduate students enrolled at a large, mid-South university completed a 20-minute interview. Questions included inquiring on current household, occupational, active transportation, leisure time, and overall physical activity during the graduate and past undergraduate programs. All interviews were transcribed, and major themes were derived using thematic analysis. Twenty-one (62% female; 52% master's students) participants completed interviews. Overall, participants perceived their physical activity decreased, including occupational, active transport, and leisure-time physical activity. Major themes discussed by participants included: increased academic and occupational responsibilities, changes in the physical and social environment, increased awareness of health and activity, and life transitions. The decline in physical activity once individuals enter their graduate program necessitates an intervention, like EIM-OC, during or after undergraduate studies to promote the initiation or continuation of regular physical activity to improve graduate students' overall health.

Assessing Immediate and Lasting Impacts of COVID-19-Induced Isolation on Green Space Usage Patterns

The COVID-19 pandemic has profoundly influenced urban lifestyles, particularly the utilization of green spaces. While existing studies have primarily focused on the immediate effects of COVID-19-induced isolation, less attention has been given to the enduring impacts on green space usage patterns. This study addresses this gap by conducting three comprehensive surveys in Dezhou, China-before, during, and after the first wave of social isolation (December 2019, March 2020, December 2020). These surveys assessed socioeconomic conditions, commuting habits, green space usage habits, and landscape preferences, specifically focusing on usage frequency, duration of stays, and activities undertaken. Using Mann-Whitney U tests and Spearman's rho correlations, we identified significant long-term changes, including an increase in the frequency of visits by previously infrequent users, a reduction in visit durations, and a rise in high-intensity activities. These trends persisted 9 months post-isolation, highlighting the pandemic's lasting impact on green space usage and its critical role in enhancing public health and pandemic preparedness through thoughtful urban environmental design. This study not only sheds light on behavioral adaptations during a public health crisis but also offers evidence-based strategies for urban planning to bolster societal resilience in the face of future pandemics.

Inflammation, but not skeletal muscle index, is associated with coronavirus disease 2019 mortality in patients with cancer

BACKGROUND & AIMS

Patients with cancer and coronavirus disease 2019 (COVID-19) have characteristics that can cause the most severe forms of the disease and higher mortality. We aimed to assess the association between computed tomography (CT)-derived muscle abnormalities, anthropometric parameters, inflammation, and mortality in patients with cancer and COVID-19.

METHODS

This retrospective study included patients with cancer and COVID-19 admitted between March 1st and December 31st, 2020. All information was collected from medical records (clinical and nutritional parameters, serum albumin, and C-reactive protein [CRP]). Weight loss and body mass index (BMI) were assessed using Global Leadership Initiative on Malnutrition phenotypic criteria. Skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) at the fourth thoracic vertebra level were assessed using computed tomography scans.

RESULTS

This study included 80 patients (61% men, mean age: 58 ± 17 years). Of the patients analyzed, 49% had weight loss >5%, and 14% had low BMI. The median length of hospital stay was 7 (interquartile range: 4-14 days), 27% needed mechanical ventilation, 34% died as a direct consequence of COVID-19 infection and 15% to complications associated with cancer condition. In multivariate logistic regression analysis, low SMI was associated with increased in-hospital mortality [odds ratio (OR): 4.81; 95% confidence interval (95% CI): 1.63; 14.2; p = 0.005), while CRP was associated with COVID-19-related mortality (OR: 1.08; 95% CI: 1.01; 1.15, p = 0.018).

CONCLUSION

SMI independently predicts in-hospital mortality in patients with cancer and COVID-19. Additionally, an independent association was observed between CRP and mortality specifically related to COVID-19.

Feasibility and validity of the push-up test for synchronous and asynchronous strength tele-assessment in spinal cord injury individuals with paraplegia

OBJECTIVES

This study aimed to determine whether the synchronous and asynchronous push-up tele-assessment in individuals with spinal cord injury (SCI) is feasible and valid and to identify the relationship between the participants' self-reported asynchronous strength tele-assessment and asynchronous push-up tele-assessment.

STUDY DESIGN

Cross-sectional study.

METHODS

Thirty-three men and women with SCI were included in this study. The participants were assessed using the one-maximum repetition test (1RM), the maximum repetitions with 60% of 1RM (MRT) of the bench press exercise, and synchronous and asynchronous push-up tele-assessment. The videos and the total repetitions performed were recorded. The primary outcomes were 1RM, MRT, synchronous push-up tele-assessment and asynchronous volume loads, and the participants' self-reported asynchronous strength tele-assessment volume load.

RESULTS

The synchronous push-up tele-assessment and asynchronous volume loads presented significant correlations with 1RM (0.73 and 0.45, p < 0.001, respectively) and MRT volume loads (0.87 and 0.66, p < 0.001, respectively). The asynchronous push-up tele-assessment presented significant correlations with the synchronous version (intraclass correlation coefficient, ICC = 0.86; 95% CI: 0.72-0.93, p < 0.001) and participants' self-reported asynchronous strength tele-assessment volume loads (ICC = 0.88; 95% CI: 0.75-0.94, p < 0.001). The difference between the synchronous push-up tele-assessment and asynchronous volume load means was 254.9 kg, and the interval around the differences was 1856.1 kg. The difference between asynchronous push-up tele-assessment and participants' self-reported asynchronous strength tele-assessment means was -239.4 kg, and the interval around these was 1884.1 kg.

