Danjuma Moudu Momoh
Department of Human Kinetics and Health Education
Adekunle Ajasin University, Akungba-Akoko, Nigeria
It is worth remembering that, for healthy and asymptomatic individuals, the WHO recommends at least 150 minutes of physical activity per week for adults and 300 minutes per week for children and adolescents (World Health Organization, 2010). The physical activity time should be accumulated during the days of the week; it may be divided according to individual routine and it should preferably be composed of moderate- to vigorous-intensity activity. We emphasize the importance of advice from physical exercise professionals in order to adequately adapt practice of physical activities for the population. It is fundamental that individuals who regularly perform physical exercise maintain their practice, adapting them, however, to the current conditions of restricted movement. The importance of staying physically active should be even further emphasized for elderly individuals, who have been proven to present more co-morbidities and greater cardiovascular risk, in addition to being more vulnerable to COVID-19. Populations with cardiovascular co-morbidities should perform physical activities on a daily basis, maintaining pharmacological treatment and respecting their eventual physical limitations and the recommendations of healthcare professionals. Practice of physical exercise should be interrupted when symptoms related to COVID-19, such as fever, dry cough, and dyspnea, appear.
With the continuing corona virus spread, the public has been advised by various health authorities to reduce traveling and stay at home as a basic means of limiting people’s exposure to the virus. Health authorities, including the Nigeria Centre for Disease Control, WHO and U.S. Center for Disease Control and Prevention, have issued safety recommendations for taking simple precautions to reduce exposure to and transmission of the virus. Unfortunately, the mandated restrictions on travel and directives against participating in outdoor activities, including regular physical activity and exercise, will inevitably disrupt the daily routine activities of tens of millions of people (WHO, 2019; USCDC, 2019).
The link between physical activity and mental well-being is clear. Studies have reported that enforced sedentary behavior has led to depressive feelings and low moods in healthy people within seven days (Endrighi, Steptoe & Hamer 2016). Taking into consideration the current situation worldwide with countries in enforced periods of lockdown and isolation, this may potentially have a mammoth impact on the mental well-being of many people and even more so if they do not engage in any form of physical activity.
This musculoskeletal deconditioning may have a significant impact on these vulnerable populations and may potentially increase the risk of injuries related to falls, such as hip fractures.
It is fundamental to encourage the population to maintain a physically active lifestyle routine as a preventative health measure during this period of confronting the spread of the virus. During periods of confinement at home, the population tends to adopt a sedentary routine, which favors increased body weight gain, as well as the emergence of co-morbidities associated with greater cardiovascular risk, such as obesity, increased blood pressure, and glucose intolerance, in addition to psychosocial disorders such as anxiety and depression. Sedentary behavior, whether sitting, watching TV, or spending time in front of electronic devices, has in fact been associated with increased body weight in children, adolescents, adults and elderly, as well as with a marked increase in the risk of cardiovascular mortality (Banks, Jorm, Rogers, Clements & Bauman, 2011). Patterson, McNamara, Tainio, de Sá, Smith & Sharp (2018) opined that it has, on the contrary, been shown that the risk of developing cardiovascular diseases and mortality is reduced in individuals with physically active life habits, such as going on moderately intense walks. Hamer and Chida (2008) said it has furthermore been demonstrated that the risk of upper respiratory tract infection due to corona virus is potentially greater in the presence of immune system deficiency. Channappanavar and Perlman (2017) mentioned that in this sense, there is strong evidence in the literature that practicing physical exercise is a beneficial measure for improving immunity
With decreased physical activity there is the likelihood of musculoskeletal deconditioning (Kramer, Gollhofer, Armbrecht, Felsenberg and Gruber, 2017). During periods of lockdown where many people’s daily activity movements are restricted, musculoskeletal deconditioning is likely to happen in most people. In fit and healthy people this will be less noticeable, but in older people, people with diagnosed health conditions or people who function very close to the functional threshold, musculoskeletal deconditioning will be more pronounced. This musculoskeletal deconditioning may have a significant impact on these vulnerable populations and may potentially increase the risk of injuries related to falls, such as hip fractures (Low & Balaraman, 2017). This will in turn have implications for health and social care services already under stress.
It is fundamental that individuals who regularly perform physical exercise maintain their practice, adapting them, however, to the current conditions of restricted movement. The importance of staying physically active should be further emphasized for elderly individuals, who have been proven to present more co-morbidities and greater cardiovascular risk, in addition to being more vulnerable to COVID-19.
