Associations between sociodemographic factors and physical activity and sedentary behaviors in adults with chronic diseases during COVID-19 pandemic

Correlation Between Self-reported or Supervised Physical Activity in Noncommunicable Diseases and Comorbidities During COVID-19 Pandemic: A Systematic Review

OBJECTIVE

The aim of the study is to systematically identify the protective and ameliorative effects of physical activity among people with noncommunicable diseases such as diabetes, cancer, chronic respiratory disease, chronic vascular disease, hypertension, and existing comorbidities during the coronavirus disease (COVID-19) pandemic.

METHODS

The trial is registered in the PROSPERO registry and used the PICO (population, intervention, comparison, and outcomes) strategy to perform the search strategy. Assessors analyzed related studies in the MEDLINE, PROQUEST, PubMed, Cochrane Library, CINAHL, Embase, Google Scholar, Physiotherapy Evidence, and Science Direct databases between December 2022 and January 2023. Researchers independently conducted a quality assessment of each study using a predeveloped quality assessment tool adapted from established tools for quantitative studies.

RESULTS

Eighteen trials were included (chronic vascular disease-7, diabetes-4, hypertension-1, cancer-3, and chronic respiratory disease-3). The total number of individuals included in the systematic review was 780,003, and the total with or without COVID-19 was 188,435. Qualitative rating by the Newcastle-Ottawa Score for cross-sectional and cohort studies and the Physiotherapy Evidence Database scale revealed fair to good evidence for physical activity as a tool to reduce complications.

CONCLUSIONS

There is evidence that exercise can protect people with noncommunicable diseases during the COVID-19 pandemic.Registration: Registered with Prospero registry.

Sedentary behaviour among elderly patients after total knee arthroplasty and its influencing factors

To understand the status of sedentary behaviour in elderly patients after total knee arthroplasty and analyse its influencing factors so as to provide a reference for developing targeted interventions. Conveniently selected elderly patients undergoing total knee arthroplasty (> 6 months) in a tertiary hospital in Jiangsu Province were investigated using a general information questionnaire, the Charlson Comorbidity Index, patients' self-reported sedentary behaviour information, the WOMAC Score, The Groningen Orthopaedic Social Support Scale, and Lee's Fatigue. The median daily sedentary time was 5.5 h (4.5 h, 6.625 h) in 166 elderly patients after total knee arthroplasty, of whom 82 (49.40%) showed sedentary behaviour (≥ 6 h per day). Logistic regression analysis showed that being retired/unemployed (OR = 8.550, 95% CI 1.732-42.207, P = 0.0084), having a CCI score ≥ 3 (OR = 9.018, 95% CI 1.288-63.119, P < 0.0001), having high WOMAC scores (OR = 1.783, 95% CI 1.419-2.238, P < 0.0001), having a high social support score (OR = 1.155, 95% CI 1.031-1.294, P = 0.0130), and having a fatigue score ≥ 5 (OR = 4.848, 95% CI 1.084-21.682, P = 0.0389) made patients more likely to be sedentary. The sedentary time of elderly patients after total knee arthroplasty is long, and sedentary behaviour is common among them. Healthcare professionals should develop targeted sedentary behaviour interventions based on the influencing factors of sedentary behaviour in order to reduce the occurrence of sedentary behaviour in elderly patients after total knee arthroplasty.

Association of Sociodemographic Factors with Physical Activity and Sleep Quality in Arab and Non-Arab Individuals of Both Sexes during the COVID-19 Pandemic

We explored the association of sociodemographic and anthropometric factors with self-reported physical activity (PA) and sleep quality in Arab and non-Arab individuals of both sexes during the COVID-19 pandemic. In this cross-sectional study, 638 participants (those recovered from COVID-19 = 149, and non-infected = 489) of both sexes aged 18-55 years were recruited. Their sociodemographic and anthropometric information, PA (self-reported using the International Physical Activity Questionnaire Short-form [IPAQ-SF)]) and sleep quality (self-reported using the Pittsburgh Sleep Quality Index [PSQI]) were documented. The association between participants' characteristics, PA levels, and sleep quality were determined using the chi-squared test. Variables significantly associated with IPAQ and PSQI in bivariate analyses were included in a multivariate binary logistic regression model. Men were more active than women (odds ratio [OR] = 1.66, p = 0.010), and non-Arab participants were more active than Arab ones (OR = 1.49, p = 0.037). Participants ≥40 years, men, non-Arab participants, and those who were working were more likely to have a good sleep quality than those ≤40 years (OR 1.70, p = 0.048), women (OR 1.10, p = 0.725), Arab individuals (OR 1.95, p = 0.002), and unemployed people (OR 2.76, p = 0.007). Male and non-Arab participants seemed to have a better self-reported PA and sleep quality compared to female and Arab participants, during the pandemic.

