Population level physical activity before and during the first national COVID-19 lockdown: A nationally representative repeat cross-sectional study of 5 years of Active Lives data in England

Compulsive Exercise and Changes in Physical Activity Among Females: A Longitudinal Analysis During the First 12 Months of the COVID-19 Pandemic

This study had two aims; first to explore changes in compulsive exercise among adult females across the first year of the COVID-19 pandemic, and second, to explore how changes to physical activity early in the pandemic impacted compulsive exercise. Participants were 174 adult females who completed online surveys four times (T1-T4) during the first 12 months of the pandemic. Participants reported changes in physical activity (T1) and completed the compulsive exercise test (CET) at each time point (T1-T4). Mixed ANOVAs with time (T1-T4) and group (did versus did not report changes in physical activity) as factors revealed that compulsive exercise significantly differed across timepoints for the whole sample. Furthermore, females who reported that their physical activity levels had changed early in the pandemic reported higher levels of CET Weight Control Exercise compared to those who reported no change. No significant interactions were found. Among this sample of adult females, attitudes towards exercise changed during the first year of the pandemic, which may reflect the impact of varying lockdown restrictions. Additionally, changes to physical activity early in the pandemic were linked with exercising to control body weight. This suggests that externally influenced changes in physical activity may be an influential factor in the development of compulsive exercise. This may have implications for understanding and managing risk in a range of transition situations that impact upon physical activity.

Causes of COVID-19 Outbreaks During Sports and Exercise: A Systematic Review

BACKGROUND

Physical activity is beneficial for preventing non-communicable and infectious diseases, such as pneumonia. Physical activity is also a potential protective factor for reducing coronavirus disease 2019 (COVID-19) severity. Conversely, outbreaks of respiratory viral infections are more likely to occur owing to group activities, opportunities for contact with individuals and vocalisations. Since the onset of the COVID-19 pandemic, several cases of COVID-19 outbreaks during various sports and exercise have been reported. However, the common causes underlying these outbreaks remain unclear.

OBJECTIVE

The objective of this study is to identify the causes of COVID-19 outbreaks during sports and exercise using systematic review approach.

METHODS

Our eligibility criteria were published articles reporting case investigation on COVID-19 outbreaks and the cause during sports and exercise. Studies such as reviews and observational studies without case investigations were excluded. PubMed, CINAHL, WHO COVID-19 Research Database and Ichushi Web were searched on 28 August 2023. The quality of included studies was rated using a quality criteria checklist adapted from a previous systematic review of influenza outbreaks. Vote counting of outbreak causes was performed by type of sports (team or individual).

RESULTS

Twenty-one articles reporting 22 outbreaks were identified (quality: high, 9; medium, 9; and low, 3). The outbreaks were most frequently reported in fitness classes, followed by soccer. Most studies listed multiple causes of the outbreaks. The most common suspected cause of outbreaks in individual exercise, mostly from fitness classes, was poor ventilation and not wearing masks, followed by not maintaining physical distance and participation of individuals with some symptoms. In team sports, the most common cause was interaction outside the game, such as social events.

CONCLUSIONS

This systematic review found a limited number of case investigations suggesting that COVID-19 outbreaks during sports and exercise may be associated with the inhalation of aerosols in indoor settings, interactions outside of team sports games and participation of individuals with some symptoms. Prevention strategies that focus on mitigating these issues may be effective at preventing sports and exercise-associated respiratory infectious diseases outbreaks.

PROSPERO REGISTRATION NUMBER

CRD42023443158.

Psychological detachment from work predicts mental wellbeing of working-age adults: Findings from the 'Wellbeing of the Workforce' (WoW) prospective longitudinal cohort study

BACKGROUND

There is an urgent need to better understand the factors that predict mental wellbeing in vocationally active adults during globally turbulent times.

AIM

To explore the relationship between psychological detachment from work (postulated as a key recovery activity from work) in the first national COVID-19 lockdown with health, wellbeing, and life satisfaction of working age-adults one year later, within the context of a global pandemic.

METHODS

Wellbeing of the Workforce (WoW) was a prospective longitudinal cohort study, with two waves of data collection (Time 1, April-June 2020: T1 n = 337; Time 2, March-April 2021: T2 = 169) corresponding with the first and third national COVID-19 lockdowns in the UK. Participants were >18 years, who were employed or self-employed and working in the UK. Descriptive and parametric (t-tests and linear regression) and nonparametric (chi square tests) inferential statistics were employed.

RESULTS

Risk for major depression (T1: 20.0% to T2: 29.0%, p = .002), poor general health (T1: 4.7% to T2: 0%, p = .002) and poor life satisfaction (T1: 15.4% to T2: 25.4%, p = .002) worsened over time, moderate-to-severe anxiety remained stable (T1: 26.1% to T2: 30.2%, p = .15). Low psychological detachment from work was more prevalent in the first wave (T1: 21.4% and T2: 16.0%), with a moderate improvement observed from T1 to T2 (t (129) = -7.09, p < .001). No differences were observed with work status (employed/self-employed), except for self-employed workers being more likely to report poor general health at T1 (16.1%, p = .002). Better psychological wellbeing, lower anxiety and higher life satisfaction at T2 were observed in those who reported better psychological detachment from work at T1 (β = .21, p = .01; β = -.43, p < .001; β = .32, p = .003, respectively), and in those who improved in this recovery activity from T1 to T2 (β = .36, p < .001; β = -.27, p < .001; β = .27, p = .008, respectively), controlling for age, gender and ethnicity.

CONCLUSION

The ability to psychologically detach from work during the first pandemic lockdown, and improvement in this recovery activity over time, predicted better mental wellbeing and quality of life in vocationally active adults after one year of a global crisis, irrespective of work status. Interventions to encourage workers to psychologically detach from work may help to support employee wellbeing at all times, not only in the extreme circumstances of pandemics and economic uncertainty.

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.

