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 Table of Contents  
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 35-38

Impact of CoronaVirus Disease-19 lockdown on physical activity and energy expenditure among middle adolescence - A cross-sectional e-survey

Assistant Professor, SPB Physiotherapy College, Surat, Gujarat, India

Date of Submission28-Sep-2020
Date of Decision02-May-2021
Date of Acceptance03-May-2021
Date of Web Publication26-Jun-2021

Correspondence Address:
Dr. Vandana Jivatsinh Rathod
SPB Physiotherapy College, Ugat Bhesan Road, Surat - 395 005, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amhs.amhs_257_20

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Background and Aim: Coronavirus disease-19 (COVID-19) is a pandemic disease spreading throughout the world. Lockdown declared by the Indian government to control the spread of this disease leads to change an entire lifestyle of the population. Individual's lives are greater affected due to lockdown which leads to a reduction in their physical activity (PA). It might increase the chance of infection by reducing immunity. How much PA is reduced during this lockdown period among middle adolescence is not known. This study attempts to find out PA level and energy expenditure (EE) among middle adolescence during the lockdown. Materials and Methods: One hundred and twenty-three volunteered students participated in an open e-survey. The survey was carried out by the International PA questionnaire-short form through social networking sites during the COVID-19 lockdown period through the Google Forms link. PA and EE have been measured. Results: Among identified 147 potential survey participants, 123 responded. Total PA during COVID–19 lockdown period was 6262.21 metabolic equivalent task-min/week. While EE during COVID–19 lockdown period was 6009.28 cal/week. Conclusions: A significant reduction in self-report PA and EE levels was observed among middle adolescent students during the COVID–19 lockdown period.

Keywords: Coronavirus, coronavirus disease-19, energy expenditure, middle adolescence, physical activity

How to cite this article:
Rathod VJ. Impact of CoronaVirus Disease-19 lockdown on physical activity and energy expenditure among middle adolescence - A cross-sectional e-survey. Arch Med Health Sci 2021;9:35-8

How to cite this URL:
Rathod VJ. Impact of CoronaVirus Disease-19 lockdown on physical activity and energy expenditure among middle adolescence - A cross-sectional e-survey. Arch Med Health Sci [serial online] 2021 [cited 2021 Dec 6];9:35-8. Available from: https://www.amhsjournal.org/text.asp?2021/9/1/35/319386

  Introduction Top

Novel Coronavirus (nCoV) is a global epidemic disease of the year 2020 which affects probably the whole world. It is a viral respiratory disease affecting most countries. Coronavirus disease-19 (COVID-19) has recently been discovered. This virus is originated from Wuhan (Hubei, China), and spread throughout the world with rapid infection and deaths.[1] The virus is more susceptible to individuals due to the lack of immunity found after infection.[2] According to an analysis published on March 22, 2020, by the COVID-19 study group, this virus is spreading continuously all over the world. According to the World Health Organization (WHO), a total of 216 countries were affected till now with 22,492,312 confirmed cases as of August 21, 2020.[3] The virus is transmitted by inhalation or contact with infected droplets. The incubation period of this virus ranges from 2 to 14 days.[4] First reported case of a COVID-19 patient in India was on January 31, 2020. As on August 17, 2020, 08:00 IST, there were 676,900 active cases 1,919,842 cured/discharged, and 50,921 deaths in India.[5] On January 30, 2020, the WHO declared a public health emergency to outbreak the (2019-nCoV).[6] Indian government announces lockdown to prevent individuals from exposure to infection of COVID-19 since March 22, 2020, in the form of social distances, implementing travel bans, closing crowded public places, and school/colleges.[7] Although the lockdown unlocks process has been initiated, the schools remain closed for a temporary period. Due to this, outdoor activities and regular PA of most of the individuals are affected.[8]

In aging adolescence represents an important period of development. It includes establishing healthy behaviors, the pattern of living, lifestyle changes, etc., physical inactivity, sedentary behavior, and low cardiorespiratory fitness are strong risk factors for the development of chronic diseases which result from morbidity and mortality at a later age. It may lead to lifestyle-related noncommunicable diseases. It creates an economic burden on society. Kumar et al. proved the importance of physical activities in middle adolescence.[9] However during schooling; youngsters may have outdoor activities in the form of cycling, physical activity (PA) periods, walking and stair climbing, and also indoor activities in the form of games such as badminton, table tennis, skating, and many others. Owen et al. told staying home for a long time may lead to inactive behaviors, such as sleeping, spending more time on sitting activities, playing sitting games, and watching television. It leads to decreasing regular outdoor activity and exercises. The risk of chronic health conditions may increase due to this inactivity.[10] Physical as well as mental health is affecting due to reduced activity in day-to-day life due to the lockdown effect. Previous studies reported psychological stress among the individuals during COVID-19 pandemic. They told psychological stress affecting 35% of individuals nationally during this period. Among them, female shows higher (24.87 ± 15.03) psychological stress.[11],[12]

Adolescence is the transitional period between childhood and adulthood. During this teenage, roughly 3 years of rapid growth occurs early. Along with the rapid changes in body proportions, PA shows a very diverting role. However, long-term physical inactivity may reduce the immune function of the individuals and can affect the normal physiological system of the body.[2],[13] Therefore, it is essential to understand the potential physical inactivity during this period among middle-age group students. The present study aimed to see the level of PA and energy expenditure (EE) among middle adolescence during lockdown due to COVID-19.

