Effect of Physical Activity on Anxiety Due to Corona-Virus Outbreak and Cognitive Function in Adolescent Girls

Background and Purpose
One of the recent global crises that impacted everyone was the spread of the coronavirus (COVID-19). Emerging in December 2019, COVID-19 is an infectious disease that has caused millions of deaths worldwide. Research indicates that during epidemics, many individuals experience stress or anxiety responses stemming from fears of infection (Taylor, 2019). Factors such as the uncertain nature of the coronavirus and its treatment methods, constant exposure to information about the disease and its impacts, reduced social interactions, and recommendations or restrictions like staying at home as much as possible, could negatively affect people's mental health. While behavioral measures such as quarantine and social distancing proved effective in preventing and slowing the transmission of the COVID-19 virus,
contributing positively to physical health in various countries, they were unable to mitigate the psychological and cognitive consequences of the pandemic.  Research evidence demonstrates that exercise enhances mental health by reducing anxiety, depression, negative mood, and improving cognitive function.  The ability of physical activity to improve both physical and mental health is well-supported by numerous studies. However, the lack of sufficient research on the effect of physical activity on anxiety during the COVID-19 quarantine led to its underuse as a strategy for reducing anxiety during this period.  Therefore, the present study aimed to investigate whether physical activity has an impact on the level of anxiety caused by COVID-19 and on the cognitive function of adolescent girls.
 Materials and Methods
The current research is applied and descriptive- ex post facto in nature. Data collection was conducted online through a questionnaire and a test. A total of 232 female students, aged 13-15, from Ershad First High School in Shahre Ray, were selected using purposive and convenience sampling methods. The active group (n=116) regularly participated in physical activities during COVID-19 period, while the inactive group (n=116) did not participate in any regular physical activities during the same period due to health concerns.
The Corona Disease Anxiety Scale (Ali Pour et al., 2020) was administered online using Google Forms. This tool consists of 18 items and two components: psychological symptoms and physical symptoms. The reliability of the questionnaire was assessed using Cronbach's alpha, with values of α = 0.879 for the first factor, α = 0.861 for the second factor, and α = 0.919 for the entire questionnaire.
To measure cognitive performance, the classic Stroop test was conducted under web-based conditions. The Stroop test involved 96 color-word pairs, consisting of 48 incongruent pairs (where the color and word meaning differed) and 48 congruent pairs (where the color and word meaning were the same). The pairs were presented in four colors: green, yellow, red, and blue, with the display randomized on a gray background. Participants were required to quickly touch or click on the four colored squares, regardless of the word meaning, as quickly as possible.
The Shapiro-Wilk test was used to assess the normality of data distribution. The Mann-Whitney U test and independent t-test were employed to examine anxiety variables and cognitive performance between the active and inactive groups, with a significance level set at 0.05. Additionally, all statistical analyses were conducted using SPSS software version 24.
 Findings
A statistical description of the coronavirus anxiety variables and cognitive performance revealed that psycho-physical symptoms, the total coronavirus anxiety score, as well as interference reaction time and interference scores were lower in the active group compared to the inactive group. The results of the Mann-Whitney U test comparing coronavirus anxiety between the active and inactive groups showed a significant difference in total corona anxiety and its subscales between the two groups. The comparison of mean ranks across all three variables indicated that total corona anxiety (P = 0.001), the psychological symptoms component (P = 0.001), and the physical symptoms component (P = 0.001) were significantly lower in the active group than in the inactive group. The results of the Shapiro-Wilk and Levene's tests, which were conducted to check the normality of data distribution and the homogeneity of variances in cognitive performance, indicated that both hypotheses were confirmed. The results of the independent t-test revealed a significant difference in both the interference score and interference reaction time of the Stroop task between the active and inactive groups. The comparison of means showed that the interference score (P = 0.011) and the interference reaction time (P = 0.03) in the active group were significantly lower than those in the inactive group.
Conclusion
The aim of the present study was to assess the impact of physical activity on anxiety related to the coronavirus and on the cognitive performance of adolescent girls. The results showed that active adolescent girls exhibited significantly lower levels of corona anxiety compared to inactive group. Additionally, the active group demonstrated better cognitive performance in the Stroop task compared to the inactive group. The findings of the present research align with recent studies in this area. Research has shown that physical activity can reduce perceived psychological stress (Naeimi Kia & Gholami, 2020) and anxiety (Bagheri Sheykhangafshe et al., 2020) during the COVID-19 pandemic.The positive effects of physical activity and exercise on mood changes and anxiety reduction can be attributed to the secretion and regulation of hormones such as endorphins, as well as a decrease in cortisol secretion, the stress hormone (Yu et al., 2020). Regular exercise promotes improvements in cognitive functions such as information processing speed, working memory, control strategies, and planning. Dietrich's Transient Hypofrontality hypothesis suggests that moderate-intensity activity enhances cognitive performance by increasing the optimal level of physiological arousal. Samadi et al. (2019) stated that high-intensity aerobic physical activity can reduce cognitive function during and immediately after exercise. However, since the physical activity in the present study was of moderate intensity and the cognitive test was conducted after a period of time following the exercise, the findings align with the Transient Hypo frontality hypothesis.
Periods of isolation and quarantine, along with reduced access to daily needs, financial concerns, feelings of insecurity, and fear of
contagion, can all contribute to stress and mental anxiety. Studies have shown that moderate-intensity exercise can mitigate the negative effects of stress and help maintain the functioning of the body's immune system, particularly during extended periods of quarantine. During the COVID-19 pandemic, social distancing measures were implemented to reduce the spread of the virus, which likely resulted in a significant decrease in physical activity. To minimize the long-term consequences of inactivity and the effects of social isolation, adopting active living practices, such as exercising at home, became essential.
Ethical Considerations Compliance with ethical guidelines
The present study was conducted in accordance with ethical principles.
Funding
No specific funding was received for this study.
Authors’ contribution
All authors contributed equally to this study.
Conflict of interest
The authors declared no conflict of interest.
Acknowledgments
We would like to thank all those who helped us in this study.