The Associations of COVID-19 Lockdown Restrictions With Longer-Term Activity Levels of Working Adults With Type 2 Diabetes: Cohort Study

Abstract

Background Lockdown restrictions reduce COVID-19 community transmission; however, they may pose challenges for noncommunicable disease management. A 112-day hard lockdown in Victoria, Australia (commencing March 23, 2020) coincided with an intervention trial of reducing and breaking up sitting time in desk workers with type 2 diabetes who were using a provided consumer-grade activity tracker (Fitbit). Objective This study aims to compare continuously recorded activity levels preceding and during COVID-19 lockdown restrictions among working adults with type 2 diabetes participating in a sitting less and moving more intervention. Methods A total of 11 participants (n=8 male; mean age 52.8, SD 5 years) in Melbourne, Australia had Fitbit activity tracked before (mean 122.7, SD 47.9 days) and during (mean 99.7, SD 62.5 days) citywide COVID-19 lockdown restrictions. Regression models compared device (Fitbit Inspire HR)–derived activity (steps; metabolic equivalent tasks [METs]; mean time in sedentary, lightly, fairly, and very active minutes; and usual bout durations) during restrictions to prerestrictions. Changes in activity were statistically significant when estimates (Δ%) did not intercept zero. Results Overall, there was a decrease in mean steps (–1584 steps/day; Δ% –9%, 95% CI –11% to –7%); METs (–83 METs/day; Δ% –5%, 95% CI –6% to –5%); and lightly active (Δ% –4%, 95% CI –8% to –1%), fairly active (Δ% –8%, 95% CI –21% to –15%), and very active (Δ% –8%, 95% CI –11% to –5%) intensity minutes per day, and increases in mean sedentary minutes per day (51 mins/day; Δ% 3%, 95% CI 1%-6%). Only very active (+5.1 mins) and sedentary (+4.3 mins) bout durations changed significantly. Conclusions In a convenience sample of adults with type 2 diabetes, COVID-19 lockdown restrictions were associated with decreases in overall activity levels and increases in very active and sedentary bout durations. A Fitbit monitor provided meaningful continuous long-term data in this context. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618001159246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001159246

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

“…Another contributing factor to the increase in revascularisations during the pandemic is a general decline in patient health during the pandemic. This has been reported by several studies and a systematic review which found reduced physical activity and increased sedentary behaviours in several populations of adults with a variety of medical conditions during lockdowns [17–19]. Additionally, reduced physical activity and increased sedentary behaviours are associated with poor glycaemic control which overtime likely contributed to deterioration of PAD further in diabetic patients [20, 21].…”

The Importance of Research on Occupational Sedentary Behaviour and Activity Right Now

“…Adding to the considerations for measurement selection for researchers is the rapid increase in the technology available for measuring activity [ 33 ]. Technology-based methods of smartphone accelerometers [ 34 ], Fitbits [ 35 ] and research-grade accelerometers [ 36 ] were used to measure physical activity and sedentary behaviour during the pandemic and can be used across work and home environments. These provide higher accuracy than self-reports, but minimal information regarding context, which is necessary to target setting-specific changes in active and sedentary behaviour.…”