Long-COVID and post-COVID effects on childhood related to physical inactivity: A home-based exercise prescription

Document Type : Review Articles

Authors

1 Assistant Professor, Department of Sport Sciences, Ardakan University, Yazd, Iran.

2 Ph.D. Student of Exercise Physiology, Department of Sport Sciences, Shahrekord University, Shahrekord, Iran.

3 Assistant Professor, Department of Sport Sciences, Shahrekord University, Shahrekord, Iran.

4 M.Sc, Department of Sport Sciences, Guilan University, Guilan, Iran.

5 Associate Professor, Department of Sport Sciences, Shahrekord University, Shahrekord, Iran.

Abstract

The prevalence of obesity among children and adolescents is one of the most serious public health challenges of the 21st century. Implementing social distancing policy measures, such as the stay-at-home order, to control the spread of coronavirus disease 2019 (COVID-19) not only has affected lifestyles and weights in children but has also created an obesity-inducing environment, leading to modifications in the patterns of interactions between this age group and their surrounding environment. Therefore, the COVID-19 pandemic has been effective in childhood obesity and its prevalence rate may continue increasing. This narrative review aimed to synthesize evidence from global studies on physical inactivity, and obesity among children and adolescents during COVID-19, and then prescribe an evidence-based home exercise guideline for this age group. The study findings revealed that the COVID-19 restrictions have drastically multiplied physical inactivity and obesity in children. It has been further established that childhood obesity leads to numerous chronic diseases, including diabetes mellitus, cardiovascular diseases (CVDs), psychosomatic disorders, lung diseases, and other metabolic problems in childhood and even as children grow up. Physical activity/exercise at home during and after COVID-19 has been correspondingly demonstrated to mitigate the problems associated with obesity. A wide range of resistance, aerobic, balance, flexibility and other types of exercises have been accordingly shown to protect against the negative effects of the pandemic on child health. Hence, efforts to facilitate such exercises are suggested to continue and be scaled up to prevent childhood obesity and relevant diseases during and after this unusual period.

What is already known on this subject?

Implementing social distancing policy measures, such as the stay-at-home order, to control the spread of coronavirus disease 2019 (COVID-19) not only has affected lifestyles and weights in children but has also created an obesity-inducing environment, leading to modifications in the patterns of interactions between this age group and their surrounding environment.

 

What this study adds?

A wide range of resistance, aerobic, balance, flexibility and other types of exercises have been accordingly shown to protect against the negative effects of the pandemic on child health. Hence, efforts to facilitate such exercises are suggested to continue and be scaled up to prevent childhood obesity and relevant diseases during and after this unusual period.

