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ORIGINAL RESEARCH article

Front. Psychol., 12 April 2022
Sec. Health Psychology
This article is part of the Research Topic Effects of Physical Activity on Psychological Well-being View all 20 articles

Effect of Neuromuscular Training Program on Quality of Life After COVID-19 Lockdown Among Young Healthy Participants: A Randomized Controlled Trial

Updated
\r\nDragan Marinkovic*Dragan Marinkovic1*Drazenka MacakDrazenka Macak1Dejan M. MadicDejan M. Madic1Goran SporisGoran Sporis2Dalija KuvacicDalija Kuvacic3Dajana Jasic,Dajana Jasic2,4Vilko PetricVilko Petric5Marijan SpehnjakMarijan Spehnjak6Aleksandra ProjovicAleksandra Projovic7Zoran Gojkovic,\r\nZoran Gojkovic8,9
  • 1Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
  • 2Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
  • 3Department of Economics, University of Applied Sciences Zagreb, Zagreb, Croatia
  • 4Department of Teachers’ and Preschool Teachers’ Education, University of Zadar, Zadar, Croatia
  • 5Faculty of Teacher Education, University of Rijeka, Rijeka, Croatia
  • 6Archdiocese of Zagreb, Zagreb, Croatia
  • 7Primary School “Stefan Nemanja”, Niš, Serbia
  • 8Government of the Autonomous Province of Vojvodina, Provincial Secretariat for Health Care, Novi Sad, Serbia
  • 9Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

Study in the period of coronavirus disease 2019 (COVID-19) lockdown and the effect of different exercise training programs on the quality of life (QoL) dimension are limited. This randomized control study as a part of which the impact of an 8-week neuromuscular training program on the 90 healthy young individuals’ QoL after COVID-19 lockdown was assessed using a short form of the WHOQOL-BREF questionnaire comprising of four domains (physical health, psychological health, social relations, and the environment). The intervention group (NT) (n = 47) took part in a neuromuscular training program consisting of dynamic neuromuscular stabilization and whole-body vibration training. In contrast, the control group (CG) (n = 43) did not participate in any programmed physical activity. From pre- to post-intervention test, the NT group significantly and substantially improved [mean change (95% CI)] all the QoL domains, physical for 12.78 scores (8.89, 16.64), psychological for 13.12 scores (9.51, 16.74), social relationships for 20.57 scores (16.12, 25.02), and environmental for 24.40 scores (21.45, 27.35). These results suggest that the NT program could enhance QoL in young and healthy participants following COVID-19 lockdown.

Introduction

In an effort to curb coronavirus disease 2019 (COVID-19) spread, governments across the world have adopted different public health policies (Nussbaumer-Streit et al., 2020), some of which have had an adverse impact on mental health and quality of life (QoL) (Battaglia et al., 2016; Ku et al., 2016; Bernard et al., 2018; Delle Fave et al., 2018; Nawrocka and Polechoński, 2019; Brooks et al., 2020). Extant study on mental health in the context of COVID-19 epidemic and government-imposed restrictions on movement and social contact indicate that such policies have had a detrimental effect on emotional and social functioning (Pfefferbaum and North, 2020) and mental health (Gunnell et al., 2020; Hossain et al., 2020), thus increasing the incidence of depression, anxiety, post-traumatic stress, anger, and confusion (Pieh et al., 2020), and risk of psychosocial strain (Ammar et al., 2021). Pandemics are also linked to a variety of sociopsychosocial stresses induced by quarantine and significant changes in daily routine, such as the limited potential for physical activity (PA) (Ammar et al., 2020; Carriedo et al., 2020; Maugeri et al., 2020; Pišot et al., 2020; Trabelsi et al., 2021; Schoofs et al., 2022). As during lockdown, PA levels decreased considerably in the most population groups (among young people in particular), the resulting lifestyle that exacerbated these mental and physical health issues (Yanovski et al., 2000; Altena et al., 2020; Clay and Parker, 2020; Jiménez-Pavón et al., 2020). COVID-19 confinement has made it difficult to comply with the WHO guidelines stipulating 150 min of moderate-to-mild PA per week or 75 min of intensive PA per week (World Health Organization, 2020). Consequently, given the well-established link between a low-level PA lifestyle and mental health and, thus, QoL, it is important to investigate if these adverse impacts can be reversed by a short-term training program.

Previous studies on this topic indicate that exercise and physical training have a significant positive impact on QoL (Spirduso and Cronin, 2001; de Vreede et al., 2007). Similarly, ample body of evidence confirms that different depression symptoms are inversely correlated with physical fitness (Galper et al., 2006; Tolmunen et al., 2006; Valtonen et al., 2009). More recently, Becofsky et al. (2015) reported that lack of fitness is more strongly linked to the risk of depression than being overweight.

