05/05/2020
Keeping physically active during COVID-19 Pandemic: A step by step guide
Nigeria, like her counterpart in the global arena is facing a precarious situation and the way we live and do things will as a matter of necessity have to change. We may have to continue with our routines while adopting new approaches as dictated by the prevailing situation. The Coronavirus disease (COVID-19) pandemic has brought upon humans an extremely unpredictable situation, creating more than ever before, the need to become innovative to beat the disease. The pandemic has affected all that we do from how we socialize to how we go about our businesses and even our family routine. Yet, one other important aspect of our life that the pandemic has affected is our ability to fully exert our will on our body, a situation can greatly challenge our ability to stay healthy globally.
Although the relevance of physical activity and exercise for the prevention and control of disease conditions can be traced as far back as the beginning of man, generally many individuals still grapple with its preference and use. Some of the reasons adduced to this include inability to make time to exercise, lack of facilities and expertise on what to do, perceived strenuous nature of physical activity and some holding the believe that it is easier to swallow peels than to exercise. It is however remarkable to note that physical activity and exercise is almost irreplaceable whenever it needs be adopted and utilized. Hence, the functions of physical activity and exercise are unique and cannot be readily relegated no matter how ingenious man becomes.
The benefit of physical activity and exercise to man predates the COVID-19 pandemic and will most certainly outlive it. In the general population, physical activity and exercise will help people to keep well and live healthy by enhancing blood sugar control, reducing risk of cardiovascular diseases, burning excess body fat, improving muscle strength, increasing bone density and strength and lowering blood pressure. Equally, physical activity and exercise will help to further protect against heart and blood vessel disease, increase energy level and enhance work capacity, reduce stress, promote relaxation, release tension and anxiety, keep joints flexible, help lose weight and lower risk of falling. These and many more benefits have been evidently documented in favour of physical activity and exercise.
However, specifically in the period of COVID-19 pandemic, the resultant partial or full lockdowns, curfew and all other alternative restrictions adopted to curtail the spread of the virus will no doubt reduce physical activity capacity of the citizens. Because these restrictions are relevant to ensure a faster combat of the diseases, it becomes imperative for people to be guided on opportunities to be physically active without disobeying any COVID-19 preventive measures. Before we consider these options, it will be ideal to explore some specific relevance of physical activity and exercise in the fight against COVID-19 especially as relates to the period of lockdown.
There are lots of benefit in keeping physically active in the COVID-19 pandemic and this includes the general ones that have been mentioned above. However, a few specific ones will be presented here. Adopting appropriate physical activity will help the immune system thereby increasing the capacity of the person to fight the disease and reducing the impact of the disease progression on the entire person. As we may also be aware, many people with COVID-19 disease may have been living with one or a combination of other preexisting noncommunicable diseases such as diabetes, hypertension, obesity etc. Evidence suggests that people with COVID-19 who also have underlying diseases have more severe outcomes. Considering the enormous amount of evidence to support the role of physical activity and exercise in the prevention and control of noncommunicable diseases, it therefore becomes logical adopt it as a way of keeping well during the COVID-19 pandemic. Another reason is based on the premise that the various episodes of lockdowns and restrictions across various cities will certainly have a toll on the way of life of people including the aspects of socializing, free movements, loss of job and earning power. These situations may have consequence on the mental health and wellbeing of people leading to feelings of isolation, anxiety, depression, and many other psychological disorders. Physical activity and exercise have been shown to achieve highly improved outcomes in these situations.
Another strong point in support of physical activity and exercise is the highly flexible, readily applicable, and relatively less cost intensive nature of physical activity. By flexibility, it means the option can be utilized as suites the user. While there may be several gadgets useful in physical activity, the reality is several gadget-based activities can be adapted to suite the need of everyone while utilizing locally available resources. For instance, while seeking the service of a gymnasium is useful in keeping fit, the opportunity to do so may not present itself during lockdowns and restrictions. We have research outputs that support the fact that exercises that are undertaken in the confines of the home are equally effective and achieve essentially the same results as the ones achieved in the gymnasium. In the light of this, I will dwell at this point on physical activities that can be undertaken within our homes or immediate neighborhood in keeping with the lockdowns and various restrictions aimed at combating COVID-19.
