Impact of online learning on physical activity during COVID-19 lockdown period among female undergraduate students in Saudi Arabia: a cross-sectional study

Introduction

Physical activity (PA) is defined as any motion performed by the human body using the musculoskeletal system that causes energy expenditure (Caspersen, Powell & Christenson, 1985). Physical inactivity has been reported as a risk factor for multiple cardiovascular and chronic diseases, including hypertension, diabetes mellitus, cancer, osteoarthritis, obesity, and depression (Warburton, Nicol & Bredin, 2006). Modifying this risk factor has several benefits, as regularly performing PA can reduce the risk of premature death, disability, and chronic diseases (Brownson, Boehmer & Luke, 2005).

In the general population, engaging in higher levels of PA has been shown to be associated with better mental health (Biddle, 2016). Engaging in PA can reduce depression and anxiety (Kandola et al., 2019; Rebar et al., 2015) and increase self-esteem (Robert, 2013). Moreover, PA showed a generalized positive influence on mental health among undergraduate university students of both sexes (Tyson et al., 2010). A previous study conducted among middle-aged female participants reported that higher levels of PA were positively associated with higher self-esteem (Dabrowska-Galas & Dabrowska, 2021).

In early 2020, because of the COVID-19 pandemic, most education systems—including universities—shifted from on-campus classes (face-to-face learning) to online learning, allowing students to take their classes while socially isolating (Zheng et al., 2020). In Saudi Arabia, this transition continued until the end of the academic year 2020–2021. Online-based learning has several benefits, including time flexibility, time saving for both students and educators, and cost effectiveness related to traveling and space booking for on-campus learning activities. However, some challenges were faced and reported by students and educators during this online learning phase, including lack of student attention during online classes, lack of active student engagement with educators, lack of social interaction, difficulties in applying online learning to hands-on and practical courses, and most importantly, lack of physical movement during online learning (Hiranrithikorn, 2019; Dung, 2020; Yuhanna, Alexander & Kachik, 2020). These factors may contribute to an overall decreased level of PA and increased sedentary behaviour among young adults (Zheng et al., 2020). However, the impact of shifting to online-based learning on PA among undergraduate students in Saudi Arabia is still unknown.

Two studies investigated mental health among young adults between 18 and 25 years old (Stroud & Gutman, 2021) and anxiety and stress among university students (Talapko et al., 2021) during COVID-19 period, and both studies reported that female young adults between 18 and 25 years old were significantly more affected by COVID-19 on the mental health level and reported greater levels of stress and anxiety (Stroud & Gutman, 2021; Talapko et al., 2021). However, no consensus has been reached in literature regarding differences in PA between male and female university students during COVID-19 as one study reported similar reduction in PA in both male and female students (Talapko et al., 2021), while another study revealed that 61% of female students reported that they performed PA less than usual compared to male students (56%) during COVID-19 (Gallo et al., 2020). Therefore, this study focused on female undergraduate students. It was hypothesized that online learning negatively affected PA levels during the COVID-19 lockdown period among female undergraduate students in Saudi Arabia. Therefore, the purpose of this study was to investigate the association between online learning and PA during the COVID-19 period among female undergraduate students in Saudi Arabia.

Materials & Methods

Results

Association between online learning and physical activity

Table 3 and Fig. 1 show the association between online learning and physical activity. The results showed a significant association between online learning and physical activity (Fig. 1). Compared with those attending <25 hours/week of online learning, those who attended >30 hours/week had lower PA (r =  − 363.24; 95% confidence interval (CI) [−593.97, −132.50]), followed by those attending 25–30 hours/week (r =  − 277.66; 95% CI [−484.65, −70.66]).

Table 3:

Association between online learning and physical activity.

Online learning, hours/week	Coefficient (95% CI)ab	Pvalue
<25	Referent	–
25–30	−277.66 [−484.65, −70.66]	0.002
>30	−363.24 [−593.97, −132.50]	0.002

DOI: 10.7717/peerj.16579/table-3

Notes:

CI

confidence interval

aAdjusted for body mass index.

bGeneralised linear model coefficients; coefficients indicate mean differences (in physical activity (metabolic-minutes/week)) between the reference category (<25 hours/week) and each of the other online learning groups, e.g., a value of −3 indicates that a specific category had a mean score that is 3 units lower than the referent group.

