Abstract
Background: The COVID-19 pandemic prompted movement restrictions in countries worldwide, impacting on physical activity (PA), a major non-communicable disease risk factor. In semi-rural areas of low-middle-income-countries (LMICs), where occupational activity is the main source of PA, changes in PA associated with COVID-19 restrictions are unknown. We investigated the impact of Movement Control Order (MCO) restrictions in a semi-rural region of Malaysia.Methods: The South East Asia Community Observatory (SEACO) is a dynamic prospective community cohort . We contacted a random sample of 1007 adults (18+) who had previously provided PA data in 2018. We asked about PA during the MCO (March-May 2020) and at the time of interview (June 2020).Findings: During the MCO, PA reduced by a mean of 6·7 hours/week (95% CI: 5·3, 8·0) compared to 2018, with the largest reductions among those in employment. By June, PA was 3·4 hours/week (95% CI: 2·0, 4·8) less than 2018, leaving 34% of adults currently inactive (20% in 2018). Reductions in occupational PA were not replaced with active travel or activity at home. Despite these observed reductions, most participants did not think the MCO had affected their PA.Interpretation: Movement restrictions are associated with lower PA lasting beyond the period of strict restrictions. Future MCOs should include options to encourage people to be active, but may additionally need targeted messaging for those who don’t necessarily realise they are at risk. In particular, policies in more affluent countries may not easily translate to LMICs. Funding: Elizabeth Blackwell Institute, University of BristolDeclaration of Interest: None to declare. Ethical Approval: A project using existing SEACO data (Risk factor surveillance update; Project ID: 13142) received ethical approval on 13th June 2018 and further ethical approval was obtained from the Monash University Human Research Ethics Committee (Project ID: 13142 approved 5th June 2020)
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