Promoting Physical Activity Among Health Professional Students, Faculty, and Staff Members: A Competition-Based Intervention

This program review presents data for the Deans' Fit Family Challenge (DFFC) and proposes future directions for improvement, informed by the Social Cognitive Theory. The DFFC is a multi-week physical activity competition held annually between three health professional programs, focusing on the development of self-efficacy, self-regulation, and social support of health-related fitness. Participants competed in teams of two and tracked their activity minutes weekly using the ChallengeRunner app or through manual entry. Weekly winners were announced, and the winning college was determined from a composite score of active minutes and weight loss. Since 2019, 1164 participants reported an average of 217.1 weekly minutes of physical activity during the DFFC. An average of 94.0% of participants reported minutes in week 1, compared to 56.3% in week 8. The DFFC is an important initiative to potentially promote physical activity levels among participating programs. While motivational strategies are being incorporated and executed in the DFFC, there is a need for ongoing exploration and improvement to enhance future competition-based interventions among health professional students, faculty, and staff.

A Conceptual Primer on the Potential of Adaptive Policies to Reduce Physical Inactivity

BACKGROUND

Despite the existence of physical activity policies across many countries, insufficient physical activity remains a major global public health problem. Physical inactivity is an emergent feature of complex systems; it results from a wide range of factors at multiple levels that interact to influence behavior. Traditional approaches to public policy often fail within complex systems, largely due to unpredictability in how the system will respond. Adaptive policies, which are designed to allow for uncertainty about future system behavior and to change over time, may offer a promising solution. In this paper, we introduce the concept of adaptive policies and illustrate how this innovative approach to policy making may be beneficial for reducing physical inactivity.

DESIGN

Drawing on existing literature and guiding principles for policy making, we provide 3 examples to illustrate how the concept of adaptive policies can be applied to address physical inactivity.

DISCUSSION

The examples illustrate how changes to the way policies and interventions are developed, implemented, and evaluated could help to overcome some of the limitations in existing practices. A key challenge will be engaging policymakers to take a broader perspective of the physical activity system, develop policies that are designed to be adaptable across a range of different future scenarios, and embrace uncertainty and long-term adaptability.

CONCLUSION

Adaptive policies may support decision makers globally to achieve the widespread and sustained changes necessary to increase population levels of physical activity.

What determines participation in sport for older adults in England: A multilevel analysis of Active Lives data

Physical inactivity within an ageing population is an ongoing public health concern for policymakers. Engagement in sport forms a foundation of policy designed to encourage physical activity participation and improve health and wellbeing. This study aimed to (i) understand the extent to which older adults participate in sport and the (ii) correlates that predict this involvement within an English population sample of older adults. A further aim was (iii) to examine the extent in which sports participation may vary due to the opportunity provided across Active Partnerships in England. To address this, a multi-level analysis framed through COM-B was conducted of the 2021 English Active Lives dataset (i.e., during the COVID-19 pandemic). The Active Lives survey provides population-level insight into sport, exercise, and physical activity participation across England. It samples upwards of n = 180,000 participants beyond the age of 16 years and asks questions on factors that influence participation. Our findings drawn from a sample of n = 68,808 older adults (i.e., >60-years of age) indicate that when accounting for variation across regions sports participation was significantly predicted by age (β = -.246, p = .040) and multiple deprivation (β  = .706, p = .030). Further, our analysis suggests sports participation across regions is associated with changes in the perceptions of opportunity to participate (β = -28.70, p = .001). As the UK transitions from the COVID-19 pandemic, findings have implications for the promotion of sports participation for older adults, in that local, regional, and national stakeholders must do more to change perceptions of social and physical opportunity within an ageing population. This may be achieved through adaptations to the recreational sporting landscape, raising awareness, and supportive policy changes on a national level.

LymphActiv: A Digital Physical Activity Behavior Intervention for the Treatment of Lymphedema and Lipedema

Background: Lymphedema and lipedema are debilitating conditions with no proven drug or surgical therapy. Effective treatment requires self-management through movement and compression to reduce limb volume and the incidence of cellulitis. The addition of personalized everyday physical activity (PA) could be transformative, increasing the therapy window to include all waking hours per week and enabling an increased dose of PA. Aim: This service evaluation aimed to determine the feasibility of LymphActiv as a treatment option for lymphedema and lipedema patients. Methods: This service evaluation followed an open observational cohort design, including 55 patients who participated in LymphActiv over 24 weeks. Patients wore an objective PA monitor and interacted with their data in an online dashboard, alongside remote mentor support. Primary outcomes were changes to PA, body weight, limb volume and quality of life. Clinical assessments occurred at baseline and after the 24-week program. Noncompleters were used as a quasi-control group for comparison. Results: Thirty-seven patients completed, of which 81% improved PA. On average, completers reduced their right and left lower limb volumes by -1.8% and -2.1%, respectively. Completers also experienced small average weight losses of -1.2 kg. Noncompleters experienced small average increases in each of these outcome measures. Discussion: These results establish the value of LymphActiv, providing benefit to patients who might otherwise have deteriorated. For services, this could lead to substantial cost-savings through reduced admissions, greater patient independence, and less need for community health care input. The next step is to undertake a randomized, controlled trial comparing the intervention with standard care.

Engaging underrepresented groups in community physical activity initiatives: a qualitative study of parkrun in the UK

BACKGROUND

Underrepresented groups, including racial/ethnic minority groups and individuals with low socioeconomic status face complex barriers to engaging in community-based health initiatives. This research uses parkrun, an outdoor, mass-participation, weekly physical activity and volunteering initiative, to explore the engagement strategies ('outreach activities') that have been used to promote the inclusivity and diversity of parkrun events.

METHODS

Ten adult parkrun Ambassadors who fulfilled volunteer roles that involved promoting parkrun to underrepresented groups in the UK were interviewed. Interviews took place via telephone or video call in April-July 2021. Interview transcripts were analysed thematically.