Indirect and direct benefits of PA and exercise for physical health and overall well-being are well-known (Stathi et al., 2002; Lehnert et al., 2012). Nonetheless, in the last few decades, there has been a growing interest in the effects of exercise or PA interventions on mental health and QoL dimensions (Becofsky et al., 2015). The results obtained by Khosravi (2020) suggest that regular PA can help to minimize the risk of developing mental health issues (namely, depression, anxiety, and stress), while findings published by Sui et al. (2009) and Kandola et al. (2019) indicate that being physically active might help to avoid symptoms of depression. Following a randomized controlled experiment, Martin et al. (2009) similarly concluded that there was a substantial and positive association between the quantity of PA and improvements in physical and mental health measured via QoL parameters. When the benefits of a 24-week resistance training program were investigated by McLafferty et al. (2004), most participants reported significant improvements in overall mood and marked reduction in anger, confusion, and mental tension, after completing the experimental program. More recently, it was reported that the intervention group was more satisfied with their health and QoL compared to the controls with improvement in body weight and body mass index (BMI) and the authors posited that these benefits of exercise could have contributed to QoL improvements (Colak and Baskan, 2020). Askari et al. (2020) adopted aerobic exercise intervention with the multidimensional approach in addition to normal care and found that this intervention was beneficial in alleviating different categories of depression (physical, emotional, and cognitive), while improving the participants’ psychological health and social interactions aspects of QoL. Several researchers have also explored the link between exercise intensity, type of exercise, and QoL domains. Low-intensity jogging, cycling, aerobic exercises, swimming, walking, and dancing have been shown to diminish depression and anxiety symptoms (Guszkowska, 2004). Stracciolini et al. (2020) and Su et al. (2021) similarly noted that participation in different sports activities can improve mental health and anxiety QoL scores. Moreover, findings from Slimani et al. (2020) study yielded that low-intensity PA can also help minimize the negative psychological effects of isolation. West et al. (2004) and Nguyen et al. (2021) concurred with this view and proposed alternative PA programs like Hatha yoga, unsupervised exercise, and African dancing as a means of improving psychological and mental health, suggesting that such activities should be promoted to enhance QoL.

As most of the aforementioned studies were conducted on samples drawn from the general population, it is important to investigate the link between PA and QoL in young and healthy individuals. As to the best of the authors’ knowledge, the effects of complex neuromuscular training (NT) in this cohort have never been investigated, especially in the context of COVID-19 lockdown, these gaps are addressed in this study. Therefore, this study aimed to determine the effects of 8-week NT on four QoL dimensions in a group of untrained healthy young individuals after COVID-19 lockdown with the hypothesis that an 8-week intervention consisting of three NT exercise sessions per week should result in significant increases in psychological dimensions and QoL.

Materials and Methods

Study Design and Procedures

This randomized control study evaluated the effects of an 8-week experimental training program on quality of life of faculty of sport and physical education students at the University of Novi Sad, Serbia. The initial and final evaluations were performed on the 2 days preceding and following the 2 months intervention period, respectively. Participants performed a 2-months neuromuscular training (NT) intervention program with dynamic neuromuscular stabilization (DNS) protocol and whole-body vibration training (WBVT), while the control group (CG) did not exercise or use any training intervention or other habitual training during 8 weeks. Experimental programs were valid when the participants finished at least 80% of all the training sessions. To guarantee the quality and correct execution of training protocols, professional coaches and researchers supervised all the training programs.

Participants

A gender-balanced group of 90 healthy young participants (age 24.02 ± 2.07 years; height 174.98 ± 8.98 cm; and weight 68.16 ± 12.28 kg) was enrolled in this study. Exclusion criteria were: (i) history of neurological or musculoskeletal disorders; (ii) clinical conditions that could impair balance; (iii) a regular PA practice during lockdown; and (iv) using drugs, alcohol, and other substances. The study sample was randomly divided into the NT group (n = 47) and the CG group (n = 43). At baseline no significant differences (p > 0.05) were found between the groups in age, height, weight, and BMI (Table 1). Each subject, after explanation of the experimental protocol, provided a written informed consent before participating in this study, in accordance with the Declaration of Helsinki and approved by the Novi Sad University Human Research Ethics Committee (ethical approval number: 234/2020). The flow diagram of participants through this study is given in Figure 1.

TABLE 1
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Table 1. Characteristics of participants.

FIGURE 1
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Figure 1. Flow diagram of participant enrollment, allocation, and analysis.

Measures

Quality of Life

In this study, QoL was assessed using the short form of the WHOQOL-BREF questionnaire (World Health Organization, 1998) comprising of 26 items pertaining to four domains: physical health, psychological health, social relations, and the environment. Each item was rated by the respondents on a five-point Likert scale (1—Not at all; 2—A little; 3—A moderate amount; 4—Very much; and 5—An extreme amount). As the WHOQOL-BREF reliability and validity have been confirmed in prior study (Kalfoss et al., 2021), it was adopted in this study without further evaluations or modifications.

Training Intervention

In Serbia, the first case of COVID-19-positive patient was reported on 6 March 2020 and national authorities declared a state of emergency on 15 March 2020 to keep people at home, minimizing physical contacts, namely, restrictions of closing universities, schools, fitness centers, sports facilities, parks, and entertainment centers. In different periods during March, April, and May, restrictions were applied by the official complete ban from leaving homes for all the age groups. According to the national lockdown strategy, most of the restrictions were finished by the end of May 2020 (Vuković et al., 2021) when the research training program was started.

