Influence of adherence to social distancing due to the COVID-19 pandemic on physical activity level in post-bariatric patients

Objectives

To assess physical activity levels in post-bariatric patients who adhered or not to social distancing measures due to the Covid-19 pandemic. Our secondary aim was to compare physical activity estimates between objectively measured and self-reported physical activity level.

Methods

In this descriptive, cross-sectional study, we assessed physical activity level using accelerometers and a validated questionnaire in 33 post-bariatric patients who reported to be adherent (n=15) or not (n=18) to social distancing measures.

Results

Patients adherent to social distancing measures spent more time in sedentary behavior (1.1 hours/day [95%CI: 0.1, 2.2]; p=0.045) and less time in moderate-to-vigorous physical activity (−12.2 min/day [95%CI: −23.8, −0.6]; p=0.040) compared to non-adherent ones. No difference was observed for light-intensity physical activity. Bland-Altman analysis comparing objective and subjective physical activity estimates showed a bias for time spent in sedentary behavior and moderate-to-vigorous physical activity of 2.8 hours/day and 8.5 min/day, respectively.

Conclusion

Post-bariatric patients who were adherent to social distancing measures due to the Covid-19 outbreak were more inactive and sedentary than non-adherent ones. Additionally, questionnaire data widely underestimated sedentary behavior. Strategies to increase or at least sustain physical activity levels in post-bariatric patients exposed to social distancing measures are necessary during the Covid-19 pandemic.

What is already known about this subject?

• Reduced physical activity is associated with poor health-related outcomes in patient undergoing bariatric surgery.

• The impact of the social distancing measures due to Covid-19 pandemic on objectively-measured physical activity in this condition remains unknown.

What are the new findings in your manuscript?

• Adherence to social distancing due to Covid-19 pandemic was associated with decreased objectively measured physical activity and increased sedentary behavior in patients who had undergone bariatric surgery.

• Questionnaire data widely underestimated sedentary behavior when compared to accelerometry data.

How might your results change the direction of research or the focus of clinical practice?

• Given the increased burden of cardiovascular diseases related to inactivity and sedentary behavior, strategies to increase physical activity in post-bariatric patients are clinically relevant during the Covid-19 pandemic.

• The use of validated accelerometers is recommended to screen and track physical activity during the pandemic.