The potential negative consciences associated with COVID-19 pandemic on health outcomes have received substantial attention and expected to have a long-lasting effect on people’s health and lifestyle. The rate of exercise and physical activity has dramatically decreased due to social restrictions related to the pandemic measures. As a consequence, reducing person-to-person contact has a direct negative impact on the lifestyle of individuals among all populations, regardless of their economic and social status [1-6]. Starting from March 2020, the World Health Organization (WHO) has forced all countries to apply extreme restrictions to contain the spread of the pandemic, including quarantines, lockdowns, closing of public and private establishments, restriction of population mobility and gathering, and social distancing [7-8]. Furthermore, the closure of playgrounds, parks, and recreational and sports facilities reduced the opportunities to engage in both organized and unorganized physical activity in indoor areas, which was utterly forbidden [9]. Moreover, practising physical activity outdoors was possible but also under the social distancing roles. These measures have enormously changed the behaviours of all populations to be more sedentary and physically less active.
Globally, before the pandemic, the levels of physical inactivity were already classified as a major public health problem, with more than 25% of all adults not meeting the required physical activity levels, which have been approved by WHO for maintaining good health [10]. In the Middle East and North Africa region (MENA), the prevalence of physical inactivity among adults, according to WHO STEPS surveys, defined as performing less than 600 MET-minute per week, exceeded 40% in all Arab countries except Egypt was (32%) and KSA it reached (68%) [11]. These percentages clearly show the missing movement culture and the high levels of sedentary behavior related to social-cultural habits [12-14]. Indeed, this is one of the most common health challenges in Saudi Arabia, and the government asserts the importance of a healthy lifestyle, particularly physical activity. This has led the Saudi Public Health Authority, with the cooperation of several specialists recommend the amount of physical activity, sleep duration, and sedentary behavior for Saudi Adults [15]. For example, Saudi adults aged 18-64 should perform at least 2 hours and 30 minutes to 5 hours of moderate-intensity physical activity or 2 hours and 30 minutes of vigorous-intensity physical activity per week [15].
During the pandemic, the available data for physical activity by Fitbit, Inc., indicated that the average step counts of more than 30 million users showed a significant decline in step count, which varied across nations, ranging from a 7 to 38% decrease during the week ending March 22, 2020, as compared with the same period from the previous year [16]. Runacres et al. reported that adults increased their sedentary time during the pandemic by 126.9 ± 42.2 min day−1, spending a cumulative 510.5 ± 167.9 min day−1 in sedentary behaviours [17]. Indeed, smartphone technology (mobile health apps) monitoring health-related physical activity status has always been classified as a valid and reliable methodology, especially among adults during the pandemic [18]. These apps, as a tool for electronic surveys, can guarantee a significant sample for screening studies, primarily when it's used to monitor daily step counts among different countries and populations [16-20].
Several studies were looking for the impact of COVID-19 pandemic on the behavior changes, including (diet, physical activity, and sleep patterns) before and during the pandemic, evaluating the effect of the pandemic measures on the lifestyle of participants from different populations on their physical and mental health with considering gender factor [21-24]. Indeed, the comparisons between countries can prove difficult due to differences in populations, government lockdown strategies, and socioeconomic and lifestyle conditions. These investigations could demonstrate some similarities in behavior change [21]. In the Middle East and North Africa (MENA) region, the physical activity levels have been rarely investigated and compared, especially in Egypt and Saudi Arabia. With missing of both regional and country-level data contributes to the continuous surveillance of physical activity participation even during the pandemic, which is essential to track progress towards regional and global physical activity targets. Therefore, this study investigated the physical activity level of Egyptian and Saudi university students before and during the first and second years of COVID-19 pandemic by recording daily step counts.