The impact of the COVID-19 pandemic on physical activity levels, and screen time of children and adolescents: a systematic review and meta-analysis

Öz

Aim: The coronavirus disease 2019 (COVID-19) has caused a pandemic. The measures taken due to the COVID-19 pandemic have affected the physical activity levels and screen time of children and adolescents. Our aim was to synthesize and analyze the available evidence regarding the impact of the COVID-19 pandemic on the physical activity levels and screen time of children and adolescents. Materials and Methods: For this systematic review and meta-analysis study, studies that quantitatively evaluated the physical activity level and screen time of children and adolescents during the COVID-19 pandemic were determined as appropriate studies. Two researchers independently assessed the methodological quality of the studies using a standardized form. Random effects model was used for meta-analysis of study results. Q and I2 tests were used to test the heterogeneity of effect sizes. The study was registered to PROSPERO with the number CRD42021241981. Results: red the physical activity levels and screen time of children and adolescents during the COVID-19 pandemic with the period before the COVID-19 pandemic. Among these 18 studies, a meta-analysis was performed for physical activity level with 15 studies and for screen time with 12 studies. According to the results of the analysis, the COVID-19 pandemic caused a decrease in the physical activity levels of children and adolescents (Hedges’s g = -0.117, 95% CI = -0.187 to 0.047, I2 = 91,024) and an increase in screen time (Hedges’s g = 0.472, 95% CI = 0.327 to). 0.617, I2 = 96,025). Conclusion: This systematic review and metaanalysis study examines the early evidence of the COVID-19 pandemic. It is important because it analyzed 18 studies involving populations of many different countries in this process. Evidence shows that the COVID-19 pandemic negatively impacts physical activity levels and screen time of children and adolescents. These results will contribute to scientists and policy makers to realize the impact of the COVID-19 pandemic and to develop strategies to take necessary precautions.

Anahtar Kelimeler

• child
• adolescent
• COVID-19
• physical activity
• screen time

COVID-19 pandemisinin çocukların ve adölesanların fiziksel aktivite düzeyi ve ekran süresi üzerindeki etkisi: bir sistematik derleme ve meta-analiz

Öz

Amaç: Koronavirüs hastalığı 2019 (COVID-19) bir pandemiye neden oldu. COVID-19 pandemisi nedeniyle alınan önlemler çocukların ve adölesanların fiziksel aktivite düzeylerini ve ekran sürelerini etkiledi. Amacımız COVID-19 pandemisinin çocukların ve adölesanların fiziksel aktivite düzeyleri ve ekran süreleri üzerindeki etkisi ile ilgili mevcut kanıtları sentezlemek ve analiz etmektir. Gereç ve Yöntem: Bu sistematik derleme ve meta–analiz çalışması için COVID-19 pandemisi sürecinde yürütülen çocukların ve adölesanların fiziksel aktivite düzeyi ve ekran sürelerini sayısal olarak değerlendiren çalışmalar uygun çalışmalar olarak belirlenmiştir. İki araştırmacı standart bir form kullanarak çalışmaların metodolojik kalitesini bağımsız olarak değerlendirmiştir. Çalışma sonuçlarının meta-analizleri için rastgele etkiler modeli kullanılmıştır. Etki büyüklüklerinin heterojenliğini test etmek için Q ve I² testleri kullanılmıştır. Çalışma PROSPERO’ya CRD42021241981 numarası ile kaydedilmiştir. Bulgular: Tarama sonucunda 363 çalışmaya ulaşılmıştır. Bu çalışmalardan 18 tanesi çocukların ve adölesanların COVID-19 pandemisi sürecindeki fiziksel aktivite düzeylerini ve ekran sürelerini COVID-19 pandemisinden önceki dönem ile sayısal olarak karşılaştırdığı için meta–analize dahil edilmiştir. Bu 18 çalışma içerisinden 15 çalışma ile fiziksel aktivite düzeyi, 12 çalışma ile de ekran süresi için meta-analiz yapılmıştır. Analiz sonuçlarına göre COVID-19 pandemisi çocukların ve adölesanların fiziksel aktivite düzeylerinde azalmaya (Hedges’s g =-0,117, 95% CI = -0,187 to 0,047, I²= 91,024) ekran sürelerinde ise artışa (Hedges’s g = 0,472, 95% CI = 0,327 to 0,617, I² = 96,025) neden olmuştur.. Sonuç: Bu sistematik derleme ve meta–analiz çalışması COVID-19 pandemisinin erken kanıtlarını incelemektedir. Bu süreçte birçok farklı ülke popülasyonunu içeren 18 çalışmayı analiz etmesinden dolayı önemlidir. Kanıtlar, COVID-19 pandemisinin çocukların ve adölesanların fiziksel aktivite düzeylerini ve ekran sürelerini olumsuz etkilediğini göstermektedir. Bu sonuçlar bilim insanlarının ve politika yapıcılarının COVID-19 pandemisinin etkisini fark etmelerine ve gerekli önlemler almaya yönelik stratejiler geliştirmelerine katkı sağlayacaktır.