CONCLUSION

The synchronous push-up tele-assessment is a feasible and valid way to assess the maximum resistance strength of individuals with SCI. Although the asynchronous push-up tele-assessment demonstrated excellent and significant correlations with the synchronous push-up tele-assessment and participants' self-reported asynchronous strength tele-assessment, the test repetitions and the volume loads were underestimated by 15.5% (synchronous push-up tele-assessment vs. asynchronous) and overestimated by 17.3% (asynchronous push-up tele-assessment vs. participants' self-reported asynchronous strength tele-assessment), and the effect sizes ranged from 0.19-0.38. The authors suggest emphasizing the criteria of repetition validity to reduce test error.

The impact of inactivity during the COVID-19 pandemic on the physical performance of high school athletes

BACKGROUND/OBJECTIVE

This study was conducted during the 2019-2020 academic year to evaluate the impact of participation in school sports on students' Body Mass Index (BMI) and Assessing Levels of Physical Activity (ALPHA) test scores. Interrupted by the COVID-19 pandemic, which led to a suspension of in-person education, the study resumed in September 2021, refocusing on the effects of pandemic-induced inactivity on the physical fitness levels of the same cohort.

METHODS

The study included twenty-nine male high school students (age: 17,24 ± 0,73 years), divided into thirteen athletes (participating in sports such as football, basketball, and track) and sixteen non-athletic counterparts. They underwent reassessment using the ALPHA test battery, evaluating cardiorespiratory, musculoskeletal, and motor skills fitness. Data were analyzed using independent and paired samples t-tests and a two-way repeated measures ANOVA to assess changes over time and between groups. Discriminant function analysis evaluated the ALPHA test's ability to classify students based on their athletic status pre- and post-pandemic.

RESULTS

Initially, athlete students exhibited significantly better BMI, 20 m shuttle run, and 4 × 10 m speed run scores compared to their non-athlete peers. After the pandemic, only the 20 m shuttle run scores remained significantly higher for athletes, with diminished distinctions in other fitness areas. The classification accuracy of the ALPHA test battery decreased from 89.7 to 75.9% post-pandemic.

CONCLUSION

The enforced sedentary lifestyle due to the COVID-19 pandemic adversely affected all students, particularly diminishing health-related fitness parameters such as body composition, cardiorespiratory and musculoskeletal strength, and motor skills. Students previously engaged in regular physical activity, notably school athletes, experienced significant fitness declines. This highlights the urgent need for targeted interventions to encourage active lifestyles among youth in the post-pandemic phase, aiming to avert long-term adverse health outcomes.

Health Behaviours and the Quality of Life of Students of Medical Fields during the COVID-19 Pandemic

(1) Background: Social distancing and closing down public spaces associated with learning, leisure and physical activity limited the spread of COVID-19. These measures had an impact not only on the economy and education but also on health behaviours and the quality of life of individuals affected by the restrictions. The aim of this study was to identify the role of health behaviours in the perception of the quality of life of students during the COVID-19 pandemic. (2) Methods: This study was conducted among 796 students of the University of Warmia and Mazury in Olsztyn in the first quarter of 2022. Subgroup 1 consisted of students at the Public Health School (n = 428; 53.8%) and subgroup 2 consisted of students belonging to the Faculty of Veterinary Medicine (n = 368; 46.2%). The diagnostic survey method was applied, and an original survey questionnaire, the Health Behaviour Inventory and the Quality of Life Questionnaire (WHOQoL-Bref version) were used. (3) Results: The largest contribution to the prediction of quality of life of students in subgroup 1 was made by a positive mental attitude related to avoiding too strong emotions, which explained 19% of the result variability in the somatic domain (ßeta = 0.24; R2 = 0.21), 20% of the result variability in the psychological domain (ßeta = 0.36; R2 = 0.20), 16% of the result variability in the social domain (ßeta = 0.52; R2 = 0.17) and 17% of the result variability in the environmental domain (ßeta = 0.19; R2 = 0.19). Moreover, in subgroup 2, a predominantly positive mental attitude significantly predicted quality of life in the somatic domain, explaining 23% of the result variability (ßeta = 0.24; R2 = 0.26), while it explained 25% of the result variability in the psychological domain (ßeta = 0.47; R2 = 0.25), 16% of the result variability in the social domain (ßeta = 0.46; R2 = 0.17) and 21% of the result variability in the environmental domain (ßeta = 0.38; R2 = 0.23). (4) Conclusions: Positive correlations between health behaviours and the quality of life among the study participants were determined. Health-promoting behaviours had a beneficial impact on the respondents' quality of life during the COVID-19 pandemic. The category of health behaviours described as a positive mental attitude was an important predictor for the participants' quality of life.

