Purpose: Covid-19 is a viral infection that affects either the respiratory system or the other systems. Studies about the effects of Covid-19 on physical activity are still scarce. This study aims to compare the changes in the physical activity levels of patients before and six months after Covid-19 in Turkey.
Methods: One hundred and six participants that have been six months after Covid-19 contraction were included in the study. Along with the Patient Assessment Questionnaire, the International Physical Activity Questionnaire Short Form was used to assess physical activity energy consumption (vigorous-intensity physical activities, moderate-intensity physical activities, walking, and total physical activities).
Results: Participants became either less physically active or more sedentary six months after Covid-19 (p=0.019). Vigorous-intensity physical activity levels were significantly decreased (Mean±SD: 341±854 vs. 109±331 Metabolic Equivalent Task minutes/week, p=0.015), and perceived fatigue during exercise was significantly increased between before and six month after infection (Mean±SD: 4.76±2.17 vs 6.17±2.27, p=0.001). Participants who had dyspnea (n=12) during the period of Covid-19, did more moderate-intensity physical activity (p=0.020) and walking (p =0.021) after Covid-19, compared to those who had not.
Conclusion: Particularly changes in vigorous-intensity physical activity levels and perceived fatigue during exercise were seen in Covid-19 infected patients. We recommend supporting gradually increased tailor-based exercise programs by health professionals in public health agencies, not only for protecting the individuals from Covid-19 outcomes, but also for returning to their preinfection fitness levels.
1- Kordzadeh-Kermani E, Khalili H, Karimzadeh I. Pathogenesis, clinical manifestations and complications of coronavirus disease 2019 (COVID-19). Future Microbiol. 2020;15(13):1287-1305. doi: 10.2217/fmb-2020-0110
2- Zheng KI, Feng G, Liu WY, Targher G, Byrne CD, Zheng MH. Extrapulmonary complications of COVID‐19: A multisystem disease? J Med Virol. 2021;93(1):323-335. doi: 10.1002/jmv.26294
3- İnal İnce D, Vardar Yağlı N, Sağlam M, Çalık Kütükcü E. Acute and post-acute physiotherapy and rehabilitation in Covid-19 infection. T Turk J Physiother Rehabil. 2020;31(1):81-93 (in Turkish). doi: 10.21653/tjpr.718877
4- Yu, C, Zhou M, Liu Y, Guo T, Ou C, Yang L, et al. Characteristics of asymptomatic COVID-19 infection and progression: a multicenter, retrospective study. Virulence. 2020;11(1):1006-1014. doi: 10.1080/21505594.2020.1802194
5- Greve JMDA, Brech GC, Quintana M, Soares ALDS, Alonso AC. Impacts of COVID-19 on the immune, neuromuscular, and musculoskeletal systems and rehabilitation. Rev Bras Med Esporte. 2020;26(4):285-288. https://doi.org/10.1590/1517-869220202604ESP002
6- Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports. 1985;100(2):126-131.
7- Franco I, Bianco A, Bonfiglio C, Sorino P, Mirizzi A, Campanella A, et al. Decreased levels of physical activity: results from a cross-sectional study in southern Italy during the COVID-19 lockdown. The Journal of Sports Medicine and Physical Fitness. 2021;61(2):294-300. doi: 10.23736/S0022-4707.20.11536-6
8- Bertheussen GF, Oldervoll L, Kaasa S, Sandmæl JA, Helbostad JL. Measurement of physical activity in cancer survivors—a comparison of the HUNT 1 Physical Activity Questionnaire (HUNT 1 PA-Q) with the International Physical Activity Questionnaire (IPAQ) and aerobic capacity. Support Care Cancer. 2013;21(2):449-458. doi: 10.1007/s00520-012-1530-8
9- de Sá-Caputo DDC, Sonza A, Bachur JA, Bernardo-Filho M. Development, validation and reliability of a questionnaire to evaluate changes on the level of physical exercises and psychological impact due to COVID-19 pandemic social distancing. Acta Biomed. 2020;91(3):e2020004. doi: 10.23750/abm.v91i3.9888
10- Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine & Science In Sports & Exercise. 2003;35(8):1381-1395. doi: 0.1249/01.MSS.0000078924.61453.FB
11- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M. International Physical Activity Questionnaire: Reliability and Validity of the Turkish Version. Perceptual and Motor Skills. 2010;11(1):278-284. doi: 10.2466/06.08.PMS.111.4.278-284
12- Elbasan B, Düzgün İ. Physical Activity Scales- Evidence Based Physical Activity. Turkiye Klinikleri J Physiother Rehabil-Special Topics. 2016;2(1):36-39 (in Turkish).