However, before going into the real physical activities, let us examine some important tips:
Physical activity and exercise for convenience have been used interchangeably in this article, but they do not mean the same thing. While physical activity is any kind of activity that involves muscular contractions, exercise is usually the more specific, structured and organized form of physical activity.
If you are not sure of what to do, you may need to talk to your Physiotherapist or other healthcare providers who will guide you accordingly.
Best outcomes from your physical activity will not be spontaneous, so you need to be patient.
Always start slowly and progress until you can do to your desired target of duration or intensity. Do not be overly ambitious as excessive physical exercise has been associated with a reduction in immunity.
In order to make the activity more fun, you can have a support network that can be made up of family members wife/husband, children etc as far as you can keep the number to the smallest possible demanded by COVID-19 infection control measures.
Activity that makes heart beat faster and/or make the individual break sweat is usually desirable and more effective.
It is important for individuals with known underlying conditions to be familiar with some tips in keeping safe during physical activity sessions. For instance, it is important for an individual that is diabetic to be familiar with what to do when blood sugar goes low.
During any activity, the individual should be sure to wear comfortable shoes and other clothing.
Drink water before, during, and after activity to prevent dehydration.
Pain or any discomfort should not be ignored. Individuals should be observant of any exercise that causes unexpected pain.
The activities to be prescribed are usually in two forms: First is the category of activities that are general in nature (physical activity). They are activities that really do not have any strict recommendations but that will keep the body active and they are quite suitable for most category of persons. A few of these activities have been selected in this article with due attention to the Nigerian terrain as applicable to the COVID-19 pandemic period (with adherence to guidelines on prevention of infections). Some examples are:
Taking a walk to nearby markets or stores instead of driving.
As it is a period of lockdown and movement restrictions, many have converted their homes into ad hoc offices. This has brought a lot of strain to the musculoskeletal system because of improperly fitted workstations. Ensuring that limbs are moved up and down and sideways, and back stretched from time to time during working at home is important.
Avoid having to stay seated for more than an hour at a stretch. Sitting should be interspaced every hour with a few minutes of stretching and little physical activity such as walking round the building at least once before going back to sit.
There seems to be more phone calls during the COVID-19 pandemic because of a modification in the way businesses are conducted generally. Hence, walking around, back and forth while on a telephone conversation will help keep active.
The lockdown and restriction provide unique opportunity to engage in physical play with the kids at home or in the neighborhood.
Pay more attention to the good inherent in personally undertaking house chores instead of living all to domestic staff. General house cleaning is an opportunity to be physically active.
For persons with gardens or bushy areas within and around perimeter of the house, engaging in clearing and raking of leaves is valuable.
Washing the car and laundry in the home are good forms of physical activity.
Take the stairs instead of the elevator if you live in or visit offices with elevators.
Offer to do other errands at work or home to be physically active.
The second category of activity are the ones that are more structured in nature that are described as physical exercise. This should be undertaken in at least three forms: aerobic, resistance and flexibility exercises.
Aerobic exercise
In this exercise, there is the need to make use of large muscles, make the heart beat faster and breathing harder. Typically, it is recommended that an individual should exercise for about 30 minutes a day, at least 5 days a week. At the least, an individual is expected to aim for a minimum 150 minutes a week with a focus on achieving about 250 to 300 minutes of moderate exercise per week. The daily schedule can however be split into several parts of 5-10 minutes per session or any other convenient chunk. It is desirable that a warm-up (an activity, usually of lighter intensity carried out before undertaking the real exercise sessions) and warm-down exercises are incorporated into the time for the exercise. The common exercises that fall under this aerobic category are listed below:
Brisk walking (about 100 steps/minute). This can be achieved while walking up and down within the compound or around the neighborhood if the lockdown is not total.