RESULTS

Engagement strategies implemented by Ambassadors varied from opportunistic promotion within communities to strategic negotiations at higher decision-making levels. Approaches were characterised by a community-centred focus that ensured community networks and assets were utilised. Stories were considered valuable indicators of successful outreach. A common challenge to outreach for Ambassadors was limited personal and organisational capacity that impeded the widescale scope, reach and scalability of parkrun's engagement attempts.

CONCLUSIONS

Parkrun Ambassadors have used a wide range of outreach activities at different levels of influence. A number of challenges to doing sustainable and effective outreach have been highlighted that need to be addressed. Working with and alongside communities where community-based health initiatives events take place to understand how to address inclusivity issues could contribute to greater participation by underrepresented groups.

Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data

This study aimed to examine changes in health behaviors and outcomes during early-pandemic (2020) vs pre-pandemic (2019) years by age groups and race/ethnicity. Multivariable logistic regressions were conducted using Behavioral Risk Factor Surveillance System datasets from 2019 (n = 418 268) and 2020 (n = 401 958). All participants reported less likelihood to exercise (aOR, .78; 95% CI: .73-.83) and have poor physical health (aOR, .91; 95% CI: .86-.98) but more likelihood to have excellent general health (aOR, 1.33; 1.17-1.53) during 2020 vs 2019. Compared to 2019, during 2020 (i) Blacks were more likely to exercise (aOR, 1.24; 95% CI: 1.02-1.51) and have excellent general health (aOR, 1.69; 95% CI: 1.13-2.54); (ii) Hispanics were less likely to exercise (aOR, .80; 95% CI: .74-.88), but more likely to have excellent general health (aOR, 2.44; 95% CI: 1.79-3.33) and mental health (aOR, 1.41; 95% CI: 1.15-1.72); and (iii) Whites were less likely to exercise (aOR, .58; 95% CI: .50-.67) and have good physical health (aOR, 0.89; 95% CI: .82-.95). All age groups, except 18-24 years, were less likely to exercise by 18%-39% during 2020 vs 2019. Furthermore, the 55-64 years age-group was 36% more likely to report excellent general health but 14% less likely to have good physical health. Identifying the most vulnerable racial/ethnic and age groups is pivotal to prioritizing public health resources and interventions to mitigate the impact of health crises.

Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany: a nationwide survey : Running head: physical activity during the COVID-19 restrictions

BACKGROUND

The COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups.

METHODS

Between April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants' physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions.

RESULTS

Out of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO's physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI: .117; .126) while engaging in more sedentary behavior (M = 0.24; 95% CI: .240; .247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines.

CONCLUSIONS

Mobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks.

Mental Health of Children With Special Educational Needs and the Return to In-Person Learning After the COVID-19 Pandemic

Importance

There is limited evidence on whether the quality of life and behavior of children with special educational needs (SEN) have improved or worsened since schools reopened after COVID-19-related school closures.

Objective

To describe the changes in the mental well-being of children and adolescents with SEN during the initial 6 months of resuming in-person learning after COVID-19-related school closures.

Design, Setting, and Participants

This repeated cross-sectional study reported data from surveys completed by parents and caregivers of children and adolescents aged 3 to 18 years with SEN studying at special schools in Hong Kong. The first cohort was obtained during COVID-19-related school closure in April 2020 (wave 1) and the second cohort was obtained 6 months after school resumption with data collection between July and October 2021 (wave 2). Data analysis occurred from January to June 2022.

Exposure

Diagnosis of a disability or disorder that required school-based special educational programming.

Main Outcomes and Measures

Children's emotional and behavioral difficulties (measured with the Strengths and Difficulties Questionnaire [SDQ]), quality of life (measured with the Pediatric Quality of Life Inventory [PedsQL]), lifestyle habits, parental stress, and parental well-being (measured with the PedsQL Family Impact Module) were assessed. Cross-sectional comparisons of well-being between the 2 waves were conducted using analysis of covariance, and multiple regression analysis was performed to identify factors associated with mental health outcomes in wave 2.

Results

In wave 1, a total of 456 parents and caregivers of children with SEN (mean [SD] age, 7.44 [3.98] years; 315 boys [69.1%]; 141 girls [30.9%]) responded to the surveys. In wave 2, 519 parents and caregivers of children with SEN (mean [SD] age, 8.16 [4.47] years; 365 boys [70.3%]; 154 girls [29.7%]) responded. After school resumption, preschoolers aged 3 to 5 years with SEN had significantly fewer emotional difficulties (mean [SD] SDQ score, 3.26 [2.39] vs 2.68 [2.03]; standardized mean difference [SMD] = 0.26; 95% CI, 0.07-0.46; Bonferroni-corrected P = .04) and conduct difficulties (mean [SD] SDQ score, 2.88 [1.89] vs 2.41 [1.91]; SMD = 0.25; 95% CI, 0.05-0.44; Bonferroni-corrected P = .01), whereas adolescents had more conduct difficulties (mean [SD] SDQ score, 1.62 [1.50] vs 2.37 [3.02]; SMD = 0.41; 95% CI, 0.13-0.70; Bonferroni-corrected P = .049). The overall quality of life of school-aged children with SEN aged 6 to 11 years worsened after school resumption (mean [SD] PedsQL score, 67.52 [17.45] vs 60.57 [16.52]; SMD = 0.41; 95% CI, 0.19-0.62; Bonferroni-corrected P = .002).

Conclusions and Relevance

The findings of this repeated cross-sectional study suggest that preschoolers with SEN had improved emotional and behavioral functioning when school resumed after COVID-19-related closures. School-aged children with SEN, adolescents with SEN, and children with intellectual disabilities were at risk of reduced quality of life, indicating that additional support should be offered to vulnerable groups as they return to schools.

Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care

Background

COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure.

Methods

A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection.

Results

A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex.

