Impact of the COVID-19 Pandemic on Exercise Habits Among US Primary Care Patients.

BACKGROUND: To explore how the COVID-19 pandemic has affected exercise habits, we hypothesized that participants' physical activity would have increased by at least 30 min/wk after the onset of the pandemic. METHODS: We distributed an anonymous survey to ambulatory patients at the Family Medicine Clinic, University of Kansas Medical Center to analyze changes in exercise habits and weight. RESULTS: Of the 500 adult patients surveyed, 382 were included. Results were stratified by demographics, including employment status before and during COVID-19. The median change in weekly exercise duration was 0.0 minutes, but the mean change was -25.7 minutes; total exercise duration decreased after the pandemic's onset (paired Wilcox signed rank test P < .001). More individuals reported participation in virtual group classes (6.3% before the pandemic vs 13.1% during the pandemic; McNemar's P < .001). Individuals with home exercise equipment before the pandemic were more likely to acquire more than were those who had none before (Chi square test P < .005). Overall, there is a significant trend in the direction of weight gain (Wilcox signed rank test P < .001). CONCLUSIONS: Most participants decreased physical activity during the unprecedented COVID-19 pandemic, expanding our understanding of how exercise habits change during stressful life events.

Telemedicine Management of Musculoskeletal Issues.

Telemedicine can provide patients with cost-effective, quality care. The coronavirus disease 2019 pandemic has highlighted the need for alternative methods of delivering health care. Family physicians can benefit from using a standardized approach to evaluate and diagnose musculoskeletal issues via telemedicine visits. Previsit planning establishes appropriate use of telemedicine and ensures that the patient and physician have functional telehealth equipment. Specific instructions to patients regarding ideal setting, camera angles, body positioning, and attire enhance virtual visits. Physicians can obtain a thorough history and perform a structured musculoskeletal examination via telemedicine. The use of common household items allows physicians to replicate in-person clinical examination maneuvers. Home care instructions and online rehabilitation resources are available for initial management. Patients should be scheduled for an in-person visit when the diagnosis or management plan is in question. Patients with a possible deformity or neurovascular compromise should be referred for urgent evaluation. Follow-up can be done virtually if the patient's condition is improving as expected. If the condition is worsening or not improving, the patient should have an in-office assessment, with consideration for referral to formal physical therapy or specialty services when appropriate.