Keywords

Main Subjects


An, R. (2017). Diet quality and physical activity in relation to childhood obesity. International journal of adolescent medicine and health, 29(2). doi: https://doi.org/10.1515/ijamh-2015-0045
Aryeetey, R., Lartey, A., Marquis, G. S., Nti, H., Colecraft, E., & Brown, P. (2017). Prevalence and predictors of overweight and obesity among school-aged children in urban Ghana. BMC obesity, 4(1), 1-8. doi: https://doi.org/10.1186/s40608-017-0174-0
Azizi, M., Hoseini, R., & Hoseini, N. (2021). Study of Prevalence of obesity and its relationship with physical activity level among children 13 to 15 years. Journal of Pediatric Nursing, 7(4), 1-8. URL: http://jpen.ir/article-1-455-en.html
Bagherian, S., Mardaniyan Ghahfarrokhi, M., Banitalebi, E. (2021). Effect of the COVID-19 Pandemic on Interest in Home-Based Exercise: An Application of Digital Epidemiology. International Journal of Epidemiologic Research, 8(1), 47-53. doi: https://doi.org/10.34172/ijer.2021.08
Banitalebi, E., Abdizadeh, T., Khademi Dehkordi, M., Saghaei, E., & Mardaniyan Ghahfarrokhi, M. (2021). In silico study of potential immunonutrient-based sports supplements against COVID-19 via targeting ACE2 inhibition using molecular docking and molecular dynamics simulations. Journal of Biomolecular Structure and Dynamics, 1-21. doi: https://doi.org/10.1080/07391102.2021.2016489
Bates, L. C., Zieff, G., Stanford, K., Moore, J. B., Kerr, Z. Y., Hanson, E. D., . . . Stoner, L. (2020). COVID-19 Impact on behaviors across the 24-hour day in children and adolescents: physical activity, sedentary behavior, and sleep. Children, 7(9), 138. doi: https://doi.org/10.3390/children7090138
Benson, A. C., Torode, M., & Fiatarone Singh, M. (2008). Effects of resistance training on metabolic fitness in children and adolescents: a systematic review. Obesity reviews, 9(1), 43-66.  doi: https://doi.org/10.1111/j.1467-789X.2007.00388.x
Best, J. R. (2010). Effects of physical activity on children’s executive function: Contributions of experimental research on aerobic exercise. Developmental review, 30(4), 331-351. Doi: https://doi.org/10.1016/j.dr.2010.08.001
Calcaterra, V., Vandoni, M., Pellino, V. C., & Cena, H. (2020). Special attention to diet and physical activity in children and adolescents with obesity during the coronavirus disease-2019 pandemic. Frontiers in Pediatrics, 8, 407. doi: https://doi.org/10.3389/fped.2020.00407
Chagas, E. F. B., Biteli, P., Candeloro, B. M., Rodrigues, M. A., & Rodrigues, P. H. (2020). Physical exercise and COVID-19: a summary of the recommendations. AIMS Bioengineering, 7(4), 236-241. doi: https://doi.org/10.3934/bioeng.2020020
Chaouachi, A., Hammami, R., Kaabi, S., Chamari, K., Drinkwater, E. J., & Behm, D. G. (2014). Olympic weightlifting and plyometric training with children provides similar or greater performance improvements than traditional resistance training. The Journal of Strength & Conditioning Research, 28(6), 1483-1496. doi: https://doi.org/10.1519/JSC.0000000000000305
Cicchella, A. (2022). Recommendations for Resuming PA after Prolonged Rest in Children and Adolescents: A Systematic Integrative Review of Relevance for Immunity. Journal of Functional Morphology and Kinesiology, 7(2), 47. Doi: https://doi.org/10.3390/jfmk7020047
Coledam, D. H. C., de Arruda, G. A., & de Oliveira, A. R. (2012). Chronic effect of static stretching performed during warm-up on flexibility in children. Brazilian Journal of Kinanthropometry and Human Performance, 14(3), 296-304. doi: https://doi.org/10.5007//1980-0037.2012v14n3p296
da Silveira, M. P., da Silva Fagundes, K. K., Bizuti, M. R., Starck, É., Rossi, R. C., & e Silva, D. T. d. R. (2020). Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature. Clinical and experimental medicine, 1-14.  doi: https://doi.org/10.1007/s10238-020-00650-3
Deckelbaum, R. J., & Williams, C. L. (2001). Childhood obesity: the health issue. Obesity research, 9(S11), 239S-243S. doi: https://doi.org/10.1038/oby.2001.125
