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      Don’t Walk So Close to Me: Physical Distancing and Adult Physical Activity in Canada

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          Abstract

          Background: In response to the COVID-19 pandemic, physical distancing measures have been implemented globally. Canadians have been instructed to stay at home, which has likely resulted in significant changes in their physical activity. Using data from a national physical activity tracking app (PAC app), we aimed to determine device-measured physical activity levels immediately prior to and following the implementation of physical distancing measures in Canada to provide evidence for the development of physical activity recommendations for future pandemics or second wave infections.

          Methods: Demographic and physical activity data were extracted from the ParticipACTION app (PAC app), using a 10-week (10 February to 19 April 2020) quasi-experimental design to determine changes in physical activity 4 weeks pre-pandemic and 6 weeks post-pandemic declaration. Weekly physical activity levels were monitored through wearable fitness trackers and health apps linked to the PAC app, to record moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and steps. Repeated measure ANOVA was used to determine changes over time (mean ± SE).

          Findings: A total of 2,338 Canadians who were mostly 35–44 years old (26.6%) and female (90.2%) were included in the analysis. MVPA, LPA, and steps significantly declined immediately following the declaration of the pandemic (MVPA: pre-pandemic: 194.2 ± 5.2 min, post-pandemic: 176.7 ± 5.0 min, p < 0.001; LPA: pre-pandemic: 1,000.5 ± 17.0 min, post-pandemic: 874.1 ± 15.6 min, p < 0.001; steps: pre-pandemic: 48,625 ± 745 steps, post-pandemic: 43,395 ± 705 steps, p < 0.001). However, 6 weeks following pandemic declaration, MVPA (week 6: 204.4 ± 5.4 min, p = 0.498) had returned to pre-pandemic levels. LPA (week 6: 732.0 ± 14.3 min, p = < 0.001) and steps (week 6: 41,946 ± 763, p < 0.001) remained significantly lower than pre-pandemic levels at week 6.

          Interpretation: Although MVPA returned to pre-pandemic levels, significant and sustained declines in incidental LPA and steps were observed. Attenuating the loss of incidental physical activity should be a public health priority in response to future pandemics or a second wave of a COVID-19 infection, as it may have significant long-term implications for the physical and mental health of Canadians.

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          COVID-19 and mental health: A review of the existing literature

          Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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            Wuhan coronavirus (2019-nCoV): The need to maintain regular physical activity while taking precautions

            The on-going Wuhan coronavirus (2019-novel coronavirus, 2019-nCoV) outbreak in China has become the world's leading health headline and is causing major panic and public concerns. On January 30, 2020, the World Health Organization (WHO) declared that the new coronavirus outbreak is a public health emergency of international concern. 1 The virus has already had a direct impact on more than 10 million people in the city of Wuhan and has reached other parts of China as well, posing a health threat of unknown magnitude globally. As of February 8, 2020, WHO reported 34,886 confirmed cases of 2019-nCoV globally, with 34,589 of them occurring in China (including 6101 severe cases and 723 deaths). A total of 288 other confirmed cases (with 1 death) have been reported in 24 countries, including Japan, Australia, Germany, and United States. 2 However, these daily estimates are expected to rise even higher as reports from health authorities in China 3 are gathered and near real-time updates of the Johns Hopkins virus dashboard are made. 4 The outbreak has caused governments in various countries to take swift and protective measures. In China, these included putting cities on lockdown, 5 implementing travel warnings/bans and cancellations, 6 extending national holidays, and closing schools and postponing classes. 7 Currently, there is no vaccine for the prevention or treatment of the illness caused by the virus; its origins and the ultimate extent of this epidemic remain unknown. There have been more than 50 research papers published within the last 20 days 8 that have allowed for the rapid sharing of scientific information about the virus, but serious questions regarding the causes or mechanisms of transmission, incubation period, risk assessments, and options for effective treatment or intervention of the virus remain largely unanswered. 9 There have been reports of significant shortages of medical staff, a lack of clinics that can handle and treat infected patients, and high demands for face masks for protection. The Chinese central government is working with extraordinary diligence to mobilize resources, including building new hospitals and developing new coronavirus vaccine, as well as sending medical experts and clinicians to the city of Wuhan 10 to help contain the highly transmittable virus outbreak from spreading further. With the continuing coronavirus spur, the public has been advised by various health authorities to reduce traveling and stay at home as a basic means of limiting people's exposure to the virus. Health authorities, including the National Health Commission of the People's Republic of China, 11 WHO, 12 and U.S Centers for Disease Control and Prevention, 13 have issued safety recommendations for taking simple precautions to reduce exposure to and transmission of the virus. Unfortunately, the mandated restrictions on travel and directives against participating in outdoor activities, including regular physical activity and exercise, will inevitably disrupt the routine daily activities of tens of millions of people. While containing the virus as quickly as possible is the urgent public health priority, there have been few public health guidelines for the public as to what people can or should do in terms of maintaining their daily exercise or physical activity routines. Arguably, staying home, while a safe measure, may have unintended negative consequences since such efforts to avoid human-to-human transmission of the virus may lead to reduced physical activity. It is likely that prolonged home stay may lead to increased sedentary behaviors, such as spending excessive amounts of time sitting, reclining, or lying down for screening activities (playing games, watching television, using mobile devices); reducing regular physical activity (hence lower energy expenditure); or engaging in avoidance activities that, consequently, lead to an increased risk for and potential worsening of chronic health conditions. 14 Therefore, there is a strong health rationale for continuing physical activity in the home to stay healthy and maintain immune system function in the current precarious environment. Exercise at home using various safe, simple, and easily implementable exercises is well suited to avoid the airborne coronavirus and maintain fitness levels. Such forms of exercise may include, but are not limited to, strengthening exercises, activities for balance and control, stretching exercises, or a combination of these. Examples of home exercises include walking in the house and to the store as necessary, lifting and carrying groceries, alternating leg lunges, stair climbing, stand-to-sit and sit-to-stand using a chair and from the floor, chair squats, and sit-ups and pushups. In addition, traditional Tai Ji Quan, Qigong exercises, 15 and yoga 16 should be considered since they require no equipment, little space, and can be practiced at any time. The use of eHealth and exercise videos, which focuses on encouraging and delivering physical activity through the Internet, mobile technologies, and television 17 are other viable avenues for maintaining physical function and mental health during this critical period. Official measures that restrict people's movements in the presence of the coronavirus crisis do not necessarily mean that physical activity must be limited or that all forms of exercise must be eliminated entirely. Exercise has been shown to have clear health benefits for healthy individuals 18 and for patients with various diseases. 19 In this respect, we strongly echo Dr. Steven Blair's quote from Dr. Ken Powell: “Some activity is better than none, and more is better than less” (p. 525). 20 The aim should be to undertake at least 30 min of moderate physical activity every day and/or at least 20 min of vigorous physical activity every other day. 18 Ideally, a combination of both intensities of physical activities is preferable in addition to practicing strengthening-type activities on a regular basis. 18 Children, the elderly, and those who have previously experienced symptoms of illness or are susceptible to chronic cardiovascular or pulmonary disease should seek advice from health care providers about when it is safe to exercise. Given the concerns about the increasing spread of 2019-nCoV, it is imperative that infection control and safety precautions be followed. Home stay is a fundamental safety step that can limit infections from spreading widely. But prolonged home stays can increase behaviors that lead to inactivity and contribute to anxiety and depression, which in turn can lead to a sedentary lifestyle known to result in a range of chronic health conditions. Maintaining regular physical activity and routinely exercising in a safe home environment is an important strategy for healthy living during the coronavirus crisis.
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              Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose.

