The impact of physical activity on psychological health during Covid-19 pandemic in Italy

Multilevel analysis of the central-peripheral-target organ pathway: contributing to recovery after peripheral nerve injury

Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities. Research on the pathogenesis of peripheral nerve injury has focused on pathological changes at individual injury sites, neglecting multilevel pathological analysis of the overall nervous system and target organs. This has led to restrictions on current therapeutic approaches. In this paper, we first summarize the potential mechanisms of peripheral nerve injury from a holistic perspective, covering the central nervous system, peripheral nervous system, and target organs. After peripheral nerve injury, the cortical plasticity of the brain is altered due to damage to and regeneration of peripheral nerves; changes such as neuronal apoptosis and axonal demyelination occur in the spinal cord. The nerve will undergo axonal regeneration, activation of Schwann cells, inflammatory response, and vascular system regeneration at the injury site. Corresponding damage to target organs can occur, including skeletal muscle atrophy and sensory receptor disruption. We then provide a brief review of the research advances in therapeutic approaches to peripheral nerve injury. The main current treatments are conducted passively and include physical factor rehabilitation, pharmacological treatments, cell-based therapies, and physical exercise. However, most treatments only partially address the problem and cannot complete the systematic recovery of the entire central nervous system-peripheral nervous system-target organ pathway. Therefore, we should further explore multilevel treatment options that produce effective, long-lasting results, perhaps requiring a combination of passive (traditional) and active (novel) treatment methods to stimulate rehabilitation at the central-peripheral-target organ levels to achieve better functional recovery.

Protective Role of Regular Physical Activity on Mental Health During the COVID-19 Pandemic

Understanding the impacts of lifestyle on mental health has become crucial. This study analyzed whether regular physical activity influences mental health indicators related to major depressive disorder, generalized anxiety, and COVID-19-related anxiety and obsession among Brazilian adults during the pandemic. Additionally, social adjustment and health and disability were assessed to measure broader impacts of physical activity on daily functioning and quality of life during the COVID-19 pandemic, an anxiogenic period. Participants completed sociodemographic, physical activity, and clinical surveys, along with standardized mental health scales: the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Brazilian version of the Coronavirus Anxiety Scale (CAS-BR), the COVID-19 Obsession Scale (PB-OCS), the Work and Social Adjustment Scale (WSAS), and the WHO Disability Assessment Schedule (WHODAS 2.0). Descriptive analysis characterized the sample, while univariate, bivariate, and multivariate analyses of variance were conducted to explore the influence of physical activity and sex on mental health outcomes. The results indicated that women exhibited poorer mental health outcomes than men across most measures. Engaging in regular physical activity significantly reduced the risk of major depressive disorder in both women and men. Additionally, physically active women-but not men-had a lower likelihood of generalized anxiety and social adjustment impairments. Furthermore, individuals with longer engagement in physical activity (> 5 years) experienced greater mental health benefits compared to those with shorter engagement (< 5 years), particularly for depressive symptoms and generalized anxiety. This study highlights the protective effects of regular physical activity on mental health, with sex-specific differences in its impact. Long-term engagement in physical activity provides greater mental health benefits, reinforcing the importance of promoting sustained participation rather than short-term engagement.

How did the depression and anxiety levels of older New Zealanders change during the COVID-19 pandemic?

There has been widespread concern about the mental health impact of the global COVID-19 outbreak. Fears have been raised that depression and anxiety among older people may have increased in the pandemic, and that adverse health behaviours, such as increased alcohol use and decreased physical activity, may have contributed to the mental health decline. This study aimed to examine changes in depression, anxiety, alcohol use and physical activity scores of people aged 55 and older in New Zealand over the initial months of the pandemic. The sample included 3,171 people who responded to wave 7 (August-November 2018) and wave 8 (June-September 2020) of the Health, Work and Retirement Study. Analyses were carried out using paired t tests and multilevel mediation modelling. There was no evidence of significant changes in depression or anxiety. Alcohol use and physical activity were shown to decrease significantly, albeit to a small degree, and there was evidence of an indirect effect of time on depression via physical activity. These findings suggest a general resilience among older people 3 to 6 months into the pandemic. However, increased attention should be paid to promoting physical exercise among older people, as a means of decreasing depression risk.

Physical Activity and Neurocognitive Symptoms in Older Adults During COVID-19 Pandemic

Objectives: Examine whether physical activity (PA) changes during the COVID-19 pandemic were related to subjective cognitive decline (SCD), depression, and anxiety in older adults and whether these varied by sociodemographic variables. Methods: 301 older adults completed an online survey between May and October 2020 and 3 months later, including self-report questionnaires of SCD, depression, and anxiety. PA changes were determined with a question. Results: 60% of participants reported decreased PA. Those who reduced their PA were more likely to be from low to middle income and younger. PA increase was related to less SCD and depressive symptoms compared to those who decreased it. Participants who maintained their PA had fewer SCD concerns, depressive, and anxiety symptoms than those who decreased it. Discussion: Reducing PA was associated with worse neuropsychiatric and cognitive symptoms. Encouraging older adults to increase PA may help mitigate some of the pandemic's adverse effects on psychological well-being.

Occupational burnout during war: The role of stress, disruptions in routine, sleep, work-family conflict, and organizational support as a moderator

BACKGROUND

Occupational burnout, resulting from long-term exposure to work-related stressors, is a significant risk factor for both physical and mental health of employees. Most research on burnout focuses on routine situations, with less attention given to its causes and manifestations during prolonged national crises such as war. According to the Conservation of Resources theory, wartime conditions are associated with a loss of resources, leading to accelerated burnout. This study aimed to examine burnout among employees during the war in Israel that broke out in October 2023, placing the population nationwide in a state of existential threat and functional crisis. The researchers hypothesized that Stress, work-to-family conflict, family-to-work conflict, sleep disruption, and routine disruption (H1-H5) would be positively associated with occupational burnout. In addition, the study examined whether organizational strategies, such as flexibility and volunteering, would be negatively associated with burnout (H6) and whether they would moderate the relationship between work-family conflict and burnout during wartime (H7).

METHODS

The study involved 374 employees recruited through social networks via a snowball sampling method during the war. Participants completed a questionnaire assessing demographic details, burnout, stress, routine disruptions, work family conflict (work-to-family and family-to-work conflict), sleep disturbances, and organizational support measures. Hierarchical linear regression and Pearson correlation were utilized to model the outcome variable of occupational burnout and Process Model 1 was utilized for the moderation hypothesis.

RESULTS

Findings revealed a notable level of burnout during wartime (M = 3.95, SD = 1.15). Routine disruptions, work-to-family conflict, and sleep disturbances significantly contributed to burnout beyond stress levels, thus hypotheses H1 to H5 were partly supported. Additionally, the organizational resource variable of offering volunteering opportunities was associated with lower burnout levels and moderated the relationship between work-to-family conflict and burnout, thus partially supporting hypotheses H6 and H7.

CONCLUSION

The findings enhance the understanding of burnout during prolonged crises like war, highlighting the importance of maintaining routine as a key resource for order and control. They also emphasize the role of organizational volunteering in preventing burnout. The theoretical and practical implications are discussed.