Conclusion

The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

Socioeconomic inequalities in physical activity among older adults before and during the COVID-19 pandemic: evidence from the English Longitudinal Study of Ageing

Introduction

The influence of the COVID-19 pandemic on physical activity behaviour in older adults is of particular concern. However, little is yet known about how pre-existing socioeconomic inequalities in older adults' physical activity have been affected by the COVID-19 pandemic. The aim of this study was to explore socioeconomic disparities in physical activity levels and change over time among older adults in England, using data collected before and during the COVID-19 pandemic.

Methods

This longitudinal cohort study analysed data from 3720 older adults (aged 60+ years) who participated in wave 9 (2018/2019) of the main English Longitudinal Study of Ageing (ELSA) survey and wave 2 of the ELSA COVID-19 substudy (November/December 2020). Using multilevel ordinal logistic models, we investigated associations between socioeconomic variables (education, occupational class and wealth) and physical activity, adjusting for potential confounders. We also examined interactions between socioeconomic variables and time (prepandemic vs intrapandemic) to investigate changes in the magnitude of inequalities in physical activity across the two survey periods.

Results

The proportion of participants considered 'inactive' rose from 5.7% before the COVID-19 pandemic to 12.5% in November and December 2020. Higher education, occupational class and wealth were positively associated with physical activity before the lockdown. These socioeconomic disparities generally persisted during the COVID-19 pandemic. There was some evidence that differences in physical activity based on education and occupational class reduced during the COVID-19 pandemic, relative to prepandemic data. However, these associations were no longer statistically significant when the three socioeconomic variables and their interactions with time corrected for one another (p>0.05).

Conclusion

Our results suggest there was no additional influence of the COVID-19 pandemic on pre-existing socioeconomic inequalities in older adults' physical activity levels.

Barriers and enablers to delivering opportunistic behaviour change interventions during the COVID-19 pandemic: A qualitative study in healthcare professionals

BACKGROUND

In line with public health policy, healthcare professionals (HCPs) working in the UK's National Health Service (NHS) are encouraged to deliver opportunistic health behaviour change interventions during routine consultations. The impact of the COVID-19 pandemic on healthcare delivery has been wide-ranging, but little is known about how the pandemic has affected the delivery of health behaviour change interventions. The present study aimed to examine the barriers and enablers to delivering opportunistic behaviour change interventions during the COVID-19 pandemic.

METHODS

Twenty-five qualitative semi-structured interviews were conducted in January 2022 with a range of patient-facing healthcare professionals (including nurses, physiotherapists, dieticians, doctors and midwives) working in the NHS. Data were analysed using reflexive thematic analysis.

RESULTS

Two overarching themes were generated: (1) the healthcare system's response to COVID-19, and (2) maintaining good HCP-patient relationships: reluctance and responsibility. COVID-19-related barriers included exacerbated staffing pressures and a perceived inability to use IT equipment to facilitate conversations about health behaviour change (due to poor internet connectivity or ill-equipped platforms). COVID-19-related enablers included the use of video consultations enabling less awkward and more honest conversations about health behaviours. However, some barriers and enablers remained the same as pre-pandemic, such as issues of role responsibility for discussing health behaviour change with patients, balancing holistic wellbeing advice with maintaining positive patient-HCP relationships, and reluctance to deliver opportunistic behaviour change interventions.

DISCUSSION

The increased use of remote consultations may facilitate the delivery of opportunistic health behaviour change interventions by healthcare professionals. However, there is also a strong need to improve staffing levels, in order that staff have the psychological and physical capabilities to engage patients in these conversations.

Lest we forget. Illuminating lived experience of the Covid-19 pandemic and lockdown

The COVID-19 pandemic and associated 'lockdowns' profoundly impacted people's lives in 2020-2021 and beyond. This study sought to understand unique person-centred insights into health and wellbeing during the restrictive measures in the United Kingdom and to enable us to remember and give testimony to these lived experiences. Using photo-methods, participants from a larger cohort study which tracked people's behaviours during the pandemic were invited to share photographs and short text to visually illustrate their ephemeral and unique COVID-19 experiences. In total 197 participants shared 398 photographs. Using a critical realist approach in our design and analysis, we sought to gain an alternative viewpoint on what 'lockdown' and the pandemic meant. Our major findings revealed starkly contrasting experiences illustrated in our two major themes. Firstly loss, including ambiguous losses and a sense of loss, loss of freedoms and death. Secondly, salutogenesis (what makes us well) whereby participants were able to draw on assets which helped to keep them well by maintaining social connection, 'making the best of it', reconnecting with nature and appreciating the outdoors, creativity for pleasure and faith. Our findings illuminate widely differing experiences and indicate the powerful effect of assets that were perceived by our participants to protect their wellbeing. Understanding differential vulnerability will be essential going forward to target resources appropriately to those who have the least control over their lives, those with the greatest vulnerabilities and least assets which in turn could support a self-perpetuating recovery.

Repercussions of Pandemic and Preventive Measures on General Well-Being, Psychological Health, Physical Fitness, and Health Behavior: Mediating Role of Coping Behavior

BACKGROUND

Pandemic prevention measures increased physical inactivity due to travel restrictions that led to negative physical fitness, health behavior, psychological health, and general well-being. The mediating role of coping behavior must be identified before developing interventional strategies for this pandemic.

OBJECTIVE

The study investigates the mediating role of coping behavior to mitigate the Coronavirus disease impact on physical fitness, health behavior, psychological health, and general well-being.

METHODS

A web-based survey was used under convenience sampling to collect the primary data. Smart-PLS 3.0 was used to analyze the collected data.

RESULTS

All 14 direct correlations (H1-H14) were correct, and coping behavior's mediating impact was shown to be statistically significant (H9a- H14d).

CONCLUSION

Our study findings indicate that mediating role of coping behavior in mitigating the pandemic impacts was statistically significant. It is concluded that coping behavior is a healthy adaptation to protecting the barrier against COVID-19 adverse effects on health.

