1. A systematic review and meta-analysis including more than 14,000 children showed significantly decreased physical activity during the COVID-19 pandemic.

2. Children’s duration of moderate-to-vigorous physical activity decreased by 28%, an average of 17 minutes per day.

Evidence Rating Level: 2 (Good)

Study Rundown: Initial lockdowns and changes in educational and extracurricular activities implemented during the COVID-19 pandemic have affected the day-to-day lives of both children and adults. This systematic review and meta-analysis aimed to evaluate the effect of the pandemic on children’s physical activity internationally. Longitudinal studies comparing durations of either child- or parent-reported activity for a total of 14,216 study participants before and after the beginning of the pandemic were included. Total duration of physical activity decreased by 20%, with greater decreases in more intense activity. The 28% decrease in moderate-to-vigorous physical activity corresponded to a 17-minute decrease in activity per day. There was no significant overall change in duration of light activity. This study provides strong evidence for a significant but somewhat modest effect of the COVID-19 pandemic on children’s physical activity. The pooling of moderately heterogenous studies from many different countries allowed for greater statistical strength and examination of differences based on factors like intensity of activity. However, the nature of the meta-analysis also prevents analysis of the effects of specific pandemic policies and changes. Decreased exercise and activity has the potential to contribute to and compound known mental health effects of the ongoing COVID-19 pandemic, so it is particularly important to both quantify and understand reductions in activity.

Click to read the study in JAMA Pediatrics

Relevant Reading: COVID-19 pandemic impact on children and adolescents’ mental health: Biological, environmental, and social factors

In-Depth [systematic review and meta-analysis]: Studies from around the world including children with pre-existing medical conditions and athletes were excluded. From 126 reviewed articles, 22 studies were included reporting data from 46 independent samples; 79 effect sizes were extracted. The 90% confidence interval (CI) for the decrease in total physical activity was -34% to -4%. The τ statistic was 36%, representing moderate to large heterogeneity between studies. Moderation analysis was performed using sex, age group, child or parent reporting, study quality graded as 0 or 1, amount of pre-pandemic physical activity, intensity of activity, duration between longitudinal assessments of activity, and geographic latitude as moderators. There was a 37% increase in the effect of the pandemic on activity levels with increasing latitude (90% CI -1–89%). Reduction in activity levels was also 25% greater for studies with a longer duration between assessments (90% CI -0.5–58%). The β coefficient for the regression model of publication bias was relatively small at 9.5%.

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