the covid 19 pandemic and exercise cope trial a multi group randomized controlled CORD-Papers-2021-10-25 (Version 1)

Title: The COvid-19 Pandemic and Exercise (COPE) Trial: A multi-group randomized controlled trial comparing effects of an app-based, at-home exercise program to waitlist control on depressive symptoms
Abstract: Background: The number of adults across the globe with significant depressive symptoms has grown substantially during the COVID-19 pandemic. The extant literature supports exercise as a potent behavior that can significantly reduce depressive symptoms in clinical and non-clinical populations. Objective: Using a suite of mobile applications, at-home exercise, including high intensity interval training (HIIT) and/or yoga, was completed to reduce depressive symptoms in the general population in the early months of the pandemic. Methods: A 6-week, parallel, multi-arm, randomized controlled trial was completed with 4 groups: [1] HIIT, [2] Yoga, [3] HIIT+Yoga, and [4] waitlist control (WLC). Low active, English-speaking, non-retired Canadians aged 18-64 years were included. Depressive symptoms were measured at baseline and weekly following randomization. Results: A total of 334 participants were randomized to one of four groups. No differences in depressive symptoms were evident at baseline. The results of latent growth modeling showed significant treatment effects for each active group compared to the WLC, with small effect sizes in the community-based sample of participants. Treatment groups were not significantly different from each other. Effect sizes were very large when restricting analyses only to participants with high depressive symptoms at baseline. Conclusions: At-home exercise is a potent behavior to improve mental health in adults during the pandemic, especially in those with increased levels of depressive symptoms. Promotion of at-home exercise may be a global public health target with important personal, social, and economic implications as the world emerges scathed by the pandemic.
Published: 4/20/2021
DOI: 10.1101/2021.04.14.21255519
DOI_URL: http://doi.org/10.1101/2021.04.14.21255519
Author Name: Puterman, E
Author link: https://covid19-data.nist.gov/pid/rest/local/author/puterman_e
Author Name: Hives, B
Author link: https://covid19-data.nist.gov/pid/rest/local/author/hives_b
Author Name: Mazara, N
Author link: https://covid19-data.nist.gov/pid/rest/local/author/mazara_n
Author Name: Grishin, N
Author link: https://covid19-data.nist.gov/pid/rest/local/author/grishin_n
Author Name: Webster, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/webster_j
Author Name: Hutton, S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/hutton_s
Author Name: Koehle, M
Author link: https://covid19-data.nist.gov/pid/rest/local/author/koehle_m
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
Author Name: Beauchamp, M
Author link: https://covid19-data.nist.gov/pid/rest/local/author/beauchamp_m
sha: a46790e1d903b7c4cfecede92b9482b66aa3af71
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: https://doi.org/10.1101/2021.04.14.21255519 http://medrxiv.org/cgi/content/short/2021.04.14.21255519v1?rss=1
has_full_text: TRUE
Keywords Extracted from Text Content: participants [4] waitlist COVID-19 Canadians [1] HIIT globe [2] Yoga, [3] HIIT+Yoga unhide medRxiv preprint COVID-19 children US$ HIIT+Yoga medRxiv preprint COVID-19 Feingold's medRxiv preprint Table S3 . UK app-based PI ePARmed-X+ DownDog HIIT+Yoga participants smallto-medium ES HIIT parks Facebook Q. COVID- 19. medRxiv women US participants Figure 3a body Canadians globe alpha www.copetrial.ca ES Instagram medRxiv preprint medRxiv preprint COVID-19 permission.(which medRxiv
Extracted Text Content in Record: First 5000 Characters:Background: The number of adults across the globe with significant depressive symptoms has grown substantially during the COVID-19 pandemic. The extant literature supports exercise as a potent behavior that can significantly reduce depressive symptoms in clinical and non-clinical populations. Objective: Using a suite of mobile applications, at-home exercise, including high intensity interval training (HIIT) and/or yoga, was completed to reduce depressive symptoms in the general population in the early months of the pandemic. Methods: A 6-week, parallel, multi-arm, randomized controlled trial was completed with 4 groups: [1] HIIT, [2] Yoga, [3] HIIT+Yoga, and [4] waitlist control (WLC). Low active, English-speaking, non-retired Canadians aged 18-64 years were included. Depressive symptoms were measured at baseline and weekly following randomization. Results: A total of 334 participants were randomized to one of four groups. No differences in depressive symptoms were evident at baseline. The results of latent growth modeling showed significant treatment effects for each active group compared to the WLC, with small effect sizes in the community-based sample of participants. Treatment groups were not significantly different from each other. Effect sizes were very large when restricting analyses only to participants with high depressive symptoms at baseline. Conclusions: At-home exercise is a potent behavior to improve mental health in adults during the pandemic, especially in those with increased levels of depressive symptoms. Promotion of athome exercise may be a global public health target with important personal, social, and economic implications as the world emerges scathed by the pandemic. Trial registration number: clinicaltrials.gov #NCT04400279 All rights reserved. No reuse allowed without permission. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 20, 2021. ; https://doi.org/10.1101/2021.04.14.21255519 doi: medRxiv preprint COVID-19 Pandemic and Exercise (COPE) Trial 7 Summary Box This randomized controlled trial provides strong evidence suggesting that at-home app-based exercise in various forms (high intensity interval training or yoga or their combination) can significantly improve depression symptoms over a 6-week period in community adults during the pandemic. When the sample was restricted to only those with high baseline depression symptoms, the weekly effects were substantially large. At-home exercise during the COVID-19 pandemic proved to be an impactful and affordable health behavior in which community living adults, especially those with high depression symptoms, can engage to bolster their mental health. In light of the long-term mental health consequences of COVID-19 with which many adults are expected to struggle, even after a return to normal, promoting and supporting programming in communities at the individual level will emerge as a necessary health policy initiative. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 20, 2021. Introduction Early in the COVID-19 pandemic, fears of infection, economic hardship, and global stayat-home mandates were widely predicted to have substantial negative effects on mental health. [1] [2] [3] The prediction has been borne out. A nationally representative study in 1,441 United States (US) residents reported that 27.8% of Americans experienced depressive symptoms in April 2020 compared to 8.5% two years earlier, a greater than 3-fold increase. 4 Declines in mental health during the early months of the pandemic from pre-pandemic levels were also apparent in a national survey completed in the United Kingdom (UK). 5 Researchers and healthcare professionals promoted a wide range of approaches to maintain the mental health of all individuals during this pandemic, from actions individuals can take within their homes and outdoors, such as exercise, to assessment and treatment considerations that healthcare providers and institutions can implement. [1] [2] [3] The World Health Organization 6 and global government agencies (e.g., US Center for Disease Control 7 and Public Health England 8 ) similarly recommended that the public engage in physical activity and exercise to attain and maintain mental health during the pandemic. These recommendations were supported by an extant literature providing compelling evidence for impactful prevention of 9 and reductions in 10 depressive symptoms in clinical and non-clinical populations following the adoption of physical activity programming. Yet, with the mandated closure of fitness centres and outdoor recreat
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