Scaling up urban infrastructure for physical activity in the COVID-19 pandemic and beyond

Abstract

Urban design, planning, and transport play an important role in the promotion of physical activity. 1 Since 2010, active transportation systems and active urban design have been recognised as among the best investments for encouraging physical activity at scale. 2 Designing and planning activity-promoting cities can help prevent premature mortality, 3 reduce the high costs associated with physical inactivity, 4,5 and help countries achieve some of the UN Sustainable Development Goals. 6 During the COVID-19 pandemic, Scaling up urban infrastructure for physical activity in the COVID-19 pandemic and beyond with bothersome shoulder pain. Compared with no injection, injection provided superior outcomes at 8 weeks for pain and function as well as most other patient-relevant secondary outcomes, including insomnia severity and return to desired activities. Rapid, although modest, short-term alleviation of pain and its disruptive effects on sleep, cognition, emotional wellbeing, activity, and participation is likely to be highly valued by patients. 9 Injections can easily and cheaply be given by trained GPs or physiotherapists within the consultation as was done in this trial. As noted by Hopewell and colleagues, image guidance is unnecessary and adds significantly to the costs but not to the benefits. 6,10 Further trials of these interventions are unnecessary because they are unlikely to alter the conclusions from this well conducted trial. By contrast with previous trials, its strengths include its large size, adequately powered to assess the independent effects of two relevant interventions, inclusion of a comprehensively described progressive exercise programme that reflects usual practice, and its parallel economic analysis. Although the trial did not include a placebo control and participants and treating physiotherapists were not masked to treatment, the observed effect sizes would predictably be even smaller if these limitations had been addressed. In view of its relatively short half-life, the rationale for looking for benefits of a single corticosteroid injection beyond the short to medium term could also be questioned. 11 To make a best evidence-informed decision about their care, patients should be advised about the favourable long-term prognosis of this condition and the lack of added benefit of a progressive exercise programme over a single consultation that provides best practice advice and instruction on self-guided home exercise. From both an individual and health-service perspective, given the evidence of improvement over time regardless of intervention, watchful waiting with or without corticosteroid injection might also be an option to consider.

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

“…For example, social media may play an important role in facilitating the self-management of behaviors related to physical activity, diet, and quality of life [43]. Besides, the rapid implementation of large-scale urban transformations may increase access to public open spaces and active transport infrastructure with the aim to promote physical activity and reduce sedentariness [44]. It has been suggested that there are different patterns of lifestyle changes for people all over the world during the COVID-19 pandemic, so there is a need to tailor support, interventions, and advice to different population groups [45], with the aim of providing appropriate strategies to rebuild balanced lifestyle patterns.…”

Physical Activity and Its Barriers and Facilitators among University Students in Qatar: A Cross-Sectional Study

“…Additionally, Qatar is one of the safest countries in the world. A well-designed environment can contribute to increasing PA, preventing premature mortality, and reducing costs associated with physical inactivity [ 34 , 35 , 36 ]. Our study might reflect the increase in PA among Qatar’s adults occurring before the COVID-19 pandemic when many construction projects were delivered.…”

COVID-19 and aerobic exercise: possible role of angiotensin converting enzyme 2

“…During and after the pandemic, several studies have recommended physical exercise. Different protocols have been proposed combining aerobic and anaerobic exercises, indoors and outdoors, at different intensities and durations [34][35][36]. In the current situation our hypothesis suggests that high intensity outdoor physical activity requiring a high level of ventilation in urban environment is not recommended.…”