The COVID-19 pandemic, declared in March 2020, led to widespread lockdowns and restrictions globally. These measures significantly altered daily life, impacting physical activity (PA), sedentary behavior (SB), and sleep, collectively known as 24-hour movement behaviors. Studies have documented substantial decreases in PA and increases in SB during this period, along with changes in sleep patterns. Given the interconnectedness of these behaviors, integrating their study is crucial for effective health promotion. The 24HMG provides a framework for this integrated approach, offering quantifiable recommendations for PA, SB, and sleep. While pre-pandemic research using the 24HMG examined prevalence, secular trends, correlates, and health outcomes, limited research explored these aspects during the pandemic. Existing studies indicated a lower prevalence of meeting the 24HMG during the pandemic compared to before, but a comprehensive synthesis of this evidence was lacking. This review aimed to address this gap by systematically synthesizing the evidence from studies utilizing the 24HMG during the COVID-19 pandemic, focusing on prevalence changes and associated factors.

The introduction adequately cites prior research demonstrating the impact of the COVID-19 pandemic on physical activity, sedentary behavior, and sleep. It highlights the importance of the 24-Hour Movement Guidelines (24HMG) as an integrative framework for studying these behaviors. The review mentions existing research using the 24HMG both before and during the pandemic but points to the absence of a comprehensive synthesis of the pandemic-era findings, justifying the current study's purpose.

This systematic scoping review followed the PRISMA guidelines. Three electronic databases (Web of Science, PubMed, and EBSCO) were searched from January 2020 to November 30, 2022, using keywords related to 24-hour movement behaviors, sleep, physical activity, guidelines, and COVID-19. Inclusion criteria specified studies published between January 2020 and November 30, 2022, involving human participants (including those with disabilities), reporting combined 24-hour movement behaviors using the guidelines (PA, SB, and sleep), focusing on populations during the pandemic, and written in English. Exclusion criteria included duplicates, case studies, dissertations, conference papers, reviews, qualitative studies, and studies not reporting the percentage adherence to the 24HMG. Two authors independently screened titles/abstracts and full-text articles, with a third author resolving discrepancies. Data extraction included study characteristics (population, design, measurement), which were categorized according to the VIRTUE epidemiology framework (composition, determinants, health outcomes). Studies were coded based on the changes in meeting the 24HMG (significant decrease, non-significant decrease, non-significant increase, no change).

The review included 16 studies, predominantly focusing on children and adolescents (in total 15 studies) from various countries, mostly in the West. The majority (62.5%) employed cross-sectional designs. Most studies (76.5%) reported a prevalence of meeting the 24HMG below 5% during the pandemic, significantly lower than pre-pandemic levels. Eight studies reported a decreased percentage of the population meeting the 24HMG, with half showing a statistically significant decrease. In terms of correlates, most studies concentrated on sociodemographic factors, with fewer exploring social, cultural, or environmental aspects. Two studies examined the association between 24-hour movement behaviors and mental health. The findings suggest that the prevalence of meeting the 24HMG was very low (mostly below 5%) during the COVID-19 pandemic in children and adolescents, and it significantly decreased compared with the prevalence before the COVID-19 pandemic.

The low prevalence of meeting the 24HMG during the pandemic, especially among children and adolescents, aligns with previous research showing decreased PA, increased SB, and disrupted sleep during lockdowns. The reliance on cross-sectional studies limits the ability to definitively establish causal relationships. The overrepresentation of Western countries and children/adolescents as study populations suggests potential research biases. The dominance of sociodemographic factors in examining correlates reflects ease of data collection rather than a complete understanding of the influencing factors. Future research should employ longitudinal designs, incorporate diverse populations, and explore a broader range of correlates, including social, cultural, and environmental factors, to better understand the complex interplay between 24HMG adherence and various determinants.

This review highlights the negative impact of the COVID-19 pandemic on 24-hour movement behaviors, particularly among children and adolescents. The low prevalence of meeting the 24HMG during the pandemic underscores the need for interventions to promote healthy movement behaviors. Future research should address the identified limitations, utilizing longitudinal studies, diverse populations, and broader range of factors to inform effective public health strategies.

The limited number of studies using the 24HMG during the pandemic, the predominance of cross-sectional designs, the geographic and age-group biases, and the focus on sociodemographic factors as correlates are significant limitations. The inclusion of only English-language studies from three databases might have led to publication bias. The lack of consideration for specific COVID-19 policies in the analysis represents another limitation. Future research should address these gaps.