Walking on the spot at a rate that is convenient for the individual is also found to be useful.
For those who can, jogging on the spot is also beneficial.
A fleet of stairs is a good form of aerobic exercise which is easily adaptable at home. If staircase is not available, a solid object of about 10 to 12 inches high with enough space width to accommodate the feet can be adapted to suit this purpose.
There is a lot of benefit in dancing. It is a lot of fun while keeping the body and mind healthy during the lockdown. Dancing to any music of choice is just fine and the music can be varied to different rhythms to provide desired intensity for the dance.
Of course, for those who can, riding bicycle outdoors or the stationary bicycles indoors can be of great benefit.
Resistance exercise
Resistance exercises are the ones we do when we carry out a movement of any segment of the body against another opposing force. The opposing force gives the resistance that is needed. The exercise ensures that muscles are kept in shape and in form to be able to undertake their routine with comfort and vigour. It helps to build muscles, allows for less fat accumulations, burn more calories and makes daily chores easier. It also improves balance and coordination, as well as healthy bones. Usually, what is needed to set up a resistance exercise are weights of different sizes that can be purchased from stores or improvised using materials sourced within the home. Any object that has a weight and can be easily grabbed or attached to the limbs will be adequate for this. Examples are to make a sandbag, or any other container containing sand or water. Fairly big lumps of stones can also be used for this. Example:
Exercise with hand weights, elastic bands, spring, or weight machines can be interspaced with the aerobic exercises that have been described earlier.
Weight shoulder press can be done by lifting weights above the head and down many times.
If convenient, squatting to overhead raise is done by carrying weights in both hands and squatting, come up straight and lift the weights as far above the head as possible.
For those who can, push up is also a useful exercise in this category.
Any other convenient manipulation of a weight or stationery/fixed object can be adapted in this category.
Its more convenient especially in the home front to focus on upper and lower limbs.
Stretching exercise
The period of lockdown has inadvertently encouraged prolonged immobility of body segments, sedentary lifestyle, postural malalignment, and muscle imbalances. Unfortunately, any factor that limits mobility, that is, causes decreased extensibility of soft tissues, may also impair muscular performance. Stretching exercise increases flexibility, lowers stress, and prevents muscle soreness after engaging in other types of exercise. It is usually adopted as some form of warm-up or warm-down exercise, but it can also be standalone as a form of exercise. It is beneficial to start up and end the other exercises earlier mentioned with stretching exercises. In carrying out stretching exercise:
Stretching should ensure to attain an increase in the extensibility of soft tissues, thereby improving flexibility by elongating (lengthening) structures that have adaptively shortened and have become hypomobile due to lockdown or movement restrictions.
Stretching should ensure that the neck, back, arms and legs are involved.
Each of the major body segments should be moved across the adjoining joint and the stretch should be sustained for a few seconds before returning to normal position. This should be repeated as many times as convenient.
In conclusion, kindly note that suggested activities in this article are carefully selected to provide a programme that will generally be suitable for most age groups. The list of physical activity and exercises are by no means exhaustive, and these are mere suggestions as individuals are free to device some other related activities that best fit into their routine and circumstances. It is recommended that people take to some of these physical activity and exercise practices in this lockdown and movement restrictions occasioned by COVID-19 pandemic. This will make up for the drop in our routine, keep people in good health and minimize the adverse consequence of inactivity on our health.
Written by:
Ade Fatai Adeniyi
Professor of Physiotherapy & Specialist Adviser
University of Ibadan and University College Hospital, Ibadan, Nigeria
Member, Nigeria Society of Physiotherapy
Director of Physical Activity, Nigerian Heart Foundation
Director, Exercise is Medicine, Nigeria National Centre
adeniyifatai@yahoo.co.uk
08057325888