Impact of coronavirus (COVID-19) pandemic on physical activity levels in different sub-populations of Iranians: a national survey

During the COVID-19 pandemic, the level of physical activity (PA) has been reported to decrease worldwide. A sedentary lifestyle is widely recognized as a significant risk factor for various diseases, necessitating extensive big data analysis to uncover the diverse aspects linked to the COVID-19 pandemic. Therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic on PA levels across diverse population subsets in Iran and to identify the barriers to PA during the fifth wave of COVID-19 outbreak. Data from 7810 individuals (50.8% male, 54.8% married, 69.6% 18-49 years) were collected using a standardized questionnaire comprising demographic details, levels of high, moderate, and low PA, daily sedentary time, PA at home, and barriers to PA. The questionnaire was distributed online via social platforms such as Telegram, WhatsApp, and Instagram. The obtained data were analyzed using the Chi-Square goodness-of-fit test and the Chi-Square test at a significance level of α < 0.05. During the COVID-19 pandemic, there was a significant decrease in the number of days/week dedicated to high, moderate, and low PA, as well as a reduction in the duration of each PA session compared to pre-pandemic levels (p < 0.001). Conversely, the duration of daily sedentary time, particularly exceeding 5 h, significantly increased post-outbreak (p < 0.001). Notably, lack of appropriate space and time constraints were identified as the primary barriers to PA during the COVID-19 pandemic (p < 0.001). In this nationally representative study, the findings underscore a substantial decline in PA levels across diverse sub-populations in Iran and an increase in sedentary behaviors during the COVID-19 crisis.

Changes in Lifestyle Behaviors, Shopping Habits and Body Weight Among Adults in Cyprus and Greece During COVID-19 Lockdown: A Cross-Sectional Study

Background: During the COVID-19 pandemic, people were asked to stay at home. Places where people interacted such as schools, universities, and cafes were closed, and all gatherings were forbidden. Only stores offering fast-moving consumer goods were open, so citizens could purchase all food categories. The aim of this cross-sectional study was to investigate the effect of the COVID-19 lockdown on the eating and buying habits of consumers in Cyprus and Greece, and any changes in their lifestyles. Methods: An online survey including 1011 participants took place using an electronic questionnaire. Results: The results showed that lockdown significantly affected individuals by increasing weight gain (p < 0.01). The explanatory investigation of related lifestyle habits and nutrition traits showed that the dietary patterns behind these changes included increased meal frequency (p < 0.05)-even without an increased appetite-and subsequent increases in both purchases (p < 0.05) and consumption of several food groups (p < 0.05). Moreover, even though exercise per se was not discontinued due to COVID-19, it was apparent that exercise type was altered to adapt to the relevant restrictions (p < 0.05). Conclusions: In conclusion, the COVID-19 lockdown significantly affected Cypriots and Greeks in many aspects like their eating behavior, food purchasing habits, and lifestyle, all resulting in increased weight and potentially adverse health outcomes.

Investigating a middle‑step COVID‑19 unit in Greece

During the coronavirus disease-19 (COVID-19) pandemic, there was an unprecedented requirement for hospital bed availability. The present study aimed to examine the characteristics and outcomes of patients hospitalized in a COVID-19 unit that operated as a novel middle-step unit in Greece. The present study aimed to determine whether the middle-step unit supported the central general hospitals; thus, highlighting the potential of these models in future pandemics. During the 9-month period of operation, a total of 631 patients were admitted. In addition, 539 (85.4%) patients were discharged, 57 (9%) patients were referred to surrounding hospitals for further management and 35 (5.6%) patients succumbed. Based on the results of the present study, an algorithm for patient referral to middle-step units was outlined for future pandemics.

Comparison on self-determination, peer-relationship, and alienation in physical education of early adolescent in Korea and China

Introduction

In order to identify effective strategies for enhancing a high-quality physical education system, it is imperative to undertake research that examines the nuances of educational culture, specifically focusing on the psychological experiences of early adolescents within physical education classes. This study aims to compare self-determination, peer-relationships, and feelings of alienation in physical education among adolescents from Korea and China, both situated in East Asia, with respect to their nationality and gender.

Methods

One hundred and twenty two early adolescent males (M = 14.34, SD = 0.65) and 78 females (M = 14.34, SD = 0.64) from South Korea and 125 early adolescent males (M = 14.13, SD = 0.58) and 70 females (M = 14.13, SD = 0.59) from China participated in this study, with a mean age of 14.24 ± 0.62. The Academic Self-Regulatory Scale (SRQ-A), Peer-relationship Questionnaire, and a Scale for Measuring Student Alienation in Physical Education were utilized for data analysis. For statistic comparisons, a t-test was used.

Results

Self-determination of male and female students in China was significantly higher than that of male and female students in Korea, respectively. Peer-relationship of male students in Korea was significantly higher than that of male students in China. Physical education alienation of the female students in Korea was significantly higher than that of male students in Korea.

Discussion

Given that the influence of self-determination, peer relationships, and physical education alienation varies by nationality and gender, it is crucial to seek and implement strategies to develop an effective physical education system. By doing so, physical education alienation can be minimized and prevented, ultimately preserving the health and well-being of adolescents. This approach is vital for fostering a supportive and inclusive environment that promotes lifelong fitness and health.

Consensus in Action: Context-Specific Physical Activity Guidelines for Undergraduate Students at a South African University

Physical inactivity among undergraduate university students has been considered a public health concern. To address this, researchers have utilized consensus workshop approaches to develop effective physical activity (PA) recommendations. However, the existing research has limitations: it is outdated, not context-specific to young adults, and does not account for psychosocial factors (such as mental health, motivation, and social support) that hinder or promote PA behavior, particularly in South Africa. Therefore, the purpose of this study was to engage with stakeholders to achieve a consensus on a set of context-specific guidelines to enhance the physical activities of undergraduate university students. Utilizing the Social Ecological Model, this study employed two online consensus workshops with 25 purposively selected stakeholders (Round 1 = 8 and Round 2 = 17). Stakeholders were divided into breakout rooms via the Google Meets feature, to discuss and brainstorm the guidelines, expressing their agreement or disagreement with the proposed names and descriptions. The consensus was considered achieved when the majority of stakeholder responses fell into the 'Agree with the guideline' category. An inductive thematic analysis approach was used to generate common themes, which were then coded via Atlas Ti. V8. Stakeholders reached a consensus on four categories and 32 guidelines, namely, PA (9 guidelines), mental health (7 guidelines), motivation (9 guidelines), and social support (7 guidelines). Each category, along with its respective set of guidelines, provides insights into the type of information undergraduate students require to enhance their PA participation. Using a consensus workshop facilitated the co-creation of context-specific guidelines to enhance the physical activities of undergraduate university students. This approach proved to be a valuable tool for fostering collaboration between academic staff and students.

Active sport participation and walking before and during COVID-19 pandemic in a large cohort of Polish adults: results of the National Test for Poles' Health

OBJECTIVES

The COVID-19 pandemic has led to significant changes in daily life, including changes in physical activity levels. This study aims to examine the impact of the pandemic on sport participation and walking among Polish adults.

MATERIAL AND METHODS

The data was collected using the National Test for Poles' Health, a large-scale online survey. The survey was conducted before and 1 year after the pandemic onset in Poland (March 2020 and March 2021), with >300 000 participants in each year.