The seasonal variation of physical activity and quality of life during the first wave of the COVID-19 pandemic in Finnish older golfers: A cross-sectional study

Background and Aims

The COVID-19 pandemic was associated with reduced physical activity and increased sedentary behavior. Golf is a health-enhancing outdoor exercise and is associated with low risk of viral transmission. The purpose of this study was to describe the seasonal differences in physical activity and quality of life during the first wave of COVID-19 pandemic in 2020 in Finnish older golfers.

Methods

Older golfers (n = 325) from eight golf clubs retrospectively responded to a questionnaire in summer 2020 on their physical activity and golf activity in winter 2019/20 (pre-COVID-19 winter season) and summer season 2020. In addition, they reported their quality of life after the first wave of pandemic in summer 2020. To evaluate the seasonal differences in physical activity, life quality and its association with golf activity, the data were analyzed using the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman's correlation test, and linear regression analysis.

Results

Despite COVID-19 restrictions, golfers' physical activity increased by 24% (p < 0.001) during the COVID-19 restrictions in the summer of 2020. Moderate physical activity increased by 37% (p < 0.001), walking activity increased by 26% (p < 0.001), and sitting decreased by 21% (p < 0.001) compared with the pre-COVID-19 winter season. The full 18-hole golf round activity was positively associated with moderate physical activity both in the summer and winter season, and with walking in the summer season. Over 90% of golfers reported good quality of life during the 2020 summer restrictions.

Conclusion

In contrast to physical activity levels generally decreasing during the first wave of pandemic, physical activity levels in Finnish golfers increased, and these golfers reported a good quality of life. Golf can provide health enhancing physical activity and older golfers seems to be physically active throughout the year.

Sarcopenia parameters in active older adults - an eight-year longitudinal study

BACKGROUD

Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population.

METHODS

The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants' overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements.

RESULTS

In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and - 48.5%; p < .001, respectively).

CONCLUSIONS

Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature.

TRIAL REGISTRATION

The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.

Covid-19 restrictions: An opportunity to highlight the effect of neighbourhood deprivation on individuals' health-related behaviours

RATIONALE

Neighbourhood socio-economic deprivation is strongly related to health-risk behaviours, which are predictors of overall health and mortality. During the Covid-19 pandemic, individuals have been forced to spend more time within their residential areas, which might have had an effect on health-risk behaviours.

OBJECTIVE

We assess the consequences of living in a more or less deprived neighbourhood during the pandemic on individual behavioural changes in four health-related outcomes: smoking, drinking, physical activity and healthy eating. We hypothesise that the pandemic and related lock-downs had negative effects on health-related behaviours, but that this negative effect had been stronger for people living in more deprived areas. We additionally explore sex and ethnicity as sources of heterogeneity in these effects.

METHODS

We use data from four nationally representative cohort studies in England. We perform longitudinal individual and neighbourhood fixed effects estimations focusing on comparing the pre-pandemic period with the first lockdown (May 2020) period and up to one year after the outbreak of the pandemic (March 2021).

RESULTS

During the first lockdown, as compared to pre-pandemic levels, on average, people smoked more, drunk more and did more physical activity. However, compared to people in less deprived neighbourhoods, people living in more deprived areas showed a smaller increase in their levels of physical activity, consumed less fruit and vegetables and increased the number of cigarettes smoked. We additionally find that the combined effect of Covid-19 and area deprivation varies significantly by both sex and ethnicity.

CONCLUSION

Results add to evidence on the impact of the Covid-19 pandemic and associated lockdowns on health-risk behaviours, highlighting the relative contribution of the neighbourhood environment and individual characteristics. We argue that reducing levels of neighbourhood deprivation may contribute to positively influence behaviours, especially for some sub-groups of the population, leading to a reduction of social inequalities in health.

Risk of severe and opportunistic infections and the impact of SARS-COV-2 on this risk in a nationwide cohort of patients with inflammatory bowel disease

BACKGROUND

The Inflammatory Bowel Disease (IBD) patients have adopted lifestyle modifications to prevent infection via SARS COV-2.

AIMS

This study aims to examine rate of serious infections and opportunistic infections in the pre-pandemic and pandemic period, and to analyse if the risk associated with medications used to treat IBD were potentially modified by associated change in lifestyle.

METHODS

We conducted a retrospective cohort study of patients from the US national Veteran Affairs Healthcare System (VAHS). Patients were stratified into two groups: pre-pandemic (prior to SARS COV-2 pandemic) and pandemic (during SARS COV-2 pandemic) and outcomes were measured in these groups. Primary outcome was occurrence of any serious infection. Secondary outcome was occurrence of any opportunistic infection.

RESULTS

There were 17,202 IBD patients in the pre-pandemic era and 15,903 patients in the pandemic era. The pre-pandemic era had a significantly higher proportion of serious infections relative to the pandemic era (5.1% vs. 4.4%, p = 0.002). The proportion of opportunistic infections were similar between pre-pandemic and pandemic eras (0.3% vs. 0.3%, p = 0.82). Relative to 5-ASA, patients taking anti-TNF (HR = 1.50 (1.31-1.72)), anti-TNF+TP (HR = 1.56 (1.24-1.95)) or vedolizumab (HR = 1.81 (1.49-2.20)) had an increased hazard of serious infection (p > 0.001).

CONCLUSION

In a nationwide cohort of IBD patients, we found that risk of serious infections could possibly be affected by behavioural modifications due to SARS-COV-2 pandemic.

The Hospital to Home study (H2H): smartwatch technology-enabled rehabilitation following hip fracture in older adults, a feasibility non-randomised trial

Introduction

Hip fractures are associated with significant morbidity and mortality. This study assessed the feasibility of smartwatches supporting rehabilitation post-surgical fixation.

Methods

This UK-based non-randomised intervention study recruited patients who had sustained a hip fracture (age ≥65 and Abbreviated Mental Test Score ≥8/10), following surgical fixation, at one hospital to the intervention group, and at a second hospital to a usual care group. The intervention group received a smartwatch (Fitbit Charge 4) and app (CUSH Health©). Feasibility measures included retention and completion of outcome measures.