Dehghani, M., & Gunay, M. (2015). The effect of balance training on static and dynamic balance in children with intellectual disability. Journal of Applied Environmental and Biological Science, 5(9), 527-531. Corpus ID: 212566915
Duhig, S. (2013). Strength training for the young athlete. J Aust Strength Cond, 21, 5-13.
Emara, H. A. M. A. H. (2015). Effect of a new physical therapy concept on dynamic balance in children with spastic diplegic cerebral palsy. Egyptian Journal of Medical Human Genetics, 16(1), 77-83. doi: https://doi.org/10.1016/j.ejmhg.2014.09.001
Engel, F. A., Ackermann, A., Chtourou, H., & Sperlich, B. (2018). High-intensity interval training performed by young athletes: a systematic review and meta-analysis. Frontiers in physiology, 9, 1012. doi: https://doi.org/10.3389/fphys.2018.01012
Epstein, L. H., Paluch, R. A., Kalakanis, L. E., Goldfield, G. S., Cerny, F. J., & Roemmich, J. N. (2001). How much activity do youth get? A quantitative review of heart-rate measured activity. Pediatrics, 108(3), e44-e44. doi: https://doi.org/10.1542/peds.108.3.e44
Faigenbaum, A. D., Bellucci, M., Bernieri, A., Bakker, B., & Hoorens, K. (2005). Acute effects of different warm-up protocols on fitness performance in children. The Journal of Strength & Conditioning Research, 19(2), 376-381. doi: https://doi.org/10.1519/R-15344.1
Faigenbaum, A. D., & McFarland, J. E. (2016). Resistance training for kids: Right from the Start. ACSM's Health & Fitness Journal, 20(5), 16-22. doi: https://doi.org/10.1249/FIT.0000000000000236
Fakhouri, T. H., Hughes, J. P., Burt, V. L., Song, M., Fulton, J. E., & Ogden, C. L. (2014). Physical Activity in US Youth Aged 12-15 Years, 2012. NCHS Data Brief. Number 141. Centers for Disease Control and Prevention.
Gil, J., & Takourabt, S. (2017). Socio‐economics, food habits and the prevalence of childhood obesity in Spain. Child: care, health and development, 43(2), 250-258.  doi: https://doi.org/10.1111/cch.12408
Gómez-Bruton, A., Matute-Llorente, A., González-Agüero, A., Casajús, J. A., & Vicente-Rodríguez, G. (2017). Plyometric exercise and bone health in children and adolescents: a systematic review. World Journal of Pediatrics, 13(2), 112-121. doi: https://doi.org/10.1007/s12519-016-0076-0
Guan, H., Okely, A. D., Aguilar-Farias, N., del Pozo Cruz, B., Draper, C. E., El Hamdouchi, A., . . . Kontsevaya, A. (2020). Promoting healthy movement behaviours among children during the COVID-19 pandemic. The Lancet Child & Adolescent Health, 4(6), 416-418. doi: https://doi.org/10.1016/S2352-4642(20)30131-0
Halabchi, F., Ahmadinejad, Z., & Selk-Ghaffari, M. (2020). COVID-19 epidemic: exercise or not to exercise; that is the question!. Asian Journal of Sports Medicine, 11(1), e102630.  doi: https://doi.org/10.5812/asjsm.102630
Hammami, A., Harrabi, B., Mohr, M., & Krustrup, P. (2022). Physical activity and coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training. Managing Sport and Leisure, 27(1-2), 26-31. https://doi.org/10.1080/23750472.2020.1757494
Hamosh, M. (1995). Lipid metabolism in pediatric nutrition. Pediatric Clinics, 42(4), 839-859. doi: https://doi.org/10.1016/S0031-3955(16)39020-4
Harsha, D. W., & Berenson, G. S. (1995). The benefits of physical activity in childhood. The American journal of the medical sciences, 310, S109-S113. Doi: https://doi.org/10.1016/S0031-3955(16)39020-4
Houghton, K. M., & Guzman, J. (2013). Evaluation of static and dynamic postural balance in children with juvenile idiopathic arthritis. Pediatric Physical Therapy, 25(2), 150-157. doi: https://doi.org/10.1097/PEP.0b013e31828a2978
Jazi, S. D., Purrajabi, F., Movahedi, A., & Jalali, S. (2012). Effect of selected balance exercises on the dynamic balance of children with visual impairments. Journal of Visual Impairment & Blindness, 106(8), 466-474. doi: https://doi.org/10.1177/0145482X1210600803