During the 2 months, participants’ training consisted of 3 weekly training sessions. The protocol consisted of a 50-min exercises program with a warm-up and cool-down period per training session. The structural core of training included 20 min of DNS training and a 20-min WBVT. Both protocols were designed in line with the previous research and training recommendations. Exercises in WBVT were performed on Power Plate Next Generation vibration platform (Power Plate North America, Chicago, Illinois, United States). The program consisted of 6–8 exercises (static and dynamic) for balance and postural stability (PS). Exercise progressively increases by the level of difficulty. During the training process, the frequency was also increased in range from 20 to 35 Hz in the last week of the experiment (1.8 Hz increase per week); duration of exercise ranged from 20 to 60 s (5 s increase per week) followed by 1-min seated rest. Resting periods between sets were constant from the start to the end of the training process. Basic principles and the procedures were adapted from previous research (Torvinen et al., 2002; Jordan et al., 2005; Fort et al., 2012; Piecha et al., 2014). WBVT followed by a 20-min period of DNS training including specific movement exercises according to the DNS approach accompanied by breathing exercises and in line with principles from previous studies (Frank et al., 2013; Mahdieh et al., 2020). To ensure that each exercise was executed correctly, participants were supervised by the coaches and the research team. The control group did not participate in any exercise, training, or sport-specific program during the 8-week experiment.

Data Analysis

G*power 3.1 power analysis software (Heinrich-Heine-University, Düsseldorf, Germany) determined the minimum total sample size (n = 50) given the critical F = 4.04, an effect size f = 0.20 (partial η2 = 0.04), p = 0.05, 1 – β = 0.80, groups and time points = 2, and correlation among the measurements = 0.50. Data are presented as mean and 95% CIs unless otherwise stated. A t-test for independent samples tested whether the baseline study outcomes differed among the groups. A 2 (pretest vs. post-test) × 2(NT vs. CG) mixed ANOVA model evaluated the 8-week effects of neuromuscular training on the QoL domains (physical, psychological, social relationships, and environmental). The Kolmogorov–Smirnov test confirmed normality of residuals, and the Levene’s and Box’s tests accepted the homogeneity of the variances and covariance matrices, respectively. We inspected whether mean changes (95% CI) from initial to final testing in each QoL domain significantly depended on whether subjects completed NT or not using a time*group interaction effect. Given a significant time*group interaction effect, the simple main effects of time followed (post-hoc) which tested the significance of mean changes [95% CI] from initial to final testing within the groups with a Bonferroni adjusted p values and 95% CIs. Partial eta squared (partial η2) is reported as the effect size measure for the interaction effects and classified as small (0.01), moderate (0.06), and large (0.14) (Cohen, 2013). The Hedges’s gav with 95% CIs designated the size of simple main effect of time and interpreted as small (± 0.20), moderate (± 0.50), and large (± 0.8). The level of significance was set at p ≤ 0.05. All the statistical analyses were performed with the SPSS statistical software (SPSS 23.0, IBM Incorporation, Chicago, Illinois, United States).

Results

Baseline values of physical (p = 0.47), psychological (p = 0.47), social relationships (p = 0.74), and environmental (p = 0.61) QoL domains were similar across the groups (Table 2). Both the groups achieved, on average, similar levels of QoL.

TABLE 2
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Table 2. Baseline values of outcomes for neuromuscular training (NT) group (n = 47) and control group (CG) (n = 43).

The 8-week-mean changes of all the QoL domains significantly differed between the NT group and CG to a large extent [physical: F(1,88) = 16.19, p < 0.001, partial η2 = 0.16; psychological: F(1,88) = 32.21, p < 0.001, partial η2 = 0.27; social relationships: F(1,88) = 76.45, p < 0.001, partial η2 = 0.47; and environmental: F(1,88) = 151.57, p < 0.001, partial η2 = 0.63]. On average, the NT group significantly and substantially improved all QoL domains [mean change (95% CI)], physical for 12.78 scores (8.89, 16.64), psychological for 13.12 scores (9.51, 16.74), social relationships for 20.57 scores (16.12, 25.02), and environmental for 24.40 scores (21.45, 27.35). In CG, no significant mean changes, however, were observed in any QoL domains after 8 weeks (p > 0.05), except mean scores for social relationships QoL domain which significantly lowered for −7.75 scores (−12.40, −3.10) to a moderate extent. Figure 2 illustrates the comparison of effect sizes for 8-week-mean changes within the groups and the space above the green line presents large improvements.

FIGURE 2
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Figure 2. Effect sizes with 95% CIs (Hedges’s gav) for pre-post changes of Physical, Psychological, Social Relationships, Environmental QoL domains in the NT and CG.