Health Benefits of Antioxidant Bioactive Compounds in Ginger (Zingiber officinale) Leaves by Network Pharmacology Analysis Combined with Experimental Validation

Network pharmacology is an ideal tool to explore the effects of therapeutic components derived from plants on human metabolic diseases that are linked to inflammation. This study investigated the antioxidant effects of ginger leaves (GLs) and predicted targets for antioxidant activity. Quantitative and free radical scavenging analyses were performed to detect the main bioactive compounds of GLs and evaluate their antioxidant activities. Chemical diversity and network pharmacology approaches were used to predict key antioxidant components of GLs and their molecular targets. Nine major bioactive compounds of GLs were quantified using an internal standard method, and the antioxidant activity was evaluated using the DPPH and ABTS free radical scavenging methods. We first built the compound-gene-pathways and protein-protein interaction networks of GLs-related antioxidant targets and then conducted gene ontology and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway enrichment analyses. Molecular docking results show that astragalin, a compound isolated from GLs, had the highest level of connectivity in the compound-target network and was involved in inflammation-related biosynthesis by directly impacting cytokine gene expression and PTGS2 inhibition markers. These findings not only suggest that the compounds isolated from GLs can be developed as potential antioxidants, but also demonstrate the applicability of network pharmacology to assess the potential of foods for disease treatment.

Analysis of Changes in Physical Fitness in Children and Adolescents (11-15 Years) From Kraków (Poland) During COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed a threat to society worldwide. The aim of the study was to analyze changes in the physical fitness of 11- to 15-year-olds during the COVID-19 pandemic.

METHODS

Cross-sectional research was conducted in randomly selected schools in Kraków (Poland) during the years 2020 and 2022. The study group included 1635 adolescents aged 11-15 years. The results of fitness tests such as flexibility, standing broad jump, handgrip strength, overhead medicine ball throw, shuttle run (10 × 5 m), and 30-second sit-ups were analyzed. Body height and weight measurements were also taken. The standing broad jump and handgrip strength were normalized. A statistical analysis was performed to compare the differences between groups using 2-way analysis of variance with the Tukey HSD post hoc test or Kruskal-Wallis test.

RESULTS

The test results revealed a deterioration decrease in sit-ups, standing broad jump, shuttle run, and normalized standing broad jump in both sexes. Furthermore, the test results among girls showed a decrease in overhead medicine ball throw and flexibility. An increase in test results of both sexes was noticed in handgrip strength of the right and left hand. Among boys in 2022, the results were better in the flexibility test and overhead medicine ball throw compared with their peers from 2020.

CONCLUSION

This study indicates a decrease in overall physical fitness in adolescents. The observed results may be associated with a decrease in physical activity, changes in nutrition, and restrictions imposed during the COVID-19 pandemic.

Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study

OBJECTIVE

To understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic.

DESIGN

A sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews.

SETTING

For the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online.

PARTICIPANTS

368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis.

RESULTS

Responses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity.

CONCLUSIONS

The number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.

The Role of Diet and Physical Activity in Shaping COVID-19 Severity: Design, Validation, and Application of a Retrospective Questionnaire

After the global challenges posed by COVID-19, researchers strived to identify risk factors for severe cases, which lead to various complications-including death. Lifestyle modifications, such as implementing a healthy diet and recommended physical activity, have been shown to be protective against severe COVID-19 cases. Despite an association of a plant-based diet with reduced COVID-19 severity, specific dietary characteristics have not been identified. Also, the methodology for measuring physical activity is variable, with studies overlooking the intensity or the habit components of physical activity. To bridge this gap, our study designed, validated, and applied a retrospective questionnaire with aims of exploring the relationship between lifestyle factors, specifically diet and physical activity, and severe COVID-19. We considered the intensity and years of physical activity habit, which is a limitation of other questionnaires. Results reveal associations of age and BMI with severe COVID-19. An excessive sugar diet was found to be associated with severe COVID-19 and increased symptom duration. We also observed an inverse relationship pattern of moderate- and vigorous-intensity physical activity across case severity, which is absent in walking physical activity. This study lays a foundation for research aiming to identify lifestyle factors that prevent severe COVID-19 cases.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development.

METHODS

The study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic's impact varied depending on SES or regional inequality.

RESULTS

This study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22; P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17; P-value: < 0.0001) domains among children of 30-36 months' ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group.

CONCLUSIONS

These findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.

The Global Impact of COVID-19: A Comprehensive Analysis of Its Effects on Various Aspects of Life

In this study COVID-19 effects on different aspects of life that how this virus created a mess in every discipline of life starting from a small tuck shop of a street to a huge business with a chain between different countries; and some preventive measures are also suggested. Not only mental healthiness as well as physical health of people was also disturbed to a large extent. People being quarantined did not do any practice and had nothing to do, their boredom made them mentally and physically inactive. For minimization the effect of this pandemic on mental healthiness, interventions were practiced and psychological support systems were developed to help mentally effected people; on the other hand, to improve physical health the hospital workers worked day and night in return they got affected too either mentally or physically. Many of the youngsters started alcohol consumption during quarantine. Because of the closure of educational institutes, the students were sent back to their homes where there was no proper guidance for them and they lost their interests in studies; and in a sense educational impact of COVID-19 was also unbearable. Agricultural system was affected badly and the whole world passed through a huge economic loss. The flights and traffic were blocked throughout the world, and it is the only positive impact that COVID-19 led to the environment by improving water and air quality as there was a remarkable reduction in the emission of greenhouse gases.

Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand

Introduction

This study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial.

Methods

A cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed. Survival analysis and the Cox proportional hazard ratio were employed to assess factors influencing time-toreferral.

