A Guide to Maintain Physical and Mental Health During the COVID-19 Pandemic

The COVID-19 pandemic has brought this fast-moving world to a standstill. The impact of this pandemic is massive, and the only strategy to curb the rapid spread of the disease is to follow social distancing. 

The imposed lockdown, resulting in the closure of business activities, public places, fitness and activity centers, and overall social life, has hampered many aspects of the lives of people including routine fitness activities of fitness freaks, which has resulted in various psychological issues and serious fitness and health concerns.

In the present paper, the authors aimed at understanding the unique experiences of fitness freaks during the period of lockdown due to COVID-19. The paper also intended to explore the ways in which alternate exercises and fitness activities at home helped them deal with psychological issues and physical health consequences. 

Semi-structured telephone interviews were conducted with 22 adults who were regularly working out in the gym before the COVID-19 pandemic but stayed at home during the nationwide lockdown. 

The analysis revealed that during the initial phase of lockdown, the participants had a negative situational perception and a lack of motivation for fitness exercise. They also showed psychological health concerns and overdependence on social media in spending their free time. 

However, there was a gradual increase in positive self-perception and motivation to overcome their dependence on gym and fitness equipment and to continue fitness exercises at home. 

Participants also tended to play music as a tool while working out. The regular fitness workout at home during the lockdown greatly helped them to overcome psychological issues and fitness concerns.

Introduction

The COVID-19 pandemic is a massive global health crisis (Bavel et al., 2020) and a rapidly spreading pandemic (Bentlage et al., 2020) of recent times. As compared to the earlier pandemics the world has witnessed, the current COVID-19 pandemic is now on the top of the list in terms of worldwide coverage. 

This is the first time the whole world is affected simultaneously and struck strongly in a very short span of time. Initially, the death rate due to COVID-19 was around 2%, which has now increased to around 4–6% (World Health Organization [WHO], 2020). 

The statistics do not look so severe, but the total number of cases and the rate at which these cases are increasing day by day make the situation alarming. Exponential growth in COVID-19 cases has led to the isolation of billions of people and worldwide lockdown.

COVID-19 has affected the lives of nearly every person around the world. The difference between personal or professional lives has narrowed due to work-from-home instructions, and people’s lives are revolving around these two due to the lockdown. People have also been pondering over a vital concern at home, i.e., the importance of their health and fitness.

Although imposing lockdown or quarantine for the population has been one of the widely used measures across the world to stop the rapid spread of COVID-19, it has severe consequences too. 

Recent multinational investigations have shown the negative effect of COVID-19 restrictions on social participation, life satisfaction (Ammar et al., 2020b), mental well-being, psychosocial and emotional disorders as well as on sleep quality (Xiao et al., 2020), and employment status (Ammar et al., 2020d). 

The announcement of a sudden lockdown of all services and activities, except few essential services, by the authorities has resulted in a radical change in the lifestyle of affected people (Jiménez-Pavón et al., 2020) and has severely impaired their mental health, which has been manifested in the form of increased anxiety, stress, and depression (Chtourou et al., 2020). 

The sudden changes in people’s lifestyle include, but are not limited to, physical activities and exercise. Ammar et al. (2020a) have reported that COVID-19 home confinement has resulted in a decrease in all levels of physical activities and about a 28% increase in daily sitting time as well as an increase in unhealthy patterns of food consumption. Similar results are also reported by other researchers (Ammar et al., 2020c; de Oliveira Neto et al., 2020) as well. 

Although these abrupt changes have influenced every individual, many people who were regularly following their fitness activities in gyms, or on the ground, or in other places before the lockdown have been affected intensely. 

The closure of fitness centers and public parks have forced people to stay at home, which has disturbed their daily routines and hampered their fitness activities. 

While compulsion to stay at home for a long period of time poses a challenge to the continuity of physical fitness, the experience of hampered physical activities, restricted social communication, uncertainty, and helplessness leads to the emergence of psychological and physical health issues (Ammar et al., 2020a,c). Varshney et al. 

(2020) have found that psychological problems are occurring in adults while adjusting to the current lifestyle in accordance with the fear of contracting the COVID-19 disease. 

However, effective coping strategies, psychological resources, and regular physical exercise can be helpful in dealing with such health-related problems during the COVID-19 pandemic (Chtourou et al., 2020). 