The coronavirus (COVID-19) pandemic can make it challenging to maintain a physically active lifestyle. COVID-19 is spread by someone sneezing or coughing into the air or onto a surface, and then the virus enters and infects a new person through their mouth, nose or eyes. Based on what we know about how the virus moves from one person to another, it is recommended to avoid public gatherings and keep a social distance of 6 feet or more. That, along with advice related to personal care (hand washing, not touching your face) has created concern about exercising in gyms, where hundreds of people are in and out every day. Those at greatest risk for severe complications of COVID-19 are: older adults (age 65 and older), people with chronic diseases (such as diabetes, heart disease and lung disease) and those with compromised immune systems (such as those going through cancer treatment or with HIV). These individuals (and those under “shelter in place” orders) should avoid gyms altogether and exercise at home or in their neighborhood. For all of us, young and old, regular physical activity is important for staying healthy! Compared to just sitting around most of the time, moderate-intensity physical activity is associated with better immune function. Regular physical activity can help reduce your feelings of stress and anxiety (which many of us may be feeling in the wake of the COVID-19 pandemic).
Exercise at home using various safe, simple, and easily implementable exercises is well suited to avoid the airborne coronavirus and maintain fitness levels. Such forms of exercise may include, but are not limited to, strengthening exercises, activities for balance and control, stretching exercises, or a combination of these. Examples of home exercises include walking in the house and to the store as necessary, lifting and carrying groceries, alternating leg lunges, stair climbing, stand-to-sit and sit-to-stand using a chair and from the floor, chair squats, and sit-ups and pushups. In addition, the use of eHealth and exercise videos, which focus on encouraging and delivering physical activity through the Internet, mobile technologies, and television are other viable avenues for maintaining physical function and mental health during this critical period (Tate, Lyons & Valle, 2015).
Despite all these many benefits, physical inactivity costs 5.3 million lives per year globally. It is important therefore to find ways to limit the impact of the COVID-19 pandemic as well as the wider impact it will have on long term chronic diseases (Mcleod , Stokes & Phillips 2019).
Guidelines for Physical Activities
The WHO Guidelines for the amount of physical activity include:
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- Infants under the age of 1 year need to be physically active several times a day.
- Children under 5 years of age should spend at least 180 minutes a day in physical activities, with 3–4-year-old’s being moderately or vigorously active for an hour a day.
- Children and adolescents aged 5–17 years should do at least 60 minutes a day of moderate to vigorous-intensity physical activity, including activities that strengthen muscle and bone, at least 3 days per week.
- Adults aged 18–64 years should do a total of at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, including muscle-strengthening activities 2 or more days per week.
- Adults aged 65 years should do a total of at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, including muscle-strengthening activities 2 or more days per week. Older adults with poor mobility should do physical activity to enhance balance and prevent falls on 3 or more days per week.
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Benefits of Physical Activity
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- Reduces high blood pressure
- Weight management
- Reduces the risk of heart disease
- Reduces the risk of diabetes
- Reduces the risk of stroke
- Reduces the risk of certain cancers
- Improves bone and muscle strength
- Improves balance
- Improves flexibility
- Improves fitness
- Improves mental health
- Reduces the risk of depression
- Reduces the risk of cognitive decline
- Delays the onset of dementia
- Improves overall feeling of well-being
- In children, physical activity may:
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- support healthy growth and development
- reduce the risk of disease in later life
- help in development of fundamental movement skills
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The Benefits of Strength and Balance Training
Often, strength and balance training is forgotten as being part of physical activity and many people only focus on the aerobic fitness component and the benefits thereof.
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- Improves blood liquid profile
- Improves vascular function
- Improves immune function
- Builds and maintain muscle mass
- Increases oxidative capacity
- Helps to maintain independence and functional status
- Improves the ageing trajectory
- Improves blood glucose sensitivity
- Improves blood pressure and is a healthy way to manage blood pressure
- Improves body composition – this helps to maintain a healthy weight over time
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Keeping Safe While Exercising During COVID-19
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- Do not exercise if you have a fever, cough or difficulty breathing (symptoms of COVID-19)
- Practice social distancing when exercising outdoors and practice good hand hygiene before and after.