Results

Age ≥ 60 years, neurologic disorders, cardiovascular disease, and human immunodeficiency virus infection were identified as significant risk factors for severe COVID-19 referral. Patients who received full- or booster-dose vaccinations had a lower risk of experiencing severe symptoms compared to unvaccinated patients. Notably, individuals vaccinated during the Omicron-dominant period had a substantially lower time-to-referral than those unvaccinated during the Delta-dominant period. Moreover, patients vaccinated between 1 and 6 months prior to infection had a significantly lower risk of time-to-referral than the reference group.

Discussion

These findings demonstrate early intervention in high-risk COVID-19 patients and the importance of vaccination efficacy to reduce symptom severity. The study provides valuable insights for guiding future epidemic management strategies and optimising patient care during infectious disease outbreaks.

Assessment of Physical Activity During Pandemic Periods: Development of the Questionnaire, Determination of Primary Validity, and Psychometric Properties

This study aimed to develop the "Pandemic Period Physical Activity Scale (PPPAS)" to determine the physical activity level of healthy individuals during the pandemic period. Research data were collected from the "Socio-Demographic Questionnaire Form," "International Physical Activity Short Form," "Tampa Scale for Kinesiophobia," "Coronavirus Anxiety Scale," "Epidemic Anxiety Scale," "Expert Evaluation Form," and "Pandemic Period Physical Activity Scale," exploratory factor analysis revealed that the scale consisted of 3 sub-dimensions and 31 items. Confirmatory factor analysis suggested that the fit indices χ2/Df: 2.343; root mean square error of approximation: 0.048; incremental fit index: 0.955; comparative fit index: 0.954; goodness of fit index: 0.912; normed fit index: 0.923; non-normed fit index: 0.950; adjusted goodness of fit index: 0.896; root mean square residuals: 0.060; standardized root mean square residual: 0.047. The total Cronbach Alpha coefficient of the scale was found to be 0.912 while the intraclass correlation coefficient of the scale was calculated as 0.958 (p<0.001). As a result of the analyses conducted, it was concluded that the PPPAS is a valid and reliable measurement.

The mediating role of coping styles in the relationship between fear of COVID-19 and mental health problems: a cross-sectional study among nurses

Fear of being infected by coronavirus disease 2019 (COVID-19) could trigger mental health problems among nurses at the frontline. In such a situation, coping strategies are needed to deal with the imminent threat. The purpose of this study was to test the mediating effects of coping on relationships of fear of COVID-19 with anxiety, depression and post-traumatic syndrome among nurses who were in contact with COVID-19 patients. A cross-sectional and correlational research design was used to recruit a sample of 278 nurses who treated COVID-19 patients in four government referral hospitals in Indonesia. A bootstrap resampling procedure was used to test the significance of the total and specific indirect effects of coping on relationships of Fear of COVID-19 with anxiety, depression and post-traumatic syndrome. The nurses reported moderate levels of fear of COVID-19, considerable anxiety and depression, and a moderate level of coping. We found coping to be significantly negatively correlated with the reported levels of anxiety, depression and post-traumatic syndrome (p < 0.001). Coping mediated relationships of fear of COVID-19 on depression, anxiety and post-traumatic syndrome after controlling for relevant confounders for each dependent variable. This shows that enacting coping mechanisms is important to achieve an adaptive effect on nurses' mental health. Proper assessments and interventions should be tailored and implemented for nurses who have contact with COVID-19 patients to facilitate their use of coping strategies when needed in stressful situations.

The effect of a web-based lifestyle intervention on nutritional status and physical activity on prevention of COVID-19: a randomized controlled trial in women's empowerment

Background

Healthy dietary intake and physical activity affect the immune systems. The present study aimed to investigate the effects of a web-based lifestyle intervention on nutritional status, physical activity, and prevention of COVID-19.

Methods

Three hundred-three women (30-60 years old), who did not have COVID-19 in the City of Ardabil, participated in this study. Participants were randomized into an intervention (n = 152) or control group (n = 151). The intervention group received eight online educational sessions focusing on a healthy diet and physical activity via the website. There was no educational session for the control group during the intervention, but they were placed on the waiting list to receive the intervention and given access to the website and educational content after the follow-up. Outcomes were nutritional status, physical activity, immunoglobulin G (IgG), and immunoglobulin M (Ig M) antibody titers against the virus. They were evaluated at the baseline, after 4 and 12 weeks.

Results

Significant improvements in weight (P < 0.001), BMI (P < 0.001), total energy (P = 0.006), carbohydrate (P = 0.001), protein (P = 0.001), and fat (P < 0.001) were found for the intervention group compared to the control group during the study. MET-min/week for moderate physical activity increased during the time for the intervention and control groups (P < 0.001 and P = 0.007, respectively). MET-min/week for walking activity rose in the post-intervention and follow-up compared to that in the baseline in the groups (P < 0.001 for both groups). Total physical activity was increased during the study (P < 0.001) for both groups. The mean of serum IgG and IgM titers against the virus were increased during the study in both groups in time effect (P < 0.001). There was a significant time x group interaction for carbohydrate and fat intakes (P = 0.005 and P = 0.004, respectively).

Conclusion

The web-based lifestyle intervention may improve nutritional status and physical activity, and have the potential to reduce the risk of contracting a COVID-19 infection.

