Factors affecting exercise during COVID-19 pandemic

The sudden and rapid outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) pandemic, which has immensely affected the global healthcare system and economy.

Similar to many countries around the world, the United Kingdom government also introduced various strategies, such as social distancing, closure of hospitality venues and gyms, and travel restrictions. In some areas, full lockdowns were implemented and people residing in those areas were advised to “stay at home.”

Study: Exploring barriers and facilitators to physical activity during the COVID-19 pandemic: a qualitative study. Image Credit: Drazen Zigic / Shutterstock.com

Background

Implementation of various non-pharmaceutical interventions (NPIs) restricted physical activity (PA) outside homes. Previous studies based on quantitative analyses have investigated the effect of pandemic restrictions on PA.

Although some studies have reported reduced PA during the lockdown periods, others reported differential findings. For instance, one study reported that as compared to older adults, a significant decline in PA was observed in younger adults. 

Several studies have also indicated that some demographic groups, such as individuals with long-term health conditions (LTCs), experienced prolonged restrictions as compared to others. These groups, along with those with mental health conditions (MHCs), showed a decline in PA during the pandemic. Typically, parents of younger children have additional caring responsibilities, which also resulted in reduced PA for these individuals during the lockdown periods.

Scientists have indicated the scarcity of documents related to qualitative studies on the barriers and facilitators of PA during the pandemic. Some of the barriers to PA include cancellation of group activities, closure of exercise facilities, and lack of relevant equipment for exercise.

Researchers have described some of the facilitators of PA during the pandemic including the urge of an individual to maintain fitness, experiencing a positive mental state after PA, exercising with another person, and access to proper exercising equipment and technology.

Several studies conducted in France and the United States reported that older adults stopped attending exercise classes due to the fear of contracting SARS-CoV-2 infection. Another barrier highlighted by a previous study was the lack of information about online PA resources. Some other barriers to PA indicated by various studies were lack of routine, low motivation, and lack of club activities.

Previous studies have revealed that the key factors associated with achieving target behavior are capability (knowledge and skills), opportunity (social and environmental factors), and motivation (cognitive processes directing behavior). Scientists have indicated the usefulness of the Capability, Opportunity, Motivation Model of Behavior (COM-B) in constructing barriers and facilitating factors maps. This type of map could be beneficial in predicting the need for developing interventions for future pandemics and health emergencies. 

About the study

A new study published on the medRxiv* preprint server discusses the results of a qualitative investigation on the barriers and facilitators to PA during the COVID-19 pandemic across different demographic groups.

The current study was a qualitative part of the UCL-COVID-19 Social Study (CSS) 2020. Although the main aim of the CSS study was to determine the impact of COVID-19 restrictions on mental health and well-being, the scientists also extended their research to determine the impact of COVID-19 restrictions on PA.

In this study, researchers conducted one-on-one telephone/video call interviews with both younger individuals between the ages of 18 and 24 years, as well as older adults over the age of 70. The researchers acquired information about the mental health, long-term health conditions, and PA levels of the study participants. The authors also identified barriers and facilitators using reflexive thematic analysis, while also mapping themes using the COM-B model.

Study findings

Most of the themes reflected the physical opportunity and motivation COM-B domains. There were no themes associated with capabilities for PA. The findings of this study are in line with previous survey reports, which observed that physical opportunity and reflective motivation are reliable predictors of behavior.

The significance of the outdoor environment was identified as a key theme, as the lack of garden access was found to inhibit PA. Previous studies have reported that individuals from rural settings have more conducive settings to PA engagement, in contrast to those living in urban areas, where population density enhances the possibility of SARS-CoV-2 transmission.

The researchers of the current study believe that these findings will help in the development of future pandemic guidance. For example, instead of restricting, individuals must be encouraged to use open spaces and gardens for PA engagements. Additionally, adopting PA promotion initiatives, such as video guidance for exercising at home and outside following pandemic guidance, will be highly beneficial.

Notably, those residing in LTCs were significantly more impacted by “shielded” restrictions. Thus, in future pandemics, vulnerable groups must be advised to maintain PA safely by exercising in-home or using home exercising equipment. 

Conclusions

One of the strengths of this study is the large sample size, which enabled researchers to analyze a wide range of views. Taken together, the observations reported in this study can be used to consider strategies for enhancing physical activity in future lockdowns and pandemics. To prevent further negative health outcomes following periods of lockdown, future interventions should encourage physical activity and increase opportunities for reflection. Among the strategies that could be used are tailoring physical activity guidance based on location and providing education on the benefits of physical activity.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Dr. Priyom Bose

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.