Barriers and facilitators affecting physical activity among adults in Saudi Arabia during COVID-19 quarantine.

The quarantine period in Saudi Arabia from May to June 2020 due to the coronavirus disease (COVID-19) pandemic prevented many people from engaging in physical activity (PA), which may have had negative effects on their health. Therefore, it is important to understand the factors, barriers, and facilitators affecting PA of people during quarantine. This cross-sectional study was conducted using an electronic survey that was distributed to adults between 18 and 69 years old. The survey included demographic-related questions and the International Physical Activity Questionnaire-Short Form. The survey was completed by 1859 participants ranging in age from 18 to 69 years old (42.5% male, 57.5% female). The major factors influencing exercise were being male (odds ratio [OR] = 1.26; 95% confidence interval [CI] 1.03-1.53), being single (OR = 1.37; 95% CI 1.12-1.67), completing higher education at a Master/Doctorate level (OR = 1.83; 95% CI 1.23-2.72), and being resilient (OR = 1.05; 95% CI 1.03-1.08). The facilitators for doing regular exercise were having enough space at home (OR = 1.62), free time (OR = 1.77), good motivation (OR = 1.56), and being free from work (OR = 1.43) and family responsibilities (OR = 1.40). Sex, marital status, level of education and resilience were important factors affecting the type and level of PA during the quarantine period resulting from the COVID-19 pandemic.

Saudi Arabia, like many countries, implemented social distancing, quarantining, travel restrictions and closing recreation facilities to prevent the spread of coronavirus disease (COVID-19). As a result, many people were prevented from engaging in physical activity (PA), which may have had negative effects on their health. This study aims to understand the barriers and facilitators affecting PA of people during quarantine due to COVID-19. We distributed an electronic survey to adults aged between 18 and 69 years old. The survey included demographic-related questions and the 'International Physical Activity Questionnaire-Short Form' to measure their PA levels. There were 1859 survey respondents, of which 42.5% were male and 57.5% were female. The results showed that being a male, being single, completing higher education at a Master/Doctorate level and being resilient were the major factors influencing exercise. In addition, having enough space at home, free time, good motivation and being free from work and family responsibilities were the facilitators for doing exercise regularly.

Exploring the Influence of the Coronavirus Disease 2019 Pandemic on the Accessibility of Rehabilitation Services Provided to Children with Disabilities: A Cross-Sectional Study.

Background and Objectives: Children with disabilities (such as cerebral palsy, autistic spectrum disorder, and Down syndrome) are the most vulnerable and marginalized subset of the population, representing 2.7% of the total population of Saudi Arabia. The COVID-19 outbreak might have disproportionately affected children with disabilities, augmented their isolation, and induced severe disruptions to the services on which these children rely. Limited research has been conducted in Saudi Arabia to understand the impact of the COVID-19 pandemic on the rehabilitation services provided to children with disabilities and barriers. This study aimed to investigate the effect of the lockdown implemented as a result of the coronavirus disease-2019 (COVID-19) pandemic on the accessibility of rehabilitation services, including communication, occupational therapy, and physical therapy, in Riyadh, Kingdom of Saudi Arabia. Materials and Methods: In this cross-sectional study, a survey was conducted between June and September 2020 during the lockdown in Saudi Arabia. A total of 316 caregivers of children with disabilities from Riyadh participated in the study. The accessibility of rehabilitation services provided to children with disabilities was assessed by designing a valid questionnaire. Results: A total of 280 children with disabilities received rehabilitation services before the COVID-19 pandemic and showed improvement following therapeutic sessions. However, during the pandemic, most children stopped receiving therapeutic sessions because of lockdown, which deteriorated their condition. This shows a significant reduction in the accessibility of the rehabilitation services provided during the pandemic. Conclusions: The findings of this study revealed a drastic decline in services provided to children with disabilities. This caused a notable deterioration in the abilities of these children.

Tele-Physical Activity Promotion Program among College Students during the COVID-19 Pandemic.

Background and Objectives: During the COVID-19 pandemic, lockdown and distance learning affected physical activity (PA) levels among college students. The aims were to assess the effectiveness of a tele-health PA promotion program for 6 weeks, among junior college students, on PA level and on the proportion of physically active students during the pandemic. Materials and Methods: A pre-post study design was conducted on 46 students aged 19 (±0.9) years old in Saudi Arabia. The study consisted of online introductory and educational PA classes, followed by a 6-week course during which students received daily online PA promotive messages. Wilcoxon signed-rank and McNemar's tests were used to measure the mean differences in PA level and the changes in proportion of physically active students before and after the program, respectively. Results: The proportion of students who perform walking increased significantly from 47.4% to 68.4% (p = 0.02), while the number of students who perform moderate PA in their leisure time increased significantly from 38.9% to 69.4% (p = 0.02). No significant differences were detected between other PA levels. Conclusions: This program is effective in encouraging more college students to be physically active, but not in improving PA levels. Larger scale studies using PA objective measurement tools are needed.