Discussion

The purpose of this study focusing on a group of healthy young individuals was to determine the effects of 8-week NT administered after COVID-19 lockdown on all the four QoL dimensions. Baseline results confirmed previous studies that indicate a low level of mental and psychological domains in people during COVID-19 lockdowns (Bonichini and Tremolada, 2021; Epifanio et al., 2021; Ferreira et al., 2021). Analysis of their results and comparison with the control group revealed that participation in the NT program could lead to QoL enhancement in young healthy participants. These results also concur with the findings reported in extant literature focusing on the link between PA and QoL in the general population (Stracciolini et al., 2020; Su et al., 2021) and specifically during COVID-19 (Slimani et al., 2020).

Dynamic neuromuscular stabilization and vibration training present a multidimensional approach that combines different breathing, core strength, and stabilization exercises with specific exercises performed on a vibration platform. Even though they adopted a different methodology, both Prem et al. (2013) and Montoro et al. (2018) noted that diaphragmatic breathing exercise and vibration training could improve QoL in both the short term and long term. Similarly, Guszkowska (2004) and Slimani et al. (2020) observed that even moderate exercise (as was the case in our study) can lead to marked improvements in QoL.

In this respect, this study provides a modest contribution to the ongoing discussions about the side effects of COVID-19 lockdown on QoL and its specific domains, indicating that NT could lead to improvement in QoL parameters and minimal negative mental health consequences in circumstances similar to the pandemic. Given the well-established link between PA (whether as a part of an exercise program or a generally active lifestyle) and QoL dimensions, namely, physical health (Battaglia et al., 2016; Nawrocka et al., 2019) mental wellness and psychological well-being (Bernard et al., 2018; Trabelsi and Ammar, 2021), environmental domain (Valenti et al., 2008; Ku et al., 2016), and emotions (Delle Fave et al., 2018), it is reasonable to assume that PA would be beneficial following a prolonged period of physical inactivity, as was the case during COVID-19 lockdown. This hypothesis was supported in this study, as an 8-week intervention consisting of just three NT exercise sessions per week resulted in significant increases in psychological dimensions and QoL. Thus, we argue that incorporating NT programs into daily lifestyle would be essential to support mental health in all populations, especially among young people, to combat the adverse effects of lifestyle caused by COVID-19 lockdown or circumstances similar to the pandemic. Furthermore, varied exercise routines should be customized to the participant’s fitness level, and a progressive strategy of intensity and workout volume should be used (Chtourou et al., 2020). In addition, main educational authorities should pay much more attention to providing enough knowledge and improving health literacy in conditions like COVID-19 lockdown (Geets Kesic et al., 2021).

When interpreting these findings, it is important to note some of the study limitations, including the relatively small sample size and the fact that the intervention was conducted after COVID-19 lockdown, during which all participants significantly reduced their PA levels. Nonetheless, as all our research subjects were young and healthy individuals, recruited from the same social setting, it is possible that the same intervention would yield different results in cohorts with different socioeconomic and demographic characteristics. Finally, we acknowledge that, since the participants were not asked to report on their activity levels outside of the study protocol, our results could be influenced by variations in their daily routine. However, those activities were not included organized, systematic, and planned PA. Therefore, including accelerometer, mobile application or wearable sensors in future studies would clarify the intervention-induced effects.

Conclusion

This study aimed to determine the effects of 8-week NT on four QoL dimensions in a group of untrained healthy young individuals after COVID-19 lockdown. Our findings indicate that, due to the beneficial effects of our intervention on all four QoL domains, the NT and different PAs should be considered for inclusion in public health policy to lessen the adverse effects of lockdown or situation similar to the pandemic.

Data Availability Statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

Ethics Statement

The studies involving human participants were reviewed and approved by Ethics Committee of the Faculty of Sport and Physical Education, University of Novi Sad Human Research Ethics Committee guidelines (ethical approval number: 234/2020). The participants provided their written informed consent to participate in this study.

Author Contributions

DMar and DMac: conceptualization, editing, and revision. DMac, DK, and DJ: methodology. DMad and GS: validation. DMac: formal analysis. DM and MS: investigation. DM and DK: writing—original draft preparation. ZG, DJ, VP, and AP: writing—review and editing. DM, GS, and DMad: supervision. ZG and DM: revision and correction of the manuscript. All authors have read and agreed to the published version of the manuscript.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

References

Altena, E., Baglioni, C., Espie, C. A., Ellis, J., Gavriloff, D., Holzinger, B., et al. (2020). Dealing with sleep problems during home confinement due to the COVID-19 outbreak: practical recommendations from a task force of the European CBT-I Academy. J. Sleep Res. 29, e13052. doi: 10.1111/jsr.13052

PubMed Abstract | CrossRef Full Text | Google Scholar

Ammar, A., Chtourou, H., Boukhris, O., Trabelsi, K., Masmoudi, L., Brach, M., et al. (2020). COVID-19 home confinement negatively impacts social participation and life satisfaction: a worldwide multicenter study. Int. J. Environ. Res. Public Health 17:6237. doi: 10.3390/ijerph17176237

