# Influence of Restrictions During COVID-19 Pandemic on Physical Activity and Quality of Life in Cardiovascular, Kidney Transplant and Healthy Adults

## TL;DR

This study examines how pandemic restrictions affected physical activity and quality of life in cardiovascular, kidney transplant patients, and healthy adults, highlighting the vulnerability of rehabilitation patients.

## Contribution

The study identifies rehabilitation patients as a high-risk group for significant declines in physical activity during lockdowns.

## Key findings

- All groups experienced a significant reduction in daily and sporting physical activity during lockdown.
- Rehabilitation participants showed a greater reduction in sporting activity compared to kidney transplant and healthy groups.
- Most individuals maintained sufficient physical activity levels (≥150 min/week) despite restrictions.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This study Investigates the effects of pandemic-related restrictions on physical activity and quality of life, key determinants of public health.It provides evidence on particularly vulnerable groups (rehabilitation patients) during social crises.

This study Investigates the effects of pandemic-related restrictions on physical activity and quality of life, key determinants of public health.

It provides evidence on particularly vulnerable groups (rehabilitation patients) during social crises.

Public health significance—Why is this work of significance to public health?
It shows that sufficient physical activity (>150 min/week) can often be maintained even under lockdown conditions.It identifies rehabilitation patients as a high-risk group for greater loss of activity and thus potential consequential risks.

It shows that sufficient physical activity (>150 min/week) can often be maintained even under lockdown conditions.

It identifies rehabilitation patients as a high-risk group for greater loss of activity and thus potential consequential risks.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Rehabilitation and aftercare programs should integrate targeted adaptive exercise options (e.g., digital or local formats) in times of crisis.Health policy measures should be tailored to vulnerable patient groups in order to minimize declines in activity and long-term health consequences.

Rehabilitation and aftercare programs should integrate targeted adaptive exercise options (e.g., digital or local formats) in times of crisis.

Health policy measures should be tailored to vulnerable patient groups in order to minimize declines in activity and long-term health consequences.

Background: During the COVID-19 restrictions in Germany, individuals were permitted to engage in individual physical activity (PA). However, limited information exists regarding the impact of these restrictions on PA and mental health. The aims of this study were to identify changes in PA behavior and Quality of Life (QoL) during the Corona-Virus restrictions to develop strategies to mitigate negative health effects. Methods: Internet-based questionnaires on PA and QoL were distributed to outpatients with heart disease (Reha), participants in an in-clinic rehabilitation program, patients enrolled in a structured post-kidney transplant program (KTx), and healthy adults (HG). Results: Compared to pre-lockdown levels, all groups experienced a significant reduction in daily and sporting physical activity (all p < 0.05). Reha participants showed a significantly greater reduction in sporting activity compared to KTx and HG (p < 0.05). However, 88.3% (Reha), 85.5% (KTx), and 92.6% (HG) met the WHO recommendation of ≥150 min/week of moderate activity (p = 0.001). No significant differences were observed in the mental sum score of the SF-36 between groups (p = 0.263). Conclusions: The majority of individuals managed to maintain sufficient PA levels even during the lockdown. However, Reha participants appeared to experience the greatest burdens, leading to a more pronounced reduction in sports activity.