RESULTS

The results revealed that the percentage of respondents engaging in at least 2 h/week of sport increased by 2.3% (from 24.6% to 26.9%) (p < 0.0001) and percentage of respondents not engaging in any sport decreased by 2.5% (from 48.0% to 45.5%) (p < 0.0001). These trends were observed across different age, sex, dwelling-place, education level, and employment groups. Percentage of respondents declaring they spend >2 h/day on walking also increased, from 5.6% to 6.6% (p < 0.0001). Furthermore, a positive association was found between sport participation and walking time (p < 0.0001).

CONCLUSIONS

The findings suggest a slight improvement in physical activity levels among Polish adults during the pandemic, which may be attributed to factors such as increased time available due to remote work and the prioritization of health during the crisis. Further research is needed to explore the long-term consequences of the pandemic on physical activity and public health. Int J Occup Med Environ Health. 2024;37(4):468-81.

Impact of COVID-19 pandemic on cross-country runners: changes in training, sleep, diet, and mental health

Objective: Determine the impact of the COVID-19 pandemic on the changes in training, sleep, diet, and mental health of cross-country runners. Participants: Cross-country runners from NCAA Division II institutes. Methods: Wilcoxon signed-rank test was performed to analyze survey responses to ordinal questions on the survey while Spearman's rank correlation analysis (ρ) was used to calculate correlation between after the start of pandemic questions. Data was marked significant at p < 0.05. Results: Analysis of the survey responses revealed that cross-country runners were more likely to experience feelings of depression (p < 0.001), lack of motivation (p < 0.001), and higher daily stress (p < 0.001) after the start of the pandemic. After the start of the pandemic, runners running less days per week were more likely to report an increased feeling of depression (ρ=-0.315, p = 0.008) and lack of motivation (ρ=-0.458, p < 0.001). Conclusions: The present study underscores the importance of training, sleep, diet, and mental health amongst cross-country runners.

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.

Individual Characteristics Associated with Fears and Prevention Behaviors Related to Respiratory Infectious Disease among South Korean Adults Using Complex Sample Design

OBJECTIVES

This study aimed to identify the relationships among individual characteristics, COVID-19-related fears, and infection-prevention behaviors using data from 228,932 adults (weighted to 43,583,798.71) aged 19 and older who participated in the 2021 Community Health Survey conducted by the Korea Disease Control and Prevention Agency.

METHODS

The complex sample design analysis using SPSS 20.0 revealed the following.

RESULTS

Women had statistically significantly higher COVID-19-related fears and a higher level of preventive behaviors compared to men. During the COVID-19 pandemic, the level of physical activity among men was higher than that of women. Compared to the period before COVID-19, the frequency of smoking and drinking decreased for both men and women, with the reduction being more pronounced in men than in women. The high-exercise group had a lower level of COVID-19-related fears. Self-perceived health status was inversely and significantly related to COVID-19-related fears. The low-exercise group had a lower score for self-perceived health status than the high-exercise group.

CONCLUSIONS

This study demonstrated that maintaining sufficient physical activity positively influences self-perceived health and reduces anxieties related to COVID-19 infection and fatalities. The results highlight the importance of physical activity and the need to identify strategies that effectively maintain regular exercise while adhering to infection-prevention measures during pandemics.

Greater weekly physical activity linked to left resting frontal alpha asymmetry in women: A study on gender differences in highly active young adults

Physical activity, beneficial for physical and psychological health, may facilitate affective mechanisms of positive emotion and approach-motivation. Greater resting frontal alpha asymmetry (FAA), an index of greater relative left than right frontal cortical activity, is a neural correlate of affective mechanisms possibly associated with active lifestyles. This study sought to amplify limited literature on the relationship between physical (in)activity, FAA, and gender differences. College students (n = 70) self-reported physical activity (Total PA) and sedentary activity (Total Sitting) via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), followed by a resting electroencephalography session to record FAA. A Total PA × gender interaction (β = 0.462, t = 3.163, p = 0.002) identified a positive relationship between Total PA and FAA in women (β = 0.434, t = 2.221, p = 0.030) and a negative relationship for men (β = -0.338, t = -2.300, p = 0.025). Total Sitting was positively linked to FAA (β = 0.288, t = 2.228, p = 0.029; no gender effect). Results suggest affective mechanisms reflected by FAA (e.g., positive emotion, approach-motivation) are associated with physical activity for women, indicating a possible mechanism of the psychological benefits linked with physically active lifestyles. A positive relationship between sedentary behavior and greater left FAA may also reflect motivated mechanisms of behavior that aid in minimizing energy expenditure, particularly within the context of our highly active sample.

What explains adolescents' physical activity and sports participation during the COVID-19 pandemic? - an interpretable machine learning approach

Adolescents' physical activity (PA) and sports participation declined due to the COVID-19 pandemic. This study aimed to determine the critical socio-ecological factors for PA and sports participation using a machine learning approach. We did a cross-sectional secondary data analysis utilising the 2021 National Survey of Children's Health (NSCH) dataset (N=16,166; 49.0% female). We applied an interpretable machine learning approach (e.g. decision tree-based models) that examined the critical factors associated with PA and sports participation. The factors related to the intrapersonal, interpersonal, organisational, and community levels of the socio-ecological model. Out of the 25 factors examined, our findings unveiled the 11 critical factors associated with PA and the 10 critical factors associated with sports participation. Factors at the intrapersonal levels (e.g. age, screen time, and race) held greater importance to PA than those at the other three levels. While interpersonal factors (e.g. parent participation in children's events/activities, family's highest educational level, and family income level) were most important for sports participation. This study identified that the common critical factors of physical activity and sports participation during the COVID-19 pandemic mainly relied on intrapersonal and interpersonal levels. Unique factors were discussed.

Meeting the WHO Physical Activity Guidelines is Associated With Lower Odds of Depression in Older Adults: Potential Psychosomatic Mechanisms

OBJECTIVES

Limited data exist on the association between physical activity (PA) and depression in older adults from low- and middle-income countries (LMICs). In this study, we examine the association between meeting the World Health Organization (WHO) PA guidelines and depression in adults aged ≥50 years in Ghana and investigate the psychosomatic factors explaining this association.

METHODS

Cross-sectional data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (2016-18) were analyzed. Depression was assessed with the Center for Epidemiological Studies Depression Scale (CES-D-10). PA was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Multivariable logistic regression and Hayes PROCESS macro with bootstrapping mediation analyses were performed to evaluate the hypothesized associations.

RESULTS

The study included 1201 individuals (mean [SD] age 66.1 [11.9] years; 63.3% women). The prevalence of meeting PA guidelines and depression was 36.7% and 29.5%, respectively. Meeting the WHO-recommended PA guidelines was associated with a 16% lower rate of developing depression even after adjusting for potential confounders (OR = 0.84, p <0.001). This association was much stronger among men and those aged 50-64 years. Loneliness, social isolation, sleep problems, functional limitations, and pain characteristics largely mediated the association of PA with depression.

CONCLUSIONS

PA was negatively associated with depression among older adults in Ghana, and psychosocial and physical factors partially explained the association. The promotion of PA in old age may aid in the prevention of depression, especially in men and those aged 50-64 years. Longitudinal data may confirm our findings.

Exploring the challenges of social participation during COVID-19 in Saudi Arabia through an occupational therapy lens

Aim

To measure the social participation of people in Saudi Arabia during the COVID-19 pandemic.