PubMed Abstract | CrossRef Full Text | Google Scholar

Ammar, A., Trabelsi, K., Brach, M., Chtourou, H., Boukhris, O., Masmoudi, L., et al. (2021). Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study. Biol. Sport 38, 9–21. doi: 10.5114/biolsport.2020.96857

PubMed Abstract | CrossRef Full Text | Google Scholar

Askari, J., Saberi-Kakhki, A., Taheri, H., Yassini, S. M., and Hassanbeigi, A. (2020). The effect of aerobic exercise on various symptoms of depression: the mediating role of quality of life. Sport Sci. Health 16, 273–280. doi: 10.1007/s11332-019-00601-w

CrossRef Full Text | Google Scholar

Battaglia, G., Bellafiore, M., Alesi, M., Paoli, A., Bianco, A., and Palma, A. (2016). Effects of an adapted physical activity program on psychophysical health in elderly women. Clin. Interv. Aging 11, 1009–1015. doi: 10.2147/cia.s109591

PubMed Abstract | CrossRef Full Text | Google Scholar

Becofsky, K. M., Sui, X., Lee, D. C., Wilcox, S., Zhang, J., and Blair, S. N. (2015). A prospective study of fitness, fatness, and depressive symptoms. Am. J. Epidemiol. 181, 311–320. doi: 10.1093/aje/kwu330

PubMed Abstract | CrossRef Full Text | Google Scholar

Bernard, P., Doré, I., Romain, A.-J., Hains-Monfette, G., Kingsbury, C., and Sabiston, C. (2018). Dose response association of objective physical activity with mental health in a representative national sample of adults: A cross-sectional study. PLoS One 13:e0204682. doi: 10.1371/journal.pone.0204682

PubMed Abstract | CrossRef Full Text | Google Scholar

Bonichini, S., and Tremolada, M. (2021). Quality of life and symptoms of PTSD during the COVID-19 Lockdown in Italy. Int. J. Environ. Res. Public Health 18:385. doi: 10.3390/ijerph18084385

PubMed Abstract | CrossRef Full Text | Google Scholar

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., et al. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 395, 912–920. doi: 10.1016/s0140-6736(20)30460-8

CrossRef Full Text | Google Scholar

Carriedo, A., Cecchini, J. A., Fernandez-Rio, J., and Méndez-Giménez, A. (2020). COVID-19, psychological well-being and physical activity levels in older adults during the nationwide lockdown in spain. Am. J. Geriatr. Psychiatry 28, 1146–1155. doi: 10.1016/j.jagp.2020.08.007

PubMed Abstract | CrossRef Full Text | Google Scholar

Chtourou, H., Trabelsi, K., H’mida, C., Boukhris, O., Glenn, J. M., Brach, M., et al. (2020). Staying physically active during the quarantine and self-isolation period for controlling and mitigating the COVID-19 pandemic: a systematic overview of the literature. Front. Psychol. 11:708. doi: 10.3389/fpsyg.2020.01708

PubMed Abstract | CrossRef Full Text | Google Scholar

Clay, J. M., and Parker, M. O. (2020). Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? Lancet Public Health 5:e259. doi: 10.1016/S2468-2667(20)30088-8

CrossRef Full Text | Google Scholar

Cohen, J. (2013). Statistical power analysis for the behavioral sciences. Cambridge: Academic press.

Google Scholar

Colak, H., and Baskan, A. H. (2020). The effect of exercise on quality of life in middle-aged individuals. Int. J. Appl. Exerc. Physiol. 9, 253–258.

Google Scholar

de Vreede, P. L., van Meeteren, N. L., Samson, M. M., Wittink, H. M., Duursma, S. A., and Verhaar, H. J. (2007). The effect of functional tasks exercise and resistance exercise on health-related quality of life and physical activity. A randomised controlled trial. Gerontology 53, 12–20. doi: 10.1159/000095387

PubMed Abstract | CrossRef Full Text | Google Scholar

Delle Fave, A., Bassi, M., Boccaletti, E. S., Roncaglione, C., Bernardelli, G., and Mari, D. (2018). Promoting well-being in old age: the psychological benefits of two training programs of adapted physical activity. Front. Psychol. 9:828. doi: 10.3389/fpsyg.2018.00828

PubMed Abstract | CrossRef Full Text | Google Scholar

Epifanio, M. S., Andrei, F., Mancini, G., Agostini, F., Piombo, M. A., Spicuzza, V., et al. (2021). The Impact of COVID-19 pandemic and lockdown measures on quality of life among italian general population. J. Clin. Med. 10:289. doi: 10.3390/jcm10020289

PubMed Abstract | CrossRef Full Text | Google Scholar

Ferreira, L. N., Pereira, L. N., Bras, M. D., and Ilchuk, K. (2021). Quality of life under the COVID-19 quarantine. Qual. Life Res. 30, 1389–1405. doi: 10.1007/s11136-020-02724-x

PubMed Abstract | CrossRef Full Text | Google Scholar

Fort, A., Romero, D., Bagur, C., and Guerra, M. (2012). Effects of whole-body vibration training on explosive strength and postural control in young female athletes. J. Streng. Cond. Res. 26, 926–936. doi: 10.1519/JSC.0b013e31822e02a5

PubMed Abstract | CrossRef Full Text | Google Scholar

Frank, C., Kobesova, A., and Kolar, P. (2013). Dynamic neuromuscular stabilization & sports rehabilitation. Int. J. Sports Phys. Ther. 8, 62–73.