Impacts of COVID-19 lockdown on time allocation for sedentary and physical activities - The context of Indian university students

Introduction

Covid-19 pandemic has impacted individuals' time allocation decisions. As it is known that university students display behaviors different from the general population, very few studies have examined their activity participation and time allocation behavior during the pandemic. The present study investigates the changes in time allocations to sedentary, physically active, and eat-sleep activities before and during the pandemic.

Methods

The study hypothesizes that active mode (walk, bicycle) and transit users would compensate for the physical efforts by increasing physical activities at home during the lockdown. Students' perception of personal well-being, anxiety, and individual leisure during the pandemic and their impacts on time allocation decisions after controlling for demographic variables and temporal effects are also explored. A pan India behavioral data of 203 samples collected using an online survey conducted between May to July 2020, during India's lockdown phase, is used for analysis. A series of segmented analyses (using ANOVA's and Kruskal-Wallis Test) and empirical modeling (linear mixed-effect regression) were conducted based on the time use distribution.

Results

Findings showed that university students from low-income households and students who own a bicycle show a higher tendency to spend time in physical activities during lockdown periods. Students accessing college using active modes (before lockdown) allocate less time to sedentary and eat-sleep activities than physical activities during the lockdown period. Students' perception of Leisure items among those who use active modes is significantly different from those of private and public mode users.

Conclusions

From a policy viewpoint, such investigation would help implicitly understand and publicize the health benefits of active modes and transit and encourage their use. For instance, policymakers and transport planners can temporarily allocate less-used motorized streets (due to the pandemic) to students who prefer walking and cycling as universities still function online in India.

Self-care Behaviours and Technology utilised during COVID-19: Systematic Review

Background

Self-care behaviors are essential for people living with chronic conditions; however, the outbreak of the COVID-19 pandemic has imposed additional complications on their daily routines. Few studies have analyzed how self-care behaviors have changed during COVID-19 and the role of digital technology, especially among people with chronic conditions.

Objective

This study aims to review how self-care behaviors have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period.

Methods

A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, and Google Scholar, including articles from December 2019 onward. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (ie, self-care maintenance, monitoring, and management). The methodological quality of the included articles was assessed with the McMaster Critical Review Forms for Quantitative or Qualitative Studies.

Results

In total, 36 primary research articles were included. Changes to self-care behaviors during COVID-19 among people with chronic conditions were organized according to the middle-range theory of self-care of chronic illness focusing on self-care maintenance (ie, medication adherence, physical activity, and diet control), self-care monitoring (ie, monitoring signs and symptoms), and self-care management (ie, consultations with health care providers). Positive self-care behaviors observed include the following: individuals trying to maintain good glycemic control during COVID-19 increased their medication adherence in 27% (10/36) of studies; and diet control improved in 50% (18/36) of studies. Negative self-care behaviors observed include the following: decline in physical activities and increased sedentariness were observed in 65% (23/36) of studies; poor diet control was observed in 57% (21/36) of studies; and self-monitoring of health status dropped in 43% (15/36) of studies. The use of technology to support self-care of chronic conditions during COVID-19 was reported in 72% (26/36) of studies. The actual use of telehealth in place of physical consultations during COVID-19 was observed in 50% (18/36) of studies, and other digital technologies (eg, social media apps, smartphone apps, web-based platforms, and web browsing) were used in 50% (18/36) of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% (28/36) of studies.

Conclusions

This review highlighted the necessity to rethink how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) among a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.

Changes in Physical Activity Compared to the Situation before the Outbreak of COVID-19 in Korea

The purpose of this study is to examine changes in physical activity in Korean society, after the outbreak of COVID-19. Method This study was conducted using the Korean Community Health Survey conducted in 2019 and 2020. Subjects that have been diagnosed with hypertension and diabetes were excluded; a total of 355,914 cases were involved for analysis. In terms of the analysis method, General Linear Model (GLM) was conducted to examine the changes in physical activities in 2019 and 2020 depending on the presence of a spouse, educational status, and economic activities. In addition, the GLM was adopted to divide the subjects by gender and age, and analyze their physical activity changes in 2019 and 2020 with spouse presence, educational status, and economic activities as adjusted variables. Result In terms of Koreans, those without a spouse, high educational attainment, and economically inactive were less engaged in physical activities. Differences were found in subjects regarding moderate-intensity physical activities after social distancing following the spread of COVID-19. Senior females without a spouse, both males and females with low educational attainment, economically inactive adult females, and economically active senior males showed a greater drop in physical activities. For walking hours, both adult males and females without a spouse, adult females with all educational attainment level excluding elementary and middle school graduates, and economically inactive adult males and females also showed a downward trend. Conclusion The study recommends that people develop a strategy to increase their post-outbreak physical activity, taking into account the sociodemographic.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults

Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.