*3.1. Tools/Variables Which Quantify Motor and Emotional Status in Healthy Adults during Home Confinement*

Participation in social life or active integration in community activities improves everyone's mental health, increases self-control and self-efficacy by demonstrating psychological and social wellbeing [13].

The major concern in lockdown was to better quantify the decrease in physical activity and its negative impact of cognitive function and life quality.

Through semi-structured electronic studies and interviews launched on online platforms by specialized organizations, the participants' answers regarding mental wellbeing, the appearance and development of depressive symptoms as well as the comparison of situations before and during home confinement were requested.

The most relevant instruments for these purposes were: the Short Warwick–Edinburgh Mental. Wellbeing Scale (SWEMWBS), which assessed mental wellbeing [14] with a score between 7–35, and the superior shows considerable mental wellbeing; the Short Mood and Feelings Questionnaire (SMFQ), which demonstrated a depression measure where a high score means worsening psychic symptoms; the Short Life Satisfaction Questionnaire for Lockdowns (SLSQL), which quantifies the wellbeing of life [15]; the Short Social Participation Questionnaire for Lockdowns (SSPQOL) [15]; the social participation of individuals was quantified by the International Physical Activity Questionnaire Short Form (IPAQ-SF), which suggests participation in physical activity [15]; the Pittsburgh Sleep Quality Index (PSQI) [15], a tool that monitors sleep quality; the Short Diet Behaviors Questionnaire for Lockdowns (SDBQL), the scale that monitors eating habits [2]; the Short Technology use Behaviors Questionnaire for Lockdowns (STBQL), which provides demographic information and which allows psychological and social support [16]; and the Short Life Satisfaction Questionnaire for Lockdowns (SLSQOL) [16], framed as a score between 3 and 21, is a scale that measures the degree of satisfaction on the life of the respondents during the period of isolation at home, and the lowest scores appreciate a high degree of dissatisfaction in terms of active participation in social life. Decreasing socialization and communication with friends, neighbors, lack of visits to the respondents' homes or to other relatives of their families, changed mental wellbeing and altered emotional status with increased anxiety, loneliness or sadness [12] are all considered here.

In the four studies [13–16] with 1047 participants each, using ECBL (Effects of Home Confinement on psychosocial health status and multiple lifestyle behaviors- COVID-19), an electronic survey was delivered on Google platforms, such as mail, WhatsApp, Facebook, ResearchGate, Twitter, LinkedIn, translated in the several languages, questions were administered about lifestyle, daily activities, diet, rest and mental state of participants before and during home confinement. Individuals were about 54% female and 46% male and the percentages by geographical areas were as follows: 40% Africa, 36% Asia, 21% Europe and 3% others.

For instance, in one of the four papers, the most significant tools used were: *SWEMWBS* who assessed the functioning of mental wellbeing with a score range between 7–35, so that the low values represented a low mental wellbeing and the higher ones appreciated a high functioning of the psychic status and SMFQ scale, which measures degree of depression (0–26). Thus, a total score greater than (>12) indicated altered emotional status that indicate the presence of depression.

In another study that used the platform of ECLB COVID-19, monitoring was carried out on physical training through evaluation activities daily living (ADL), exercise class or gym class home-based. The basic tools used were SSPQOL who evaluated the social participation before and during home confinement, so that the 14 items in the questionnaires were based on the active participation of the respondents in social life. The range of scale was established between 15–70, so the higher scores, the more active the participation in social life in various ways was. Another variable, SLSQOL, used a questionnaire with answers and evaluated satisfaction life, and the score between 3–21 estimated the degrees of satisfaction or dissatisfaction. The lower scores showed different levels of disagreement and upper scores translated to being extremely satisfied. The other tools used were *SWEMWBS*, SMFQ, IPAQ-SF and PSQI, that estimated decreasing mental wellbeing, impairing sleep quality, changes in physical activity in the sense of decreasing it, or altering emotional status, with serious psychological consequences [14].

