Access to exercise for people with visual impairments during the Coronavirus-19 pandemic

People with blindness and visual impairments have reduced access to exercise compared to the general population during typical societal functioning. The Coronavirus-19 pandemic completely disrupted daily life for most individuals worldwide, and in the United Kingdom, a stay-at-home order was enforced. One of the sole reasons an individual could leave their home was for the purpose of daily exercise. Here, we examined how the UK national lockdown impacted access to exercise for people with blindness and visual impairment. We used a mixed methods design, collecting quantitative data from two established measures (the Exercise Barriers and Benefits Scale and the International Physical Activity Questionnaire), and qualitative data from open-ended questions. We found that, during the initial stages of the lockdown, perceived barriers to exercise increased compared to pre-pandemic levels, driven by factors, such as the closure of exercise facilities and additional difficulties posed by social distancing. Interestingly, during the later stages of the UK Coronavirus-19 response, perceived barriers decreased to lower than pre-pandemic levels. Thematic analysis indicated that this may have been due to participants finding new online methods to exercise at home, in combination with the tentative reopening of facilities.

Relationships between Participation in Volunteer-Managed Exercises, Distance to Exercise Facilities, and Interpersonal Social Networks in Older Adults: A Cross-Sectional Study in Japan

This study aimed to examine the factors related to participation in volunteer-managed preventive care exercises by focusing on the distance to exercise facilities and interpersonal social networks. A postal mail survey was conducted in 2013 in Kasama City in a rural region of Japan. Older adults (aged ≥ 65 years) who were living independently (n = 16,870) were targeted. Potential participants who were aware of silver-rehabili taisou exercise (SRTE) and/or square-stepping exercise (SSE) were included in the analysis (n = 4005). A multiple logistic regression analysis revealed that social and environmental factors were associated with participation in SRTE and SSE. After adjusting for confounding variables, exercise participation was negatively associated with an extensive distance from an exercise facility in both sexes for SRTE and SSE. Among women, participation in SRTE was negatively associated with weak interpersonal social networks (odds ratio (OR) = 0.57), and participation in SRTE and SSE was negatively associated with being a car passenger (SRTE, OR = 0.76; SSE, OR = 0.60). However, there were no significant interactions between sex and social and environmental factors. Our findings suggest the importance of considering location and transportation to promote participation in preventive care exercise.

Exercise facilities and the prevalence of obesity and type 2 diabetes in the city of Madrid

Aims/hypothesis We aimed to study the association between the availability of exercise facilities and the likelihood of obesity and type 2 diabetes in the adult population of Madrid, Spain. Methods We analysed the electronic medical records of all 1,270,512 residents of Madrid aged 40–75 years in 2017. Exercise facility availability was defined as the count of exercise facilities in a 1000 m street network buffer around each residential building entrance. Poisson regression with standard errors clustered at census tract level was used to assess prevalence ratios of exercise facility availability tertiles and obesity and type 2 diabetes. We also examined stratified results by tertiles of area-level socioeconomic status (SES) and sex. Results People living in areas with lower availability of exercise facilities had a higher prevalence of obesity (prevalence ratio [PR] 1.22 [95% CI 1.20, 1.25]) and diabetes (PR 1.38 [95% CI 1.34, 1.43]). We observed effect modification by area-level SES (p<0.001), with stronger associations for residents living in low-SES areas and no association for residents living in high-SES areas. Associations with type 2 diabetes were stronger among women compared with men, while associations with obesity were similar by sex. Conclusions/interpretation People living in areas with low availability of exercise facilities had a higher prevalence of obesity and type 2 diabetes, and this association was strongest in low-SES areas and for women. Understanding the potential role of exercise facilities in driving inequities in obesity and type 2 diabetes prevalence may inform interventions to reduce health inequities. Graphical abstract

710Do exercise facilities moderate the effect of socioeconomic inequities in Body Mass Index?

Background The influence of area-level socioeconomic status (SES) on Body Mass Index (BMI) and adiposity is well known. There is an unequal distribution of exercise facilities (EF), which is dependent on area-level SES. However, is unclear whether EF intervenes on the relationship between SES and BMI. Methods BMI data were obtained from baseline of the Heart Healthy Hoods Cohort. Overall, 1,258 (40-75 years old) residents of Madrid, Spain were recruited between 2017 and 2019. Area-level SES was calculated for each census section based on 7 indicators in 4 domains: education, welfare, employment and living conditions. Availability of EF was defined as the count of EF in a 1,000m street network buffer around participants’ census sections of residence. A five-step mediation analysis was carried out to quantify the effect of EF availability. Analysis of each specific path was carried out with multilevel regression model, adjusted by sex and population density. Results Increases in SES were associated with decreases in BMI (β=-0.723, IC95% -1.003; -0.444). Alike, increases on availability of EF were associated with decreases on BMI (β=-0.09, IC95% -0.132; -0.048). Multilevel regression confirmed availability of EF was a significant moderator between SES and BMI (β=-0.566, IC95% -0.959; -0.173). Thus, the indirect effect of EF on the association between SES on diabetes was -0.258. Conclusions Availability of exercise facilities moderate socioeconomic inequities in BMI. Key messages Increasing the availability of EF in disadvantaged areas may have the potential to moderate inequities related to body size.