Moderating Effects of Self-Esteem on the Relationship between Communication Anxiety and Academic Performance among Female Health College Students during the COVID-19 Pandemic.

Unprecedented quarantine due to COVID-19 exposes individuals to withdraw from face-to-face interactions, which may influence communication and self-esteem (SE). Therefore, the overarching aims of this study are to examine the communication apprehension levels among female college students, and thus to investigate the moderating role of self-esteem on the relationship between communication apprehension and academic achievement. In this cross-sectional study, 287 female college students completed the survey, which was circulated through email. The survey included the following questionnaires: General Health Characteristics, Rosenberg Self-esteem Scale, and Personal Report of Communication Apprehension Scale. The results showed that 28.2% of participants were categorized as having a high level of communication apprehension, and only 9.8% had a low level of communication apprehension. The SE reported an overall score of 24.3 ± 2.14, indicating a high self-esteem level among students. The students' grade point average (GPA) was positively correlated with SE. However, self-esteem as a moderator variable had no significant effect on the relationships between all predictors and GPA. The finding of the study highlights the need to implement different strategies to enhance students' group discussions, meetings, and interpersonal communication to ensure the best learning outcomes. Future studies are required to investigate gender-based disparities in the relationship between communication apprehension and SE.

Effectiveness of Pulmonary Rehabilitation among COVID-19 Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Many COVID-19 patients presented with detrimental features, such as impaired respiratory function, physical capacity, and overall poor quality of life. The present study evaluates the effectiveness of pulmonary rehabilitation on COVID-19 patients. METHODS: We searched PubMed, Scopus, ScienceDirect, and Google Scholar from 2019 to 2021. The protocol was registered in PROSPERO with the registration number CRD42021273618. We performed statistical analyses via random effects and expressed the outcomes as standardized mean difference (SMD) for continuous variables, with 95% confidence intervals (CI). RESULTS: We included six trials involving 432 patients. The primary outcome showed a significant improvement in physical function (SMD 0.83, 95% CI -0.58 to 1.09; p < 0.001; four trials, 266 participants; high-quality evidence). There was significant difference in anxiety (SMD -0.80, 95% CI -1.23 to -0.37; p = 0.003), physical activity intensity levels (SMD -1.27, 95% CI -2.23 to -0.32; p = 0.009), sleep quality (MD -0.05, 95% CI -0.83 to -0.16; p = 0.004), peripheral muscle performance of lower limbs (SMD 0.90, 95% CI -0.60 to 1.20; p < 0.001), and dyspnoea outcomes (SMD -0.55, 95% CI -0.87 to -0.23; p = 0.007). CONCLUSIONS: Pulmonary rehabilitation is an effective adjuvant therapy that minimizes COVID-19 severity in the intervention group compared to the conventional treatment. The findings of this study will need to be considered in the framework of the clinical outcome as observed in the intervention outcome. Additionally, safer data on guideline rehabilitation would be needed to examine whether pulmonary rehabilitation would be a fruitful intervention to reduce COVID-19 severity.

Evaluation of physical activity among undergraduate students in Mogadishu Universities in the aftermath of COVID-19 restrictions.

Background: International restrictions were enacted during the COVID-19 pandemic to limit social interaction and viral transmission. These measures had a negative impact on physical activity (PA), creating changes in students' health and lifestyles. The present study aimed to evaluate the levels of PA among undergraduate students in three different universities in Mogadishu after the relaxation of COVID-19 lockdown using the international physical activity questionnaire-long version (IPAQ-L) and its potential associated factors. Methods: This study is a multicentral study conducted at Somali International University, Horn of Africa University, and Daha International University. A total of 1,189 respondents were asked to answer the online questionnaire provided via a link shared using their social media. Results: After COVID-19 restrictions approximately ≥ 150 minutes of PA per week was reported by 500 men (97.3%) and 652 women (96.6%) at work. While 7 (1.4%) of men and 20 (3%) of women participate in < 150 minutes each week, respectively. Furthermore, only seven (1.4%) of males and three (0.4%) of women reported to have not performed any PA at work. Conclusion: The majority of the undergraduate students at the selected universities in Mogadishu were physically active after the relaxation of COVID-19 rules in Somalia. Such a high level of PA is a significant advantage to public health.

A pilot study of the moderating effect of gender on the physical activity and fatigue severity among recovered COVID-19 patients.