Another paper that used the questionnaire delivered through ECLB COVID-19, discussed IPAQ-SF guidelines, the variable, which quantified physical exercises of different intensity, estimating the time spent weekly a physical training, including time spent standing. Several categories of physical activities were performed, such as vigorous physical exercises with aerobic exercises or fast bicycling, moderate physical exercises meaning carrying light loads or cycling at normal speed, walking training and finally the time spent in the last 7 days sitting. In this sense, answers were requested for two sets of questions related to the different categories of physical activities performed during seven days, one addressed to young people and adults able to perform vigorous and moderate PA and the second set was delivered to older adults who did walking training and spent time sitting. The second tool used was SDBQ-L, which assessed diet behavior before and during the home confinement period. The requests in the questionnaires addressed five issues: (1) unhealthy food, (2) snacking between meals or late at night, (3) excessive alcohol consumption, (4) overeating and (5) a high number of meals/day. The trend observed during isolation at home is to address unhealthy eating habits that lead to weight gain, impaired health and wellbeing [15].

The scores of variables SWEMWBS, SMFQ and SLSQL, were significantly altered during isolation at home imposed by pandemic restrictions by altering mental wellbeing, increasing depressive states, accentuate nervousness, disorders of sleep, or changes in emotional status with accentuate sadness, feelings of loneliness, uselessness and personal dissatisfaction [16]. The scores from the other tools, including IPAQ-SF, SDBQL, PSQI, STBQ-L, SSPQ-L and SLSQL, demonstrated psychosocial impact imposed by home confinement, and the importance for technology intervention involved in active and healthy lifestyle.

Another article studied the impact of home confinement on the wellbeing of mental health correlated with physical activities performed at home of different intensities, eating habits acquired during the isolation period but also with the quality of sleep in Arabian communities. The impairment of mental well-being was more pronounced in Arab women (53.9%) compared to men (46.1%). In terms of the quality of the diet obtained through questionnaires, the highest score means maintaining mental wellbeing through the use of good meals and food. The quality of sleep was assessed through a range between 0 and 21 points with PSQI scale, so that the maximum values were associated with sleep disorders during the period of isolation at home affecting mental status. For physical activity, which was evaluated through IPAQ with seven items, the questioning proved that in the case of performing moderate and vigorous physical activity (measured by the distribution metabolic equivalents minutes per week (MET), wellbeing mental is improves. Furthermore, it was associated with increasing aerobic physical exercise and endurance physical activity [17].

Increased depression, anxiety, sleep disturbances, disturbances of attention or psychological changes were discussed in another study conducted in adolescents, through the excessive use of social networks and dangerous exposures to them, such as cyber bulling, sexting in desire of communication and compression of social distancing during the quarantine of COVID-19.

However, there was a greater resistance of adolescents to external stressors as there was an effective alternative to promote socialization, minimize social distance, by using online technology that they mastered very well. Monitoring was performed by counting text and chat messages that were sent or received from online platforms during the lockdown. There were even very well maintained physical activities at home, promoted sustained periods of time or daily activities that improved the physical and culinary performance of the participants. Relationships between participants and other family members were

greatly improved during this period, and eating habits were much healthier than during direct socialization [18].

Physical Activity in Healthy Adults during Home Confinement

The physical activity (PA) has been studied in terms of types of physical activity and is presented in Figure 2.

**Figure 2.** Type of physical activity (ADL: Activity of Daily Living) for healthy people [12–17].

We illustrate in Table 1, the instruments discussed, the characteristics, the physical activities performed, the interventions and the conclusions derived from the clinical trials studied at healthy adults:





et

**Table 1.** *Cont.*

Satisfaction FFQ: Food Frequency

Questionnaire

 for Lockdowns; EQ-5D-5L: Euro QoL-5 dimensions; ADL: Activity of Daily Living; HADS: Hospital Anxiety and Depression Scale;

Questionnaire;

 WHO-5: World Health

Organization—wellbeing

 score.

According to Ammar [16], significant increases in uses of the technology allowing the development of PA during home confinement were observed. Mood and feeling has a negative correlation with PA participation, but life satisfaction has a positive correlation with PA. Moreover, the anxiety, depression and other psychological issues during COVID-19 are related with physical activity and its role on the immune function.

Furthermore, Kilani [17] speaks about PA, which could be considered to be a very good predictor of mental wellbeing score and health status, but this depends on PA intensity.
