Quantitative information about the intensity levels of PA were not gathered in the present study. Although apparatus like Fitbit and similar can be used for addressing PA in the adult population19, it is unusual to have these types of gadgets used by children, and in the wake of the sudden situation it was not possible to distribute such apparatus to families. Regardless, in our results, the value found in the PA average time for both sexes is less than half of the total time of PA reported by accelerometry for Portuguese children (5.0h for boys and 4.5h for girls)20. In a normal school day, children have several physical activities opportunities like walking to school, engaging in physical education classes, playing in recess, participating on sport clubs, etc. All these normal activities are forbidden in this situation. The fact that %PA decreases along the growing age groups is not strange given the knowledge we have on PA behavior of children21, but the findings that boys and girls present no differences on this decrease is somehow new and not fully anticipated13–15. Boys use more play areas and equipment, tend to display higher levels of moderate-to-vigorous PA when using them22 and seem to be more physically intense on the exploration of the playground features, while girls experience a higher enjoyment for activities like playing tag games, walking, creative tasks, climbing, sliding, hiding, sitting, and relaxing23. The same tendency occurs in organized sport participation during childhood, with boys engaging more often organized and high physically intense sports than girls20. In our results, girls and boys showed equal participation on organized physical activities before confinement (66% and 67% reported respectively for girls and boys) and that can help to explain why both sexes showed similar PA behavior along age groups. Another explanation can be that they are all “in the same boat”, without access to the kind of space, equipment, or social organization that usually afford sex-biased movement differences in the normal day time. Furthermore, the non-existence of sex differences in PA might be related to the fact that the majority of activities reported during confinement are probably of light intensity, which is usually not significantly different between boys and girls24,25. Although the government decision was the same for all people, it is wrong to think that this decision affects all equally. Most of the children in our study live in apartments (60,2%) and we found that having an outdoor space influences positively the %PA. The home environment is an important influence on the PA and sedentary behavior of children, being especially relevant for those who have limited independent mobility and spend much of their time at home and indoors12,13. Our results indicate that having a small outdoor space at home (up to 12 m2) did not make a difference, but having a larger space positively impacted the %PA. These results are in line with other studies, that mention that the amount or lack of outdoor space can have a great impact on the children PA7,16–18. Some studies showed that as the amount of home space increased, so did children’s PA16,26, and the lack of a yard space at home was identified as a barrier to PA and active play of children 7,17. Yard features were positively associated with the minutes per day preschoolers spent in home-based outdoor play27. We believe that the results are in accordance with the knowledge that both boys and girls of lower socioeconomic status areas have decreased odds of spending more than 2h outdoors on weekends28 and lower levels of fitness and activity compared to their peers from higher socioeconomic status areas29–31.
Having all adults in the household working from home had a detrimental effect on children’s %PA. This situation can surely be a stressful situation for a home confined family and it has been related with an increase in the depressive symptoms among working women with young children36. The number of tasks that parents have to undertake at this time is immense. They have to do work tasks, house tasks, children school tasks, meal related tasks, all this while trying to give emotional support to their kids and family. This can be a challenge for promoting PA, as fatigue is reported as an health barrier to be active with their children37. Furthermore, with no parent free to engage in interaction with the children, and the need for a quiet work environment at home, surely that children’s movement and noise inside the house are heavily censured.
Our findings showed that, although confined to their house, boys and girls still allocate some time to PA tasks (movement play and physical exercise). The %PA daily time reduces with age, but boys and girls showed no differences unlike what is usually reported for normal days. For children of both sexes and of all ages, the %PA showed to be positively affected by the existence of a big outdoor space in the house, and by the presence of other children in the house. On the opposite side, a negative effect was found when all adults were working from home, probably because of the related lack of attention to children and the need for a quiet home environment.
Even though this study provides important information regarding the role of several variables on the %PA during this confinement situation, it is important to highlight that it has some limitations. First, it is a cross-sectional study design and thus susceptible to biases. Second, it is a parental report online and not a direct or quantifiable observation of the children’s time. We believe that these methodological options were necessary considering the confinement situation we are living.
The conclusions of this study highlight the fact that the COVID-19 response had a differential effect on children according to their household characteristics, being of outmost importance for parents and policy makers. Nobody can change their house size or add an outdoor area instantaneously, but governments can regulate about both parents working from home when there are children confined with them. Parents must be aware of the need to prioritize PA time for their children, since they are not getting the usual stimulation during this period. This effort should be even greater for parents of older children with no outdoor space available, especially because this can constitute a double burden situation when the family already presents a socioeconomic profile at risk. Furthermore, in the post-confinement stage, additional efforts will be required to offer PA and outdoor play opportunities for children who were most affected by the COVID-19 pandemic response.