COVID-19 Döneminde Fiziksel İnaktivite: Belirleyicileri ve Olumsuz Psikolojik Etkilerle Muhtemel İlişkisi

Yıl 2023, Cilt: 10 Sayı: 2, 469 - 483, 31.08.2023

Caner Karartı , Fatih Özyurt , İsmail Özsoy

https://doi.org/10.21020/husbfd.1088705

Öz

Amaç: Bu çalışmanın amacı birincil olarak COVID-19 döneminde fiziksel inaktivite ile ilişkili olası faktörleri araştırmaktır. İkincil olarak ise sokağa çıkma yasağını takiben fiziksel aktivite (FA) seviyesinin kişisel bildirimli psikolojik bulgulara etkisinin araştırılmasıdır.
Gereç ve Yöntem: Fizyoterapi ve Rehabilitasyon Kliniğinde kesitsel bir çalışma yapıldı. 18-65 yaşları arasında toplam 105 sağlıklı katılımcı dâhil edildi. Klinik ve demografik veriler kaydedildikten sonra katılımcılar, pandemi öncesi ve pandemi dönemi için toplam Uluslararası Fiziksel Aktivite Anketi (IPAQ) puanlarına göre üç gruba ayrıldılar: Grup 1: yüksek FA (≥3000 MET dk/hafta), Grup 2: orta FA (600≤MET<3000 dk/hafta) ve Grup 3: düşük FA (<600 MET dk/hafta). Katılımcıların pandemi öncesi ve sonrası depresyon, anksiyete ve stres düzeylerini değerlendirmek için Depresyon, Kaygı ve Stres Ölçeği (DASS-21) kullanıldı. COVID-19 döneminde FA ile ilişkili olası faktörlerin belirlenmesinde klinik ve demografik veriler değişken olarak kullanılırken, FA seviyeleri ve psikolojik problemlerin ilişkisinde IPAQ ve DASS-21 skorlarının zaman içindeki değişimi ölçüt alındı.
Bulgular: ANCOVA, sırasıyla depresyon, anksiyete ve stres ile ilgili olarak anlamlı bir grup*dönem etkileşim etkisi ortaya çıkardı. Katılımcıların depresyon, kaygı ve stres düzeyleri iki dönem arasında anlamlı farklılık gösterdi [sırasıyla (p<.001; η2p=.175); (p=.033; η2p=.064); (p=<.001; η2p=.132)]. Sonuçlar, her iki dönem açısından düşük FA ile duygusal durumun kötüleşmesi arasında açık bir ilişki olduğunu gösterdi. İki değişkenli analizde, kadın cinsiyet, yüksek ortalama uyku süresi (≥9.2 saat), sigara içmek, daha yüksek depresyon (≥7.3), anksiyete (≥4.9) ve stres (≥9.2) seviyeleri, pandemi dönemindeki düşük FA ile ilişkili bulundu (p=<.001-.049).
Sonuç: Bu çalışmada, azalmış FA ile duygusal durumun kötüleşmesi arasında açık bir ilişki olduğu saptandı. Belirlenen bu ilişkisel faktörleri göz önünde bulundurmak ve bireylerin farkındalığını artırmak önemli görülmektedir.

Anahtar Kelimeler

Anksiyete, COVID-19, depresyon, fiziksel inaktivite, stres

Physical Inactivity in the COVID-19 Period: Determinants and Possible Relationship with Adverse Psychological Effects

