Analysis examines modifications in bodily exercise, sitting and sleep throughout Scotland’s COVID lockdown
The 2019 coronavirus disease (COVID-19) pandemic has brought the world to a standstill on many levels. Researchers at the University of Strathclyde have examined the lasting effects of changes in behavioral outcomes during lockdowns enforced to mitigate COVID-19 infection. While there have been reports of changes in 24-hour physical activity behavior at the start of the national closures in Scotland, little is known of these behaviors throughout the lockdown period and as the restrictions begin to relax.
A new study by researchers at the University of Strathclyde, published as a preprint on the medRxiv * server, examined changes in 24-hour physical activity behavior in three specified time periods: from 1) pre-lockdown (T1) to the 1st national lockdown in Great Britain (T2); and 2) UK first national lockdown until lockdown is initially relaxed (T3).
Understanding this 24-hour exercise behavior during lockdown that emerges from this study will help people maintain or return to healthy lifestyles after COVID-19, the authors write. The determinants of these positive changes, once identified, can be used to inform intervention evolution.
Several studies looked at the immediate effects of the COVID-19 pandemic on 24-hour physical activity behavior (i.e. physical activity, sitting and sleeping). There is evidence that COVID-19 has changed behavioral patterns. Many people reported a decrease in physical activity, increased sedentary lifestyle, and poor sleep. Changes in 24-hour exercise behavior can further exacerbate the negative changes in mental and physical health during the pandemic. Before the COVID-19 epidemic, it was common knowledge that 24-hour physical activity behavior was linked to physiological and mental health. Since then, changes in physical activity due to COVID-19 have been suggested to increase the risk of cardiovascular disease. Studies have also reported that those who did more physical activity, did less sedentary work, and got enough sleep reported better mental outcomes at the start of the Covid-19 pandemic.
In this study, the study cohort included participants who were primarily recruited through social media ads on Facebook and Twitter, with a sample size of 2,458. The average age of the participants in this study was 46.2 years, most of whom were women (about 80.4%). Participants reported the frequency and duration of moderate and vigorous physical activity, including walking, during each period. Sedentary behavior was measured during a typical week prior to lockdown (T1), during the first UK lockdown (T2), and when restrictions initially subsided (T3). Sleep measurements were also taken based on the number of hours the participants slept each night during the study period. Although the study is a longitudinal study with a large sample size, the limitations are self-reporting, predominantly women, and the underrepresentation of important socio-demographic groups.
With the change in the period blocks shown in the study – from T1 to T2 to T3 – changes in the 24-hour exercise behavior were observed. Due to lockdown restrictions, people reduced walking. However, moderate to vigorous physical activity (MVPA), sleep, and sitting from pre-lockdown to lockdown increased. And when the restrictions were relaxed (the T3 period), walking, sleeping, and sitting returned to the levels they were before they were locked.
“Understanding the barriers and facilities for positive change during lockdown enables researchers, practitioners, and policy makers to provide opportunities for healthy behavior change for the most vulnerable in the post-COVID era,” the researchers said.
When examining shifts in each individual’s behavior, 20 to 30% of participants saw positive or negative changes for each behavior. People who did moderate to vigorous physical activity for 30 to 60 minutes at T1 or who walked for 6 to 8 hours per week, and reported either insufficient sleep or too much sleep, had the highest proportion of positive switchers at T2. The pattern of results was repeated during the simple blocking measures.
The study found evidence of clustering in these changes in physical activity – walking, sitting, and sleeping. They also found that one positive behavior influenced at least one other positive behavior. Since the accumulative impact of lifestyle changes on health is greater than just the sum of the two behaviors, this has been called a very encouraging observation.
Interestingly, from this study, the researchers found that lockdown measures had positively improved behavior change in those with bad behavior.
This will require future qualitative studies to better understand what made it possible for those who behaved badly during lockdown.
* Important NOTE
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.
- Janssen, Xanne and Leanne Fleming, Alison Kirk, Lesley Rollins, David Young, Madeleine Grealy, Bradley MacDonald, Paul Flowers and Lynn Williams (2020) Changes in physical activity, sitting and sleeping during the COVID-19 embargo in Scotland. medRxiv 2020.11.05.20226381; doi: https://doi.org/10.1101/2020.11.05.20226381, https://www.medrxiv.org/content/10.1101/2020.11.05.20226381v1