Subject and methods

A cross-sectional survey was conducted among people in Saudi Arabia to measure their participation in social activities during the COVID-19 pandemic. A validated questionnaire of Social Participation Scale was used to collect data from five main regions in Saudi Arabia through social media platforms. Means, frequencies, and percentages were calculated through descriptive analysis. Mean scores and standard deviation of social participation of participants were also presented.

Results

The total number of participants was 1,560 including Saudi (87.3%) and non-Saudi (12.7%) nationals. Most participants (60.2%) were female. The age of participants ranged between 16 and 24 years old. Around 62.1% of participants were married, 63.2% were educated, 48.4 were employed and 82% were from the Eastern region. Around 72% of participants earned <10,000 riyals per month compared to those (27.3%) who earned <5,000 riyals per month. A total 72.7% of the participants have been diagnosed by COVID-19. The mean score of social participation was 47.81 (SD = 0.27). Most participants (62.7%) reported that social participation was severely restricted. Around 68.2% of the participants were quarantined at the facilities.

Conclusion

The social participation of people in Saudi Arabia had been severely restricted during the COVID-19 pandemic. An early assessment of people's social participation would help to identify their problems and needs, to help them improve their participation in social activities and thus increase their overall quality of life.

Relationship between Pain, Physical Activity, Screen Time and Age among Young Children during the COVID-19 Pandemic

INTRODUCTION

During the COVID-19 pandemic, many countries implemented restrictions, social distancing measures, and lockdowns to limit the spread of the disease. These lockdowns have affected children's screen time (ST), pain, and physical activity (PA) levels. The present study aimed to explore the relationships between ST, pain, age, and PA before, during, and after the COVID-19 pandemic.

METHODS

The caregivers of 329 children (median age = 8 years) filled out an online self-reported survey about the children's PA, ST, and pain before, during, and after the COVID-19 curfew. Spearman's rank correlation coefficient was used to explore the associations between these variables.

RESULTS

After the curfew, pain that existed before the pandemic had a weak negative relationship with PA intensity (-0.11, p = 0.04) and a weak positive relationship with ST (r = +0.12, p = 0.04). There was a strong positive relationship between ST in all time periods (p > 0.01). PA and ST had a weak negative relationship (p > 0.05) during the curfew and after the curfew but not before the COVID-19 pandemic. Age had a weak positive correlation with ST in all time periods (p > 0.01). In addition, ST was affected by the curfew.

CONCLUSION

The study findings indicated that young children had longer ST during the curfew and after the curfew compared with before the curfew. Increasing PA could lessen children's ST, which could, in turn, increase the probability that their general pain would decrease.

Remote Exercise Training Intervention During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND

Societal measures to contain the spread of COVID-19 (eg, lockdown and contact restrictions) have been associated with decreased health and well-being. A multitude of prepandemic studies identified the beneficial effects of physical exercise on both physical and mental health.

OBJECTIVE

We report on the feasibility of a remote physical exercise intervention and its stress-buffering potential in 2 untrained cohorts: a pre-COVID-19 cohort that completed the intervention in 2019 and a lockdown cohort that started the intervention shortly before pandemic-related restrictions were implemented.

METHODS

In a randomized controlled trial, participants were assigned to either an intervention group (IG; pre-COVID-19 cohort: n=7 and lockdown cohort: n=9) or a control group (CG; pre-COVID-19 cohort: n=6 and lockdown cohort: n=6). IG participants received weekly individualized training recommendations delivered via web-based support. The intervention period was initially planned for 8 weeks, which was adhered to in the pre-COVID-19 cohort (mean 8.3, SD 0.5 weeks) but was extended to an average of 17.7 (SD 2.0) weeks in the lockdown cohort. Participants' health parameters were assessed before and after the intervention: aerobic capacity was measured as peak oxygen uptake (VO2peak) via cardiopulmonary exercise testing. Depressive symptoms were scored via the depression subscale of the Brief Symptom Inventory-18.

RESULTS

Dropout rates were low in both cohorts in the IG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 16.7%) and the CG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 20%). The mean adherence to the training sessions of the IG for both cohorts was 84% (pre-COVID-19 cohort: SD 5.5% and lockdown cohort: SD 11.6%). Aligned rank transform ANOVAs in the lockdown cohort indicated deterioration of VO2peak and depressive symptoms from before to after the intervention in the CG but no longitudinal changes in the IG. Analyses in the pre-COVID-19 cohort revealed significant increases in VO2peak for the IG compared to the CG (P=.04) but no intervention effects on depressive symptoms.

CONCLUSIONS

With low dropout rates and high adherence, the remote intervention was feasible for healthy adults under regular conditions and in the face of pandemic-related stressors. Moreover, our results hint at a stress-buffering effect as well as a buffering of a lockdown-induced deconditioning of remote physical exercise interventions in the pandemic scenario, which can be used in future studies to overcome equally stressful periods of life. However, due to limited statistical power, these findings should be replicated in similar scenarios.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00018078; https://drks.de/search/en/trial/DRKS00018078.

Physical activity, anxiety, depression, and coping in Turkish men and women during the first wave of COVID-19

A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19's impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, and coping status of adults, although no significant gender-based difference was found regarding hope scores. Furthermore, physical activity directly influenced coping (β = 0.10), hope (β = 0.12), and anxiety (β = -0.08). Hope directly and positively influenced coping (β = 0.45) and directly and negatively influenced anxiety (β = -0.25) and depression (β = -0.28). Moreover, gender did not directly affect physical activity, but it was associated with decreased coping and increased depression and anxiety. Finally, gender had no effect on the relation between physical activity and hope, coping, depression, and anxiety (p > 0.01). These outcomes support the critical importance of physical activity and hope when coping with COVID-19 regardless of gender.

The COVID-19 Experience in Adolescents: Emotional and Behavioral Recall at the End of the Pandemic

The COVID-19 pandemic and the resulting lockdown countermeasure may have significantly affected adolescents' physical and mental health. This study aims to assess adolescents' recollections of this period, also analyzing their current weight status along with factors they traced back to the epidemic phase and their current sports practice. A survey among 233 Italian adolescents aged 12.4 ± 0.9 years was conducted in October 2023. To achieve the research objectives, a new questionnaire was developed: the COVID-19 AdolesceNt/chilDren Lockdown Experience questionnaire (CANDLE). The new questionnaire was employed to gather data on the adolescents' recollections of the lockdown situation they experienced. The stature and weight of participants were measured directly. The results indicated that middle schoolers remember both positive and negative experiences of the lockdown: the change perceived as the most positive was spending more time with family, while social detachment from peers represents the most negative aspect. According to multivariate regression analysis, certain behaviors they assumed during the lockdown, such as comfort food consumption in boys and sleeping disturbances in girls, in addition to their current sports practice, affected their actual Body Mass Index. This study supports the evidence that changes caused by the COVID-19 lockdown affected adolescents' physical and mental health, albeit with sex differences.

Exercise, grit, and life satisfaction among Korean adolescents: a latent growth modeling analysis

BACKGROUND

Life satisfaction among Korean students is declining substantially, and multifaceted improvement efforts are required.

METHODS

We analyzed longitudinal change trajectories for exercise, grit, and life satisfaction levels among Korean adolescents using latent growth modeling with longitudinal data from the Korean Children and Youth Panel Surveys of 2,142 students (male: 1,070, female: 1,072) from sixth grade (2020) through eighth grade (2022).