Helps From Diseases

It is important to note that physical activities (PA) and exercise not only maintain physical and psychological health but also help our body to respond to the negative consequences of several diseases such as diabetes, hypertension, cardiovascular diseases, and respiratory diseases (Owen et al., 2010; Lavie et al., 2019; Jiménez-Pavón et al., 2020). 

In a recent review of 31 published studies, Bentlage et al. (2020) concluded that physical inactivity due to current pandemic restrictions is a major public health issue that is a prominent risk factor for decreased life expectancy and many physical health problems (Jurak et al., 2020). 

Exercise is shown to keep other physical functions (respiratory, circulatory, muscular, nervous, and skeletal systems) intact and supports other systems (endocrine, digestive, immune, or renal systems) that are important in fighting any known or unknown threat to our body (Lavie et al., 2019; Jiménez-Pavón et al., 2020).

Regular physical activity, while taking other precautions, is also considered effective in dealing with the health outcomes of the COVID-19 pandemic (Chen et al., 2020). Researchers from the University of Virginia Health System (Yan and Spaulding, 2020) suggest that regular exercise might significantly reduce the risk of acute respiratory distress syndrome, which is one of the main causes of death in COVID-19 patients. 

Exercise and physical activities have important functions for individuals’ psychological well-being as well (Stathi et al., 2002; Lehnert et al., 2012). There is sufficient literature to show that exercise can play a vital role in the promotion of positive mental health and well-being (e.g., Mazyarkin et al., 2019). 

However, when health promotion activities such as sports and regular gym exercises are not available in this pandemic situation, it is very difficult for individuals to meet the general WHO guidelines (150 min moderate to mild PA or 75 min intensive PA per week or a combination of both) (cf. Bentlage et al., 2020). 

Amidst this pandemic-related restriction (home confinement and closed gyms, parks, and fitness centers), how people cope up and find ways to continue their physical fitness remains an important question. 

The rationale for the Present Research

Since the onset of this disease, people have been confined to their homes, which has not only resulted in various psychological health issues but also challenged their physical fitness and health (Ammar et al., 2020a,b,c,d; Chtourou et al., 2020; Xiao et al., 2020). 

Although this pandemic situation has led to the unexpected cessation of almost all the outside routine activities of all the individuals, it has profoundly hampered the physical activities of fitness freaks (those who regularly go to the gym for their physical fitness), as gyms and other such places have been shut down due to the lockdown. 

However, studies addressing the issues of fitness freaks, who used to spend a significant amount of time for regular workouts in order to maintain their physical fitness, health, and appearance, seem to have found no place so far in the literature in relation to the current pandemic situation. 

Supposedly, the unique experiences of such people, their health issues, and the ways in which they have dealt with these issues during the COVID-19 pandemic have remained underexplored.

Also, it is well-known that the COVID-19 pandemic has made it difficult for people to adequately maintain their normal physical activity patterns at home (Ammar et al., 2020a). 

There are plenty of studies that have addressed the impact of COVID-19 on the physical activities of the general public (Ammar et al., 2020a,b,c,d; Chtourou et al., 2020; Xiao et al., 2020), demonstrated a significant decrease in physical activities and exercise patterns, and illustrated its ill effects on physical and mental health status. 

There is also a growing body of literature that suggests strategies to encourage people to be involved in home-based exercises and fitness activities (Ammar et al., 2020a,b,c,d; Chtourou et al., 2020; de Oliveira Neto et al., 2020). 

However, all these studies were conducted in the earlier phase of the pandemic. There is a lack of studies investigating the way in which people have dealt with the problems arising from the COVID-19 pandemic and subsequent lockdown/home confinement. In fact, it would be interesting to explore how and to what extent people were able to follow and benefited from the workout at-home advice. 

Therefore, the present research aims at understanding people’s unique experiences during the period of lockdown due to COVID-19 and exploring the ways in which regular exercise engagements helped them deal with the psychological and physical consequences of home confinement.

Methods

In order to gain a rich and extensive understanding of experiences into people’s lives during this pandemic and their efforts to maintain a healthy lifestyle, a qualitative approach was adopted for the study. 

