Exercise frequency during the COVID-19 pandemic: A longitudinal probability survey of the US population

Abstract

Regular physical activity is important for general health and reduces the risk for COVID-19 infections and for severe outcomes among infected people. However, measures to mitigate COVID-19 likely decrease population physical activity. This study aimed to examine 1) changes in exercise frequency in a representative sample of US adults during the pandemic (04/01/2020–07/21/2021), and 2) how sociodemographic characteristics, pre-COVID health-related behaviors and outcomes, and state-level stringency of COVID-19 containment measures predict exercise frequency. Self-reported exercise frequency and its individual-level predictors were determined based on 151,155 observations from 6,540 adult participants (aged ≥ 18 years) in all US states from the Understanding America Study. State-level stringency of COVID-19 control measures was examined from the Oxford COVID-19 Government Response Tracker. Exercise frequency varied significantly over 28 survey waves across 475 days of follow-up ( F 1,473 = 185.5, p < 0.001, η 2 = 0.28, 95% CI = 0.23-1.00), where exercise frequency decreased between April 2020 and January 2021, and then increased from January 2021 to July 2021. Those who were younger, living alone, non-White, had no college degree, lower household income, low pre-pandemic physical activity levels, obesity, diabetes, kidney disease and hypertension had lower exercise frequency. State-level stringency of COVID-19 control measures was inversely associated with exercise frequency (B = 0.002, SE = 0.001, p < 0.01) between April and December 2020 when the overall stringency level was relatively high; but the association was non-significant (B = 0.001, SE = 0.001, p > 0.05) between January and July 2021, during which the stringency index sharply declined to a low level. This longitudinal probability survey of the US population revealed significant fluctuations in exercise during COVID-19. Low exercise levels are concerning and deserve public health attention. Health inequalities from physical inactivity are likely to exacerbate because of COVID-19. Physical activity promotion in safe environments is urgently warranted, especially in at-risk population subgroups.

Physical Activity Among Adults in Rural Western North Carolina During the COVID-19 Pandemic

“…The lack of diversity reflects the demographics of rural western North Carolina. Other participants in other studies had similar demographic characteristics: a high percentage of females ( 5 , 6 , 8 ), non-Hispanic people, and residents with post-secondary education ( 5 ). According to the Western North Carolina Health Network, the racial and ethnic population of western North Carolina is 89.9% White, 4.3% Black or African American, 1.5% American Indian/Alaska Native, and 6.0% Hispanic or Latino (of any race) ( 18 ); 50.2% of the population in the county we studied were female ( 19 ).…”

“…Additionally, outdoor activity became especially desirable ( 5 , 13 ) because it facilitated social distancing ( 12 ). At the same time, concerns about exposure to COVID-19, lack of available exercise equipment, state or local restrictions, and living conditions were barriers to being physically active ( 7 , 8 ), as were reported “worry/stress” and “lack of motivation” ( 6 ).…”

Physical Activity Behavior During and After COVID-19 Stay-at-Home Orders—A Longitudinal Study in the Austrian, German, and Italian Alps

“…Our results support their findings, as PA levels in our study were also low during both lockdown periods in spring and winter. Wijngaards et al ( 72 ) observed a decrease in exercise frequency between April 2020 and January 2021 and subsequently an increase from January 2021 to July 2021 in a representative sample of US adults. It should be noted, however, that in contrast to Europe, different COVID-19 measures were introduced in the US at different times and that sport is also structured and organized differently there, making comparisons between both studies difficult to make.…”

“…Mata et al ( 69 ), however, observed a steady increase in participants' PA after the initial lockdown in Germany with PA levels in June surpassing pre-lockdown PA. Scottish adults also increased the amount of walking they did after the initial lockdown and returned to pre-lockdown levels ( 71 ). While the longitudinal studies that have already been published, primarily examined the changes in PA from pre-lockdown to the period after the initial lockdown, there is little literature that observes a longer time period and includes the subsequent waves of the COVID-19 pandemic ( 72 ).…”

Physical activity lowers the risk for acute respiratory infections: Time for recognition

“…Data collected during the COVID-19 pandemic reveal that highly stringent governmental containment measures were a barrier to physical activity, especially for those who needed it the most, which includes those suffering with chronic health problems. [68] , [69] , [70] , [71] During the early part of the pandemic, many areas of the country closed gyms, sports clubs, rehabilitation centers, and swimming pools. Some local public health agencies even shut down beaches, golf courses, and walking, running, and mountain biking trails.…”