Accelerometer-measured physical activity and sedentary time among children and their parents in the UK before and after COVID-19 lockdowns: a natural experiment

Abstract

Background Restrictions due to the coronavirus disease 2019 (COVID-19) pandemic reduced physical activity provision for both children and their parents. Recent studies have reported decreases in physical activity levels during lockdown restrictions, but these were largely reliant on self-report methods, with data collected via unrepresentative self-report surveys. The post-pandemic impacts on children’s activity levels remain unknown. A key question is how active children become once lockdown restrictions are lifted. Methods Active-6 is a repeated cross-sectional natural experiment. Accelerometer data from 1296 children aged 10–11 and their parents were collected in 50 schools in the Greater Bristol area, UK in March 2017-May 2018 (pre-COVID-19 comparator group), and compared to 393 children aged 10–11 and parents in 23 of the same schools, collected in May-December 2021. Mean minutes of accelerometer-measured moderate-to-vigorous physical activity (MVPA) were derived for weekdays and weekend and compared pre- and post-lockdown via linear multilevel models. Results After adjusting for seasonality, accelerometer wear time and child/parent demographics, children’s mean weekday and weekend MVPA were 7.7 min (95% CI: 3.5 to 11.9) and 6.9 min (95% CI: 0.9 to 12.9) lower in 2021 than in 2018, respectively, while sedentary time was higher by 25.4 min (95% CI: 15.8 to 35.0) and 14.0 min (95% CI: 1.5 to 26.5). There was no evidence that differences varied by child gender or household education. There was no significant difference in parents’ MVPA or sedentary time, either on weekdays or weekends. Conclusions Children’s MVPA was lower by 7–8 min/day in 2021 once restrictions were lifted than before the pandemic for all groups, on both weekdays and weekends. Previous research has shown that there is an undesirable age-related decline in children’s physical activity. The 8-min difference reported here would be broadly comparable to the decline that would have previously been expected to occur over a three-year period. Parents’ physical activity was similar to pre-pandemic levels. Our results suggest that despite easing of restrictions, children’s activity levels have not returned to pre-pandemic levels. There is an urgent need to understand why these changes have occurred and how long they are maintained.

Parents’ perceptions of their children’s physical activity during the COVID-19 pandemic

“…While public health measures offered protection from COVID-19 transmission, parents indicated that the protocols negatively impacted their children's health behaviours. Consistent with local [28], national [9,29] and international findings [13,[30][31][32], many parents reported their children's physical activity declined during the COVID-19 pandemic; the change in activity levels was primarily credited to the loss of organized activities and limited physical activity opportunities. To meet the government's health and safety measures, recreational facilities were either closed or were running at low capacity, disrupting children's regular afterschool programming [33].…”

A multi-perspective qualitative exploration of the reasons for changes in the physical activity among 10–11-year-old children following the easing of the COVID-19 lockdown in the UK in 2021

“…Note. Qualitative results are displayed in green; the reduction in MVPA reported by Salway and colleagues [ 14 ] is displayed in yellow …”

“…Due to the impact of extended periods of social disconnection, children experienced significant emotional overwhelm and fatigue when they were eventually able to reengage with a society that more closely represented a pre-pandemic normality. This led to avoidance of physical activity, particularly unstructured active play, which provides explanation for the observed decrease in MVPA and increase in sedentary time among children who participated in Active-6 [ 14 ]. The narrative relating to changes to active play within two recent qualitative studies were mixed.…”

“…Table 3 highlights key findings and implications from this study. The primary message is the emotional and physical challenges experienced by children following the easing of COVID-19 restrictions are key contributors to the decreased MVPA and increased sedentary behaviour identified in a related quantitative study [ 14 ]. It is important to develop new approaches to provide support for children to address these issues.…”

“…The Active-6 project [ 20 ] seeks to examine the impact of changes that have resulted from the COVID-19 pandemic on physical activity behaviour among Year 6 children (aged 10–11 years) and their parents/guardians. Using accelerometer data collected between May and December 2021 we found that Year 6 children were taking part in an average of 7–8 fewer minutes of MVPA and 25 additional minutes of sedentary time per day than a pre-pandemic comparator group who were recruited from the same schools and assessed using the same methods before the pandemic [ 14 ]. These results indicate that the detrimental impact of the pandemic on children’s physical activity appears to continue beyond the immediate period of actual restrictions.…”