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

ABSTRACT 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.