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Global Changes in Child and Adolescent Physical Activity During the COVID-19 PandemicA Systematic Review and Meta-analysis

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  To what extent has the COVID-19 pandemic affected the global physical activity levels of children and adolescents?

Findings  In this systematic review and meta-analysis of 22 international longitudinal studies that included 14 216 children 18 years and younger, pooled estimates revealed a decrease of 17 minutes per day in children’s moderate-to-vigorous physical activity from prepandemic to during the COVID-19 pandemic.

Meaning  Restrictions implemented during the COVID-19 pandemic have affected children’s levels of physical activity, particularly moderate-to-vigorous physical activity; children’s movement behaviors should be at the forefront of pandemic recovery efforts.


Importance  Numerous physical distancing measures were implemented to mitigate the spread of the COVID-19 virus, which could have negatively affected child and adolescent physical activity levels.

Objectives  To conduct a systematic review and meta-analysis of the literature that used validated measures to document changes in child and adolescent physical activity during the COVID-19 pandemic and to estimate whether changes in physical activity differed between participant-level, contextual, and methodological moderators.

Data Sources  PubMed, PsycInfo, SPORTDiscus, Web of Science, Scopus, CINAHL, and MEDLINE were searched (from January 1, 2020, to January 1, 2022). A total of 1085 nonduplicate records were retrieved.

Study Selection  Studies were included if they reported (1) changes in the duration of physical activity at any intensity for children or adolescents (age ≤18 years) comparing before and during the COVID-19 pandemic using validated physical activity measurement tools and were (2) from general population samples, (3) peer-reviewed, and (4) published in English.

Data Extraction and Synthesis  A total of 126 articles underwent full-text review. Data were analyzed using a random-effects meta-analysis, which was conducted in January 2022.

Main Outcomes and Measures  Change in the duration of engagement in physical activity at any intensity comparing before and during COVID-19.

Results  Twenty-two studies including 46 independent samples and 79 effect sizes from 14 216 participants (median age, 10.5 years; range, 3-18 years) were included. The percentage change in the duration of engagement in total daily physical activity from before to during COVID-19 was −20% (90% CI, −34% to −4%). Moderation analyses revealed that changes were larger for higher-intensity activities (−32%; 90% CI, −44% to −16%), corresponding to a 17-minute reduction in children’s daily moderate-to-vigorous physical activity levels. The reduction in physical activity was also larger for samples located at higher latitudes (37%; 90% CI, −1% to 89%) and for studies with a longer duration between physical activity assessments (25%; 90% CI, −0.5% to 58%).

Conclusions and Relevance  Children and adolescents have experienced measurable reductions in physical activity during the COVID-19 pandemic. Findings underscore the need to provide bolstered access to support and resources related to physical activity to ensure good health and social functioning among children and adolescents during pandemic recovery efforts.

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Article Information

Accepted for Publication: May 4, 2022.

Published Online: July 11, 2022. doi:10.1001/jamapediatrics.2022.2313

Corresponding Author: Ross D. Neville, PhD, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland D04 V1W8 (ross.neville@ucd.ie).

Author Contributions: Drs Neville and Hopkins had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Neville, Lakes, Madigan.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Neville, Lakes, Tarantino, Madigan.

Critical revision of the manuscript for important intellectual content: Neville, Lakes, Hopkins, Draper, Beck, Madigan.

Statistical analysis: Neville, Hopkins, Tarantino.

Administrative, technical, or material support: Lakes, Tarantino, Beck, Madigan.

Supervision: Lakes.

Conflict of Interest Disclosures: None reported.

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