Review of the Quality of YouTube Videos Recommending Exercises for the COVID-19 Lockdown.

BACKGROUND: The world is experiencing a pandemic caused by COVID-19. Insufficient physical activity can increase the risk of illness. Trying to replicate a normal search that any user/patient could do in YouTube, the objective of this study was to evaluate the quality of YouTube videos related to home exercises during lockdown and their adherence to World Health Organization (WHO) recommendations. METHODS: A simple search was carried out on YouTube. The first 150 videos were selected. After applying exclusion criteria, 68 videos were analyzed and evaluated. Two statistical analyses based on machine learning techniques were carried out. Videos were classified according to principal component analysis (PCA) models as 'Relevant' and 'Non-Relevant'. Popularity was assessed using the video power index (VPI). Information's quality and accuracy were gauged using the DISCERN scale and global quality score (GQS). Reliability and credibility of information that can be found on health-related websites was assessed using the Health On the Net Code (HONCode). Exercises were evaluated according to WHO recommendations. RESULTS: DISCERN, HONCode, and GQS scored a mean of 2.29, 58.95, and 2.32, respectively. The PCA calculation allowed videos to auto-classify into high- and low-quality videos. CONCLUSIONS: The quality of YouTube videos recommending exercises during lockdown is low and doesn't reflect WHO recommendations. Effective strategies and tools capable of indicating the quality of this information are needed to filter out erroneous or non-rigorous information that may affect people's health. These tools should help any user/viewer to distinguish videos of high and low quality.

Behavior Modification Techniques on Patients with Chronic Pain in the Context of COVID-19 Telerehabilitation: An Umbrella Review.

The aim of this systematic review (SR) of SRs was to assess the effectiveness of telerehabilitation based on behavior modification techniques (t-BMT) in patients with chronic musculoskeletal pain. We searched in PubMed, PEDro, Web of Science, CINAHL, PsycINFO, and Google Scholar (January 2022). The outcome measures were pain intensity, disability, psychological distress, pain-related fear of movement, disease impact, depressive symptoms, anxiety symptoms, and physical function. This review was previously registered on the international prospective register of systematic reviews PROSPERO (CRD42021262192). Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the Physical Activity Guidelines Advisory Committee grading criteria. Four SRs with and without meta-analyses covering 25 trials and involving 4593 patients were included. Of the three SRs that assessed pain intensity, two reported a significant decrease compared to usual care. Contradictory results were also found in the management of psychological distress, and of depressive and anxiety symptoms. However, two reviews found that t-BMT has significant effects on disability, and one review found that t-BMT seems to be effective for improving pain-related fear of movement and disease impact. Finally, one review found that t-BMT does not seem to be an effective modality to improve physical function. The quality of evidence was limited for all outcomes assessed. The results obtained showed that t-BMT was effective in improving disability, disease impact, and pain-related fear of movement, but it was not effective in improving physical function in patients with chronic pain. Mixed evidence was found for pain intensity, psychological distress, and depressive and anxiety symptoms, with a limited quality of evidence.

Implementation of Online Behavior Modification Techniques in the Management of Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

PURPOSE: The main aim of this systematic review and meta-analysis (MA) was to assess the effectiveness of online behavior modification techniques (e-BMT) in the management of chronic musculoskeletal pain. METHODS: We conducted a search of Medline (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioral Collections, from inception to the 30 August 2021. The main outcome measures were pain intensity, pain interference, kinesiophobia, pain catastrophizing and self-efficacy. The statistical analysis was conducted using RStudio software. To compare the outcomes reported by the studies, we calculated the standardized mean difference (SMD) over time and the corresponding 95% confidence interval (CI) for the continuous variables. RESULTS: Regarding pain intensity (vs. usual care/waiting list), we found a statistically significant trivial effect size in favor of e-BMT (n = 5337; SMD = -0.17; 95% CI -0.26, -0.09). With regard to pain intensity (vs. in-person BMT) we found a statistically significant small effect size in favor of in-person BMT (n = 486; SMD = 0.21; 95%CI 0.15, 0.27). With respect to pain interference (vs. usual care/waiting list) a statistically significant small effect size of e-BMT was found (n = 1642; SMD = -0.24; 95%CI -0.44, -0.05). Finally, the same results were found in kinesiophobia, catastrophizing, and self-efficacy (vs. usual care/waiting list) where we found a statistically significant small effect size in favor of e-BMT. CONCLUSIONS: e-BMT seems to be an effective option for the management of patients with musculoskeletal conditions although it does not appear superior to in-person BMT in terms of improving pain intensity.

Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = -0.35; 95% CI -0.46, -0.24) and anxiety (n = 2578; SMD = -0.32; 95% CI -0.42, -0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.

Corrigendum: COVID-19 Confinement and Health Risk Behaviors in Spain.

[This corrects the article DOI: 10.3389/fpsyg.2020.01426.].

Cardiorespiratory fitness in adolescents before and after the COVID-19 confinement: a prospective cohort study.