RESULTS

The model, which tracked linear changes in the students' exercise, grit, and life satisfaction, showed consistent declines over three school years for all variables. We also identified a longitudinal causal relationship among exercise, grit, and life satisfaction. A higher grit intercept was associated with higher intercept for-and a partial mediating effect between-exercise and life satisfaction. The grit slope was positively related to the life satisfaction slope, and both the intercept and exercise slope had positive effects on life satisfaction. Moreover, grit had a longitudinal mediating effect between exercise and life satisfaction.

CONCLUSIONS

We discuss the longitudinal change trajectories of exercise, grit, and life satisfaction, the causal and mediating effects among them, and the implications of the findings. These findings bolster our understanding of Korean adolescents' life satisfaction and have practical significance for designing programs to improve their quality of life.

Effects of the COVID-19 associated United Kingdom lockdown on physical activity in older adults at high risk of cardiovascular disease: a mixed methods perspective from the MedEx-UK multicenter trial

Introduction

Physical inactivity and sedentary behaviour are linked to increased risk of cardiovascular disease, infections and dementia, as well as placing a significant economic burden on healthcare systems. The implementation of COVID-19 pandemic lockdown measures aimed at reducing virus transmission posed challenges to the opportunity to be physically active. This study investigates how the first UK COVID-19 lockdown affected objectively measured physical activity in older adults at higher risk of cardiovascular disease.

Methods

We studied 48 individuals aged 55-74 years (81.3% female) with self-reported PA levels < 90 min/week and a QRISK2 score ≥ 10 (indicative of a ≥ 10% risk of a major cardiovascular event in the next 10 years) without mild cognitive impairment or dementia. Physical activity data was collected using objective wrist-based activity monitors and analysed across three time periods, usual activity (pre-pandemic), the precautionary phase when the UK began advising on limiting social contact and finally during the first UK lockdown period was collected (27 January 2020 and 07 June 2020). Data was analysed using linear mixed effects model was used to investigate PA levels over the measured 12-week period. Effects of BMI, age, deprivation score and baseline PA levels on PA across the three measurement periods were also examined. Focus-group and individual interviews were conducted, and data were thematically analysed.

Results

Average daily step count (-34% lower, p < 0.001) and active energy expenditure (-26% lower, p < 0.001) were significantly lower during the precautionary period compared with the usual activity period. Physical activity remained low during the UK lockdown period. Participants with a lower BMI engaged in significantly more (+45% higher daily steps p < 0.001) physical activity and those over 70 years old were more physically active than those under 70 years across the 12-week period (+23% higher daily steps p < 0.007). The risk of COVID-19 infection and restrictions because of lockdown measures meant some individuals had to find alternative methods to staying physical active. Participants described a lack of access to facilities and concerns over health related to COVID-19 as barriers to engaging in physical activity during lockdown. For some, this resulted in a shift towards less structured activities such as gardening or going for a walk.

Discussion

The data presented shows that lockdown measures during the COVID-19 pandemic significantly reduced physical activity among older individuals at risk of cardiovascular disease, particularly those with a higher body mass index. To support this population group in staying active during future lockdowns, a multifaceted strategy is needed, emphasizing psychosocial benefits and home-based physical activity. The MedEx-UK study was pre-registered with ClinicalTrials.gov (NCT03673722).

The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model

OBJECTIVE

To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency.

METHODS

A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress.

RESULTS

A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency.

CONCLUSION

COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.

A cross-sectional study of university students' mental health and lifestyle practices amidst the COVID-19 pandemic

OBJECTIVES

University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students' mental health, specifically depression, anxiety, and stress, during Lebanon's extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it.

METHODS

An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05.

RESULTS

Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the "poor" and "fair" overall-reported health groups having higher odds than the "Excellent" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours.

CONCLUSION

Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.

Moderate Physical Activity Increases the Expression of ADNP in Rat Brain

Activity-dependent neuroprotective protein (ADNP) is a neuroprotective protein essential for embryonic development, proper brain development, and neuronal plasticity. Its mutation causes the autism-like ADNP syndrome (also called the Helsmoortel-Van der Aa syndrome), characterized by neural developmental disorders and motor dysfunctions. Similar to the ADNP syndrome, the ADNP haploinsufficient mouse shows low synapse density, leading to motor and cognitive ability delays. Moderate physical activity (PA) has several neuroprotective and cognitive benefits, promoting neuronal survival, differentiation, neurogenesis, and plasticity. Until now, no study has investigated the effect of moderate exercise on ADNP expression and distribution in the rat brain. The aim of the current investigation was to study the effects of moderate exercise on the ADNP expression and neuronal activation measured by the microtubule protein β-Tubulin III. In pursuit of this objective, twenty-four rats were selected and evenly distributed into two categories: sedentary control rats and rats exposed to moderate physical activity on a treadmill over a span of 12 weeks. Our results showed that moderate PA increases the expression of ADNP and β-Tubulin III in the dentate gyrus (DG) hippocampal region and cerebellum. Moreover, we found a co-localization of ADNP and β-Tubulin III in both DG and cerebellum, suggesting a direct association of ADNP with adult neuronal activation induced by moderate PA.

Impact of COVID-19 lockdown on physical activity behavior among students in Somalia

Background

Due to the worldwide reach of the COVID-19 pandemic, authorities across the globe deemed it essential to enforce exceptional containment measures. Maintaining physical activity (PA) during this time was only feasible through engaging in activities at home. Therefore, this study focused on elucidating the levels of PA and well-being among Somali students in the aftermath of the lockdown measures implemented by governments at the onset of the COVID-19 pandemic.

Methods

This study was conducted in Somalia among undergraduate students studying at Somali International University. A total of 1266 students were included in the present study. An online survey was utilized to measure participant PA behavior. The assessment of PA was conducted in the aftermath of the COVID-19 pandemic, utilizing the Godin Leisure questionnaire. The study showed that 85.8% of the study participants (n = 1086) were between the ages of 17 and 22. More than half of the participants (58.7%, n = 743) were female and had no other employment (57.3%, n = 743).

Results

Jogging was the most frequently reported PA (57.3%, n = 726), and PA level was on average 59.7 minutes per day (SD = 25.9). Also, most of the study participants were in their last year (82.1%). In the regression analysis, age, gender, academic year, and work status were significant predictors of being physically active after the COVID-19 pandemic.

Conclusion

Factors affecting PA after the COVID-19 pandemic include age, gender, academic year, and work status. Males, younger individuals, and those who engage in outdoor exercise are more likely to be physically active. Once the COVID-19 restrictions were relaxed, undergraduate students in Somalia were physically active. A high level of PA appears to be advantageous for public health. Universities in Somalia should uphold school policies that promote an active lifestyle among students, aiming to maintain or enhance the existing level of PA.

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.

Daily time spent on screens and psychological well-being: Cross-sectional association within the SUN cohort

BACKGROUND

The impact of various lifestyles on psychological well-being (PWB) remains under-studied. We aimed to explore the cross-sectional association between daily screen use (television, tablet and mobile phone) and PWB within the SUN cohort.

METHODS

PWB was assessed using the 29-item Ryff scale (ranging from 29 to 174), and participants with scores >75th percentile were considered as having optimal PWB. Participants were categorized based on their self-reported weekly screen usage hours. Postestimation logistic regression models assessing the prevalence likelihood of not achieving optimal PWB were adjusted for sociodemographic, psychological, personality and lifestyles factors. Isotemporal substitution models explored the potential impact on PWB resulting from replacing 1 h/day of screen time with 1 h/day of exercise.