Anahtar Kelimeler

• çocuk
• adölesan
• Covid-19
• fiziksel aktivite
• ekran süresi

Kaynakça

1. 1.Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
2. 2. World Health Organization. WHO DirectorGeneral’s opening remarks at the media briefing on COVID-19. Erişim: https://www.who.int/directorgeneral/speeches/detail/who-director-general-sopening-remarks-at-the-media-briefing-on-covid19---11-march-2020. Published March 11, 2020. Erişim tarihi:03.06.2022.
3. 3. World Health Organization. Advice for the public: Coronavirus disease (COVID-19); Updated 2020 May 10; cited 2022 June 15. Erişim: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/advice-for-public. Erişim tarihi: 15.06.2022.
4. 4. Schmidt SC, Anedda B, Burchartz A, EichstellerA, Kolb S, Zenci K, et al. Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: a natural experiment. Sci Rep. 2020;10(1):1-12.
5. 5. López-Gil JF, Tremblay MS, Brazo-Sayavera J. Changes in healthy behaviors and meeting 24-h movement guidelines in Spanish and Brazilian preschoolers, children and adolescents during the COVID-19 lockdown. Children. 2021;8(2):83.
6. 6. Ten Velde G, Lubrecht J, Arayess L, van Loo C, Hesselink M, Reijnders D, Vreugdenhil A. Physical activity behaviour and screen time in Dutch children during the COVID‐19 pandemic: Pre‐, during‐and post‐school closures. Pediatr Obes. 2021;16(9):e12779.
7. 7. Zhu X, Liu J. Education in and after Covid-19: Immediate responses and long-term visions. Postdigit Sci Educ. 2020;2(3):695-699.
8. 8. Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected. Prog Cardiovasc Dis. 2020;63(4):531-532.