Jia, P. (2021). A changed research landscape of youth's obesogenic behaviours and environments in the post‐COVID‐19 era. Obesity reviews, 22, e13162.  doi: https://doi.org/10.1111/obr.13162
Johnson, B. A., Salzberg, C. L., & Stevenson, D. A. (2011). A systematic review: plyometric training programs for young children. The Journal of Strength & Conditioning Research, 25(9), 2623-2633. doi: https://doi.org/10.1519/JSC.0b013e318204caa0
Knudson, D. V. (2008). Warm-up and flexibility. Chandler TJ, Brown LE. Conditioning for Strength and Human Performance. Philadelphia, PA: Lippincott-Williams & Wilkins.
Knudson, D. V., Magnusson, P., & McHugh, M. (2000). Current Issues in Flexibility Fitness. President's Council on Physical Fitness and Sports Research Digest. doi: http://www.indiana.edu/~preschal.
Kohl III, H. W., & Cook, H. D. (2013). Educating the student body: Taking physical activity and physical education to school: National Academies Press. doi: https://doi.org/10.17226/18314
Lang, J. E. (2014). Exercise, obesity, and asthma in children and adolescents. Jornal de Pediatria, 90(3), 215-217. doi : https://doi.org/10.1016/j.jped.2014.01.002
Lee, W. A. S. S., Shabeshan, A., Rengasamy, L., Subramaniam, A., & Raju, L. (2018). The Effectiveness Of An Additional Stretching Exercise Program In Improving Flexibility Level Among Preschool Boys. MOJES: Malaysian Online Journal of Educational Sciences, 2(3), 53-62.
Liu, J.-X., Zhu, L., & Deng, J.-M. (2019). The effects of high-intensity interval training versus moderate-intensity continuous training on fat loss and cardiometabolic health in pediatric obesity: A protocol of systematic review and meta-analysis. Medicine, 98(10), e14751. doi: https://doi.org/10.1097/MD.0000000000014751
Lloyd, L., Langley-Evans, S., & McMullen, S. (2012). Childhood obesity and risk of the adult metabolic syndrome: a systematic review. International journal of obesity, 36(1), 1-11. doi: https://doi.org/10.1038/ijo.2011.186.
Lloyd, R. S., Meyers, R. W., & Oliver, J. L. (2011). The natural development and trainability of plyometric ability during childhood. Strength & Conditioning Journal, 33(2), 23-32. doi: https://doi.org/10.1519/SSC.0b013e3182093a27
Lloyd, R. S., & Oliver, J. L. (2019). Strength and conditioning for young athletes: science and application: Routledge.
Mardaniyan Ghahfarrokhi, M., Banitalebi, E., Faramarzi, M., Ghorbanpoor Dashtaki, M., & Earnest, C. P. (2020). 2019 Novel Coronavirus: Emphasis on Maintaining Optimal Levels of Physical Activity Under Self-quarantine Conditions. International Journal of Epidemiologic Research, 7(2), 49-51. doi: https://doi.org/10.34172/IJER.2020.09
McManus, A. M., & Mellecker, R. R. (2012). Physical activity and obese children. Journal of sport and health science, 1(3), 141-148. doi: https://doi.org/10.1016/j.jshs.2012.09.004
McMurray, R. G., Zaldivar, F., Galassetti, P., Larson, J., Eliakim, A., Nemet, D., & Cooper, D. M. (2007). Cellular immunity and inflammatory mediator responses to intense exercise in overweight children and adolescents. Journal of investigative medicine, 55(3), 120-129. doi: http://dx.doi.org/10.2310/6650.2007.06031
Mohammadi, V., Alizadeh, M., & Gaieni, A. (2012). The Effects of six weeks strength exercises on static and dynamic balance of young male athletes. Procedia-Social and Behavioral Sciences, 31, 247-250. doi: https://doi.org/10.1016/j.sbspro.2011.12.050
Moore, S. A., Faulkner, G., Rhodes, R. E., Brussoni, M., Chulak-Bozzer, T., Ferguson, L. J., . . . Vanderloo, L. M. (2020). Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 1-11. doi: https://doi.org/10.1186/s12966-020-00987-8
Moradi, J., Jalali, S., & Bucci, M. P. Effects of Balance Training on Postural Control of Children with Attention Deficit/Hyperactivity Disorder. Iranian Journal of Pediatrics, 30(4), doi: e95542. https://doi.org/10.5812/ijp.95542f
Moreira, R., Akagi, F., Wun, P., Moriguchi, C., & Sato, T. (2012). Effects of a school based exercise program on children’s resistance and flexibility. Work, 41(Supplement 1), 922-928. doi: https://doi.org/10.3233/WOR-2012-0264-922
