Our study revealed a marked variability in PA patterns during the COVID-19 pandemic. After a reduction in the first months of pandemic, an increase in PA levels was observed in roughly 10 months of social distancing, yet it did not reach the same level as before the pandemic. Also, women showed decreased PA when compared to men. This PA scenario during social distancing was evident regardless of socioeconomic characteristics, such as educational and income level.
The decrease in PA levels in the first months of the COVID-19 pandemic was expected due to social restrictions imposed by governments to reduce virus spread[8]. We hypothesized that the magnitude of this scenario would be related to the restrictions level. However, there is a disparity of data observed in our study and state-level social distancing measures in the three survey timepoints. From May 2020 to May 2021, the Rio Grande do Sul state adopted the “Controlled Social Distancing Model”, which outlined the risk of COVID-19 infection in a flag color-coded approach. Each region was evaluated by several health indicators (e.g. ICU availability, rate of new COVID-19 cases), and regions of the state were categorized based on risk of infection, as follows: low (yellow), medium (orange), high (red), and extremely high (black)[19]. In the first data collection (Jun/Jul 2020), all the Rio Grande do Sul state was either at orange or red colors, which indicated a strengthened social restriction level, corresponding with the lower PA level observed. Such levels could also be related to the fact that the winter (Jun/Jul/Aug) in Rio Grande do Sul is very cold and humid, which might be a barrier to PA[20]. Similarly, by Dec/Jan, the social restrictions were also strengthened after a period of easiness. Thus, we hypothesized that PA levels would be at a similar level when compared to Jun/Jul assessment. Nevertheless, the increase in PA levels observed in Dec/Jan was probably related to weather conditions (summer season), as many people feel encouraged to practice PA, especially outdoors. In addition, several individuals did not follow governments' recommended social distancing instructions, which might also explain our findings[21].
A survey conducted in Brazil indicated that lack of appropriate facilities and equipment, were barriers to PA practice during pandemic[22]. In both cohort assessments, gyms and sports facilities were closed in most cities of the Rio Grande do Sul state. Thus, people had to find ways and other spaces to remain active. A decreased PA in the first assessment (Jun/Jul) of social restrictions followed by an increase in the second assessment (Dec/Jan) was observed for activities performed out of home. This was expected, since summer season (Dec/Jan/Feb) is tempting to perform PA outdoors, and people were never forbidden of walking or riding bicycles as well as performing exercises in public spaces (e.g., parks). The weak social restrictions adopted by the state, along with encouragement messages from the national government that people could keep their “normal lives” and routines despite de pandemic[21], could also be related to the increased practice of PA out of home.
The gender inequalities related to PA are well described[23] and was further aggravated because of COVID-19 pandemic social restrictions. The burden on women regarding home chores and care taking was even more evident with the routine imposed by the pandemic, as well as the social barriers related to PA practice for women[24]. These inequalities have a negative effect on women’s leisure time, which is related to their lack of time and possibility to include PA in their daily routine[24]. Also, due to these inequalities, it is possible that women are more likely to experience incidental PA, such as home-related chores[25]. Unfortunately, we have only assessed leisure-time PA.
Educational level is a strong determinant of leisure-time PA. People with high educational levels are more likely to have access and resources to engage in healthy behaviours, such as PA[26]. There were no marked differences of PA prevalence among educational level groups, with a difference only in the Jun/Jul timepoint for activities performed out of home, where participants with low educational level (i.e. High school or low) showed less PA. However, our sample has a high proportion of participants with academic degree (40.2%), which is overexpressed when compared to the national data (16.9%)[1, 27]. The high educational level of our sample might hide disparities among classes and explain the small education effect of PA in our results.
Strength and limitations
Some limitations of our study should be listed. First, our study presented a retention rate of 52%[15], which is not very high. However, even studies in wealthier countries, where more people have internet access achieved similar response rates when compared to our study[28]. Second, as face-to-face interviews were not allowed by ethics boards in Brazil at the time of our data collection, self-reported assessments were used. Third, as previously stated, our sample has a high proportion of participants with an academic degree, thus, sampling bias is an issue since less educated people have limited access to internet[29]. However, one feature of our study stands out, we tracked PA behaviour from pre-COVID-19 levels into 10 months of social restrictions. Such information can contribute to a better understanding of not only how people behave but also how the pandemic scenario has affected their health on a long term.
Perspective
COVID-19 pandemic increased the concern with physical inactivity due to social restriction measures. Although a lot of studies were conducted at the beginning of pandemic and showed a decrease on PA levels, continuous tracking of this behaviour is important. Our study demonstrates how PA varied along the first 10 months of COVID-19 pandemic, and is still far from the desirable levels. An ongoing tracking of PA behavior during COVID-19 pandemic is important to understand how this behaviour varies and what actions are needed in order to increase PA on populational level.