Results

Between November 2020 and November 21, 66 participants were recruited (median age 78 (IQR 74-84)). The intervention cohort were younger, with no significant differences in frailty or multi-morbidity between the cohorts. Hospital stay was shorter in the intervention cohort (10 days (7-16) versus 12 (10-18), p=0.05). There were 15 falls-related readmissions in the control cohort, including 11 fractures, with none in the intervention cohort (p=0.016). In the intervention group, median daily step counts increased from 477 (320-697) in hospital, to 931 (505-1238) 1 week post-discharge, to 5,352 (3,552-7,944) at 12-weeks (p=0.001). Of the intervention cohort, 12 withdrew.

Conclusion

This study found that smartwatch-supported rehabilitation was feasible in this cohort. A significant proportion of patients either chose not to participate or withdrew; such a decrease in participants must be addressed to avoid digital exclusion. Falls and fracture-related readmissions were more frequent at the control site compared with the intervention site.

An alternative approach-combination of lockdown and open in fighting COVID-19 pandemics

As the COVID-19 pandemic enters its third year and the omicron variant becomes dominant, we propose an alternative strategy for dealing with COVID-19, called hybrid lockdown, that is, the combination of lockdown (the centralized and organized lockdown of the high-risk population) and free mobility (normal mobility) of the low-risk population. Such an approach will enable a country or region, especially with a high population density, to achieve significant prevention and control the effects of the COVID-19 pandemic at the least cost.

Long Covid: where we stand and challenges ahead

Post-acute sequelae of SARS-CoV-2 (PASC), also known as Post-Covid Syndrome, and colloquially as Long Covid, has been defined as a constellation of signs and symptoms which persist for weeks or months after the initial SARS-CoV-2 infection. PASC affects a wide range of diverse organs and systems, with manifestations involving lungs, brain, the cardiovascular system and other organs such as kidney and the neuromuscular system. The pathogenesis of PASC is complex and multifactorial. Evidence suggests that seeding and persistence of SARS-CoV-2 in different organs, reactivation, and response to unrelated viruses such as EBV, autoimmunity, and uncontrolled inflammation are major drivers of PASC. The relative importance of pathogenetic pathways may differ in different tissue and organ contexts. Evidence suggests that vaccination, in addition to protecting against disease, reduces PASC after breakthrough infection although its actual impact remains to be defined. PASC represents a formidable challenge for health care systems and dissecting pathogenetic mechanisms may pave the way to targeted preventive and therapeutic approaches.

Correlates of Changes in Physical Activity and Sedentary Behaviors during the COVID-19 Lockdown in France: The NutriNet-Santé Cohort Study

BACKGROUND

COVID-19 lockdowns represent natural experiments where limitations of movement impact on lifestyle behaviors. The aim of this paper was to assess how lockdowns have influenced physical activity and sedentary behaviors among French adults.

METHODS

32,409 adults from the NutriNet-Santé study filled out questionnaires in April 2020 (the first 2 weeks after the start of lockdown) and in May 2020 (2 weeks before the lockdown ended). Participants were asked about changes in physical activity level and sitting time, types of physical activity performed, and main reasons for change.

RESULTS

For decreased physical activity, similar rates were found at the beginning and end of the lockdown (58 and 55%-56 and 53%, in women and men, respectively). For increased physical activity, the figures were lower (20 and 14%-23 and 18%, in women and men, respectively). The participants with a decreasing physical activity evolution were older and more likely to be living in urban areas. The main reasons for (i) decreased physical activity were limitations of movement and not liking indoor exercise, (ii) increased physical activity were to stay physically fit and healthy. Physical activity changes were inversely associated with reported depressive symptoms.

CONCLUSIONS

Changes in physical activity and sedentary behaviors are heterogenous for both genders during the lockdown.

The impact of COVID-19 lockdowns on physical activity amongst older adults: evidence from longitudinal data in the UK

Background

A sedentary lifestyle increases the risk of adverse health outcomes and frailty,particularly for older adults. To reduce transmission during the COVID-19 pandemic, people were instructed to stay at home, group sports were suspended, and gyms were closed, thereby limiting opportunities for physical activity. Whilst evidence suggests that physical activity levels reduced during the pandemic, it is unclear whether the proportion of older adults realising the recommended minimum level of physical activity changed throughout the various stages of lockdown.

Methods

We used a large sample of 3,660 older adults (aged ≥ 65) who took part in the UK Household Longitudinal Study’s annual and COVID-19 studies. We examined changes in the proportion of older adults who were realising the UK Chief Medical Officers’ physical activity recommendations for health maintenance at several time points before and after COVID-19 lockdowns were imposed. We stratified these trends by the presence of health conditions, age, neighbourhood deprivation, and pre-pandemic activity levels.

Results

There was a marked decline in older adults’ physical activity levels during the third national lockdown in January 2021. The proportion realising the Chief Medical Officers’ physical activity recommendations decreased from 43% in September 2020 to 33% in January 2021. This decrease in physical activity occurred regardless of health condition, age, neighbourhood deprivation, or pre-pandemic activity levels. Those doing the least activity pre-lockdown increased their activity during lockdowns and those doing the most decreased their activity levels.

Conclusions

Reductions in older adults’ physical activity levels during COVID-19 lockdowns have put them at risk of becoming deconditioned and developing adverse health outcomes. Resources should be allocated to promote the uptake of physical activity in older adults to reverse the effects of deconditioning.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14156-y.

COVID-19 and Cardiometabolic Health: Lessons Gleaned from the Pandemic and Insights for the Next Wave

PURPOSE OF REVIEW

To review the current evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiometabolic health, with a focus on strategies to help mitigate adverse effects on population health.