Google Scholar

Galper, D. I., Trivedi, M. H., Barlow, C. E., Dunn, A. L., and Kampert, J. B. (2006). Inverse association between physical inactivity and mental health in men and women. Med. Sci. Sports Exerc. 38, 173–178. doi: 10.1249/01.mss.0000180883.32116.28

PubMed Abstract | CrossRef Full Text | Google Scholar

Geets Kesic, M., Gilic, B., Cerkez Zovko, I., Drid, P., Korovljev, D., and Sekulic, D. (2021). Differential impact of COVID-19 lockdown on physical activity in younger and older adolescents – prospective study. Medycyna Pracy. 72, 633–643. doi: 10.13075/mp.5893.01180

PubMed Abstract | CrossRef Full Text | Google Scholar

Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., et al. (2020). Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry 7, 468–471. doi: 10.1016/s2215-0366(20)30171-1

CrossRef Full Text | Google Scholar

Guszkowska, M. (2004). Effects of exercise on anxiety, depression and mood. Psychiatr. Pol. 38, 611–620.

PubMed Abstract | Google Scholar

Hossain, M. M., Sultana, A., and Purohit, N. (2020). Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence. Epidemiol. Health 42:e2020038. doi: 10.4178/epih.e2020038

PubMed Abstract | CrossRef Full Text | Google Scholar

Jiménez-Pavón, D., Carbonell-Baeza, A., and Lavie, C. J. (2020). Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog. Cardiovasc. Dis. 63, 386–388. doi: 10.1016/j.pcad.2020.03.009

PubMed Abstract | CrossRef Full Text | Google Scholar

Jordan, M. J., Norris, S. R., Smith, D. J., and Herzog, W. (2005). Vibration training: an overview of the area, training consequences, and future considerations. J. Streng. Cond. Res. 19, 459–466. doi: 10.1519/13293.1

PubMed Abstract | CrossRef Full Text | Google Scholar

Kalfoss, M. H., Reidunsdatter, R. J., Klöckner, C. A., and Nilsen, M. (2021). Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population. Health Qual. Life Outcom. 19:13. doi: 10.1186/s12955-020-01656-x

PubMed Abstract | CrossRef Full Text | Google Scholar

Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., and Stubbs, B. (2019). Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity. Neurosci. Biobehav. Rev. 107, 525–539. doi: 10.1016/j.neubiorev.2019.09.040

PubMed Abstract | CrossRef Full Text | Google Scholar

Khosravi, M. (2020). COVID-19 quarantine: two-way interaction between physical activity and mental health. Eur. J. Transl. Myol. 30:9509. doi: 10.4081/ejtm.2020.9509

PubMed Abstract | CrossRef Full Text | Google Scholar

Ku, P. W., Fox, K. R., Liao, Y., Sun, W. J., and Chen, L. J. (2016). Prospective associations of objectively assessed physical activity at different intensities with subjective well-being in older adults. Qual. Life Res. 25, 2909–2919. doi: 10.1007/s11136-016-1309-3

PubMed Abstract | CrossRef Full Text | Google Scholar

Lehnert, K., Sudeck, G., and Conzelmann, A. (2012). Subjective well-being and exercise in the second half of life: a critical review of theoretical approaches. Eur. Rev. Aging Phys. Act 9, 87–102. doi: 10.1007/s11556-012-0095-3

CrossRef Full Text | Google Scholar

Mahdieh, L., Zolaktaf, V., and Karimi, M. T. (2020). Effects of dynamic neuromuscular stabilization (DNS) training on functional movements. Hum. Mov. Sci. 70:102568. doi: 10.1016/j.humov.2019.102568

PubMed Abstract | CrossRef Full Text | Google Scholar

Martin, C. K., Church, T. S., Thompson, A. M., Earnest, C. P., and Blair, S. N. (2009). Exercise dose and quality of life: a randomized controlled trial. Arch. Intern. Med. 169, 269–278. doi: 10.1001/archinternmed.2008.545

PubMed Abstract | CrossRef Full Text | Google Scholar

Maugeri, G., Castrogiovanni, P., Battaglia, G., Pippi, R., D’Agata, V., Palma, A., et al. (2020). The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon 6:e04315. doi: 10.1016/j.heliyon.2020.e04315

PubMed Abstract | CrossRef Full Text | Google Scholar

McLafferty, C. L. Jr., Wetzstein, C. J., and Hunter, G. R. (2004). Resistance training is associated with improved mood in healthy older adults. Percept. Mot. Skills 98, 947–957. doi: 10.2466/pms.98.3.947-957

PubMed Abstract | CrossRef Full Text | Google Scholar

Montoro, M. V. P., Montilla, J. A. P., Checa, M. A., and Aguilera, E. D. L. (2018). Influence of vibration training on pain and quality of life in women older than 65 years old. Rev de Psicol del Deporte 27, 133–140.