RESULTS

The study included 3051 participants (55.8% women, mean age 57.3 ± 11.1 years, mean Ryff's score: 139.1 ± 17.4 points). Daily screen use for ≥2 h was associated with a higher prevalence likelihood of not achieving an optimal PWB (Prevalence Ratio [PR]:1.09; 95% CI:1.01-1.18). Among PWB dimensions, screen use ≥2 h/day was linked to an increased likelihood of not achieving optimal scores in environmental mastery (PR:1.11; 95% CI:1.02-1.20), life purpose (PR:1.10; 95% CI:1.02-1.18), and personal growth (PR:1.09; 95% CI:1.01-1.18). Replacing 1 h of daily screens time with 1 h of exercise may lead to potential improvements in environmental mastery (Odds Ratio [OR]:0.87; 95% CI:0.76-0.99), purpose in life (OR:0.86; 95% CI: 0.76-0.98), personal growth (OR:0.84; 95% CI:0.73-0.96) and positive interpersonal relationships (OR:0.86; 95% CI:0.75-0.99).

CONCLUSIONS

These findings highlight the importance of reducing screen use activities and increasing physical exercise for achieving optimal PWB.

The Effects of a Guided Mindful Walk on Mental Health in University Students

College campuses in the United States are experiencing high levels of mental distress without adequate psychological resources to address the need. In addition, the majority of university students do not meet the physical activity guidelines for mental and physical health. Effective and time efficient resources are needed to address poor mental health and low physical activity among university students on college campuses. Mindful walking may be a promising solution. The purpose was to 1) measure change in mental health and 2) estimate physical activity from participation in a guided mindful walk in a diverse student sample. Students participated in a mindful walking route which included seven stops (0.85 miles) during the Spring 2022 semester. Undergraduate students (n = 44) were mean ± SD age 20.9 ± 3.8 years and 68% female. Validated surveys were given pre- and post-participation measuring mental health constructs of state mindfulness (Toronto Mindfulness Scale; TMS), state anxiety (visual analogue scale), and state stress (Short Stress State Questionnaire; SSSQ). Physical activity was estimated via steps on a Yamax pedometer worn at the hip. After the guided mindful walk, total state mindfulness score significantly improved (mean ± SD) (pre: 27.5 ± 8.2, post: 32.8 ± 9.5; p < 0.001); state anxiety significantly decreased (pre: 3.7 ± 2.4, post: 2.4 ± 2; p < 0.0001) and total state stress score was reduced (pre: 66.1 ± 10.7, post: 63.4 ± 8.3; p = 0.03). Physical activity averaged 1,726 ± 159 steps. Completion of a guided mindful walk can reduce anxiety and stress, while increasing mindfulness among university students.

An Importance-Performance Analysis of Korean Middle School Students' Health Management Awareness during the Post-COVID-19 Era Depending on Sex

This study aimed to conduct importance-performance analyses (IPAs) based on Korean middle school students' health management awareness during the post-coronavirus disease 2019 (COVID-19) era. Data were collected from 867 Korean middle school students (13-15 years old) via online and offline surveys between May and June 2023. Frequency analysis, reliability analysis, IPA based on the entire student group, and IPA depending on sex were carried out with the collected data, which revealed the following. First, regardless of sex, the IPA results indicated that four factors of mental health were located in the third quadrant, with one factor of the same variable in the fourth quadrant. The three factors of disease management were located in the third quadrant. Regarding physical activity, two factors were located in the first quadrant, one in the second quadrant, and one in the third quadrant. Regarding sleep management, two factors were located in the second quadrant, one in the third quadrant, and one in the first quadrant. Regarding eating management, two factors were located in the third quadrant and one in the fourth quadrant. Regarding the social distancing variable, all four factors were located in the third quadrant. Regarding hygiene management, two factors were located in the first quadrant, one in the third quadrant, and one in the fourth quadrant. Furthermore, the IPA results indicated sex differences in regular sports and vigorous movement activities associated with physical activity. Additionally, a sex difference was observed in regular diet associated with eating management. This study proposed possible measures for encouraging middle school students to recognize the importance of health and increase their health-related performance during the COVID-19 endemic phase.

Using telehealth to deliver Qi Gong and Tai Chi programs: A mixed-methods systematic review on feasibility, acceptability and participant engagement factors

INTRODUCTION

Due to the COVID-19 pandemic, the use of digitally delivered exercise classes to promote physical activity has become widespread amongst various populations as an alternative to in-person activities.

OBJECTIVES

To examine the feasibility, acceptability, and participant engagement variables to delivering Qi Gong and Tai Chi programs through telehealth interventions.

METHODS

Ten databases (Seven English databases; three Chinese databases) were searched between October and November 2021. Studies published in English or Chinese, or having translations in English or Chinese, were included. Titles and abstracts of identified articles were screened, relevant studies were then retrieved for full-text screening. Study selection, assessment of methodological quality, data extraction, data transformation, and data synthesis were completed following a convergent integrated approach to mixed method systematic reviews.

RESULTS

Seven articles were included in review. Digital literacy of both participants and providers was found to be a significant hurdle towards digital program implementation. There were no notable issues pertaining to access to an internet connection, participant safety, program costs, or connectivity. A major theme for sustaining program engagement was found to be individual perceived relevance for intervention involvement. Online social involvement was noted to be both a facilitator for participant acceptability and engagement. Overall, participants expressed satisfaction with the use of telehealth, while providers expressed acceptability concerns regarding quality of care.

CONCLUSION

It is recommended that planned measures be taken prior to program commencement to decrease digital literacy requirements while also including a participatory approach to encourage uptake. During the program, provision of technical support alongside appropriate social-environmental engagement facilitators would promote sustained adherence.

Psychological predictors of physical activity intensity among college students

Objective: The purpose of this study was to investigate the association of mental health, subjective well-being, and the impact of COVID-19 on quality of life with PA intensity among college students. Participants: The sample included 1262 college students from a large Midwestern research university (mean age = 21.5 ± 3.6 years). Methods: Participants voluntarily and anonymously completed the Qualtrics questionnaires which included the Patient Health Questionnaire -Anxiety and Depression Scale, the Satisfaction with Life Scale, the Impact of COVID-19 on Quality of Life (QoL) Scale, and the International Physical Activity Questionnaire. Results: Multiple linear regression models indicated that COVID-19 QoL and life satisfaction were significant predictors of the total, vigorous, and moderate PA (p's < .05). Life satisfaction was also a significant predictor of walking. Conclusion: Higher level satisfaction and lower impact of COVID-19 on quality of life were related to higher total, vigorous, and moderate PA levels.

Exploring Factors Associated with Physical Activity in the Elderly: A Cross-Sectional Study during the COVID-19 Pandemic

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

Effectiveness of Metaverse Space-Based Exercise Video Distribution in Young Adults: Randomized Controlled Trial

BACKGROUND

In response to the serious lack of physical activity among young adults, recent attempts have been made to encourage young people to exercise through exercise video distribution. However, merely distributing videos does not lead to improved physical activity levels. Metaverse space, which enables web-based interaction through avatars, allows users to watch exercise videos in the same space as other avatars.

OBJECTIVE

This study explored whether exercise video distribution using metaverse space is effective in improving physical activity levels, along with mental health and locomotive function, among young people.

