Disruptions in physical activity due to COVID-19 hurt healthcare workers’ mental health

Short-term drops in physical activity may worsen the psychological state of healthcare workers, according to a recent Singapore study.

“The outbreak of the novel coronavirus disease (COVID-19) has precipitated international lockdown measures to curb disease transmissions. The closure of public activity spaces as well as changes in pandemic workload may disrupt healthcare workers’ physical activity and self-care routines,” the researchers said.

“Given the protection that exercise confers on depression, physical activity should be promoted at the workplace and at home to support healthcare workers to cope through this protracted health crisis,” they added.

The cross-sectional analysis included 707 healthcare workers who were given a digital multidomain survey designed to assess their exercise patterns between 17 May and 18 June 2020 when the caseload in the country was high. Mental wellbeing was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21).

Exercise patterns changed significantly from before to after a lockdown was enforced in Singapore. Before the lockdown, 23.2 percent of respondents did not engage in any form of moderate-to-vigorous physical activity. After movement restrictions had been imposed, this proportion rose to 39.6 percent, corresponding to an over 70-percent increase (p<0.001). [Stress Health 2021;doi:10.1002/smi.3078]

Among those who engaged in exercise prior to the lockdown, the duration dropped from a median of 30 minutes to 6 minutes (p<0.001) after the lockdown. Intensity was likewise affected (p<0.001), with the proportion of respondents engaging in vigorous physical activity decreasing from 13.3 percent to 8.2 percent.

In terms of mental health, DASS-21 identified depression in 40.7 percent of participants, 62.2 percent of whom had moderate-to-severe symptoms. Anxiety was detected in nearly half of the respondents and stress in 20 percent; for both conditions, moderate-to-severe symptom burden was high.

Multinomial logistic regression analysis showed a significant and inverse correlation between the number of days per week spent on physical activities and the severity of psychological outcomes. Participants who exercised more were significantly less likely to develop mild (odds ratio [OR], 0.87, 95 percent confidence interval [CI], 0.76–0.99; p=0.041) and moderate-to-severe (OR, 0.85, 95 percent CI, 0.76–0.95; p=0.005) depression.

On the other hand, reduced physical activity correlated with a greater risk of moderate-to-severe depressive symptoms (OR, 1.58, 95 percent CI, 0.76–0.95; p=0.005) and of mild stress symptoms (OR, 2.49, 95 percent CI, 1.34–4.65; p=0.004).

Limitations of the study included its cross-sectional design and limited generalizability, preventing causality from being determined. Retrospective self-reported data on physical activity could have also introduced recall bias.

Future studies should employ longer-term follow-up to determine directionality of the above associations and look at other factors that could affect healthcare workers’ disposition, such as exposure to COVID-19 and losses or deaths in the workplace, the researcher said.