BACKGROUND: Clinical data point toward gender-based differences in COVID-19 severity. However, there is insufficient research examining whether gender predicts physical activity (PA) and fatigue severity in patients recovering from COVID-19. Therefore, this study aimed to characterize the PA and fatigue severity in a cohort of patients recovering from COVID-19 infection and measure the extent to which gender-based differences moderate the relationship of PA with fatigue. METHOD: A cross-sectional survey was conducted in Riyadh, Saudi Arabia. The sample comprised patients recovering from COVID-19 over at least 3 months. Recovered patients were stratified into two groups based on gender. The survey included items pertaining to sociodemographic, a fatigue severity scale and a self-reported international PA questionnaire. RESULTS: Eighty-seven patients (44 women and 43 men) met the inclusion criteria. Compared with men, women reported sedentary behavior (70%) and high fatigue severity (64%). A significantly higher number of women had a low PA score compared with men (p = .002). The findings indicated that gender significantly moderates the effect of total PA in metabolic equivalents (METs; min/wk) on fatigue severity [F = 4.8, p = .03, ΔR2 = 0.24]. CONCLUSIONS: The current study suggests that women might be at risk of higher fatigue severity, in addition to engaging less in PA. Physical activity may plays a significant role in modulate the fatigue severity. Consequently, interventions aimed at promoting physical activity in women stand high chances of addressing the disparity in the distribution of prevalence of fatigue between men and women.

Impact of the loss of smell on the sleep quality and fatigue level in COVID­19 survivors.

PURPOSE: Patients with Coronavirus disease 2019 (COVID-19) are reported to have symptoms such as shortness of breath, dry cough, headache, fatigue, and diarrhea. Loss of smell is a symptom that some patients have suffered from due to inflammation of olfactory epithelium and neuroinvasion of COVID-19 resulting in damage to the olfactory nerves and olfactory bulb. Losing an important sense such as smell might have unfavorable consequences on the lives of COVID-19 survivors; however, these unfavorable consequences have not been sufficiently investigated. METHODS: This was a cross-sectional descriptive study, 81 COVID-19 survivors (51.85% male) answered the Pittsburgh Sleep Quality Index, Fatigue Severity Scale, and Patient Health Questionnaire. RESULTS: COVID-19 survivors who lost their smell were more likely to have poor sleep quality, high fatigue severity, and depression symptoms compared to others who did not lose their smell. Most COVID-19 survivors who lost their smell were women and had breathing difficulties. CONCLUSION: Our knowledge of this relationship will assist in establishing more efficient treatment regimens that consider both psychological and physiological factors. Future research is needed to investigate the causality relationship between poor sleep quality, increased fatigue, and depression symptoms in COVID-19 survivors who experienced loss of the sense of smell.

Physical activity patterns in adult population during the coronavirus pandemic: consideration of the role of resilience.

BACKGROUND: The aim of this study was to characterize patterns of physical activity (PA) and to examine whether resilience contributed to PA levels among adults during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted during the COVID-19 quarantine period among adult population in the Kingdom of Saudi Arabia. The International Physical Activity Questionnaire Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) were used to assess the participants' activity and resilience levels. The Kruskal-Wallis Test was used to examine differences in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA levels. Data were reported as medians and interquartile ranges. RESULTS: In total, 1859 individuals were included in the study (40% aged 26-35 years). The findings showed that 85% of the respondents engaged in PA and 15% were physically inactive. The majority (71%) participated in moderate-intensity PA. The median resilience score was 3.50 (0.85), indicating a medium level of resilience. A positive correlation was shown between the average resilience score and both walking (rs=0.01, P<0.001) and vigorous-intensity PA (rs=0.08, P=0.007). Data did not show a significant correlation between moderate-intensity PA and resilience score. CONCLUSIONS: Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA.

Quality of Life, Needs and Fears of Mothers of Children with Disabilities in Saudi Arabia during the COVID-19 Lockdown.

Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers of children with disabilities (MCD) to the QoL of mothers of children without disabilities (CON) in Saudi Arabia during COVID-19 lockdown. It explored mothers' concerns and the type of support they need during the quarantine. A comparative cross-sectional study was conducted during the lockdown. An online questionnaire was distributed to mothers raising children with and without disabilities in Saudi Arabia. A total of 340 mothers participated in the study by completing the survey: 93 MCD and 247 CON. The QoL of MCD and CON was assessed using the WHOQOL-BREF questionnaire. Furthermore, detailed information was provided by the mothers regarding their needs and concerns during the lockdown. The results of the study revealed that the overall QoL was significantly higher in the CON group, compared to the MCD group, during the COVID-19 lockdown. The social well-being and environmental well-being reported by MCD were significantly lower on the total scale of the WHOQOL-BREF than those reported by the CON group. The comparison between the two groups revealed significant differences in the support required by mothers during the COVID-19 pandemic: a higher percentage of MCD needed emotional and psychological support, especially from family members. The major concerns reported by MCD were the deterioration of their children's medical conditions and the lack of medical supplies during the lockdown.