Cross-sectional and longitudinal neural predictors of physical activity and sedentary behaviour from a 6-month randomized controlled trial

A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels. At baseline, a subset of participants (n = 26/61) underwent task-based functional magnetic resonance imaging (fMRI) to examine neural activity underlying executive control using the Now/Later task. MVPA and SB were measured objectively using the Sensewear Mini at baseline, and 2, 4, and 6 months follow-up. We then examined the associations of baseline neural activation underlying executive control with: (1) baseline MVPA or SB; and (2) changes in MVPA and SB over 6 months. Our results determined that there is a complex neurocognitive system associated with MVPA levels, while SB appears to lack any neurocognitive control. In other words, MVPA appears to require neurocognitive effort, while SB may be the default behavioural pattern in adults.

Effectiveness of a multicomponent activity and horticultural intervention for the hospitalized older adults: A randomized controlled trial: Effectiveness of Intervention for the Hospitalized Older Adults

This study evaluated the effectiveness of different intervention programs in improving function among hospitalized older individuals using the Comprehensive Geriatric Assessment (CGA). A randomized controlled trial consisted of three groups: routine care, horticulture, and multicomponent activities (n = 32 each). Horticultural and multicomponent activity interventions showed beneficial effects on the CGA in hospitalized older individuals, particularly regarding cognitive function and quality-of-life. Additionally, horticultural activities significantly contributed to the perception of older adults' health status. We recommend to select older patients in geriatric wards with long-term hospitalization and adjust the frequency of activities or choose a single intervention program to provide long-term and effective intervention effects.

Korean Adolescents before and after COVID-19: Changes in Physical Activity, Mental Health, and Hygiene Management

Background

Adolescence is when health behaviors, namely, physical activity (PA), mental health, and hygiene management, are established. As the young represent our future societal welfare, their health requires attention, particularly in the face of a pandemic. We explored changes in Korean adolescent PA, mental health, and hygiene management before and after the COVID-19 pandemic to identify recommendations for improving adolescent health.

Methods

We collected 2019-2021 data from the Korea Youth Risk Behavior Surveys from the Korea Disease Control and Prevention Agency for 166,590 middle and high school students (2019: 57,069; 2020: 54,809; 2021: 54,712). We analyzed seven variables (regular PA, high-intensity PA, and strength exercise participation, stress recognition, sleep-time satisfaction, brushing practice, and handwashing practice) to examine changes in adolescent behavior during these years.

Results

The findings indicated statistically significant differences in all seven variables over the three years (P<0.05). Specifically, regular PA was higher in 2019 and 2021 than in 2020; high-intensity PAs were highest in 2019, followed by 2021 and 2020; strength exercises were the highest in 2020, followed by 2021 and 2019; stress recognition was higher in 2019 and 2021 than in 2020; sleep-time satisfaction was the highest in 2020, followed by 2021 and 2019; brushing practice was the highest in 2019, followed by 2020 and 2021; and handwashing practice was the highest in 2020, followed by 2021 and 2019.

Conclusion

The results recommend the need to encourage structured moderate-to-vigorous adolescent PA and systematic health education to improve Korean adolescent health behavior after COVID-19.

A comparative study of changes in smoking cessation attempt rates and related factors before and during COVID-19

This study aimed to identify whether smoking cessation attempts (SCA) for health promotion changed during the coronavirus disease 2019 (COVID-19) pandemic and how the characteristics of people who undertook SCA before versus during COVID-19 differed. This was a secondary data analysis of the South Korean 2019-2021 Community Health Survey data for 163,334 smokers that compared sociodemographic factors, health behaviors, and health status by SCA and year using χ2 statistics and multiple logistic regression analysis. The SCA rate significantly decreased from 72.6 % in 2019 to 44.1 % in 2021. In 2019, the rate was high for those over 60 years old but decreased by half by 2021. The ORs for SCA were higher in women than men in all years and were lower in 2019 for all age groups except those in their 70 s; however, in 2021, the ORs for those in their 20 s were higher than those in their 70 s and were slightly higher for non-high-risk drinkers than for high-risk drinkers. ORs were higher among those trying to lose or gain weight than among those who were not. Despite its health benefits, the SCA rate significantly decreased. Issuing public statements encouraging SCA is critical. Measures are necessary to increase the rate of SCA among people in their 70 s and support those seeking to control their weight for successful smoking cessation. In addition, a strategy to maintain the SCA rate in people in their 20 s is required to ensure their future health.

The Impact of the COVID-19 Pandemic and a Physical Therapy Program on Students' Health Outcomes

The COVID-19 pandemic affected many aspects of everyday life including school, fitness regimens, and social interactions. The purpose of this study is to understand how COVID-19 restrictions affect the cardiovascular and mental health of Doctor of Physical Therapy (DPT) students as they progressed through the program. Data collection occurred in 16 DPT students (8F:8M, 24±3 years) over a total of 3 visits from 2020 to 2022, during high, moderate, and low COVID-19 restrictions. Outcome measures included VO2max, Venous Occlusion Plethysmography (VOP), %fat mass measured via DEXA, Perceived Stress Scale (PSS) and International Physical Activity Questionnaire (IPAQ). A RM-ANOVA with pairwise comparisons was utilized. Significance was set prior at an α level of 0.05. There was a significant increase (p<0.05) from visit 1 to 2 in VO2max, VOP baseline, BMI, and METs. There was a significant decrease (p<0.05) from visit 2 to 3 in VO2max. Finally, a significant increase in visit 3 was seen from visit 2 in VOP peak. Overall, there was no significant difference observed for PSS and %fat mass (p>0.05). Between high and moderate restrictions, there was an increase in VO2max, VOP baseline, and METs. However, between moderate and low restrictions, only VOP Peak increased. This could be attributed to gyms being closed and limiting the type of physical activity a person could do to exercises like running or walking. When restrictions were lifted, traveling to and from classes, traveling to gyms, and socializing all increased, limiting the time for physical activity.