Google Scholar

Nawrocka, A., and Polechoński, J. (2019). Functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity. Int. J. Environ. Res. Public Health 16:972. doi: 10.3390/ijerph16060972

PubMed Abstract | CrossRef Full Text | Google Scholar

Nawrocka, A., Polechoński, J., Garbaciak, W., and Mynarski, W. (2019). Functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity. Int. J. Environ. Res. 16:972. doi: 10.3390/ijerph16060972

PubMed Abstract | CrossRef Full Text | Google Scholar

Nguyen, T. M., Nguyen, V. H., and Kim, J. H. (2021). Physical exercise and health-related quality of life in office workers: a systematic review and meta-analysis. Int. J. Environ. Res. 18:3791. doi: 10.3390/ijerph18073791

PubMed Abstract | CrossRef Full Text | Google Scholar

Nussbaumer-Streit, B., Mayr, V., Dobrescu, A. I., Chapman, A., Persad, E., Klerings, I., et al. (2020). Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst. Rev. 4:13574. doi: 10.1002/14651858.cd013574

PubMed Abstract | CrossRef Full Text | Google Scholar

Pfefferbaum, B., and North, C. S. (2020). Mental health and the Covid-19 Pandemic. N. Engl. J. Med. 383, 510–512. doi: 10.1056/NEJMp2008017

PubMed Abstract | CrossRef Full Text | Google Scholar

Piecha, M., Juras, G., Krol, P., Sobota, G., Polak, A., and Bacik, B. (2014). The effect of a short-term and long-term whole-body vibration in healthy men upon the postural stability. PLoS One 9:88295. doi: 10.1371/journal.pone.0088295

PubMed Abstract | CrossRef Full Text | Google Scholar

Pieh, C., Budimir, S., and Probst, T. (2020). The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. J. Psychosom. Res. 136:110186. doi: 10.1016/j.jpsychores.2020.110186

PubMed Abstract | CrossRef Full Text | Google Scholar

Pišot, S., Milovanović, I., Šimunič, B., Gentile, A., Bosnar, K., Prot, F., et al. (2020). Maintaining everyday life praxis in the time of COVID-19 pandemic measures (ELP-COVID-19 survey). Eur. J. Public Health 30, 1181–1186. doi: 10.1093/eurpub/ckaa157

PubMed Abstract | CrossRef Full Text | Google Scholar

Prem, V., Sahoo, R. C., and Adhikari, P. (2013). Effect of diaphragmatic breathing exercise on quality of life in subjects with asthma: a systematic review. Physiother. Theory Pract. 29, 271–277. doi: 10.3109/09593985.2012.731626

PubMed Abstract | CrossRef Full Text | Google Scholar

Schoofs, M. C. A., Bakker, E. A., de Vries, F., Hartman, Y. A. W., Spoelder, M., Thijssen, D. H. J., et al. (2022). Impact of Dutch COVID-19 restrictive policy measures on physical activity behavior and identification of correlates of physical activity changes: a cohort study. BMC Public Health 22:147. doi: 10.1186/s12889-022-12560-y

PubMed Abstract | CrossRef Full Text | Google Scholar

Slimani, M., Paravlic, A., Mbarek, F., Bragazzi, N. L., and Tod, D. (2020). The relationship between physical activity and quality of life during the confinement induced by COVID-19 outbreak: a pilot study in tunisia. Front. Psychol. 11:1882. doi: 10.3389/fpsyg.2020.01882

PubMed Abstract | CrossRef Full Text | Google Scholar

Spirduso, W. W., and Cronin, D. L. (2001). Exercise dose-response effects on quality of life and independent living in older adults. Med. Sci. Sports Exerc. 33, 598–608. doi: 10.1097/00005768-200106001-00028

PubMed Abstract | CrossRef Full Text | Google Scholar

Stathi, A., Fox, K. R., and McKenna, J. (2002). Physical activity and dimensions of subjective well-being in older adults. J. Aging Phys. Act 10, 76–92. doi: 10.1123/japa.10.1.76

CrossRef Full Text | Google Scholar

Stracciolini, A., Amar-Dolan, L., Howell, D. R., Alex, T., Berkner, P., Sandstrom, N. J., et al. (2020). Female sport participation effect on long-term health-related quality of life. Clin. J. Sport Med. 30, 526–532. doi: 10.1097/jsm.0000000000000645

PubMed Abstract | CrossRef Full Text | Google Scholar

Su, K. X., Jung, W., Zhang, G. F., and Zhao, N. N. (2021). The effect of physical fitness to change human health and improve the quality of life. Rev. Bras. Med. Esporte. 27, 319–322. doi: 10.1590/1517-8692202127032021_0095

