The COVID-19 pandemic altered many facets of life. We aimed to evaluate the impact of COVID-19-related public health guidelines on physical activity (PA), sedentary behavior, mental health, and their interrelations. Cross-sectional data were collected from 3052 US adults 3–8 April 2020 (from all 50 states). Participants self-reported pre- and post-COVID-19 levels of moderate and vigorous PA, sitting, and screen time. Currently-followed public health guidelines, stress, loneliness, positive mental health (PMH), social connectedness, and depressive and anxiety symptoms were self-reported. Participants were grouped by meeting US PA guidelines, reporting ≥8 h/day of sitting, or ≥8 h/day of screen time, pre- and post-COVID-19. Overall, 62% of participants were female, with age ranging from 18–24 (16.6% of sample) to 75+ (9.3%). Self-reported PA was lower post-COVID among participants reporting being previously active (mean change: −32.3% [95% CI: −36.3%, −28.1%]) but largely unchanged among previously inactive participants (+2.3% [−3.5%, +8.1%]). No longer meeting PA guidelines and increased screen time were associated with worse depression, loneliness, stress, and PMH (p < 0.001). Self-isolation/quarantine was associated with higher depressive and anxiety symptoms compared to social distancing (p < 0.001). Maintaining and enhancing physical activity participation and limiting screen time increases during abrupt societal changes may mitigate the mental health consequences.

Exercise training reduces anxiety symptoms among sedentary patients who have a chronic illness.

RET significantly improves anxiety symptoms among both healthy participants and participants with a physical or mental illness. Improvements were not moderated by sex, or based on features of RET. Future trials should compare RET to other empirically-supported therapies for anxiety.

Exercise reduces depressive symptoms among patients with a chronic illness. Patients with depressive symptoms indicative of mild-to-moderate depression and for whom exercise training improves function-related outcomes achieve the largest antidepressant effects.

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Resistance exercise training significantly reduced depressive symptoms among adults regardless of health status, total prescribed volume of RET, or significant improvements in strength. Better-quality randomized clinical trials blinding both allocation and assessment and comparing RET with other empirically supported treatments for depressive symptoms are needed.

Purpose of ReviewThe purpose of this paper was to provide a comprehensive narrative review of the relationship between physical activity (PA) and anxiety and the rationale for including it as a treatment option for anxiety disorders. Several gaps in the literature are highlighted alongside recommendations for future research.Recent FindingsPA in the general population has established efficacy in preventing and managing cardiovascular disease and improving wellbeing. Recent epidemiological data further suggests that people who are more active may be less likely to have anxiety disorders. In addition, evidence from systematic reviews of randomised control trials suggests that exercise training, a subset of PA, can reduce symptoms in anxiety and stress-related disorders, such as post-traumatic stress disorder, agoraphobia and panic disorder.SummaryAnxiety disorders are common, burdensome and costly to individuals and wider society. In addition to the profound negative impact on individuals’ wellbeing and functioning, they are associated with worsened physical health, including a higher risk for cardiovascular diseases and premature mortality. Although pharmacotherapy and psychological interventions are helpful for many, these treatment approaches are not effective for everyone and are insufficient to address common physical health complications, such as the elevated risk of cardiovascular disease. Given the combined anxiolytic and physical health benefits of increased activity, PA presents a promising additional treatment option for people with anxiety disorders. However, there remain key gaps in the literature regarding the mechanisms underlying the effects of PA, optimal PA protocols, methods of improving adherence and the importance of physical fitness. These must be addressed for PA to be successfully implemented in mental health services.

Aims: The COVID-19 pandemic and associated global response have significantly altered people's behaviour, likely decreasing physical activity, increasing sitting and screen time, while simultaneously worsening mental health. The objective of this project was to evaluate the impact of COVID-19-related public health restrictions on physical activity, sedentary time, mental health, and their interrelations. Methods: Cross-sectional data were collected from 3,052 US adults between April 3 rd-7 th , 2020. Participants were recruited through convenience sampling from mass emails to faculty, staff, students, and alumni of Iowa State University and additional snowball sampling resulting in responses from all 50 states and the District of Colombia. Moderate and vigorous physical activity, sitting, and screen time, both pre-and post-COVID-19-related restrictions, along with currently-followed public health restrictions were self-reported. Current mental health was reported including stress (Perceived Stress Scale-4), loneliness (3-item Loneliness), positive mental health (Short Warwick-Edinburgh Mental Wellbeing Scale), social connectedness (Lubben Social Network Scale), and depressive and anxiety symptoms (Beck Depression and Anxiety Inventories). Participants were grouped by meeting US physical activity guidelines (active/inactive), reporting ≥8 hrs/day of sitting, or ≥8 hrs/day of screen time, pre-and post-COVID-19-related restrictions. Results: Of the 3,052 participants (62% female), age ranged from 18-24 (16.6% of sample) to 75+ (9.3%). Weekly physical activity was reduced after COVID-19-related restrictions among previously active participants (mean change:-32.3% [95% CI:-36.3%,-28.1%]) but largely unchanged among previously inactive participants (+2.3% [-3.5%, +8.1%]). Large increases in