Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 30, 2022
Date Accepted: Apr 27, 2023
The COVID-19 Pandemic and Daily Steps in the General Population: A Meta-Analysis of Observational Studies
ABSTRACT
Background:
The COVID-19 pandemic has the potential to accelerate another pandemic, that of physical inactivity. Daily steps, the proxy of physical activity, are closely related to health. Studies have shown that the risk of cardiovascular events increased by 8% for every 2,000 steps/day decrement.
Objective:
To quantify the impact of the COVID-19 pandemic on global and region-specific daily steps in the general adult population.
Methods:
This study follows the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) checklist. PubMed, EMBASE, and Web of Science were searched before 22 November 2021. Eligible studies were observational studies reporting monitor-assessed daily steps before and during the confinement period of the COVID-19 pandemic in the general adult population. Two reviewers independently selected studies and extracted data. The modified Newcastle-Ottawa Scale was used to assess study quality. A random-effects meta-analysis was conducted. The primary outcome was the global change in daily steps during the confinement period. Other outcomes included subgroup analyses by geographic location and gender.
Results:
Fourteen studies (18,961 participants) from 12 countries were included. Compared with a period before the COVID-19 pandemic (February 2019 to March 2020), all studies reported a significant decline in daily steps during the confinement period of the COVID-19 pandemic (January to September 2020) and the pooled change in daily steps was -2,519 (95% confidence interval [CI]: ‐3,331 to ‐1,708). The decline in daily steps varied across countries, with the most decline in Spain (-5,771, 95%CI: ‐7,519 to ‐4,023), followed by Italy (-4,990, 95%CI: ‐5,819 to ‐4,161) and Singapore (-3,813, 95%CI: ‐4,077 to ‐3,549). The decline was smaller in Canada (-1,012, 95%CI: ‐1,947 to ‐77), Norway (-1,131, 95%CI: ‐2,003 to ‐259) and South Korea (-1,136, 95%CI: ‐1,408 to ‐864). There was no apparent difference in decline between men (-2,770, 95%CI: ‐4,059 to ‐1,481) and women (-2,630, 95%CI: ‐3,594 to ‐1,666).
Conclusions:
Daily steps declined substantially during the confinement period of the COVID-19 pandemic and varied by geographic location. Further research is needed to monitor whether this downward trend in physical activity levels has been reversed following removal of strict pandemic containment measures. Clinical Trial: The PROSPERO database (CRD42021291684).
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