The characteristics of the study sample are presented in Table 1. A total of 2540 participants from 62 regions commenced the survey with 18 participants (0.7%) failing to complete and their data not being used in the analyses. Of the 2432 participants who completed the survey, 83% were females. Compared with males, females tended to be older, married, have children under 18 living with them, and in full-time employment, less likely to have completed higher education, and more likely to follow self-isolation recommendations. In terms of employment status, 1714 (70.5%) participants had a full-time job, 399 (16.4%) were students, 65 (2.7%) were unemployed, and 47 (1.9%) were retired.
During the COVID-19 period, most participants completely or partially followed the self-isolation recommendations (n=2160, 88.8%). The preventive measures followed most frequently were “wash hands more often” (90.3%) and “maintain social distancing” (79.7%). Over 90% of participants still had access to outdoor areas and 70% had access to a green space during the restriction period. Two-thirds of participants reported that COVID-19 affected their physical activity, mostly as a result of their fitness centre closing, of not being able to leave the house and of being able to undertake only simple calesthenic exercises at home. One-third of participants reported using online physical activity resources to help them be active, during this period.
Changes in sleep and physical activity from pre-COVID to during COVID are reported in Table 2. There was a significant decline in the number of days per week participants reported not getting enough sleep (3.21±2.44 to 2.86±2.57; p<0.001) and participants also reported an increase in the number of days per week they had trouble falling asleep (1.70±2.24 to 2.13±2.48; P<0.001). All physical activity outcomes declined significantly from pre- to during COVID. The average time spent in MPA and VPA each declined by around 12 minutes per day (42.43±37.57 to 30.44±35.35 and 37.79±37.80 to 26.56±34.69, respectively [all P<0.001]). The number of minutes per day spent walking decreased by around 20 minutes from 60.5±38.66 to 40.83±38.6 (P<0.001).
The proportion of participants who met the WHO Guidelines for any type of physical activity declined from 68% to 49% (P<0.001). The proportion who participated in muscle strengthening activities for 2 or more days per week declined from 53% to 45% (P<0.001).
Associations between changes in days and time spent in physical activity and sleep and selected COVID-19 factors are reported in Table 3. Factors consistently associated with a greater decline in minutes per week spent in VPA, in MPA and in walking included an increase in number of days with sleep problems (β=-28, 95%CI -41 to -15; β=-42, 95%CI -59 to -29; and β=-83, 95%CI -104 to -62, respectively), closure of fitness centre/gym (β=-99, 95%CI -116 to -84; β=-77, 95%CI -96 to -59; and β=-41, 95%CI -66 to -15, respectively) and not being able to leave the house for PA (β=-93, 95%CI -109 to -78; β=-123, 95%CI -141 to -105, and β=-217, 95%CI -243 to -192, respectively). Factors associated with a smaller decline in minutes per week in VPA and MPA included using digital or online resources (β=19, 95%CI 5 to 33 and β=23, 95%CI 7 to 38, respectively) and having access to a home gym (β=38, 95%CI 15 to 62 and (β=33, 95%CI 7 to 60, respectively). Factors associated with a greater decline in days per week participating in muscle strengthening activities included closure of fitness centre/gym (β=-99, 95%CI -116 to -84) and not being able to leave the house for PA (β=-93, 95%CI -109 to -78). Factors associated with a smaller decline in days per week participating in muscle strengthening activities included using digital or online resources (β=0.4, 95%CI 0.2 to 0.6), being able to participate in simple calesthenics at home (β=1, 95%CI 0.8 to 1.3), and having access to a home gym (β=0.9, 95%CI 0.5 to 1.2). Following self-isolation recommendations (β=-0.6, 95%CI -0.8 to -0.3) and having assess to a home gym (β=-0.1, 95%CI -0.4 to 0.2) were associated with a greater reduction in the number of days per week participants reported not getting enough sleep. In contrast, having children under 18 years of age in the residence (β=0.4, 95%CI 0.2 to 0.6) and not being able to leave the house for PA (β=0.2, 95%CI 0.02 to 0.4) were associated with a smaller reduction in the number of days per week participants reported not getting enough sleep.
Associations between meeting WHO Global PA and muscle-strengthening recommendations and selected COVID-19 factors are reported in Table 4. Compared with those who did not use online PA resources, those who did were 1.4 (95%CI 1.3, 1.5) and 1.9 (95%CI 1.8, 2.1) times more likely to meet the recommendations for PA and for muscle-strengthening activities, respectively. Compared with those who did not have access to a green space, those who did were more more likely to meet the PA (OR=1.2, 95%CI 1.1, 1.2) and muscle strengthening (OR=1.1, 95%CI 1.1, 1.2) recommendations. Those who owned a pet dog (OR=1.2, 95%CI 1.1, 1.3) and those who followed the self-isolation rules (OR=1.3, 95%CI 1.2, 1.4) were more likely to meet the PA and muscle strengthening recommendations, respectively, than those who did not. Conversely, compared with their urban counterparts, rural adults were less likely to meet the PA recommendation (OR=0.9, 95%CI 0.8, 0.9).