Table 1.
Effects of the COVID-19 pandemic on physical activity and sedentary behaviors in normal children.
| References | Country | Study type | Study population | Aim and study procedures | Results | Limitations |
|---|---|---|---|---|---|---|
| European studies | ||||||
| Pietrobelli et al. (20) | Italy | Longitudinal observational study (baseline assessment: May-June 2019; second evaluation: March-April 2020) | 41 children (mean age 13.3.1 years) | To test the hypothesis that factors contributing to weight gain among children and adolescents with overweight and obesity are exacerbated during COVID-19 pandemic-associated lockdown by questionnaire | Time spent in sports activities decreased by 2.30 ± 4.60 h/week (p = 0.003); screen time increased by 4.85 ± 2.40 h/day (p < 0.001). An inverse correlation was observed between changes in sport activities and changes in time spent in front of a screen, although at borderline significant level (r = −0.27, borderline significant at p = 0.084) | Self-reported data, small sample size |
| Alonso-Martínez et al. (21) | Spain | Cross-sectional study (baseline assessment: September–December 2019; second evaluation: March–April 2020) | 268 pre-schoolers aged 4–6 years | To examine the effects of the COVID-19 lockdown on PA, sedentary time, and sleep assessed using accelerometry in the week in which the Spanish national state of alarm was declared (n = 21) | Decrease in total PA [mean difference (MD) = 43.3 min per day, 95% CI 68.1–18.5], and an increase in sedentary time (MD = 50.2 min per day, 95% CI 17.1–83.3) | Small sample size with accelerometry data and a short time of monitoring |
| López-Bueno et al. (22) | Spain | Cross-sectional study conducted in March-May 2020 | 860 children and adolescents aged between 3 and 16 years (mean age 9.6 ± 3.9 years) | To investigate the impact of the COVID-19 confinement on health-related behaviors in children using an online survey administered to parents | Significant reduction of weekly minutes of PA during the confinement (−102.5, SD 159.6) (p <0.001) and increase of daily hours of screen exposure (2.9, SD 2.1) (p <0.001) | Self-reported data, wide age range, convenience sampling |
| Nyström et al. (23) | Sweden | Cross-sectional study (baseline assessment: March–May 2019; second evaluation: May–June 2020) | 82 children (mean age 4 ± 0.5 years) | To assess how movement behaviors have been affected in pre-schoolers during the COVID-19 pandemic assessed using a questionnaire filled in by parents | PA, time spent outside on weekdays and weekend days, and screen time significantly increased (+53; +124; +68; +30 min/day, respectively, p <0.001). | Self-reported data by not validated questionnaire |
| International studies | ||||||
| Sá et al. (24) | Brazil | Cross-sectional study conducted in March–April 2020 | 806 children aged 0 to 12 years | To evaluate how families with children aged <13 years faced the period of social isolation resulting from the COVID-19 pandemic, especially regarding the time spent on PA, games, outdoor activities and screen time by questionnaire | Significant reduction in the percentage of total PA time (percentage of reported hours: 26.11% in children aged 0–2 years; 19.56% in children aged 3–5 years; 10.99% in children aged 6-9 years; 9.77% in children aged 10–12 years) and an increase in total sedentary time (percentage of reported hours: 73.89% in children aged 0–2 years; 80.44% in children aged 3–5 years; 89.01% in children aged 6–9 years; 90.23%in children aged 10–12 years) (p <0.001) | Self-reported data |
| Dunton et al. (25) | U.S. | Prospective study conducted in April–May 2020 | 211 children (mean age 8.73 ± 2.58 years) | To examine the effects of the COVID-19 pandemic on PA and sedentary behavior in children using an online survey administered to parents | The most common physical activities during the early-COVID-19 period were free play/unstructured activity (e.g., running around, tag) (90%) and going for a walk (55%). Children engaged in about 90 min of school-related sitting and over 8 h of leisure-related sitting a day. Parents of older children (aged 9–13) vs. younger children (aged 5–8) were half as likely [OR = 0.54, 95% CI (0.31, 0.93)] to have a one-unit change in the perception their children had done less sedentary behavior in past 7 days as compared to February 2020. | Self-reported data, sample not representative compared to U.S. demographic data and not geographically equally distributed |
| Dayton et al. (26) | U.S. | Retrospective case-control study (first phase March 2020; second phase June 2020) | 20 children and young adults (mean age cases: 15.2 ± 3.2; controls: 14.5 ± 3.2) | To evaluate the effect of deconditioning from social distancing and school shutdowns during the COVID-19 pandemic on the cardiovascular fitness of healthy children | The maximal oxygen uptake (VO2 max) in the post-COVID cohort was markedly lower than in the pre-COVID cohort (39.1 vs. 44.7, p = 0.031); the percentile of predicted VO2 max was significantly lower in the post-COVID cohort (95 vs. 105%, p = 0.042). There was a trend for the anaerobic threshold to be lower in the post-COVID cohort, even though it did not reach statistical significance (21.5 vs. 24.6, p = 0.082) | Small sample size, comparisons of exercise performance not obtained on the same patient pre- and post-COVID but through matched controls, different exercise protocols |