Öz

Objectives: The primary aim of this study was to look into the possible factors associated with physical inactivity during the COVID-19 pandemic period. Secondly, it seeks to investigate the effect of physical activity (PA) levels on self-reported psychological outcomes following the curfews.
Materials and Methods: A cross-sectional study was conducted in Physiotherapy and Rehabilitation Outpatient Clinic. A total of 105 healthy participants, aged between 18-65 years, were recruited. For the purposes of characterisation, clinical and demographic data were collected. The participants were divided into three groups based on their total International Physical Activity Questionnaire (IPAQ) scores in pre- and post-pandemic periods: Group 1: high PA (≥3000 MET min/week), Group 2: moderate PA (600≤MET<3000 min/week), and Group 3: low PA (<600 MET min/week). To evaluate the depression, anxiety, and stress levels of the participants, the Depression, Anxiety, and Stress Scale (DASS-21) was used. While clinical and demographic data were used as variables to determine possible factors associated with PA during the COVID-19 period, the change of IPAQ and DASS-21 scores over time was taken as a criterion in the relationship between PA levels and psychological problems.
Results: ANCOVA revealed a significant group*period interaction effect regarding depression, anxiety, and stress, respectively. The depression, anxiety, and stress levels of the participants showed significant differences between the two periods [(p<.001; η2p=.175); (p=.033; η2p=.064); (p=<.001; η2p=.132), respectively]. The results demonstrated a clear association between low PA and deterioration of emotional status in terms of both periods. In bivariate analysis, female sex, higher average hours of sleep (≥9.2 hours), being smoker, higher levels of depression (≥7.3), anxiety (≥4.9), and stress (≥9.2) were associated with a low PA during the pandemic (p=<.001-.049).
Conclusion: A clear association between reduced PA and impaired emotional state was found in this study. It seems necessary to address these factors and increase awareness of individuals.