Long periods of free-movement restrictions may negatively affect cardiorespiratory fitness and health. The present study investigated changes after the COVID-19 confinement in maximal oxygen intake (VO2 max) levels in a sample of 89 Spanish school children aged 12 and 14 years at baseline (49.8% girls). The 20-m shuttle run test served to estimate VO2 max before and after the COVID-19 confinement. Paired t-tests estimated an overall difference of - 0.5 ml.kg-1.min-1 (SD 0.3) (p = 0.12), whereas the highest significant reductions were observed for girls aged 14 years (- 1.5 ml.kg-1.min-1 (SD 0.6) (p < 0.05)). Boys aged 14 years showed a slight increase (0.4 ml.kg-1.min-1 (SD 0.5) (p = 0.44)), whereas boys aged 12 years presented an important decrease (- 1.2 ml.kg-1.min-1 (SD 0.7) (p = 0.14)). Healthy Fitness Zone (HFZ) levels also experienced a decrease of - 3.4% as regards baseline levels over the examined period. All the examined subgroups showed lower levels in relation to a normal VO2 max rate development, although girls aged 14 and boys aged 12 years accounted for the highest part.Conclusion: The results indicate that COVID-19 confinement might delay the normal development of VO2 max in adolescents. Strategies to tackle this concerning decline are warranted. What is Known: • First study analyzing cardiorespiratory fitness levels in teenagers after COVID-19 confinement. What is New: • Important delay in maximal oxygen intake identified in a sample of Spanish teenagers. • These results should be considered to develop strategies of a more active lifestyle in teenagers during and after confinements.

COVID-19 Confinement and Sexual Activity in Spain: A Cross-Sectional Study.

Restrictions of free movement have been proven effective in tackling the spread of COVID-19 disease. However, sensitive populations submitted to longer periods of restrictions may experience detrimental effects in significant areas of their lifestyle, such as sexual activity. This study examines sexual activity during the COVID-19 confinement in Spain. A survey distributed through an institutional social media profile served to collect data, whereas chi-squared tests, t-tests, analyses of variance, and multiple logistic regression analysis were used to assess differences among sample subgroups. A total of 71.3% adults (N = 536) (72.8% female) reported engaging in sexual activity with a weekly average of 2.39 times (SD = 1.80), with significant differences favoring males, middle age, married/in a domestic relationship (p < 0.001), employed (p < 0.005), medium-high annual household income, living outside the Iberian Peninsula, and smoking and alcohol consumption. Analyses adjusted for the complete set of control variables showed significant odds for a lower prevalence of weekly sexual activity in women (OR = 0.44, 95% CI 0.27-0.72). Interventions to promote sexual activity in confined Spanish adults may focus on groups with lower sexual activity.

Immediate Impact of the COVID-19 Confinement on Physical Activity Levels in Spanish Adults

Enacted measures to control the spread of COVID-19 disease such as compulsory confinement may influence health behaviors. The present study investigated changes in physical activity (PA) levels during the first days of confinement. Using an online survey, the Spanish population (n = 2042, 54% women, age 35.9 (SD 13.6) years) replied to questions concerning sociodemographic characteristics as well as PA behavior before and during the first week of enacted isolation. Physical activity vital sign (PAVS) short form was used to estimate weekly minutes of PA before and during the isolation period. Statistical analysis used the following tests: Mc Nemar Chi-squared tests, independent and paired samples t-test, and effect size (Cohen"s d). During the first week of confinement, participants reduced their weekly PA levels by 20% (~45.2 weekly minutes (95% CI: 37.4−53.0)). This led to a decrease from 60.6% to 48.9% (difference: 11.7%) (p <0.0001) in the number of participants meeting the recommended World Health Organization (WHO) PA levels. Subgroups including men, participants aged 43 or over, and those not holding a university degree had the greatest reductions in both weekly minutes of PA and adherence to guidelines. The PA levels of the Spanish population generally declined during the first days of COVID-19 confinement.

COVID-19 Confinement and Health Risk Behaviors in Spain.

The World Health Organization (WHO) has declared a world pandemic due to COVID-19. In response, most affected countries have enacted measures involving compulsory confinement and restrictions on free movement, which likely influence citizens' lifestyles. This study investigates changes in health risk behaviors (HRBs) with duration of confinement. An online cross-sectional survey served to collect data about the Spanish adult population regarding health behaviors during the first 3 weeks of confinement. A large sample of participants (N = 2,741) (51.8% women; mean age 34.2 years [SD 13.0]) from all Spanish regions completed the survey. Binomial logistic regressions adjusted for socioeconomic characteristics (i.e., gender, age, civil status, education, and occupation), body mass index (BMI), previous HRBs, and confinement context (i.e., solitude and exposure to COVID-19) were conducted to investigate associations between the number of weeks confined and a set of six HRBs (physical activity, alcohol consumption, fresh fruit and vegetable consumption, smoking, screen exposure, and sleep hours). When adjusted, we observed significantly lower odds of experiencing a higher number of HRBs than before confinement overall in a time-dependent fashion: OR 0.63; 95% CI: 0.49-0.81 for the second and OR 0.47; 95% CI: 0.36-0.61 for the third week of confinement. These results were equally consistent in all age and gender subgroup analyses. The present study indicates that changes toward a higher number of HRBs than before confinement, as well as the prevalence of each HRB except screen exposure, decreased during the first 3 weeks of COVID-19 confinement, and thus the Spanish adult population may have adapted to the new situational context by gradually improving their health behaviors.