Discussion

Numerous studies have linked PA with academic performance (Castelli et al., 2014) and overall well-being (Hyde, Maher & Elavsky, 2013). It is well documented that PA is a preventative measure for a variety of health problems, including obesity, hypertension, and diabetes (Warburton, Nicol & Bredin, 2006) and it can also reduce tension and anxiety levels (Slimani et al., 2018). The goal of the present study was to investigate the impact of online learning on the amount of PA that Saudi Arabian female undergraduate students engaged with during the COVID-19 lockdown. During the COVID-19 pandemic, online learning has been a pivotal tool for facilitating education when face-to-face learning was restricted. The results of the current study revealed that 43.6% of students were classified as having moderate or low-active PA. This finding is consistent with a previous study which found that Australian students showed a decline in PA during the lockdown (Gallo et al., 2020).

In 2021, a systematic review of 66 studies revealed that, except for individuals with eating disorders, the vast majority of research reported that PA levels dropped during the COVID-19 lockdown and most research indicated an increase in sedentary behaviour (Stockwell et al., 2021). The decline in PA is a major cause for worry owing to the potential repercussions to public health and the healthcare system in the long run. During the COVID-19 lockdown, numerous countries banned outdoor activities. However, outdoor exercising was possible in some countries, such as the United Kingdom, despite being under lockdown per their implemented social distancing guidelines (Wickersham et al., 2021). Interestingly, allowing outdoor exercising specifically among university students had a positive impact on their PA level, as reported by a study that investigated the changes in PA level among university students in the United Kingdom before and during the lockdown period. The study found that there was a gradual increase in steps walked per week following lockdown commencement. This increase was higher in males than in females (Wickersham et al., 2021).

The current study also showed that the time spent on online learning was inversely associated with the PA level. This is expected as many students attend classes from their residences, resulting in prolonged sedentary/screen-time periods. Moreover, the COVID-19 lockdown might have contributedto reduced PA frequency and duration, particularly for university students who previously used to walk or bike to work or class. Thus, it is logical to associate this finding with the loss of incidental walking during commute and daily activities such as walking between classes on campus (Gallo et al., 2020). Similar to our findings, a previous study reported that PA levels of female students fell dramatically due to the implementation of COVID-19-related isolation measures, despite calls for continued exercise during the pandemic (Lippi, Henry & Sanchis-Gomar, 2020).

Currently, 53.3% of female students in the present study perceived that their psychological status could be influenced by their PA level. Similar findings were reported by female university students in Spain, who showed higher levels of perceived anxiety than males (23) as female students perceived higher levels of apprehension, conscientiousness, neuroticism, and openness during the COVID-19 period as reported by Rodriguez-Besteiro et al. (2021); however, the study did not declare whether the data was collected during the application of lockdown restrictions in the country or not. Moreover, PA levels have been frequently associated with several mental health disorders (Kandola et al., 2019; Rebar et al., 2015), implying that declines in PA may result in an increase in negative mental health outcomes. Evidence has shown that during a COVID-19 lockdown, anxiety and despair levels rose significantly (Schuch et al., 2020).

Undoubtedly, shifting from face-to-face to online teaching and learning was challenging for most educators and students (Almahasees, Mohsen & Amin, 2021). Therefore, based on the results of the present study, diverse educational institutions may implement multidisciplinary interventions and awareness programs to counteract the negative impact of online learning on the students’ PA level and improve their psychological status and mental health. This can be attained by encouraging students to proactively increase their PA levels while receiving online education as the impact of PA on mental health among undergraduate students has already been confirmed (Rodríguez-Romo et al., 2022). One of the limitations of this study is that while we employed a convenience sample strategy to readily reach a wide and varied group of participants from various universities in Saudi Arabia, this sampling method might have introduced some bias, potentially restricting the generalizability of the results. However, this was unavoidable to ensure the reliability of the findings as the relevant data needed to be collected in a relatively short period of time—while the COVID-19 lockdown restrictions in Saudi Arabia were in place. Another limitation is that the collected sample size was small which might increase the possibility for a type 2 error.

Conclusions

This study hypothesized that online learning negatively affected the PA level of female undergraduate students in Saudi Arabia during the COVID-19 lockdown period. Indeed, online learning has negatively affected the PA level of female undergraduate students in Saudi Arabia during the COVID-19 lockdown period, as students who spent longer hours engaging in online education had lower PA levels. In turn, low PA levels might affect their psychological status; however, this relationship was not investigated in this study. Therefore, future studies are warranted to investigate this relationship.

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