Olson, M. (2014). TABATA: It’sa HIIT! ACSM's Health & Fitness Journal, 18(5), 17-24. doi: https://doi.org/10.1249/FIT. 0000000000000065
Pinto, A. J., Dunstan, D. W., Owen, N., Bonfá, E., & Gualano, B. (2020). Combating physical inactivity during the COVID-19 pandemic. Nature Reviews Rheumatology, 16(7), 347-348. doi: https://doi.org/10.1038/s41584-020-0427-z
Pitanga, F. J. G., Beck, C. C., & Pitanga, C. P. S. (2020). Should Physical Activity Be Considered Essential During the COVID-19 Pandemic? International Journal of Cardiovascular Sciences(AHEAD), 16, 347–348. doi: https://doi.org/10.1038/s41584-020-0427-z
Rahmati-Ahmadabad, S., & Hosseini, F. (2020). Exercise against SARS-CoV-2 (COVID-19): Does workout intensity matter?(A mini review of some indirect evidence related to obesity). Obesity medicine, 19, 100245. doi: https://doi.org/10.1016/j.obmed.2020.100245.
Rodríguez, M. Á., Crespo, I., & Olmedillas, H. (2020). Exercising in times of COVID-19: what do experts recommend doing within four walls?. Revista Espanola De Cardiologia (English Ed.), 73(7):527-529. doi: https://doi.org/10.1016/j.rec.2020.04.001.
Runacres, A., Mackintosh, K. A., Knight, R. L., Sheeran, L., Thatcher, R., Shelley, J., & McNarry, M. A. (2021). Impact of the COVID-19 pandemic on sedentary time and behaviour in children and adults: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(21), 11286. doi: https://doi.org/10.3390/ijerph182111286
Sarokhani, D., Sarokhani, M., Dehkordi, A. H., Gheshlagh, R. G., & Fakhri, M. (2020). Prevalence of obesity and overweight in Iranian students: a systematic review and meta-analysis. Journal of Pediatric Endocrinology and Metabolism, 33(4), 453-468. Doi: https://doi.org/10.1515/jpem-2019-0474
Seo, K. (2017). The effects of dance music jump rope exercise on pulmonary function and body mass index after music jump rope exercise in overweight adults in 20’s. Journal of physical therapy science, 29(8), 1348-1351. doi:  https://doi.org/10.1589/jpts.29.1348
Sewall, L., & Micheli, L. J. (1986). Strength training for children. Journal of pediatric orthopedics, 6(2), 143-146. doi: https://doi.org/10.1097/01241398-198603000-00004.
Shahidi, S. H., Stewart Williams, J., & Hassani, F. (2020). Physical activity during COVID‐19 quarantine. Acta Paediatrica, 109(10), 2147-2148. doi:  https://doi.org/10.1111/apa.15420
Sommer, A., & Twig, G. (2018). The impact of childhood and adolescent obesity on cardiovascular risk in adulthood: a systematic review. Current diabetes reports, 18(10):91. doi: https://doi.org/10.1007/s11892-018-1062-9.
Tremblay, M. S., & Willms, J. D. (2003). Is the Canadian childhood obesity epidemic related to physical inactivity? International journal of obesity, 27(9), 1100-1105. doi: https://doi.org/10.1038/sj.ijo.0802376
Walters, S. T., & Martin, J. E. (2000). Does aerobic exercise really enhance self-esteem in children? A prospective evaluation in 3rd-5th graders. Journal of Sport Behaviour, 23(1), 53-62. ID: 141194476
Xiang, M., Zhang, Z., & Kuwahara, K. (2020). Impact of COVID-19 pandemic on children and adolescents' lifestyle behavior larger than expected. Progress in Cardiovascular Diseases. Prog Cardiovasc Dis, 63(4):531-532. doi: https://doi.org/10.1016/j.pcad.2020.04.013.
Zhou, J., Xie, X., Guo, B., Pei, R., Pei, X., Yang, S., & Jia, P. (2021). Impact of COVID-19 Lockdown on Physical Activity Among the Chinese Youths: The COVID-19 Impact on Lifestyle Change Survey (COINLICS). Frontiers in public health, 9, 23.  doi: https://doi.org/10.3389/fpubh.2021.592795
Zolghadr, H., Sedaghati, P., & Daneshmandi, H. (2019). The Effect of Selected Balance/Corrective Exercises on the Balance Performance of Mentally-Retarded Students With Developmental Coordination Disorder. Physical Treatments-Specific Physical Therapy Journal, 9(1), 23-30. ‎ doi: https://doi.org/10.32598/PTJ.9.1.23