              We examined the associations of objectively measured sedentary time, light-intensity physical activity, and moderate- to vigorous-intensity activity with fasting and 2-h postchallenge plasma glucose in Australian adults. A total of 67 men and 106 women (mean age +/- SD 53.3 +/- 11.9 years) without diagnosed diabetes were recruited from the 2004-2005 Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Physical activity was measured by Actigraph accelerometers worn during waking hours for 7 consecutive days and summarized as sedentary time (accelerometer counts/min or =1,952). An oral glucose tolerance test was used to ascertain 2-h plasma glucose and fasting plasma glucose. After adjustment for confounders (including waist circumference), sedentary time was positively associated with 2-h plasma glucose (b = 0.29, 95% CI 0.11-0.48, P = 0.002); light-intensity activity time (b = -0.25, -0.45 to -0.06, P = 0.012) and moderate- to vigorous-intensity activity time (b = -1.07, -1.77 to -0.37, P = 0.003) were negatively associated. Light-intensity activity remained significantly associated with 2-h plasma glucose following further adjustment for moderate- to vigorous-intensity activity (b = -0.22, -0.42 to -0.03, P = 0.023). Associations of all activity measures with fasting plasma glucose were nonsignificant (P > 0.05). These data provide the first objective evidence that light-intensity physical activity is beneficially associated with blood glucose and that sedentary time is unfavorably associated with blood glucose. These objective data support previous findings from studies using self-report measures, and suggest that substituting light-intensity activity for television viewing or other sedentary time may be a practical and achievable preventive strategy to reduce the risk of type 2 diabetes and cardiovascular disease.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                27 July 2020
                2020
                27 July 2020
                : 11
                : 1895
                Affiliations
                [1] 1 Population and Physical Activity Lab, School of Kinesiology, University of British Columbia , Vancouver, BC, Canada
                [2] 2 ParticipACTION , Toronto, ON, Canada
                [3] 3 Child Health Evaluation Service, The Hospital for Sick Children , Toronto, ON, Canada
                Author notes

                Edited by: Andrea De Giorgio, eCampus University, Italy

                Reviewed by: Goran Kuvačić, University of Split, Croatia; Adilson Marques, University of Lisbon, Portugal

                *Correspondence: Guy Faulkner, guy.faulkner@ 123456ubc.ca

                This article was submitted to Health Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2020.01895
                7396577
                32849110
                e3f65035-b7e4-458a-be19-bca0f7d8a5e3
                Copyright © 2020 Di Sebastiano, Chulak-Bozzer, Vanderloo and Faulkner.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 May 2020
                : 09 July 2020
                Page count
                Figures: 5, Tables: 1, Equations: 0, References: 24, Pages: 8, Words: 6006
                Funding
                Funded by: MITACS Accelerate Award
                Funded by: CIHR Fellowship Award
                Funded by: Canadian Institutes of Health Research-Public Health Agency of Canada (CIHR-PHAC)
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                covid-19,pandemic,social distancing,moderate to vigorous physical activity,light physical activity,steps,incidental physical activity

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