- If you are not used to physical activity, start slowly with low intensity activities such as walking or low impact exercises for shorter periods of time and gradually build up over time.
- Choose the right activity to reduce the risk of injury – the intensity of the exercise should match your fitness levels and health status.
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Maycon, Maria, Fernanda, and José (2020) stated that it is important to emphasize that the home and family environment is also conducive to performing physical activity. In this manner, regardless of age range, the following behaviors and attitudes should be recommended, which will help the population stay physically active and maintain physical and mental health and which will be important for facing this moment of social isolation:
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- Perform physical activities that are pleasurable, exploring spaces around the house and using equipment to move about;
- Perform daily activities, such as cleaning, maintaining, and organizing spaces around the house;
- Play and exercise with children, adolescents, and pets, using games that promote energy expenditure higher than resting;
- Avoid sedentary behavior, alternating time spent sitting or lying down with periods of physical activity, reducing time spent using electronic devices;
- Set aside a few minutes for stretching, relaxation, and meditation activities.
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Conclusion
People who are infected, but without symptoms, can continue moderate-intensity activity, but need to use symptoms as a guide. Maintain quarantine to prevent spreading the coronavirus to others. If you develop fever, cough or shortness of breath, stop physical activity and reach out to your doctor or health care provider. Moderate-intensity physical activity can boost your immune system. However high-intensity high volume training may suppress immune function especially if you are unaccustomed to it. Balance your workout program. There are no recommendations at this time to limit physical activity if you do not have any symptoms. Contact your health care provider if you develop a cough, fever or shortness of breath. Don’t sit all day! For example: If watching television, get up during every commercial (or periodically) and do a lap around your home or an active chore. For example, throw some clothes in the laundry, do the dishes or take out the garbage. Feel productive after just one show.
References
ACSM (2020) Staying Active During the Coronavirus Pandemic. Exercise is Medicine.
Banks, E.; Jorm L, Rogers K, Clements M, and Bauman A. (2011) Screen-time, obesity, ageing and disability: findings from 91266 participants in the 45 and up study. Public Health Nutrition. 14(1):34–43.
Centers for Disease Control and Prevention. Interim guidance for persons who may have 2019 Novel Coronavirus (2019-nCoV) to prevent spread in homes and residential communities. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance (accessed 288.0.5.2020).
Channappanavar R, and Perlman S. (2017) Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathology. 39(5):529–39.
Endrighi R, Steptoe A, and Hamer M (2016) The effect of experimentally induced sedentariness on mood and psychobiological responses to mental stress. British Journal of Psychiatry. 208(3):245‐251
Faneite, A. (2020) How to stay fit and healthy during coronavirus (COVID-19) Pandemic. American Society for Nutrition.
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Kramer A, Gollhofer A, Armbrecht G, Felsenberg D, and Gruber M (2017). How to prevent the detrimental effects of two months of bed-rest on muscle, bone and cardiovascular system: an RCT. Scientific reports. 2017 Oct 13;7(1):1-0.
Low S.T, and Balaraman T. (2017) Physical activity level and fall risk among community-dwelling older adults. Journal of Physical Therapy Science. 29(7):1121-4.
Maycon, J. F; Maria, C. I; Fernanda C; and José, F K. S. (2020) Physically Active Lifestyle as an Approach to Confronting COVID-19. The journal Arquivos Brasileiros de Cardiologia 114(4)
Mcleod, J.C, Stokes T. and Phillips, S.M (2019) Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease. Front. Physiol. 10:645. doi: 10.3389/fphys.2019.00645
Patterson, R. McNamara, E. Tainio M, de Sá T.H. Smith A.D, and Sharp S.J. (2018) Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. European Journal of Epidemiology. 33(9):811–29.
Tate D.F., Lyons E.J., and Valle, C.G. (2015) High-tech tools for exercise motivation: use and role of technologies such as the internet, mobile applications, social media, and video games. Diabetes Spectr. 28:45–54.
World Health Organization. (2010) Global recommendations on physical activity for health. Geneva.
World Health Organisation (2018). Physical Activity. Published on 23 February 2018. Availablefrom https://www.who.int/news-room/fact-sheets/detail/physical-activity. (accessed 20.05. 2020).
World Health Organization. (2019) Novel coronavirus (2019-nCoV) advice for the public. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public. (accessed 27.05.2020)
Copyright © Danjuma Moudu Momoh 2020