The Impact of COVID-19 Health and Safety Measures on the Self-Reported Exercise Behaviors and Mental Health of College Students

The public-health restrictions (e.g., remote learning, restricted access to facilities and dining halls) put in place by colleges to reduce the spread of COVID-19 resulted in forced isolation and modifications to health-related behaviors. The restrictions and uncertainty associated with COVID-19 may have exacerbated the challenges of meeting exercise recommendations and mental-health concerns. The purpose of this study was to assess the impact of restrictions on students' exercise habits and their levels of anxiety, stress, and depression. Five-hundred and forty students completed a 29-question survey on individual demographics, living arrangements, exercise, sleep, diet, and mental health. Significant changes in weekly days of exercise and intensity were reported. Increases in anxiety, stress, and depression were reported. The two most frequently reported changes in exercise behavior were an increase in minutes of aerobic training (5%) and a combination of reduced minutes of aerobic and resistance training (3.9%), which could be reflective of an individual's ability and/or desire to maintain exercise behavior during the restrictions. Alternatively, for those students who reduced their exercise habits, aerobic training (11%) was the mode that suffered the most. Demographic factors such as ethnicity, regional residence, and gender were found to have significant effects on stress, anxiety, and depression. Amidst pandemics and future health emergencies, colleges should prioritize establishing opportunities for students to exercise, helping them meet physical activity recommendations and combat mental-health issues.

Bavuma C, Byiringiro JC, Ntawuyirushintege S, Niyomugabo PC, Izerimana L, Tumusiime D. The effects of COVID-19 mitigation measures on physical activity (PA) participation among adults in Rwanda: An online cross-sectional survey

INTRODUCTION

More than a third of the world's population was under full or partial lockdown during COVID-19 by April 2020. Such mitigation measures might have affected participation in various Physical activity (PA) and increased sedentary time. This study aimed to assess the effect of the COVID-19 mitigation measures on participation of adults in various PA types in Rwanda.

METHODS

We collected data from conveniently selected participants at their respective PA sites. We assessed the variation in time spent doing in four types of PA (Work related PA, PA in and around home, transportation PA and recreation, sport, and leisure purpose) across different pandemic period. We also evaluated the sedentary time over the weekdays and on the weekends.

RESULTS

A total of 1136 participants completed online assisted questionnaire. 71.4% were male, 83% of the study participants aged 18 to 35 years (mean = 29, (standard deviation = 7.79). Mean time spent doing vigorous PA as part of the work dropped from 84.5 minutes per day before COVID-19 to 58.6 minutes per day during lockdown and went back to 81.5 minutes per day after the lockdown. Time spent sitting on weekdays increased from 163 before COVID-19 to 244.5 minutes during lockdown and to 166.8 minutes after lockdown. Sitting time on weekend increased from 150 before COVID-19 to 235 minutes during lockdown and to 151 minutes after lockdown. Sleeping time on weekdays increased from 7.5 hours per day before COVID-19 to 9.9 hours during lockdown and to 7.5 hours after lockdown while it increased from 8 hours before COVID-19 to 10 hours during lockdown and to 8 hours per day after lockdown during weekends.

CONCLUSION

The study emphasizes the significance of diverse PA, including home-based programs, during pandemics like COVID-19. It suggests promoting PA types like work-related, transportation, and domestic works during lockdown and similar period.

Factors Influencing the Acceptance and Adoption of Mobile Health Apps by Physicians During the COVID-19 Pandemic: Systematic Review

BACKGROUND

During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented.

OBJECTIVE

The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic.

METHODS

A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

RESULTS

The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines.

CONCLUSIONS

This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic.

TRIAL REGISTRATION

PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu.

Impact of COVID-19 restrictions on health and well-being in the United Arab Emirates

Background

Restrictions during the COVID-19 pandemic are thought to have impacted both the physical health and well-being of individuals where lockdown was applied. The United Arab Emirates (UAE) was one of the leading countries in implementing the international guidelines to limit the intensely contagious nature of the outbreak.

Aim

To identify the impact of COVID-19 on changes to exercise and general physical activity habits, changes to the consumption of various foods and potential weight gain, as well as any differences in smoking habits among individuals residing in the UAE during the COVID-19 quarantine.

Methods

This is a cross-sectional analytical study that used a quantitative electronic questionnaire sent by the Ministry of Health and Prevention to individuals on its platform in order to collect data on the physical health and well-being of a UAE sample population. A total of 2,362 responses were received to specific questions on physical activity, eating habits, and tobacco use for the period before, during, and after the COVID-19 lockdown. Descriptive statistical analysis was used to display the sample's demographic data and the changes in physical health and well-being. Paired t-test was used to show the changes in dietary habits.