13- Tavakol Z, Ghannadi S, Tabesh MR, Halabchi F, Noormohammadpour P, Akbarpour S, et al. Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study. Journal of Public Health: From Theory to Practice. 2021;4:1-9. doi: 10.1007/s10389-020-01468-9
14- Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med. 2021;0:1-8. http://dx.doi.org/10.1136/bjsports-2021-104080
15- Halabchi F, Mazaheri R, Sabeti K, Yunesian M, Alizadeh Z, Ahmadinejad Z, et al. Regular Sports Participation as a Potential Predictor of Better Clinical Outcome in Adult Patients With COVID-19: A Large Cross-Sectional Study. J Phys Act Health. 2020;18(1):8-12. doi: 10.1123/jpah.2020-0392
16- Salgado-Aranda R, Pérez-Castellano N, Núñez-Gil I, Orozco AJ, Torres-Esquivel N, Flores-Soler J, et al. Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study. I. Infect Dis Ther. 2021;10(2):801-814. doi: 10.1007/s40121-021-00418-6
17- Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A, et al. Returning to physical activity after covid-19. BMJ. 2021;372:m4721. https://doi.org/10.1136/bmj.m4721
18- Aktaş H, Şaşmaz CT, Kılınçer A, Mert E, Gülbol S, Külekçioğlu D, et al. Study on the factors related to physical activity levels and sleep quality in adult. Mersin Univ Saglık Bilim Derg. 2015;8(2):60-70 (in Turkish).
19- Murphy EA, Davis JM, Carmichael MD, Gangemi JD, Ghaffar A, Mayer EP. Exercise stress increases susceptibility to influenza infection. Brain Behav Immun. 2008;22(8):1152-1155. doi: 10.1016/j.bbi.2008.06.004
20- Nieman DC, Nehlsen-Cannarella SL, Markoff PA, Balk-Lamberton AJ, Yang H, Chritton DB, et al. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med. 1990;11(6):467-73. doi: 10.1055/s-2007-1024839
21- Humphreys H, Kilby L, Kudiersky N, Copeland R. Long COVID and the role of physical activity: a qualitative study. BMJ Open. 2021;11:e047632. doi: 10.1136/bmjopen-2020-047632
22- Maugeri G, Castrogiovanni P, Battaglia G, Pippi R, D'Agata V, Palma A, et al. The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon. 2020;6:e04315. https://doi.org/10.1016/j.heliyon.2020.e04315
23- King AC, Kiernan M, Ahn DK, Wilcox S. The effects of marital transitions on changes in physical activity: results from a 10-year community study. Ann Behavi Med. 1998;20(2):64-69. doi: 10.1007/BF02884450
24- Li W, Procter-Gray E, Churchill L, Crouter SE, Kane K, Cheng J, et al. Gender and age differences in levels, types and locations of physical activity among older adults living in car-dependent neighborhoods. J Frailty Aging. 2017;6(3):129-135. doi: 10.14283/jfa.2017.15
Amaç: Covid-19 solunum sistemini veya diğer sistemleri etkileyen viral bir enfeksiyondur. Covid- 19’un fiziksel aktivite üzerindeki etkileri ile ilgili çalışmalar halen yetersizdir. Bu çalışmanın amacı Türkiye’de hastaların Covid-19 öncesi ve altı ay sonrası fiziksel aktivite düzeylerindeki değişiklikleri karşılaştırmaktır.
Yöntem: Çalışmaya Covid-19’un üzerinden altı ay geçmiş 106 katılımcı dahil edildi. Hasta Değerlendirme Anketi ile birlikte, fiziksel aktivite enerji tüketimini (şiddetli fiziksel aktiviteler, orta yoğunlukta fiziksel aktiviteler, yürüme ve toplam fiziksel aktiviteler) değerlendirmek için Uluslararası Fiziksel Aktivite Anketi Kısa Formu kullanıldı.