Effect of Resilience on Health-Related Quality of Life during the COVID-19 Pandemic: A Cross-Sectional Study.

The unprecedented outbreak of coronavirus disease 2019 (COVID-19) has caused a huge global health and economic crisis. The aim of the study was to examine the extent to which the resilience of a person is associated with the quality of life (QoL) of adults amongst Saudi Arabia. A cross-sectional study was conducted among a sample of adults in Saudi Arabia. A total of 385 adults voluntarily participated in and completed the survey. The quality of life was measured using the "World Health Organization QoL". The "Connor-Davidson Resilience Scale" instrument was also used to assess resilience during the COVID-19 pandemic. Amongst the 385 participants, 179 (46%) showed a good QoL, and 205 (54%) reported a relatively poor QoL. The resilience was found to be significantly associated with QoL. The study further revealed that gender-based differences were dominant in the QoL; the men respondents reported a significantly higher QoL in all the domains in comparison to the women respondents. The gender, income, and psychological health and interaction effect of resilience and age explained 40% of the variance in the total score of QoL. In reference to the predictors of the physical health domain of QoL, resilience, gender, and psychological health were significantly associated with the physical health domain of the QoL (R2 = 0.26, p = 0.001). It was also noted that gender was not associated with the social relationships and environmental domains of QoL (p > 0.05). Findings showed a statistically significant association between the score of QoL and resilience, age, gender, income, and psychological health. These findings highlight the significant contribution of gender-based differences, psychological health, and resilience on the domains of QoL.

Exploring the relationship between students' learning satisfaction and self-efficacy during the emergency transition to remote learning amid the coronavirus pandemic: A cross-sectional study.

The overarching objective of this study was to assess learning satisfaction among students and to determine whether online-learning self-efficacy was associated with online learning satisfaction during the emergency transition to remote learning. This cross-sectional study involved a survey distributed to 22 Saudi Arabian universities. The survey used in this study consisted of an online learning self-efficacy (OLSE) questionnaire and an electronic learning (e-learning) satisfaction questionnaire. A total of 1,226 respondents voluntarily participated in and completed the survey. Students in medical fields made up 289 (23.6%). A Kruskal-Wallis H test and a chi-square test were used to compare the student's satisfaction based on the educational variables. Spearman's correlation and multiple linear regression analyses were performed to assess the association between self-efficacy and satisfaction. The findings revealed degrees of satisfaction ranging between high satisfaction and dissatisfaction. The majority of students (51%) expressed high satisfaction, and 599 students (49%) reported experiencing a low level of satisfaction with e-learning. A comparison of groups with low and high satisfaction scores revealed a significant difference in the OLSE. High satisfaction was positively correlated with the OLSE domains: time management, technology, and learning. The OLSE regression analysis model significantly predicted satisfaction. It showed that the model, corrected for education level and grade point average of the students, significantly predicted e-learning satisfaction (F = 8.04, R2 = 0.59, p = .004). The study concluded that students' satisfaction with the e-learning experience is influenced by e-learning self-efficacy. The study's findings lead to the practical implications and identify the need to improve the remote learning, time management and technology self-efficacy to enhance students' satisfaction.

Internship preparedness among students in healthcare-related fields in the COVID-19 era: Exploring the attitude and knowledge in Saudi Arabia.

BACKGROUND: In the COVID-19 era, efforts are being made to increase awareness among students and enhance best practices to mitigate the outbreak. To that end, the overarching aims of this study were to understand students' attitude toward and knowledge of COVID-19 and examine the predictors of their attitude toward hand hygiene. DESIGN AND METHODS: This cross-sectional survey study, conducted in Saudi Arabia, enrolled interns from diverse healthcare-related fields. The questionnaire was divided into three sections: sociodemographic data, knowledge of COVID-19, and attitude toward hand hygiene. The data was expressed as median and interquartile range (IQR). RESULTS: In all, 371 responses were analyzed. The median knowledge score was 20, which was considered good. There were no statistically significant differences across age, hospital setting, or gender. Of the 254 respondents who had attended an educational session, 167 (65%) had a good knowledge score and 83 (33%) had a moderate score, compared with only four (2%) who had a poor score. The cumulative median score of the respondents' attitudes was 6 (IQR [2]), which reflects a suboptimal attitude-only 38 (22%) reported a good attitude. The predicted effect of knowledge on attitude (good/suboptimal) was statistically significant (p = 0.02) using univariate logistic regression. CONCLUSIONS: The results suggest a strong need to encourage the current training program that targets hand hygiene practices among students in healthcare-related fields, especially prior to the internship year.