CrossRef Full Text | Google Scholar

Sui, X., Laditka, J. N., Church, T. S., Hardin, J. W., Chase, N., Davis, K., et al. (2009). Prospective study of cardiorespiratory fitness and depressive symptoms in women and men. J. Psychiatr. Res. 43, 546–552. doi: 10.1016/j.jpsychires.2008.08.002

PubMed Abstract | CrossRef Full Text | Google Scholar

Tolmunen, T., Laukkanen, J. A., Hintikka, J., Kurl, S., Viinamäki, H., Salonen, R., et al. (2006). Low maximal oxygen uptake is associated with elevated depressive symptoms in middle-aged men. Eur. J. Epidemiol. 21, 701–706. doi: 10.1007/s10654-006-9038-5

PubMed Abstract | CrossRef Full Text | Google Scholar

Torvinen, S., Kannus, P., Sievänen, H., Järvinen, T. A., Pasanen, M., Kontulainen, S., et al. (2002). Effect of four-month vertical whole body vibration on performance and balance. Med. Sci. Sports Exerc. 34, 1523–1528. doi: 10.1097/00005768-200209000-00020

PubMed Abstract | CrossRef Full Text | Google Scholar

Trabelsi, K., and Ammar, A. (2021). Sleep quality and physical activity as predictors of mental wellbeing variance in older adults during COVID-19 Lockdown: ECLB COVID-19 international online survey. Int. J. Environ. Res. Public Health 18:4329. doi: 10.3390/ijerph18084329

PubMed Abstract | CrossRef Full Text | Google Scholar

Trabelsi, K., Ammar, A., Masmoudi, L., Boukhris, O., Chtourou, H., Bouaziz, B., et al. (2021). Globally altered sleep patterns and physical activity levels by confinement in 5056 individuals: ECLB COVID-19 international online survey. Biol. Sport 38, 495–506. doi: 10.5114/biolsport.2021.101605

PubMed Abstract | CrossRef Full Text | Google Scholar

Valenti, M., Porzio, G., Aielli, F., Verna, L., Cannita, K., Manno, R., et al. (2008). Physical exercise and quality of life in breast cancer survivors. Int. J. Med. Sci. 5, 24–28. doi: 10.7150/ijms.5.24

PubMed Abstract | CrossRef Full Text | Google Scholar

Valtonen, M., Laaksonen, D. E., Laukkanen, J., Tolmunen, T., Rauramaa, R., Viinamäki, H., et al. (2009). Leisure-time physical activity, cardiorespiratory fitness and feelings of hopelessness in men. BMC Public Health 9:204. doi: 10.1186/1471-2458-9-204

PubMed Abstract | CrossRef Full Text | Google Scholar

Vuković, J., Matić, R. M., Milovanović, I. M., Maksimović, N., Krivokapić, D., and Pišot, S. (2021). Children’s daily routine response to COVID-19 emergency measures in serbia. Front. Pediatr. 9:6813. doi: 10.3389/fped.2021.656813

PubMed Abstract | CrossRef Full Text | Google Scholar

West, J., Otte, C., Geher, K., Johnson, J., and Mohr, D. C. (2004). Effects of Hatha yoga and African dance on perceived stress, affect, and salivary cortisol. Ann. Behav. Med. 28, 114–118. doi: 10.1207/s15324796abm2802_6

PubMed Abstract | CrossRef Full Text | Google Scholar

World Health Organization (1998). Programme on mental health : WHOQOL user manual”. 2012 revision ed. Geneva: World Health Organization.

Google Scholar

World Health Organization (2020). WHO guidelines on physical activity and sedentary behaviour: at a glance. Geneva: World Health Organization.

Google Scholar

Yanovski, J. A., Yanovski, S. Z., Sovik, K. N., Nguyen, T. T., O’Neil, P. M., and Sebring, N. G. (2000). A prospective study of holiday weight gain. N. Engl. J. Med. 342, 861–867. doi: 10.1056/nejm200003233421206

PubMed Abstract | CrossRef Full Text | Google Scholar

Keywords: COVID-19, exercise, well-being, neuromuscular training, quality of life

Citation: Marinkovic D, Macak D, Madic DM, Sporis G, Kuvacic D, Jasic D, Petric V, Spehnjak M, Projovic A and Gojkovic Z (2022) Effect of Neuromuscular Training Program on Quality of Life After COVID-19 Lockdown Among Young Healthy Participants: A Randomized Controlled Trial. Front. Psychol. 13:844678. doi: 10.3389/fpsyg.2022.844678

Received: 28 December 2021; Accepted: 04 March 2022;
Published: 12 April 2022.

Edited by:

Petar M. Mitic, University of Niš, Serbia

Reviewed by:

Rui Matos, Quality of Life Research Center (CIEQV), Portugal
Hamdi Chtourou, University of Sfax, Tunisia
Goran Kuvačić, University of Split, Croatia

Copyright © 2022 Marinkovic, Macak, Madic, Sporis, Kuvacic, Jasic, Petric, Spehnjak, Projovic and Gojkovic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Dragan Marinkovic, marinkovic@uns.ac.rs

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