Anahtar Kelimeler

Anxiety, COVID-19, depression, physical inactivity, stress

Kaynakça

• Abate Daga, F., Agostino, S., Peretti, S., & Beratto, L. (2021). COVID-19 nationwide lockdown and physical activity profiles among North-western Italian population using the International Physical Activity Questionnaire (IPAQ). Sport Sciences for Health, 17(2), 459-464.
• Ammar, A., Brach, M., Trabelsi, K., Chtourou, H., Boukhris, O., Masmoudi, L., ... & ECLB-COVID19 Consortium. (2020). Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutrients, 12(6), 1583.
• Banno, M., Harada, Y., Taniguchi, M., Tobita, R., Tsujimoto, H., Tsujimoto, Y., ... & Noda, A. (2018). Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ, 6, e5172.
• Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J., Martin, B. W., & Lancet Physical Activity Series Working Group. (2012). Correlates of physical activity: why are some people physically active and others not?. The lancet, 380(9838), 258-271.
• Booth, F. W., Roberts, C. K., Thyfault, J. P., Ruegsegger, G. N., & Toedebusch, R. G. (2017). Role of inactivity in chronic diseases: evolutionary insight and pathophysiological mechanisms. Physiological reviews, 97(4), 1351-1402.
• Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., ... & Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine, 54(24), 1451-1462.
• Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public health reports, 100(2), 126.
• Choi, J., Lee, M., Lee, J. K., Kang, D., & Choi, J. Y. (2017). Correlates associated with participation in physical activity among adults: a systematic review of reviews and update. BMC public health, 17(1), 1-13.
• Conn, V. S. (2010). Depressive symptom outcomes of physical activity interventions: meta-analysis findings. Annals of behavioral Medicine, 39(2), 128-138.
• Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., Van Mechelen, W., ... & Lancet Physical Activity Series 2 Executive Committee. (2016). The economic burden of physical inactivity: a global analysis of major non-communicable diseases. The Lancet, 388(10051), 1311-1324.
• Fluetsch, N., Levy, C., & Tallon, L. (2019). The relationship of physical activity to mental health: A 2015 behavioral risk factor surveillance system data analysis. Journal of Affective Disorders, 253, 96-101.
• Foright, R. M., Presby, D. M., Sherk, V. D., Kahn, D., Checkley, L. A., Giles, E. D., ... & MacLean, P. S. (2018). Is regular exercise an effective strategy for weight loss maintenance?. Physiology & behavior, 188, 86-93.
• Francis, H. M., Stevenson, R. J., Chambers, J. R., Gupta, D., Newey, B., & Lim, C. K. (2019). A brief diet intervention can reduce symptoms of depression in young adults–A randomised controlled trial. PloS one, 14(10), e0222768.
• Füzéki, E., Groneberg, D. A., & Banzer, W. (2020). Physical activity during COVID-19 induced lockdown: recommendations. Journal of Occupational Medicine and Toxicology, 15(1), 1-5.
• Hamermesh, D. S. (2020). Lock-downs, loneliness and life satisfaction (No. w27018). National Bureau of Economic Research.
• Hao, F., Tan, W., Jiang, L. I., Zhang, L., Zhao, X., Zou, Y., ... & Tam, W. (2020). Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case- control study with service and research implications for immunopsychiatry. Brain, behavior, and immunity, 87, 100-106.
• Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 40(2), 218-227.
• Heidinger, T., & Richter, L. (2020). The effect of COVID-19 on loneliness in the elderly. An empirical comparison of pre-and peri-pandemic loneliness in community-dwelling elderly. Frontiers in Psychology, 2595.
• Heydari, G., Hosseini, M., Yousefifard, M., Asady, H., Baikpour, M., & Barat, A. (2015). Smoking and physical activity in healthy adults: a cross-sectional study in Tehran. Tanaffos, 14(4), 238.
• Hori, H., Ikenouchi-Sugita, A., Yoshimura, R., & Nakamura, J. (2016). Does subjective sleep quality improve by a walking intervention? A real-world study in a Japanese workplace. BMJ open, 6(10), e011055.
• Islam, M. S., Sujan, M. S. H., Tasnim, R., Sikder, M. T., Potenza, M. N., & Van Os, J. (2020). Psychological responses during the COVID-19 outbreak among university students in Bangladesh. PloS one, 15(12), e0245083.
• Juarbe, T., Turok, X. P., & Pérez-Stable, E. J. (2002). Perceived benefits and barriers to physical activity among older Latina women. Western journal of nursing research, 24(8), 868-886.
• Klesges, R. C., Eck, L. H., Isbell, T. R., Fulliton, W., & Hanson, C. L. (1990). Smoking status: effects on the dietary intake, physical activity, and body fat of adult men. The American journal of clinical nutrition, 51(5), 784-789.
• Lee, Y., & Ko, Y. G. (2018). Feeling lonely when not socially isolated: Social isolation moderates the association between loneliness and daily social interaction. Journal of Social and Personal Relationships, 35(10), 1340-1355.
• Li, W., Yang, Y., Liu, Z. H., Zhao, Y. J., Zhang, Q., Zhang, L., ... & Xiang, Y. T. (2020). Progression of mental health services during the COVID-19 outbreak in China. International journal of biological sciences, 16(10), 1732.