Results

This study reveals concerning changes in health risk behaviors during the COVID-19 lockdown in the UAE. Physical activity levels declined across mild, moderate and vigorous ranges in most participants. Alarmingly, sedentary behavior dramatically increased with 71% of participants spending an average of 4-8 h per day sitting and over 54% of participants spending more than 4 h watching TV on an average day during lockdown. Fast-food consumption and snacking rose, hence weight gain was observed in over 53% of participants. Smoking habits, especially among cigarette smokers, may have worsened, with 45.2% reporting an increase in cigarette smoking, 16.8% declaring an increase in shisha smoking and 35.3% reporting an increase in smoking other tobacco products. These unfavorable behaviors during confinement could have serious long-term health consequences.

Conclusion

This study demonstrates that long periods of home quarantine may have led to unhealthy consequences that increase the risk of developing disease. This study therefore aims to highlight these health impacts, and recommend strategies and policies that can encourage healthy habits.

Effect of physical exercise on sleep quality in college students: Mediating role of smartphone use

OBJECTIVE

To investigate the effect of physical exercise on sleep quality and the mediating effect of smartphone use behavior in college students.

METHODS

A cross-sectional study design was adopted. An online survey of 5,075 college students was conducted using the Physical Activity Rating Scale-3, the Pittsburgh Sleep Quality Index, and the Mobile Phone Addiction Tendency Scale.

RESULTS

The sleep quality of college students was poor, and the proportion of college students with good sleep quality was 23.567%. A significant correlation existed between sleep quality and physical exercise (r = -0.159, P < 0.001) and mobile phone addiction (r = 0.355, P < 0.001). Physical exercise can predict sleep quality in college students (β = -0.011, P < 0.001). Smartphone use plays a part in mediating the process by which physical exercise affects sleep quality.

CONCLUSION

Chinese college students have poor sleep quality. Physical exercise and smartphone use behavior are important factors affecting the sleep quality of college students. Physical exercise can directly predict the sleep quality of college students and can predict the sleep quality of college students through the mediating effect of smartphone use behavior.

Accessibility and applicability of physical activity guidelines and recommendations for adults living with long term conditions during COVID-19

To review the applicability and accessibility of physical activity guidelines for adults living with long-term conditions whilst shielding during the COVID-19. A narrative review with systematic methodology was conducted between 2015 and 2021, with two stages: 1) Search of electronic databases PubMed/Medline, Web of Science, PsycInfo, and Cinahl; 2) search of long-term condition organisations. Sixty-five articles were identified, where nine included specific guidelines during the COVID-19, 28 specific guidelines to individuals living with long-term conditions and 7 identified the utilization of online resources. Twenty-one long-term condition organizations websites were reviewed where all of them included a section regarding physical activity guidelines and seven referred to online and offline accessible resources during COVID-19. Accessibility and applicability were variable across academic databases and long-term conditions organisation websites. Findings could inform long-term condition policy and guidelines development to better and more relevant support people living with long-term conditions to be physically active.

Impact of COVID-19 on Physical Fitness in Central Indian Athletes Aged 20-30 Years: A Cross-Sectional Pilot Study

Background Physical fitness is of utmost importance to athletes as it ensures better performance in competitive sports. Athletes who contracted COVID-19 frequently experienced persistent symptoms for weeks or months afterward. Due to the direct effects of COVID-19 infection on pulmonary, cardiovascular, and neurological systems, combined with the negative effects of isolation and inactivity, it has been observed that physical fitness decreases in individuals. This study aimed to evaluate the physical fitness of young athletes in the age group of 20 to 30 years after mild-to-moderate COVID-19 infection and compare them with unaffected athletes of the same age group. Methodology A field-based, cross-sectional, comparative study was conducted from July 2022 to August 2022 in Nagpur, India. Physical fitness levels of 50 young athletes in the age group of 20-30 years who never got infected with COVID-19 were compared to 50 athletes with a recent history of mild-to-moderate COVID-19 infection using the Harvard step test, breath-holding test, and peak expiratory flow rate measurement. Participants were included based on COVID-19 diagnosis using standard procedures and confirmation of recovery through negative reverse transcriptase polymerase chain reaction tests. Results Overall physical fitness of athletes who suffered from mild-to-moderate COVID-19 infection was significantly less than those who were not infected. Compared to their non-COVID-19 counterparts, the COVID-19-recovered athletes showed reduced physical fitness index (p < 0.0001 for males and p = 0.0003 for females), reduced peak expiratory flow rate (p < 0.0001 for males and p < 0.0001 for females), and reduced breath-holding time (p < 0.0001 for males and p < 0.0001 for females). Conclusions COVID-19 had a significant impact on various components of physical fitness which may potentially affect the athletic performance and overall well-being of young athletes.

The effect of aerobic dancing on physical fitness and cognitive function in older adults during the COVID-19 pandemic-a natural experiment