Sonuçlar: Katılımcılar, Covid-19’dan 6 ay sonra ya fiziksel olarak daha az aktif ya da daha sedanter hale geldi (p=0,019). Şiddetli fiziksel aktivite seviyeleri önemli ölçüde azaldı (Ortalama±SS:341±854 vs. 109±331, Metabolik Eşdeğer dakika/ hafta, p=0,015) ve egzersiz sırasında algılanan yorgunluk enfeksiyondan önceki ve sonraki altı ay arasında önemli ölçüde arttı (Ortalama±SS: 4.76±2.17 vs 6.17±2.27, p=0,001). Covid-19 döneminde nefes darlığı (n=12) olan katılımcılar, olmayanlara göre Covid-19 sonrası daha fazla orta yoğunlukta fiziksel aktivite (p=0,020) ve yürüyüş (p=0,021) yaptı.
Tartışma: Covid-19 ile enfekte olan hastalarda özellikle şiddetli fiziksel aktivite seviyelerinde ve egzersiz sırasında algılanan yorgunlukta değişiklikler görüldü. Bireyleri sadece Covid-19 sonuçlarından korumak için değil, aynı zamanda bireylerin enfeksiyon öncesi fiziksel uygunluk seviyelerine geri dönmeleri için, halk sağlığı kurumlarındaki sağlık profesyonelleri tarafından kademeli olarak artırılan kişiye özel egzersiz programlarının desteklenmesini öneriyoruz.
1- Kordzadeh-Kermani E, Khalili H, Karimzadeh I. Pathogenesis, clinical manifestations and complications of coronavirus disease 2019 (COVID-19). Future Microbiol. 2020;15(13):1287-1305. doi: 10.2217/fmb-2020-0110
2- Zheng KI, Feng G, Liu WY, Targher G, Byrne CD, Zheng MH. Extrapulmonary complications of COVID‐19: A multisystem disease? J Med Virol. 2021;93(1):323-335. doi: 10.1002/jmv.26294
3- İnal İnce D, Vardar Yağlı N, Sağlam M, Çalık Kütükcü E. Acute and post-acute physiotherapy and rehabilitation in Covid-19 infection. T Turk J Physiother Rehabil. 2020;31(1):81-93 (in Turkish). doi: 10.21653/tjpr.718877
4- Yu, C, Zhou M, Liu Y, Guo T, Ou C, Yang L, et al. Characteristics of asymptomatic COVID-19 infection and progression: a multicenter, retrospective study. Virulence. 2020;11(1):1006-1014. doi: 10.1080/21505594.2020.1802194
5- Greve JMDA, Brech GC, Quintana M, Soares ALDS, Alonso AC. Impacts of COVID-19 on the immune, neuromuscular, and musculoskeletal systems and rehabilitation. Rev Bras Med Esporte. 2020;26(4):285-288. https://doi.org/10.1590/1517-869220202604ESP002
6- Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports. 1985;100(2):126-131.
7- Franco I, Bianco A, Bonfiglio C, Sorino P, Mirizzi A, Campanella A, et al. Decreased levels of physical activity: results from a cross-sectional study in southern Italy during the COVID-19 lockdown. The Journal of Sports Medicine and Physical Fitness. 2021;61(2):294-300. doi: 10.23736/S0022-4707.20.11536-6
8- Bertheussen GF, Oldervoll L, Kaasa S, Sandmæl JA, Helbostad JL. Measurement of physical activity in cancer survivors—a comparison of the HUNT 1 Physical Activity Questionnaire (HUNT 1 PA-Q) with the International Physical Activity Questionnaire (IPAQ) and aerobic capacity. Support Care Cancer. 2013;21(2):449-458. doi: 10.1007/s00520-012-1530-8
9- de Sá-Caputo DDC, Sonza A, Bachur JA, Bernardo-Filho M. Development, validation and reliability of a questionnaire to evaluate changes on the level of physical exercises and psychological impact due to COVID-19 pandemic social distancing. Acta Biomed. 2020;91(3):e2020004. doi: 10.23750/abm.v91i3.9888
10- Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine & Science In Sports & Exercise. 2003;35(8):1381-1395. doi: 0.1249/01.MSS.0000078924.61453.FB
11- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M. International Physical Activity Questionnaire: Reliability and Validity of the Turkish Version. Perceptual and Motor Skills. 2010;11(1):278-284. doi: 10.2466/06.08.PMS.111.4.278-284
12- Elbasan B, Düzgün İ. Physical Activity Scales- Evidence Based Physical Activity. Turkiye Klinikleri J Physiother Rehabil-Special Topics. 2016;2(1):36-39 (in Turkish).