• Lippke, S., Fischer, M. A., & Ratz, T. (2021). Physical activity, loneliness, and meaning of friendship in young individuals–a mixed-methods investigation prior to and during the COVID-19 pandemic with three cross-sectional studies. Frontiers in Psychology, 12, 146.
• Luchetti, M., Lee, J. H., Aschwanden, D., Sesker, A., Strickhouser, J. E., Terracciano, A., & Sutin, A. R. (2020). The trajectory of loneliness in response to COVID-19. American Psychologist, 75(7), 897.
• Mackay, L. M., Schofield, G. M., & Oliver, M. (2011). Measuring physical activity and sedentary behaviors in women with young children: A systematic review. Women & health, 51(4), 400- 421.
• Mathers, C. D., Stevenson, C. E., Vos, E. T., & Begg, S. J. (2000). The Australian Burden of Disease Study: measuring the loss of health from diseases, injuries and risk factors. Medical Journal of Australia, 172(12), 592-596.
• Narici, M., Vito, G. D., Franchi, M., Paoli, A., Moro, T., Marcolin, G., ... & Maganaris, C. (2021). Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. European journal of sport science, 21(4), 614-635.
• Nienhuis, C. P., & Lesser, I. A. (2020). The impact of COVID-19 on women’s physical activity behavior and mental well-being. International journal of environmental research and public health, 17(23), 9036.
• Nilsson, M. I., Mikhail, A., Lan, L., Di Carlo, A., Hamilton, B., Barnard, K., ... & Tarnopolsky, M. A. (2020). A five-ingredient nutritional supplement and home-based resistance exercise improve lean mass and strength in free-living elderly. Nutrients, 12(8), 2391.
• Özsoy, İ., Kodak, M. İ., Karartı, C., & Özsoy, G. (2021). The Effect of Isolation and Controlled Social Life Periods on Physical Activity and Anxiety in Elite Athletes During the COVID-19 Pandemic. Turkiye Klinikleri Journal of Sports Sciences, 13(2).
• Palm, A., Janson, C., & Lindberg, E. (2015). The impact of obesity and weight gain on development of sleep problems in a population-based sample. Sleep medicine, 16(5), 593-597.
• Peçanha, T., Goessler, K. F., Roschel, H., & Gualano, B. (2020). Social isolation during the COVID-19 pandemic can increase physical inactivity and the global burden of cardiovascular disease. American Journal of Physiology-Heart and Circulatory Physiology.
• Pels, F., & Kleinert, J. (2016). Loneliness and physical activity: A systematic review. International Review of Sport and Exercise Psychology, 9(1), 231-260.
• Portela-Pino, I., López-Castedo, A., Martínez-Patiño, M. J., Valverde-Esteve, T., & Domínguez-Alonso, J. (2020). Gender differences in motivation and barriers for the practice of physical exercise in adolescence. International journal of environmental research and public health, 17(1), 168.
• Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian journal of psychiatry, 52, 102066.
• Saglam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., & Tokgozoglu, L. (2010). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and motor skills, 111(1), 278-284.
• Schuch, F. B., Stubbs, B., Meyer, J., Heissel, A., Zech, P., Vancampfort, D., ... & Hiles, S. A. (2019). Physical activity protects from incident anxiety: A meta‐analysis of prospective cohort studies. Depression and anxiety, 36(9), 846-858.
• Schumann, A., Hapke, U., Rumpf, H. J., Meyer, C., & John, U. (2001). The association between degree of nicotine dependence and other health behaviours: Findings from a German general population study. The European Journal of Public Health, 11(4), 450-452.
• Silva, L. R. B., Seguro, C. S., de Oliveira, C. G. A., Santos, P. O. S., de Oliveira, J. C. M., de Souza Filho, L. F. M., ... & Rebelo, A. C. S. (2020). Physical inactivity is associated with increased levels of anxiety, depression, and stress in Brazilians during the COVID-19 pandemic: a cross- sectional study. Frontiers in Psychiatry, 1257.
• Tan, B. Y., Chew, N. W., Lee, G. K., Jing, M., Goh, Y., Yeo, L. L., ... & Sharma, V. K. (2020). Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Annals of internal medicine, 173(4), 317-320.
• Tayfur, A., Şendil, A., Sezik, A. Ç., Jean-François, K., Sancho, I., Le Sant, G., ... & Morrissey, D. (2023). Self-reported bio-psycho-social factors partially distinguish patellar tendinopathy from other knee problems and explain patellar tendinopathy severity in jumping athletes: A case-control study. Physical Therapy in Sport.
• Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15(1), 1-8.
• Troyer, E. A., Kohn, J. N., & Hong, S. (2020). Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, behavior, and immunity, 87, 34-39.
• Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research and public health, 17(5), 1729.
• Wiklund, P. (2016). The role of physical activity and exercise in obesity and weight management: Time for critical appraisal. Journal of Sport and Health Science, 5(2), 151-154.
• Yılmaz, Ö., Hakan, B. O. Z., & Arslan, A. (2017). Depresyon Anksiyete Stres Ölçeğinin (Dass 21) Türkçe Kisa Formunun Geçerlilik-Güvenilirlik Çalişmasi. Finans Ekonomi ve Sosyal Araştırmalar Dergisi, 2(2), 78-91.