RECENT FINDINGS

Individuals with cardiometabolic disease are particularly vulnerable to worse outcomes with COVID-19 infection. In addition, the pandemic itself has had significant deleterious impact on the cardiometabolic health of the population, including declines in physical activity, increases in smoking and alcohol use, worsening blood pressure and glycemic control, and detrimental effects on mental health. Targeted interventions at the patient and community level will be needed to mitigate the long-term consequences of the COVID-19 pandemic on population cardiometabolic health. The COVID-19 pandemic has worsened cardiometabolic health, but there are several opportunities and enhanced tools available to counteract these changes.

Did physical activity and associated barriers change during COVID-19 restrictions in Ireland? Repeated cross-sectional study

This repeated cross-sectional study investigated physical activity and associated barriers and facilitators during the first two waves of COVID-19 restrictions in Ireland. An online, anonymous questionnaire collated data from adults during May (n = 1274) and November (n = 810) 2020. Statistical analysis used a combination of traditional significance testing and Bayesian lasso logistic regression. The pattern of physical activity changed significantly between waves (χ2 86.8 on 3df; p < 0.001). During wave 1 restrictions, the majority [46.1% (n = 587)] of participants reported being more active than usual, decreasing to 26.3% (n = 213) during wave 2. More participants reported that their activity levels were less than usual [W1 29% (n = 369); W2 35% (n = 283)] during wave 2. Adherence to physical activity guidelines decreased from 56.5% (n = 705) to 43.7% (n = 35). Being unable to access their usual means of exercise [OR, 95% OR intervals; W1 1.611 (1.370-1.904), W2 1.638 (1.3731.968)] and advice not to leave home [OR, 95% OR intervals; W1 1.401 (1.164-1.697), W2 1.367 (1.106-1.696)] predicted less activity than usual during both waves. Increased time [OR, 95% OR intervals; W1 2.326 (1.948-2.794), W2 1.809 (1.478-2.233)], and valuing physical activity as important [OR, 95% OR intervals; W1 1.192 (1.001-1.444), W2 1.253 (1.003-1.637)] predicted increased activity during both waves, whilst finding new ways to be active [OR, 95% OR intervals; 2.515 (1.641-3.887)] predicted more activity in wave 2 only. Increases in physical activity of Irish adults during the first phase of COVID-19 restrictions were not maintained during the second wave and barriers to physical activity persisted.

Exploring Barriers and Facilitators to Physical Activity during the COVID-19 Pandemic: A Qualitative Study

Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the capability, opportunity, motivation model of behaviour (COM-B). One-to-one interviews were conducted with younger (aged 18–24) and older adults (aged 70+), those with long-term physical or mental health conditions, and parents of young children. Themes were identified using reflexive thematic analysis and were mapped onto COM-B domains. A total of 116 participants contributed (aged 18–93, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations/plans) COM-B domains. Future interventions should target these domains during pandemics (e.g., adapting PA guidance depending on location and giving education on the health benefits of PA).

Bibliometric Analysis of Literature on Physical Activity and COVID-19

The coronavirus disease 2019 (COVID-19) pandemic induced a sudden surge in COVID-19 related publications. This bibliometric analysis aimed to analyze literature on physical activity and COVID-19 published in the PubMed database. The search terms ((physical activity [MeSH Terms] OR physical inactivity [MeSH Terms]) AND COVID-19 [MeSH Terms]) were applied to obtain publications from the inception of PubMed to February 2022. The analyses included the year of publication, type of publication, and origin of publication by country, region, and country income. The research areas were analyzed for research articles and systematic reviews. Of 1268 articles, 143 articles were excluded, and 1125 articles were analyzed. A total of 709 articles (63.02%) were published in 2021. A majority of publications were research articles (n = 678, 60.27%). The USA (n = 176, 15.64%), countries in the European Region (n = 496, 44.09%), and high-income countries (n = 861, 76.53%) were dominant publishing countries. Of 699 research articles and systematic reviews, surveillance and trends of physical activity were the main research area, followed by health outcomes, and correlates and determinants of physical activity. There is a wide gap in publication productivity in the field of physical activity and health during the pandemic among different countries' economic statuses.

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

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

Accelerometer-measured physical activity and sedentary time among children and their parents in the UK before and after COVID-19 lockdowns: a natural experiment

BACKGROUND

Restrictions due to the coronavirus disease 2019 (COVID-19) pandemic reduced physical activity provision for both children and their parents. Recent studies have reported decreases in physical activity levels during lockdown restrictions, but these were largely reliant on self-report methods, with data collected via unrepresentative self-report surveys. The post-pandemic impacts on children's activity levels remain unknown. A key question is how active children become once lockdown restrictions are lifted.

METHODS

Active-6 is a repeated cross-sectional natural experiment. Accelerometer data from 1296 children aged 10-11 and their parents were collected in 50 schools in the Greater Bristol area, UK in March 2017-May 2018 (pre-COVID-19 comparator group), and compared to 393 children aged 10-11 and parents in 23 of the same schools, collected in May-December 2021. Mean minutes of accelerometer-measured moderate-to-vigorous physical activity (MVPA) were derived for weekdays and weekend and compared pre- and post-lockdown via linear multilevel models.

RESULTS

After adjusting for seasonality, accelerometer wear time and child/parent demographics, children's mean weekday and weekend MVPA were 7.7 min (95% CI: 3.5 to 11.9) and 6.9 min (95% CI: 0.9 to 12.9) lower in 2021 than in 2018, respectively, while sedentary time was higher by 25.4 min (95% CI: 15.8 to 35.0) and 14.0 min (95% CI: 1.5 to 26.5). There was no evidence that differences varied by child gender or household education. There was no significant difference in parents' MVPA or sedentary time, either on weekdays or weekends.

CONCLUSIONS

Children's MVPA was lower by 7-8 min/day in 2021 once restrictions were lifted than before the pandemic for all groups, on both weekdays and weekends. Previous research has shown that there is an undesirable age-related decline in children's physical activity. The 8-min difference reported here would be broadly comparable to the decline that would have previously been expected to occur over a three-year period. Parents' physical activity was similar to pre-pandemic levels. Our results suggest that despite easing of restrictions, children's activity levels have not returned to pre-pandemic levels. There is an urgent need to understand why these changes have occurred and how long they are maintained.

