Physical Activity in Elementary School Students During COVID-19 Lockdown (PSBB) Across Red Zone and Green Zone Areas

Introduction

The emergence of COVID-19 in late 2019 led to unprecedented public health measures worldwide, including the implementation of Large-Scale Social Restrictions (PSBB) or lockdowns. These measures aimed to control virus transmission but significantly disrupted daily life, particularly for children whose routines revolved around school and organized activities. Physical activity, essential for children's health and development, was potentially impacted differently across geographical areas based on the severity of COVID-19 cases and subsequent restriction stringency.

Elementary school students, typically aged 6-12 years, require regular physical activity for optimal growth and development. The World Health Organization recommends at least 60 minutes of moderate-to-vigorous physical activity daily for children in this age group. COVID-19 restrictions threatened to disrupt these activity patterns, with potentially varying impacts across communities designated as red zones (high COVID-19 prevalence) versus green zones (low COVID-19 prevalence).

Background

The COVID-19 pandemic prompted governments worldwide to implement various containment strategies. One common approach was the designation of geographical zones based on infection rates, with red zones representing areas with high transmission and green zones indicating areas with minimal or no transmission.

In response to the pandemic, educational institutions worldwide closed temporarily, with some regions implementing prolonged closures affecting millions of students. During this period, learning shifted to online platforms, and children remained largely confined to their homes. The lack of structured school environments, coupled with restrictions on outdoor activities and sports, created potentially significant barriers to maintaining adequate physical activity levels.

Physical Activity in Pre-Pandemic Context

Before the pandemic, elementary school students typically engaged in physical activity through multiple channels:

• Physical education classes at school
• Recess and lunchtime play
• Active transportation to and from school
• Sports and recreational activities after school
• Weekend family activities and sports participation

According to baseline studies, approximately 80% of elementary school children worldwide did not meet recommended physical activity guidelines even before the pandemic. The COVID-19 restrictions threatened to worsen this already concerning situation.

Impact on Physical Activity During Lockdown

Research conducted during lockdown periods indicated substantial declines in physical activity among elementary school students globally. Key findings included:

• Average reduction of 40-50% in daily physical activity
• Increased sedentary time by several hours per day
• Drastic reduction in outdoor play and sports participation
• Disruption of active transportation patterns

These reductions were attributed to the closure of schools, playgrounds, sports facilities, and limitations on outdoor activities. Additionally, parents working from home often created more structured indoor environments that limited spontaneous physical play.

Differences Between Red Zone and Green Zone Areas

While all zones experienced some restrictions, the stringency and duration of measures varied significantly between red and green zones, creating different environments for physical activity:

Restriction Stringency

• Red Zones: Typically implemented the strictest measures, including complete outdoor activity bans, limited time windows for essential activities, and enhanced police monitoring.
• Green Zones: Often maintained more moderate restrictions, allowing for outdoor activities with limited group sizes and maintaining some recreational facilities with social distancing requirements.

School Approach

• Red Zones: Schools remained closed for extended periods, switching exclusively to online learning without any in-person physical education components.
• Green Zones: Some regions maintained hybrid models or reopened schools earlier, incorporating modified physical education classes with safety protocols.

Outdoor Space Availability

• Red Zones: Public parks, playgrounds, and outdoor recreational facilities were completely closed, nearly eliminating opportunities for outdoor physical activity.
• Green Zones: Outdoor spaces often remained accessible with capacity limits or timed entry systems, preserving some options for outdoor physical activity.

Factors Contributing to Physical Activity Differences

Several interrelated factors contributed to the disparities in physical activity between zones:

• Socioeconomic Status: Red zones often encompassed urban centers with higher population density and more crowded housing, limiting indoor activity space and private outdoor access.
• Home Environment: Students in green zones were more likely to have home environments conducive to physical activity (e.g., private yards, larger living spaces, home exercise equipment).
• Parental Work Situation: Employment patterns differed between zones, affecting supervision availability and priorities for time management during lockdown.
• Digital Divide: Access to online physical education resources and technology varied between zones, affecting alternative activity programming availability.
• Community Resources: Green zones typically maintained more community-based adaptations for supporting child physical activity compared to more strictly regulated red zones.

Health Implications

The disparities in physical activity between red and green zones raised several health concerns:

Health Aspect	Red Zone Impact	Green Zone Impact
Cardiovascular Health	More significant declines in cardiovascular fitness indicators	Maintained slightly better cardiovascular health metrics
Body Composition	Higher rates of weight gain and increased BMI	Moderate increases in body weight but less dramatic changes
Mental Health	Higher reports of anxiety, depression, and mood disorders	Some mental health challenges but with better coping mechanisms
Sleep Patterns	More disrupted sleep schedules and quality	Better sleep maintenance despite routine disruptions

Adaptations and Mitigation Strategies

Despite restrictions, communities developed various strategies to promote physical activity:

• Online Physical Education: Schools implemented virtual physical education classes with varying success rates across zones.
• Home-based Activity Programs: Many families created structured indoor activity routines, though this resource was more prevalent in certain demographics.
• Community Initiatives: Some green zone communities organized physically distanced outdoor programs when regulations permitted.
• Technology-assisted Activities: Video games promoting movement, activity tracking apps, and online exercise challenges gained popularity.

Implications for Future Policy

The disparities in physical activity between red and green zones highlighted several important policy considerations:

1. The need for equitable physical activity promotion strategies that account for varying restriction levels and resource access.
2. Development of comprehensive remote learning approaches that incorporate physical activity components.
3. Creation of guidelines for maintaining child physical activity during public health emergencies.
4. Investment in digital infrastructure to support widespread access to online physical education resources.
5. Implementation of monitoring systems to track physical activity levels during crisis periods.

Long-term Considerations

The pandemic-related physical activity disruptions may have lasting effects on children establishing healthy habits. The physical activity disparities observed between red and green zones during lockdown periods may contribute to:

• Exacerbated health inequities among children
• Changes in sport participation and skills development
• Long-term impacts on cardiovascular health trajectories
• Differential academic performance related to physical activity levels
• Psychological effects related to movement restrictions

Conclusion

The implementation of Large-Scale Social Restrictions (PSBB) during the COVID-19 pandemic significantly impacted physical activity levels among elementary school students. Research examining differences between red zone and green zone areas demonstrated that restrictions were more disruptive in high-risk zones, where children experienced greater reductions in physical activity and fewer opportunities for active play.

These disparities highlight the need for equitable approaches to promoting physical activity during public health emergencies, ensuring that children in high-risk zones are not disproportionately disadvantaged. As communities recover from the pandemic, targeted interventions will be necessary to restore and enhance physical activity levels among all elementary school students, particularly those who experienced the most significant disruptions.

Future research should continue monitoring the long-term impacts of these activity disruptions and evaluate the effectiveness of various intervention strategies aimed at promoting equitable physical activity opportunities for all children, regardless of geographical location or pandemic restrictions.