9. 9. World Health Organization. Physical Activity. Erişim: https://www.who.int/news room/ factsheets/ detail/ physical-activity Published October 5, 2022. Erişim tarihi: 20.10.2022.
10. 10. Bell LA, Fletcher EA, Timperio A, Vuillermin P, Hesketh K. Preschool children’s physical activity and cardiovascular disease risk: A systematic review. J Sci Med Sport. 2019;22(5):568-573.
11. 11. Barker AR, Gracia-Marco L, Ruiz JR, Castillo MJ, Aparicio-Ugarriza R, González-Gross M, et al. Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA study. Int. J. Cardiol. 2018;(254):303-309.
12. 12. Knell G, Durand CP, Kohl HW, Wu IH, Gabriel KP. (2019). Prevalence and likelihood of meeting sleep, physical activity, and screen-time guidelines among US youth. JAMA Pediatr. 2019;173(4):387-389.
13. 13. Pappas S. What do we really know about kids and screens. Monitor on Psychology. 2020;51(3):42.
14. 14.Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. Environ Res. 2018;(164):149 157.
15. 15. McDool E, Powell P, Roberts J, Taylor K. The internet and children’s psychological wellbeing. J Health Econ. 2020;(69):102274.
16. 16. Guan H, Zhang Z, Wang B, Okely AD, Tong M, Wu J, et al. Proportion of kindergarten children meeting the WHO guidelines on physical activity, sedentary behaviour and sleep and associations with adiposity in urban Beijing. BMC Pediatr. 2020;20(1):1-9.
17. 17. National Physical Activity Plan Alliance. The 2018 United States Report Card on Physical Activity for Children and Youth. Washington, DC: National Physical Activity Plan Alliance, 2018.
18. 18. Statista [Internet]. Coronavirus: impact on the gaming industry worldwide; Updated 2020 Spring; cited 2022 June 25. Erişim: https://www.statista.com/study/72150/coronavirus-impact-onthe-video-game-industry-worldwide/. Published Spring, 2020. Erişim tarihi: 10.06.2022.
19. 19. Şener D, Yalçın T, Gulseven O. The Impact of COVID-19 on the Video Game Industry. Erişim: https:// ssrn .com/abstract=3766147. Published January 14, 2021. Erişim tarihi: 10.09.2022.
20. 20. Lindsay AC, Greaney ML, Wallington SF, Mesa T, Salas CF. A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries. J Spec Pediatr Nurs. 2017; 22(3):e12182.
21. 21. Cliff DP, Hesketh KD, Vella SA, Hinkley T, Tsiros MD, Ridgers ND, et al. Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta‐analysis. Obes Rev. 2016;17(4):330-344.
22. 22. Dunton GF, Do B, Wang SD. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the US. BMC Public Health. 2020;20(1):1-13.
23. 23. Zhang X, Zhu W, Kang S, Qiu L, Lu Z, Sun Y. Association between physical activity and mood states of children and adolescents in social isolation during the COVID-19 epidemic. Int J Environ Res Publich Health. 2020;17(20):7666.
24. 24. Al Hourani H, Alkhatib B, Abdullah M. Impact of COVID-19 lockdown on body weight, eating habits, and physical activity of Jordanian children and adolescents. Disaster Med Public Health Prep. 2022;16(5):1855-1863.
25. 25. Sá CDSCD, Pombo A, Luz C, Rodrigues LP, Cordovil R. COVID-19 social isolation in Brazil: effects on the physical activity routine of families with children. Rev Paul Pediatr. 2020;(39):e2020159.
26. 26. Medrano M, Cadenas‐Sanchez C, Oses M, Arenaza L, Amasene M, Labayen I. Changes in lifestyle behaviours during the COVID‐19 confinement in Spanish children: A longitudinal analysis from the MUGI project. Pediatr Obes. 2021;16(4):e12731.
27. 27. Androutsos O, Perperidi M, Georgiou C, Chouliaras G. Lifestyle changes and determinants of children’s and adolescents’ body weight increase during the first COVID-19 lockdown in Greece: The COV-EAT study. Nutrients. 2021;13(3):930.
28. 28. Nathan A, George P, Ng M, Wenden E, Bai P, Phiri Z, Christian H. Impact of covid-19 restrictions on western Australian children’s physical activity and screen time. Int J Environ Res Public Health. 2021;18(5): 2583.
29. 29. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst. Rev. 2021;10(1):1-11.
30. 30. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020.