  Experiment Work Top

The open e-survey research was not submitted for the approval due to the COVID-19 lockdown. However, study has been done with considering ethical guidelines of National guidelines for biomedical and health research involving human participants (2017). The purpose of the survey was added within the questionnaire. Separate consent has not been taken as successful return of completed survey from participants was considered as consent. A cross-sectional online survey was sent to middle adolescent students with age group of 16–19 years during COVID-19 lockdown period in the month of May, June, and July. Students who are in standard 10th, 11th, and 12th were included in the study by a simple random sampling method through personal contacts of family, friends, and relatives. Students who do not have an account in social networking sites such as WhatsApp and Instagram. Those who do not have smartphone were being contacted by their parents' phone number to fill this online form.

International PA questionnaire-short form (IPAQ-SF) for young and middle-aged adults used. As it is an already validated tool, the web-based draft of questions has not been validated by the subject experts. Questionnaire was created for the survey. It includes demographic details and questions related to physical activates. The questionnaire has 13 questions; six questions were related to demographics, seven questions of IPAQ-SF for evaluating PA during lockdown period.[14] The study was executed by sending the online link (https://forms.gle/HNWE3mHpZw9ipsbcA) to students of middle adolescence through WhatsApp, and Instagram. One hundred and forty-seven potential participants were identified and link was sent to them through the messaging services. The survey was administered using the online survey portal and Google Forms. The reminder survey link was sent to them if response was not received within a period of 3 weeks. E-survey is cost-effective, eco-friendly, time-saving, and practically feasible during the COVID-19 lockdown period.

The sample size for the study was estimated by using the formula for estimating proportion: n = Zα2 P (1 − P)/d2, where Zα =1.96; P = 90% of the response rate of the online survey, and d = 5%. Thus, the minimum number of participants required for this study was almost 132. The incomplete submission of survey questionnaire was not possible due to the function in Google Forms itself. It won't allow partially submitted answers. Hence, when the survey responses crossed 123 and above, the link has closed for accepting further responses. The received data was analyzed.

  Results Top

By contacting different participants, a total of 123 survey responses were recorded. Hence, the response rate was found to be 54.8%. Descriptive values for age and weight are given in [Table 1]. The mean age and weight of the survey participants were 16.2 (14–20) years and 54.23 (39–65.3) kg, respectively. PA expressed in (metabolic equivalent task [MET]-min/week), while EE (cal/week) is tabulated in [Table 2]. Gender distribution is shown in [Figure 1]. PA and EE have been shown in the error bar [Figure 2] and [Figure 3].
Table 1: Descriptive analysis

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Table 2: Physical activity and energy expenditure

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Figure 1: Gender distribution

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Figure 2: Physical activity

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Figure 3: Energy expenditure

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  Discussion Top

The study was designed concerning previous online survey studies.[15],[16] The study shows PA and EE among middle adolescence during the lockdown period. A simple random sampling technique was used in the study. Google form link was sent as a reminder to the various students through WhatsApp and Instagram. The survey form requires 10 min to fill. A total of 123 students and participated in the study through a link sent on WhatsApp and Instagram. IPAQ-SF21 was modified and used for this online survey to gather the information. IPAQ-SF is divided into four categories; vigorous PA, moderate PA, walking, and sitting.[17]

The study shows PA and EE among middle adolescent students during the lockdown period. The study findings revealed that students performed vigorous PA (1408.13 MET-min/week), moderate PA (562.18 MET-min/week), walking (547.74 MET-min/week), and sitting (3744.16 MET-min/week). The WHO suggested adolescence should do at least 60 min of moderate to vigorous-intensity PA daily. Daily 60 min of average PA will provide additional health benefits.[18] In adolescents, India stands at the lowest levels of insufficient PA. The WHO report tells that, >80% of school-going adolescents globally do not meet recommendations of exercises at least 1 h of PA per day.[19]

Kirsten C found that EE and PA levels of these Indian adolescents are and it is important to more accurately assess population levels of PA and the association with health outcomes in Indian adolescents.[20] Results of this study show energy level during vigorous activity (1315.50 MET-min/week), moderate activity (602.36 MET-min/week), walking (525.10 MET-min/week), and sitting (3566.32 MET-min/week). The total mean PA of physiotherapy students in their study is 6262.21 MET-min/week. The results of this study show that average PA and EE are reduced compared to other studies during this lockdown.[21],[22] Social isolation also affects health behaviors due to lockdown through their impact on social support for behavior choices.[23] The results of our study show that approximately 30% of PA was reduced in adolescence, so immunity also affects due to a decrease in PA. Various studies suggested that PA has positive as well as negative impacts on the immune system. Regular PA can reduce the days of sickness and also reduces the risk of upper respiratory tract infection.[24] Decrease in PA can affect the physiological systems of the body. It might affect the physiological process of cardiovascular function, insulin sensitivity, cholesterol level, obesity, and hypertension.[25],[26] Susceptibility to infections can be due to rapid mutations of virus and this could reduce immunity. A sedentary lifestyle at a younger age can lead to chronic disease in adulthood.[13],[27] Regular moderate exercise can enhance immune response.

Exercise helps to enhance the immune system and thus reduces the risk of infection in long term. Moderate endurance exercises enhance the number of immunological indices such as T-cell count and immunoglobulin level which reduces the risk of infection. Moreover, regular PA is beneficial to prevent infection and promoting immunity.[28] People are more using social networking sites nowadays so the e-survey method of study was adopted. The method of survey was cost-effective; minimally time-consuming, easily accessible to participants, and eco-friendly. The small sample size was small and also there was an unequal distribution of students. Furthermore, psychological status was not measured. These were the limitations of our study. Future studies should target larger sample size and individuals of another group such as pediatric and geriatric populations.

  Conclusion Top

PA and EE were decreased up to 40% in middle adolescence students during the lockdown period. Among vigorous activities, moderate activities, walking, and sitting, adolescence are spending more time sitting rather than any other activities.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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  [Figure 1], [Figure 2], [Figure 3]

  [Table 1], [Table 2]


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