Physical Activity Behaviors and COVID-19 Symptoms

Statistical modeling indicated that COVID-19 would have afflicted more than 60% of the US population. Social distancing, self-quarantine, and widespread shutdowns were imposed. The push to stay at home and the decreased availability of exercise facilities have potentially reduced physical activity (PA). The purpose of this observational, correlational study was to determine if there is a relationship between PA level and symptoms of COVID-19. Subjects were asked to complete a single Survey Monkey questionnaire. The survey asked demographic questions, PA behaviors, and questions relating to COVID-19 symptoms. Chi-square analysis was run to determine frequency differences within the PA group and specific COVID-19 symptoms. Hierarchical regression analysis was run to determine if PA was a unique predictor of the number COVID-19 symptoms experienced. Sixty male and 85 female (n = 145) subjects completed this study.

COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity

Physical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to “flatten the curve” have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.

Socio-ecological influences of leisure-time physical activity among Nepalese adults: a qualitative study

Background With economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical activity in Nepal. This study aimed to qualitatively explore the socioecological influences of participation in leisure-time physical activity among Nepalese adults aged 40 years and above. Methods A total of 51 adults (30 females and 21 males) participated in one of the nine focus groups conducted in Kathmandu, Nepal. A semi-structured guide based on the social-ecological model of physical activity was used to facilitate these focus groups. Data were analysed using a reflexive thematic analysis approach in NVivo 12. Results Participation in leisure-time physical activity was minimal and leisure time was mostly spent resting, socialising, or engaging in sedentary activities such as watching television. Walking was the most common form of leisure-time physical activity, and men reported being more active than women. Individual-level barriers included lack of knowledge, lack of skill, lack of motivation, considering oneself as sufficiently active and engagement in sedentary screen activities. Family and household responsibilities, lack of support and fear of being judged constituted the interpersonal barriers while environmental barriers included an absence of a supportive social norm, lack of open spaces, weather conditions and perceived lack of safety. Health benefits, prioritising physical activity, social support, provision of group-based activities and age-appropriate public exercise facilities were identified as major facilitators. Conclusion Critical issues that need to be addressed to increase leisure-time physical activity among Nepalese adults include traditional gender roles, family and social support, and social norms. Modifications of the built environment, such as public exercise facilities, offer further opportunities and will require coordination beyond the health sector.

Do Accessible Exercise Facilities Influence Community Physical Activities?

This study was aimed to evaluate how personal perceptions of exercise facility accessibility affect moderate physical activity in Korea. We selected research subjects using data from 2012, 2014, and 2016 community health surveys. We explored whether accessibility to exercise facilities was associated with moderate or higher physical activity. Multivariate logistic regression analysis was performed. Of the 652,954 individuals included in the analyses, 146,725 engaged in moderate physical activity (22.5%) and were more likely to have easier access to exercise facilities. Those who could access exercise facilities very easily were more likely to engage in moderate weekly physical activity compared with those who found access difficult or very difficult (odds ratio = 1.32; 95% confidence interval = 1.28–1.35). The results confirmed that in areas with good accessibility to community exercise facilities, subjects engaged in more moderate physical activity compared with subjects in areas lacking good access.

Impact of COVID-19 and Associated Preventive Measures on Cardiometabolic Risk Factors in South Korea

Background: During the COVID-19 pandemic, people have been required to follow preventive measures such as government policy including the closure of exercise facilities and movement restriction, can lead to an unhealthy lifestyle. We investigated the effect of these preventive measures on metabolic parameters in individuals with cardiometabolic disorders.Methods: In the current retrospective observational study of patients who visited the hospital at least twice a year for the past 4 years, changes in cardiometabolic factors from the COVID-19 pandemic (2019–2020) were compared with changes in the same cohort at the same annual time points during the previous seasons of 2016–2019.Results: A total of 1,485 individuals with a mean age of 61.8 ± 11.7 years were included in the analysis. During the COVID-19 pandemic, the number of patients whose metabolic syndrome worsened increased significantly by 21% compared with the 2018–2019 season. The body mass index increased by 0.09 ± 1.16 kg/m2 in the 2019–2020 pandemic period, whereas it decreased by –0.39 ± 3.03 kg/m2 in 2018–2019 and by –0.34 ± 2.18 kg/m2 in 2017–2018 (both p < 0.05). Systolic blood pressure increased by 2.6 ± 18.2 mmHg in the COVID-19 pandemic period, while it decreased in the three antecedent seasons (all p < 0.05). The lipid profiles worsened in the pandemic period compared with the previous years. The Framingham coronary heart disease risk score also increased significantly.Conclusions: With preventive procedures during the contagious disease pandemic, nationwide strategies to maintain cardiometabolic health are necessary.

Physical distancing ≠ physical inactivity

During this time of global health crisis, physical distancing, along with mask wearing, has emerged as the sine qua non social practice to protect ourselves and others from COVID-19. But as physical distancing ensues and all eyes remain fixed on the novel coronavirus, another, albeit careworn, pandemic rages on. Physical inactivity, the world’s fourth leading cause of death, may indeed be exacerbated by physical distancing measures, such as sheltering at home and closing or limiting access to recreation and exercise facilities. The purpose of this paper is to urge public health and medical professionals not to forget the importance of physical activity to whole-person health, recognize the importance of physical activity as a potential COVID-19 mitigation strategy and to serve as advocates for promoting active lifestyles. It is imperative that the national call for physical distancing not be interpreted as a call for physical inactivity.