During the Coronavirus disease (COVID-19), the physical activity of older adults is at a lower level. The study aimed to examine the effectiveness of aerobic dancing on physical fitness and cognitive function in older adults. We conducted a randomized controlled trial with 34 older adults who were assigned into an aerobic dancing group and a control group. Three dance sessions weekly for 60 ​min were scheduled for the aerobic dancing group for a total of 12 weeks. Physical fitness, blood pressure, lipids, glucose, cognitive function were assessed before and after the intervention. Baseline adjusted Analysis of Covariance (ANCOVA) was used to determine whether outcome variables varied between groups at pre-test and post-test. Effect size (Cohen's d) was calculated to determine the differences between groups from baseline to post-test. After 12 weeks, we found that the aerobic dancing group showed significant improvement in memory (portrait memory: F ​= ​10.45, p ​= ​0.003, d ​= ​1.18). The Limit of Stability (LOS) parameters in the aerobic dancing group displayed a significant increase after the intervention (right angle: F ​= ​5.90, p ​= ​0.022, d ​= ​0.60; right-anterior angle: F ​= ​4.23, p ​= ​0.049, d ​= ​0.12). Some beneficial effects were found on flexibility, grip strength, balance and subjective well-being (sit and reach: F ​= ​0.25, p ​= ​0.62, d ​= ​-0.40; grip strength: F ​= ​3.38, p ​= ​0.08, d ​= ​0.89; one-legged standing with eyes closed: F ​= ​1.26, p ​= ​0.27, d ​= ​0.50) in the aerobic dancing group. Aerobic dancing training was effective in improving memory and balance ability in older adults during the COVID-19 pandemic in China. In the future, aerobic dancing is a promising tool to encourage physical activity in older adults.

Implications of the COVID-19 pandemic on athletes, sports events, and mass gathering events: Review and recommendations

Since the coronavirus disease 19 (COVID-19), which caused several respiratory diseases, was formally declared a global pandemic by the World Health Organization (WHO) on March 11, 2020, it affected the lifestyle and health of athletes, both directly through cardiorespiratory and other health related effects, and indirectly as the pandemic has forced the suspension, postponement, or cancellation of most professional sporting events around the world. In this review, we explore the journey of athletes throughout the pandemic and during their return to their competitive routine. We also highlight potential pitfalls during the process and summarize the recommendations for the optimal return to sport participation. We further discuss the impact of the pandemic on the psychology of athletes, the variance between the team and individual athletes, and their ability to cope with the changes. Moreover, we specifically reviewed the pandemic impact on younger professional athletes in terms of mental and fitness health. Finally, we shaded light on the various impacts of mass gathering events and recommendations for managing upcoming events.

Decreased physical performance despite objective and subjective maximal exhaustion in post-COVID-19 individuals with fatigue

INTRODUCTION

Fatigue is a common symptom in post-COVID-19 patients. Individuals with fatigue often perform less well compared to healthy peers or without fatigue. It is not yet clear to what extent fatigue is related to the inability to reach maximum exhaustion during physical exercise.

METHODS

A symptom-based questionnaire based on the Carruthers guidelines (2003) was used for reporting the presence of fatigue and further symptoms related to COVID-19 from 85 participants (60.0% male, 33.5 ± 11.9 years). Cardiopulmonary exercise testing (CPET) and lactate measurement at the end of the test were conducted. Objective and subjective exhaustion criteria according to Wasserman of physically active individuals with fatigue (FS) were compared to those without fatigue (NFS).

RESULTS

Differences between FS and NFS were found in Peak V̇O2/BM (p < 0.001) and Max Power/BM (p < 0.001). FS were more likely to suffer from further persistent symptoms (p < 0.05). The exhaustion criterion Max. lactate was reached significantly more often by NFS individuals.

CONCLUSION

Although the aerobic performance (Max Power/BM) and the metabolic rate (Peak V̇O2/BM and Max. lactate) of FS were lower compared to NFS, they were equally able to reach objective exhaustion criteria. The decreased number of FS who reached the lactate criteria and the decreased V̇O2 peak indicates a change in metabolism. Other persistent post-COVID-19 symptoms besides fatigue may also impair performance, trainability and the ability to reach objective exhaustion. Trial registration Trial registration: DRKS00023717; date of registration: 15.06.2021 (retrospectively registered).

Changes in physical activity and associations with quality of life among a global sample of cancer survivors during the COVID-19 pandemic

PURPOSE

Meeting physical activity (PA) guidelines (i.e., ≥ 150 min/week of aerobic PA and/or 2 days/week of resistance training) is beneficial for maintaining cancer survivors' well-being. The impact of the COVID-19 pandemic on PA participation in cancer survivors and its association on quality of life (QoL) remains unknown. The purpose of this study was to compare PA levels prior to and during the COVID-19 pandemic, and examine the association between changes in PA and QoL in cancer survivors.

METHODS

A global sample of cancer survivors participated in a cross-sectional, online survey. Participants self-reported their PA participation before and during the pandemic using the Godin Leisure Time Exercise Questionnaire and QoL with the Functional Assessment of Cancer Therapy (FACT) scales. Paired t-tests compared PA before and during the pandemic. Analysis of covariance examined differences in QoL between PA categories: non-exercisers, inactive adopters, complete and partial relapsers, single and combined guideline maintainers.

RESULTS

PA participation of cancer survivors (N = 488) significantly decreased during the pandemic (p's < .001). Cancer survivors were classified as non-exercisers (37.7%), inactive adopters (6.6%), complete (13.1%) and partial (6.1%) relapsers, and single (23.8%) or combined (12.7%) guideline maintainers. Partial relapsers had significantly lower QoL and fatigue than inactive adopters, and combined guideline maintainers (p's < .05) that were clinically meaningful.

CONCLUSION

PA decreased during the pandemic which has negative implications for QoL and fatigue in cancer survivors.

IMPLICATIONS FOR CANCER SURVIVORS

PA is critical for maintaining QoL during the pandemic; therefore, behavioral strategies are needed to help cancer survivors adopt and maintain PA.