METHODS

In this parallel-group randomized controlled trial participants were recruited using printed poster displays. A total of 48 young adults aged between 18 and 30 years were assigned to 3 groups of 16 each: the metaverse, YouTube, and control group. To encourage exercise, the metaverse group was given an exercise video each week with a load of around 4-8 metabolic equivalents of tasks (METs) for 8 videos delivered in the metaverse space. The YouTube group was sent a URL on YouTube every week to view exercise videos with the same content as the metaverse group. The control group was given no special instructions. The intervention period was 8 weeks. Pre- and postintervention physical activity, well-being, locomotive syndrome risk tests, and social capital were measured. Although this study was not blinded to the participants, the measurers did not know to which group the participants belonged. Mixed model repeated-measures analyses and a post hoc Wilcoxon signed rank sum test were performed to detect the effects of the intervention in all groups.

RESULTS

The results of the mixed model repeated-measures analyses showed a significant interaction between groups and before and after the intervention for total physical activity (metaverse group: pre 737.1, SD 609.5 METs/week, post 1575.4, SD 1071.8 METs/week; YouTube group: pre 661.7, SD 710.7 METs/week, post 911.9, SD 1103.3 METs/week; and control group: pre 930.6, SD 665.1 METs/week, post 844.7, SD 701.8 METs/week; P=.04) but none for the indicators of well-being (P=.40), locomotive function scale (P=.17), and social capital (P=.23). A post hoc test showed a significant increase in physical activity in the metaverse group before and after the intervention (P=.006).

CONCLUSIONS

This study is the first to show that delivering exercise videos through metaverse space can increase physical activity in young adults by providing a gathering space for individuals similarly motivated for exercise practice. This way, the sense of isolation during exercise is reduced compared with merely distributing videos on YouTube. The use of metaverse space in health promotion is likely to spread, and this study provides a useful reference for its exploration.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06019156; https://ichgcp.net/clinical-trials-registry/NCT06019156.

Physical activity, acute severity and long-term consequences of COVID-19: an 18-month follow-up survey based on a Swedish national cohort

OBJECTIVE

To investigate how changes in levels of physical activity (PA) in regard to acute disease severity relate to perceived difficulties in performing daily life activities 18 months after COVID-19 infection.

DESIGN

An observational study with an 18-month follow-up survey based on registry data from a national cohort.

PARTICIPANTS

5464 responders to the 18-month follow-up survey of a Swedish national cohort of 11 955 individuals on sick leave due to COVID-19 during the first wave of the pandemic.

OUTCOMES

The follow-up survey included questions on daily life activities, as well as present and retrospective level of PA. Changes in PA level from before COVID-19 to follow-up were assessed by the Saltin-Grimby PA Level Scale and analysed by the Wilcoxon signed-rank test. Comparisons of groups were analysed by the Student's t-test, Mann-Whitney U test and χ2. Multiple binary logistic regression was performed to assess the association of changes in PA with perceived difficulties in performing daily life activities.

RESULTS

Among the 5464 responders (45% of national cohort), the PA level decreased. Hospitalised individuals had a lower PA level both prior to COVID-19 (p=0.035) and at the 18-month follow-up (p=0.008) compared with non-hospitalised responders. However, the level of PA decreased in both groups. A decrease in PA level increased the odds (OR 5.58, 95% CI 4.90 to 6.34) of having difficulties performing daily life activities.

CONCLUSIONS

PA levels were reduced 18 months after COVID-19 infection. A decrease in PA over that time was associated with perceived difficulties performing daily life activities 18 months after COVID-19. As PA is important in maintaining health and deconditioning takes time to reverse, this decline may have long-term implications for PA and health.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Level of knowledge, nutritional habits, use of stimulants, and physical activity during the COVID-19 epidemic among students of physiotherapy at Wroclaw Medical University

OBJECTIVES

The COVID-19 pandemic had a huge effect around the world. The aim of this study was to determine what eating habits, physical activity, and use of stimulants were likely among physical therapy students during the outbreak.

METHODS

The 16-65-ComPAN questionnaire for views and eating habits was used. The Fagerström Test was used to determine nicotine dependence, the International Physical Activity Questionnaire to gauge physical activity, and the Alcohol Use Disorders Identification Test to determine alcohol consumption.

RESULTS

The results indicated a relatively high percentage of alcohol consumption among this group, as well as a relationship between an unhealthy diet and years of study and smoking. A high value of unhealthy diet and the relationship between dietary knowledge, body mass index, and healthy diet index were also found. No correlation was obtained between the effect of COVID-19 on the student's life and nutritional knowledge and habits, but the percentage of students negatively affected by COVID was high (51%).

CONCLUSION

The findings presented here indicate the need to take measures to increase nutritional knowledge among physiotherapy students and to take measures to reduce the use of stimulants.

Changes in lifestyle and physical and mental health related to long-confinement due COVID-19: a study during the first and second pandemic waves in Mexico and Chile

We investigate changes in lifestyle, physical, and mental health during the confinement period of the first and second waves of COVID-19, as well as their relation to sociodemographic parameters and confinement status. Sociodemographic data and information regarding changes in their lifestyle behavior and changes in body weight and physical activity (PA) were collected. The SF-36 questionnaire was implemented for measuring the domains related to physical health (PH) and mental health (MH). The growth frequency of weight gain in the Mexican (4.8%) and Chilean (10.9%) populations was observed during the second wave. The MH component decreased in the Mexican and the Chilean population (p < 0.05). Moreover, the MH decreased significantly according to the degree of confinement (p < 0.01). Although some sociodemographic factors were related to the presence of a very low score (<50 scores) for the MH component during the first wave, it is perceived as a higher relative risk during the second wave in both populations. The long confinement due to COVID-19 is associated to negative changes in nutritional and physical lifestyle behavior, affecting mainly the MH component.

Quality of Life During the First Three Waves of the COVID-19 Pandemic and Two Earthquakes in Croatia

ABSTRACT

In a cross-sectional study, we measured the impact of the first three COVID-19 pandemic waves and two earthquakes, occurring during the same period in Croatia, on the quality of life (QoL) of the general adult population. An online survey consisting of sociodemographic questions, questions related to COVID-19 and earthquake stressors, the World Health Organization Quality of Life (WHOQoL)-BREF scale, Impact of Event Scale, and Patient Health Questionnaire 4 was completed by 220 men and 898 women (mean age, 35.1 ± 12.3 years). In a series of regressions, we examined the association among five blocks of predictors and six dependent QoL variables, four domain scores, and two global scores. Both WHOQoL-BREF global and domain scores after the prolonged stress were significantly predicted by anxiety, depression, stress symptoms, and sociodemographic characteristics. COVID-19-related stressors predicted significantly physical and psychological health, social relationships, and environmental QoL, whereas earthquake-related stressors predicted health satisfaction, physical and psychological health, and environmental QoL.