We used Interpretive Phenomenological Analysis (IPA) to delve into the participants’ perceptions and to provide a close picture of the participants’ unique experiences during the lockdown period.

Why Exercise Helps?

Although you are safer from COVID-19 at home, there are still some important health risks to be aware of in isolation. First of all, you may find yourself settling into a sedentary lifestyle that involves long stretches of sitting in front of a TV or phone screen. This may lead to weight gain, loss of muscle strength, and joint damage.

Just a few minutes of exercise a day can help you avoid these health risks. In general, you should get about 150 minutes of moderate-intensity exercise a week or 75 minutes of high-intensity exercise a week. You should also include some kind of muscle-strengthening exercises at least two days a week.

Another big risk you face while in quarantine is a decline in emotional health. Many people are having issues with anxiety and depression due to loss of social support and fears about COVID-19, but exercise can help mitigate these issues. When you exercise, your body boosts the production of endorphins which diminish pain and elevate mood. 

In a related issue, long periods of isolation with limited exposure to sunlight and normal daily activities can perturb your sleep cycle. You may find yourself having difficulty falling asleep, staying asleep, or maintaining a normal sleep cycle. Vigorous physical exertion can help you maintain a regular sleep rhythm.

It is important to consider your long-term health as well. It may not seem like a big issue if you miss a few workout sessions, but if you make it a habit, you could be at risk of serious health problems like heart disease, diabetes, or stroke. Staying active should help minimize these risks.

Most importantly, regular exercise may help you survive COVID-19 if you become infected. There are no conclusive studies that confirm this but drawing from research on other respiratory illnesses, it may be inferred. One study of 24,000 people found that mild to moderate exercise did help lessen the risk of dying from influenza.

It has been theorized that physical activity flushes bacteria and other pathogens from the lungs; this helps prevent secondary infections like pneumonia that often prove fatal in COVID-19 patients. Furthermore, exercise promotes blood circulation which enables immune system components like antibodies and white blood cells to more quickly attack foreign bodies like the COVID-19 coronavirus.

How Long Should we do Exercise?

As new COVID-19 cases continue to emerge in the WHO European Region, many healthy individuals are being requested to stay at home in self-quarantine. In some countries, fitness centers and other locations where individuals are normally active will remain temporarily closed. 

Staying at home for prolonged periods of time can pose a significant challenge for remaining physically active. Sedentary behavior and low levels of physical activity can have negative effects on the health, well-being, and quality of life of individuals. Self-quarantine can also cause additional stress and challenge the mental health of citizens. 

Physical activity and relaxation techniques can be valuable tools to help you remain calm and continue to protect your health during this time.

WHO recommends 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, or a combination of both. These recommendations can still be achieved even at home, with no special equipment and with limited space. The following are some tips on how to stay active and reduce sedentary behavior while at home in self-quarantine:

Take Short Active Breaks During the Day

Short bouts of physical activity add up to the weekly recommendations. You may use the suggested exercises below as inspiration to be active every day. Dancing, playing with children, and performing domestic chores such as cleaning and gardening are other means to stay active at home.

Follow an Online Exercise Class

Take advantage of the wealth of online exercise classes. Many of these are free and can be found on YouTube. If you have no experience performing these exercises, be cautious and aware of your own limitations. 

Walk

Even in small spaces, walking around or walking on the spot, can help you remain active. If you have a call, stand or walk around your home while you speak, instead of sitting down. If you decide to go outside to walk or exercise, be sure to maintain at least a 1-meter distance from other people.

For optimal health, it is also important to remember to eat healthily and stay hydrated. WHO recommends drinking water instead of sugar-sweetened beverages. Limit or avoid alcoholic beverages for adults and strictly avoid these in young people, and pregnant and breastfeeding women, or for other health reasons. Ensure plenty of fruits and vegetables, and limit the intake of salt, sugar, and fat. 

Prefer whole grains rather than refined foods. For more guidance on how to eat healthily during self-quarantine, please see the Food and nutrition tips during self-quarantine, prepared by WHO/Europe.

Staying active is always important but, at this time, it's best to exercise at home. If you are allowed to exercise outdoors, keep at least 1m distance from others and don't use any communal equipment.

#BreakTheChain of #COVID-19 Transmission by keeping a distance when you exercise.


Written by - Akshita Sharma

Edited By - Akash Verma