31. 31. Gilic B, Ostojic L, Corluka M, Volaric T, Sekulic D. Contextualizing parental/familial influence on physical activity in adolescents before and during COVID-19 pandemic: a prospective analysis. Children. 2020;7(9):125.
32. 32. López-Bueno R, López-Sánchez GF, Casajús JA, Calatayud J, Gil-Salmerón A, Grabovac I, et al. Health related behaviors among schoolaged children and adolescents during the Spanish Covid-19 confinement. Front Pediatr. 2020;(8):573.
33. 33. Sekulic D, Blazevic M, Gilic B, Kvesic I, Zenic N. Prospective analysis of levels and correlates of physical activity during COVID-19 pandemic and imposed rules of social distancing; gender specific study among adolescents from Southern Croatia. Sustainability. 2020;12(10):4072.
34. 34. Tulchin-Francis K, Stevens JrW, Gu X, Zhang T, Roberts H, Keller J, et al. The impact of the coronavirus disease 2019 pandemic on physical activity in US children. J Sport Health Sci. 2021;10(3):323-332.
35. 35. Elnaggar RK, Alqahtani BA, Mahmoud WS, Elfakharany MS. Physical activity in adolescents during the social distancing policies of the COVID-19 pandemic. Asia Pac J Public Health. 2020;32(8):491-494.
36. 36. Zenic N, Taiar R, Gilic B, Blazevic M, Maric D, Pojskic H, et al. Levels and changes of physical activity in adolescents during the COVID-19 pandemic: contextualizing urban vs. rural living environment. Appl Sci 2020;10(11):3997.
37. 37. Ruíz-Roso MB, de Carvalho Padilha P, MatillaEscalante DC, Brun P, Ulloa N, Acevedo-Correa D, et al. Changes of physical activity and ultraprocessed food consumption in adolescents from different countries during Covid-19 pandemic: An observational study. Nutrients. 2020;12(8):2289.
38. 38. Wunsch K, Nigg C, Niessner C, Schmidt SC, Oriwol D, Hanssen-Doose A, et al. The impact of COVID-19 on the interrelation of physical activity, screen time and health-related quality of life in children and adolescents in Germany: results of the Motorik-Modul Study. Children. 2021;8(2):98.
39. 39. Choi J, Park Y, Kim HE, Song J, Lee D, Lee E, et al. Daily life changes and life satisfaction among Korean school-aged children in the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(6):3324.
40. 40. Oflu A, Bükülmez A, Elmas E, Tahta EG, Çeleğen M. Comparison of screen time and digital gaming habits of Turkish children before and during the coronavirus disease 2019 pandemic. Turk Arch Pediatr. 2021;56(1):22.
41. 41. García-Hermoso A, Hormazábal-Aguayo I, Fernández-Vergara O, Olivares PR, Oriol-Granado X. Physical activity, screen time and subjective wellbeing among children. Int J Clin Health Psychol. 2020;20(2):126-134.
42. 42. Henderson M, Benedetti A, Barnett TA, Mathieu ME, Deladoëy J, Gray-Donald K. Influence of adiposity, physical activity, fitness, and screen time on insulin dynamics over 2 years in children. JAMA Pediatr. 2016;170(3):227-235.
43. 43. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: World Health Organization; 2020.
44. 44. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary behavior research network (SBRN)–terminology consensus project process and outcome. Int J Behav Nutr Phys Act. 2017;14(1):1-17.
45. 45. Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J Fam Med. 2020;41(6):365.
46. 46. Nagata JM, Magid HSA, Gabriel KP. (2020). Screen time for children and adolescents during the coronavirus disease 2019 pandemic. Obesity (Silver Spring, Md.). 2020;28(9):1582-1583.
47. 47. Olive LS, Sciberras E, Berkowitz TS, Hoare E, Telford RM, O’Neil A, et al. Child and parent physical activity, sleep, and screen time during covıd-19 and associations with mental health: ımplications for future psycho-cardiological disease?. Front Psychiatry. 2022;2332.
48. 48. Moore SA, Faulkner G, Rhodes RE, Brussoni M, Chulak-Bozzer T, Ferguson LJ, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. Int J Behav Nutr Phys Act. 2020;17(1):1-11.
49. 49. Neville RD, Lakes KD, Hopkins WG, Tarantino G, Draper CE, Beck R, et al. (2022). Global changes in child and adolescent physical activity during the COVID-19 pandemic: a systematic review and meta-analysis. JAMA Pediatr. 2022;176(9):886-894.