Longitudinal changes and key determinants of meeting WHO recommended levels of physical activity during the COVID-19 pandemic in a UK-based sample: Findings from the HEBECO Study.

Abstract

Background: The COVID-19 pandemic has seen government enforced restrictions on movement, with stay-at-home orders in place for a second and third time in many nations. Such restrictions have altered physical activity (PA) habits. This study aimed to evaluate longitudinal trends in PA in a self-selected UK-based sample and the key predictors of these trends. Methods: From 23 April 2020 to 30 January 2021, an online survey collected detailed measures of PA engagement in a sample of 1,947 UK-based adults. Generalised estimating equations (GEE) were fitted to explore trends in PA engagement over time, and how sociodemographic, health, lifestyle and contextual factors impacted participant s attainment of Word Health Organisation (WHO) recommended levels of PA (constituting muscle strengthening activity (MSA), and moderate or vigorous PA (MVPA)). Results: Attainment of WHO recommended levels of total PA showed a decline. While one in five achieved the recommended levels of total PA in the first UK lockdown in April-June 2020 (19.5%, 95%, CI 17.8-21.3%) and a similar proportion in June-July 2020 (17.7%, 95%CI 16.1-19.5%), this reduced significantly during the period of eased restrictions in August-September 2020 (15.2%, 95%CI 13.7-16.9%) and the second UK lockdown in November 2020-January 2021 (14.1%, 95%CI 12.6-15.9%). The same trends were observed for MSA and MVPA individually. Better quality of life, higher socioeconomic position and higher pre-COVID-19 PA levels were associated with meeting WHO recommended PA levels, while having overweight or obesity, a limiting chronic health condition, or being in strict isolation showed the inverse associations. Time-specific associations with MSA or MVPA were observed for gender, age, ethnicity, and other health behaviours. Conclusion: Among a self-selected sample of UK-based adults, there were reductions in PA levels throughout the first UK lockdown without reversal during the ensuing period. Based on observed associations of reduced PA with socioeconomic and health-related indices, such changes may point towards deepening health inequities during the pandemic.