Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

Abstract

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.

Keywords: Covid-19; SARS-CoV-2; coronavirus; exercise; physical activity; training.

Figure 1

Prisma Flow Chart.

Figure 2

Funnel plots for publication bias between studies.

Figure 3

Forest plots of PA changes during Covid-19 for Children and Adolescents, Adults, and Older Adults. Studies are presented in alphabetical order, with those representing more than one age group being presented at the lower part of each forest plot, followed by studies using device-based measurements. Abbreviations: SR: self-reported, DB: device-based; PA: physical activity, LTPA: leisure-time physical activity, WHO: World Health Organization, LPA: low physical activity, MPA: moderate physical activity, VPA: vigorous physical activity, MVPA: moderate-to-vigorous physical activity, PAL: physical activity levels. Note: The 46 studies included in the quantitative meta-analysis with the respective reference numbers can be found in Table 2.

Figure 3

Forest plots of PA changes during Covid-19 for Children and Adolescents, Adults, and Older Adults. Studies are presented in alphabetical order, with those representing more than one age group being presented at the lower part of each forest plot, followed by studies using device-based measurements. Abbreviations: SR: self-reported, DB: device-based; PA: physical activity, LTPA: leisure-time physical activity, WHO: World Health Organization, LPA: low physical activity, MPA: moderate physical activity, VPA: vigorous physical activity, MVPA: moderate-to-vigorous physical activity, PAL: physical activity levels. Note: The 46 studies included in the quantitative meta-analysis with the respective reference numbers can be found in Table 2.

Figure 3

Forest plots of PA changes during Covid-19 for Children and Adolescents, Adults, and Older Adults. Studies are presented in alphabetical order, with those representing more than one age group being presented at the lower part of each forest plot, followed by studies using device-based measurements. Abbreviations: SR: self-reported, DB: device-based; PA: physical activity, LTPA: leisure-time physical activity, WHO: World Health Organization, LPA: low physical activity, MPA: moderate physical activity, VPA: vigorous physical activity, MVPA: moderate-to-vigorous physical activity, PAL: physical activity levels. Note: The 46 studies included in the quantitative meta-analysis with the respective reference numbers can be found in Table 2.