How physical activity behavior affected well-being, anxiety and sleep quality during COVID-19 restrictions in Iran

H. A. Akbari, M. Pourabbas, M. Yoosefi, W. Briki, S. Attaran, H. Mansoor, W. Moalla, M. Damak, I. Dergaa, A. L. Teixeira, J. Nauman, D. G. Behm, N. L. Bragazzi, H. Ben Saad, C. J. Lavie, A. Ghram

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


OBJECTIVE: The Islamic Republic of Iran has displayed one of the highest rates of COVID-19 infection in the world and the highest rate of mortality in the Middle East. Iran has used a stringent package of preventive health measures to mitigate the spread of infection, which however has negatively affected individuals' physical and psychological health. This study aimed at examining whether physical- activity (PA) behavior, anxiety, well-being, and sleep-quality changed in response to the COVID-19-related public health restrictions enforced in Iran. PATIENTS AND METHODS: An online questionnaire was disseminated to adults residing in Iran from November 17, 2020, to February 13, 2021 (∼88 days), during Iran's strictest public health restrictions. Main outcome measures included Godin-Shephard Leisure-Time Exercise Questionnaire, General Anxiety Disorder-7, Mental Health Continuum-Short Form, and Pittsburgh Sleep Quality Index. RESULTS: A total of 3,323 adults (mean age 30±11 years, 54.3% female) participated in the survey. Firstly, the restrictions generally reduced PA behavior: (a) among inactive participants (IPs), 60.6% became less active vs. 5.1% who became more active; and (b) among active participants (APs), 49.9% became less active vs. 22.8% who became more active. Secondly, PA behavior was associated with higher well-being and sleep quality during the restrictions: (a) APs reported higher (or lower) levels of well-being and sleep quality (or anxiety) than did IPs; and (b) among IPs as well as among APs, the more active the participants, the greater (or lower) the levels of well-being and sleep quality (or anxiety). CONCLUSIONS: This study showed the beneficial role of PA behavior for well-being, anxiety, and sleep quality during the COVID-19 restrictions, whereas such restrictions appeared to decrease PA participation. Active lifestyle should be then encouraged during the COVID-19 outbreak while taking precautions.

Original languageEnglish (US)
Pages (from-to)7847-7857
Number of pages11
JournalEuropean Review for Medical and Pharmacological Sciences
Issue number24
StatePublished - 2021
Externally publishedYes


  • Coronavirus disease
  • Exercise
  • Lifestyle Behavior Change
  • Mental Health
  • Sedentary Behavior

ASJC Scopus subject areas

  • Pharmacology (medical)


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