13- Tavakol Z, Ghannadi S, Tabesh MR, Halabchi F, Noormohammadpour P, Akbarpour S, et al. Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study. Journal of Public Health: From Theory to Practice. 2021;4:1-9. doi: 10.1007/s10389-020-01468-9
14- Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med. 2021;0:1-8. http://dx.doi.org/10.1136/bjsports-2021-104080
15- Halabchi F, Mazaheri R, Sabeti K, Yunesian M, Alizadeh Z, Ahmadinejad Z, et al. Regular Sports Participation as a Potential Predictor of Better Clinical Outcome in Adult Patients With COVID-19: A Large Cross-Sectional Study. J Phys Act Health. 2020;18(1):8-12. doi: 10.1123/jpah.2020-0392
16- Salgado-Aranda R, Pérez-Castellano N, Núñez-Gil I, Orozco AJ, Torres-Esquivel N, Flores-Soler J, et al. Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study. I. Infect Dis Ther. 2021;10(2):801-814. doi: 10.1007/s40121-021-00418-6
17- Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A, et al. Returning to physical activity after covid-19. BMJ. 2021;372:m4721. https://doi.org/10.1136/bmj.m4721
18- Aktaş H, Şaşmaz CT, Kılınçer A, Mert E, Gülbol S, Külekçioğlu D, et al. Study on the factors related to physical activity levels and sleep quality in adult. Mersin Univ Saglık Bilim Derg. 2015;8(2):60-70 (in Turkish).
19- Murphy EA, Davis JM, Carmichael MD, Gangemi JD, Ghaffar A, Mayer EP. Exercise stress increases susceptibility to influenza infection. Brain Behav Immun. 2008;22(8):1152-1155. doi: 10.1016/j.bbi.2008.06.004
20- Nieman DC, Nehlsen-Cannarella SL, Markoff PA, Balk-Lamberton AJ, Yang H, Chritton DB, et al. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med. 1990;11(6):467-73. doi: 10.1055/s-2007-1024839
21- Humphreys H, Kilby L, Kudiersky N, Copeland R. Long COVID and the role of physical activity: a qualitative study. BMJ Open. 2021;11:e047632. doi: 10.1136/bmjopen-2020-047632
22- Maugeri G, Castrogiovanni P, Battaglia G, Pippi R, D'Agata V, Palma A, et al. The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon. 2020;6:e04315. https://doi.org/10.1016/j.heliyon.2020.e04315
23- King AC, Kiernan M, Ahn DK, Wilcox S. The effects of marital transitions on changes in physical activity: results from a 10-year community study. Ann Behavi Med. 1998;20(2):64-69. doi: 10.1007/BF02884450
24- Li W, Procter-Gray E, Churchill L, Crouter SE, Kane K, Cheng J, et al. Gender and age differences in levels, types and locations of physical activity among older adults living in car-dependent neighborhoods. J Frailty Aging. 2017;6(3):129-135. doi: 10.14283/jfa.2017.15
Taçalan, E., & Kafa, N. (2023). EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, 34(1), 29-37. https://doi.org/10.21653/tjpr.981642
AMA
Taçalan E, Kafa N. EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY. Turk J Physiother Rehabil. April 2023;34(1):29-37. doi:10.21653/tjpr.981642
Chicago
Taçalan, Ekin, and Nihan Kafa. “EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi 34, no. 1 (April 2023): 29-37. https://doi.org/10.21653/tjpr.981642.
EndNote
Taçalan E, Kafa N (April 1, 2023) EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY. Türk Fizyoterapi ve Rehabilitasyon Dergisi 34 1 29–37.
IEEE
E. Taçalan and N. Kafa, “EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY”, Turk J Physiother Rehabil, vol. 34, no. 1, pp. 29–37, 2023, doi: 10.21653/tjpr.981642.
ISNAD
Taçalan, Ekin - Kafa, Nihan. “EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY”. Türk Fizyoterapi ve Rehabilitasyon Dergisi 34/1 (April 2023), 29-37. https://doi.org/10.21653/tjpr.981642.
JAMA
Taçalan E, Kafa N. EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY. Turk J Physiother Rehabil. 2023;34:29–37.
MLA
Taçalan, Ekin and Nihan Kafa. “EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, vol. 34, no. 1, 2023, pp. 29-37, doi:10.21653/tjpr.981642.
Vancouver
Taçalan E, Kafa N. EVALUATION OF THE PHYSICAL ACTIVITY LEVELS OF COVID-19 PATIENTS IN TURKEY. Turk J Physiother Rehabil. 2023;34(1):29-37.