Risk assessment and implementation of risk reduction measures is not associated with increased transmission of SARS-CoV-2 compared with standard isolation at professional golf events

Objectives

The purpose of this prospective study was to report incidence and transmission of SARS-CoV-2, among professional golfers and essential support staff undergoing risk assessment and enhanced risk reduction measures when considered a close contact as opposed to standard isolation while competing on the DP World Tour during the 2021 season.

Methods

This prospective cohort study included all players and essential support staff participating in 26 DP World Tour events from 18 April 2021 to 21 November 2021. High-risk contacts were isolated for 10 days. Moderate-risk contacts received education regarding enhanced medical surveillance, had daily rapid antigen testing for 5 days, with reverse transcriptase-polymerase chain reaction (RT-PCR) tesing on day 5, mandated mask use and access to outside space for work purposes only. Low-risk contacts typically received rapid antigen testing every 48 hours and RT-PCR testing on day 5.

Results

The total study cohort compromised 13 394 person-weeks of exposure. There were a total of 30 positive cases over the study period. Eleven contacts were stratified as 'high risk'. Two of these subsequently tested positive for SARS-CoV-2. There were 79 moderate-risk contact and 73 low-risk contacts. One moderate-risk contact subsequently tested positive for SARS-CoV-2 but did not transmit the virus. All other contacts, remained negative and asymptomatic to the end of the tournament week.

Conclusions

A risk assessment and risk reduction-based approach to contact tracing was safe in this professional golf event setting when Alpha and Delta were the predominant variants. It enabled professional golfers and essential support staff to work.

Returning persons with SARS-CoV-2 to the field of play in professional golf: a risk assessment and risk reduction approach

Objectives

This pilot study aimed to see whether a risk assessment and risk reduction approach was a practical and feasible approach, as compared with standard isolation for fully vaccinated, asymptomatic persons positive for SARS-CoV-2.

Methods

This prospective cohort study included all players and caddies participating in two large professional golf events from 7 to 20 February 2022 in South Africa. Fully vaccinated persons testing positive who were asymptomatic were subject to risk assessment and risk reduction measures to protect the integrity of the event. Asymptomatic individuals who could socially distance in outdoor areas were allowed to participate. Close contacts were subject to daily rapid antigen tests and asked to prioritise outdoor space.

Results

The protocols put in place for the events were practical, feasible, and well accepted by event participants and staff during the study period. There was a total of 378 player-week episodes and 378 caddie-week episodes during the study period. Three persons tested positive while registered at events during the study period (0.4% of person episodes). The positive tests were returned from two players and one caddie, all of which were asymptomatic at the time of testing. There was one high-risk contact who consistently returned negative antigen tests. There was no evidence of transmission.

Conclusions

The approach was practical and feasible. A risk assessment and risk reduction approach allowed fully vaccinated asymptomatic persons with SARS-CoV-2 to participate in golf, an outdoor sport where social distancing is possible, compared with standard isolation.

Declines in Physical Activity among New Zealand Adults during the COVID-19 Pandemic: Longitudinal Analyses of Five Data Waves from Pre-Pandemic through April 2021

Insights specific to the impact of the COVID-19 pandemic on physical activity participation in New Zealand (NZ) is limited. The purpose of this study was to examine longitudinal changes in leisure-time physical activity from pre-pandemic through April 2021. Demographic characteristics (age, gender, ethnicity, deprivation, disability status) and numerous indicators of leisure-time physical activity participation were assessed in a cohort of NZ adults (n = 1854, 54.6% women) over five waves (pre-pandemic, April 2020, June 2020, September 2020, and April 2021). Repeat measures were completed for: proportion participating in any physical activity; proportion meeting aerobic physical activity recommendations; physical activity duration; number of physical activities. There was a significant (p < 0.05) decline in mean physical activity duration and number of activities during the initial lockdown period in April 2020, but the proportion participating in any physical activity and the proportion meeting physical activity recommendations remained stable. However, all four physical activity participation indicators were significantly (p < 0.05) below pre-pandemic levels in all subsequent waves. Considerable and sustained declines in NZ adult leisure-time physical activity participation were evident over the first year of the pandemic. As of April 2021, physical activity participation showed limited signs of recovering to pre-pandemic levels.

Physical Activity Is Associated with a Lower Risk of Osteoporotic Fractures in Osteoporosis: A Longitudinal Study

The purpose of our study was to examine the occurrence of osteoporotic fractures (fxs) according to the level of physical activity (PA) among osteoporosis using the Korean National Health Insurance Service (NHIS) customized database. From NHIS data from 2009 to 2017, osteoporosis was selected as requested. PA was classified into ‘high PA’ (n = 58,620), ‘moderate PA’ (n = 58,620), and ‘low PA’ (n = 58,620) and were matched in a 1:1:1 ratio by gender, age, income within the household unit, and region of residence. A stratified Cox proportional hazard model was used to calculate hazard ratios (HRs) for each type of fx comparing PA groups. The ‘low PA’ group was the reference group. For vertebral fx, the adjusted HR (95% confidence intervals (CIs)) was 0.27 (0.26–0.28) for the ‘high PA’ group and 0.43 (0.42–0.44) for the ‘moderate PA’ group. For hip fx, the adjusted HR (95% CIs) was 0.37 (0.34–0.40) for the ‘high PA’ group and 0.51 (0.47–0.55) for the ‘moderate PA’ group. For distal radius fx, the adjusted HR (95% CIs) was 0.32 (0.30–0.33) for the ‘high PA’ group and 0.46 (0.45–0.48) for the ‘moderate PA’ group. The results of this study suggest that a higher intensity of PA is associated with a lower risk of osteoporotic fxs, including vertebral fx, hip fx, and distal radius fx.