Physical Activity Recommendations during COVID-19: Narrative Review

Regular practice of physical activity plays a fundamental role in preventing and treating cardiovascular diseases such as obesity, hypertension, diabetes, and metabolic syndrome. During the pandemic caused by COVID-19 and the lockdown established, people have reduced considerably their mobility and motor activity, which has led to an increase in unhealthy lifestyle habits, raising the risk of suffering from diseases.

This paper reviews 1312 clinical studies on the topic of physical activity recommendations.

The most recommended aerobic activities are walking, climbing stairs, performing activities on static machines, and running, among others. Depending on the type of population the frequency varies from once a day for the young people, and between 2–3 times per week or between 5–7 days for adults or older people. Recommend workloads range from 150 min to 300 min per week with moderate intensity (effort 5–6 on a scale of 1 to 10) or 75 min at a vigorous intensity (effort 7–8 on a scale of 1 to 10) population; while, for school- or preschool-aged children, between 60 and 180 min of activity per day is recommended.

Strength Activity Recommendations
From the studies on strength activities, the most recommended exercises are to perform squats, abs, and push-ups, Pilates, get up and sit in the chair. Depending on the type of population, the frequency varies from 2 or 3 days per week for adults, while, for children it is recommended on 3 days per week. Working volumes range from 1–2 series, 2–4 series, or 5 series with 5 repetitions, 8–12 repetitions, 8–20 repetitions, or 10–15 repetitions. The intensity that is most recommended relates to one’s body weight. In addition, work with material such as weights or elastic bands can be done. Regarding recovery times, only two articles in the table provide this information recommending 20″–30″.

A total of 15 articles present recommendations for flexibility, stretching, relaxation and/or meditation. Most articles are aimed at the general population and recommend stretches whether dynamic or static and activities such as yoga. The recommended weekly frequency is given by two items, at 2–3 times a week. Workload varies by activity, usually recommended between 10–30 s for stretching. No information is given about intensity and recovery.

Balance Recommendations
Seven articles, whose recommendations are aimed primarily at the general and older population, compare balance training. The most recommended activities are balance exercises, Tai Ji, and fall prevention for older peopled, along with recommendations for between 2–3 weekly sessions.

Public health bodies have delivered an important message during the COVID-19 pandemic to adults and older people. They should be as active as possible, because inactivity can cause acute and chronic health implications, losing quality of life and becoming dependent, especially in older people.

Physical activity and, as a consequence, weight loss, are useful as a preventive measure to reduce COVID-19 mortality. Furthermore, regular physical activity can also improve insulin sensitivity and lower circulating insulin levels, which should lead to a public health message in order to reduce mortality.

Other studies, such as that of Chagas et al., state that systematic physical exercise has a positive effect on the immune system and in reducing the risk of diseases, being a good way of reducing mortality. Pinho et al. also point out that physically active people have significantly reduced mortality. Being physically active and reducing sedentariness during the COVID-19 pandemic is critical to reducing the risk of cardiovascular and metabolic diseases.

The present work aimed to compare and analyze studies that have proposed physical activity recommendations to combat the consequences of confinement, differentiating patterns aerobic, muscle strengthening, flexibility-stretching, meditation-relaxation, and balance exercises.

 

Exercises are recommended to maintain good physical condition during confinement. However, in the reviewed literature, there are no recommendations to be adapted to all people whatever their situation and disease. Even so, the most recommended guidelines are for aerobic exercise, strength, flexibility-stretching, and balance exercises. The form of exercise prescription from The American College of Sports Medicine (ACSM) (FITT-VP)  recommends that all healthy adults should participate in moderate intensity aerobic physical activity for a minimum of 30 min on 5 days per week or vigorous intensity aerobic activity for a minimum of 20 min on 3 days per week. In addition, every adult should perform activities that maintain or increase muscular strength and endurance for a minimum of 2 days per week, without forgetting other components of a healthy lifestyle such as flexibility and balance training . Most of the exercises proposed in this review are common activities in our daily lives and are intended to be carried out at home.

 

According to these studies, at least 150 min of moderate-intensity physical activity or 75 min of vigorous physical activity per week and 2–3 strength sessions should be performed in children, adults, or older adults. Children should take 60–180 min of daily moderate to vigorous physical activity. In strength training during confinement, it is advisable to use your own bodyweight or light weights to help maintain physical condition.

People over the age of 65 should also exercise with a frequency of 2–3 days per week to avoid risks of falling.