The Relationship between Physical Activity and Psychosocial Well-Being during and after COVID-19 Lockdown

The COVID-19 pandemic was an extremely critical event that had a major impact on the physical and mental health of the world's population. The aim of the present work is to investigate whether physical activity plays a protective role in well-being both during the lockdown and afterwards, also assessing the role played by self-efficacy and perception of the risk of contracting COVID-19, as well as past behavior. To this end, two studies were conducted, the first close to lockdown (N = 1061; 76.3% females; mean age = 37.3-range: 18-80) and the second 2 years later (N = 562; 71.0% females; mean age = 33.2-range: 18-76). Descriptive and correlational analyses were performed, along with structural equation modelling. The results confirm the hypothesis of a positive impact of physical activity on emotional well-being alone during lockdown and on more general psychosocial well-being 2 years later. This result showed that physical activity during the pandemic represented an avoidance strategy from the psychological distress that COVID-19 was generating, whereas 2 years later, it represents a proactive strategy aimed at generating a positive mental health condition. These results provide a better understanding of the role physical activity plays in well-being by representing a resource for protecting as well as promoting the mental health of individuals.

The impact of the COVID-19 pandemic on daily rhythms

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

DISCUSSION

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

CONCLUSIONS

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

Association between physical activity and health literacy in patients with Parkinson's disease: an online web survey

BACKGROUND

For patients with Parkinson's disease (PwPD), promotion of habitual physical activity (PA) assists in the prevention of disease progression. Patients' health literacy (HL) is integral for meeting PA standards and turning it into a habit. This study evaluated the association between PA level and each HL domain in PwPD.

METHODS

Online web-based assessment instruments and self-administered questionnaires, including the PA Questionnaire (IPAQ) Short Form and the Functional, Communicative, and Critical Health Literacy (FCCHL) scale, were used to assess PA levels and health literacy domains of PwPD.

RESULTS

The mean age of PwPD (n = 114) was 65.9 (SD = 11.6) years; 59.6% female, and the mean duration of disease was 6.4 (SD = 5.1) years. Of participants, 47.4% met the recommended criteria for PA. When comparing each HL domain by PA level, participants with lower PA had significantly lower critical HL (p = 0.03). Logistic regression analysis revealed that PA level correlated with critical HL (OR = 2.46; 95% CI = 1.16-5.19; p = 0.02).

CONCLUSIONS

Adherence to recommended PA standards was associated with critical HL, but not other HL domains. Proactive attitudes to critically evaluate and utilize as well as understand health information may positively influence the promotion of PA.

Higher physical activity level and perceived social support is associated with less psychological distress in people with anxiety

Introduction

Anxiety is one of the most prevalent mental illnesses in first world societies, generating discomfort in the people who suffer from it, and high expenses and economic losses in the society. The physical activity (PA) performed, together with the perceived social support (PSS) by people with anxiety could be related to the psychological distress of people with anxiety.

Objectives

To study the relationships between mental health and its dimensions, through Golberg's General Health Questionnaire (GHQ12), and the level of PA (PAL) and the PSS in the Spanish adult population with anxiety.

Hypothesis

A higher PAL, and a higher PSS, is related to a lower psychological distress in this population.

Design and Methodology

This study included 1,661 adults with anxiety, residents in Spain. It was a cross-sectional study with data obtained from the Spanish National Health Survey. A Kolmogorov-Smirnov test was applied to examine the data distribution of the variables. The median and interquartile range were used to characterize the sample for continuous variables, and absolute and relative frequencies were used for categorical variables. The Mann-Whitney U test was used to examine the differences between sexes. Dependence between PAL and sex was studied using the chi-square statistic. A Krustal-Wallis test was used to evaluate the existence of differences in the baseline medians on the GHQ-12, according to PAL level. Finally, the correlations between mental health and its dimensions with PAL and the Duke-UNC-11 scores were analysed, obtaining Spearman's rho and Pearson's correlation coefficient.

Results

Moderate inverse correlations were found between the GHQ-12 and: PAL (rho: -0.219); PSS (r: -0.347). PAL and PSS presented moderate inverse correlations with successful coping (rho: -0.206 and r: -0.325), self-esteem (rho: -0.222 and r: -0.333) and stress (rho: -0.158 and r: -0.288).

Conclusions

Greater PAL and social support are associated with reduced psychological distress in people with anxiety.

The association between type 1 diabetes and exercise/physical activity and prolongation of the honeymoon phase in patients

In type 1 diabetes (T1D), pancreatic beta cells are destroyed by the immune system, causing chronic hyperglycemia and micro and macrovascular complications. However, some people experience a 'honeymoon' phase (or partial remission) after being diagnosed with type 1 diabetes. During this phase, a substantial amount of insulin is still produced by the pancreas, helping to reduce blood sugar levels and the requirement for external insulin. The clinical significance of this phase lies in the potential for pharmacological and non-pharmacological interventions during this time frame to either slow down or arrest beta-cell destruction. Clearly, we need to continue researching novel therapies like immunomodulatory agents, but we also need to look at potentially effective therapies with acceptable side effects that can serve as a complement to the medicines currently being studied. Physical activity and exercise, regardless of its type, is one of the factors its impact on the control of diabetes is being investigated and promising results have been achieved. Although there are still limited reports in this regard, there is some evidence to suggest that regular physical exercise could prolong the honeymoon period in both adults and children. In this review, having described the immune base of type 1 diabetes, we outline the benefits of exercise on the general health of individuals with T1D. Moreover, we centered on the honeymoon and current evidence suggesting the effects of physical activity and exercise on this phase duration.

The mediating role of physical activity and health status between a health-supportive environment and well-being: a cross-sectional study

Objective

Based on the social-ecological systems theory and social support theory, this study aims to explore the relationship between a health-supportive environment and well-being among residents. It further examined the mediating role of physical activity and health status in the pathway between a health-supportive environment and well-being.

Methods

The study utilized data from 2,717 samples of the China General Social Survey (2021) and conducted multiple regression analysis and mediation analysis using statistical software Stata 16.0 and SPSS PROCESS 3.3.

Results

(1) A health-supportive environment had a significant impact on residents' well-being (t = 8.476, p < 0.001). (2) Among the three dimensions of natural environment, built environment, and neighborhood social environment, the influence of neighborhood social relationship environment had the strongest influence on residents' well-being (t = 8.443, p < 0.001). (3) Physical activity and health status played a mediating role in the relationship between a health-supportive environment and residents' well-being. The mediating effect was as follows: health-supportive environment → physical activity → well-being with a mediation effect of 0.020; health-supportive environment → health status → well-being with a mediation effect of 0.029; health-supportive environment → physical activity → health status → well-being with a mediation effect of 0.008.

Conclusion

A health-supportive environment not only directly influences residents' well-being but also indirectly affects it through physical activity and health status. It is essential to focus on improving both the natural and built environment as well as the neighborhood social relationship environment in enhancing residents' well-being. Physical activity serves as an important means to improve residents' health level and promote their well-being.

Predictors of depression: lifestyle choices during the pandemic

Our study intends to specify the impact of the singular pandemic stressors on the population and also quantify the contribution of different predictors of depression; some of them are stronger than others, and this research shows how the whole effect is divided into single items. This research included a structured online survey using data from 11,340 respondents from six European countries during the first months of the pandemic. The statistical analysis focused on how behavioural patterns appear in different groups of the population and how they mark the psychological wellbeing of these groups with regard to various factors. We targeted social media's role and analyzed the impact of its consumption on symptoms of depression in different groups divided by age and other characteristics. The analysis creates a mosaic of lifestyle choices and other characteristics that manifest different effects on depression inside selected groups whereas several groups generated by the cluster analysis are less vulnerable to their effect than others. Regarding our findings, the perceived reality through information sources and the manner of their processing seems to be more significant than the tangible reality (poor self-reported health correlated with depression more strongly than intrinsic health limitations).