The Role of Physical Therapists in Keeping Kids Active During the Covid-19 Pandemic (and beyond)

By: Jennifer Heiligman, PT, MPT

As the world navigates its way through the Covid-19 pandemic, an unforeseen consequence may be occurring.  The additional negative impact which may be overlooked is the potential rise in childhood obesity.  Extended school closures have caused children to lose the opportunity to participate in physical education classes, school and community based sports programs and other physical activities, including recess.  In addition, the stay at home orders resulted in the closures of public parks and playgrounds which took away additional opportunities for kids to be active.   The unfortunate result of these very necessary safety measures is a decrease in physical activity and an increase in sedentary behavior.

A study by Ruopeng An, “Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model”, published in the May 23rd Journal of Sport and Health Science, predicts the impact of the Covid-19 pandemic on childhood obesity.  The model predicts that if schools remain closed until the end of 2020, “by March 2021, about 1.27 million new childhood obesity cases will develop under the COVID-19 pandemic than otherwise.”   Childhood obesity is linked to adult obesity which, in turn, is a risk factor for other health problems including heart disease and diabetes. 

As the new school year is beginning, we are not certain what it will actually look like.  It will most likely be vastly different in different areas of the country.  Some schools will have in person classes, some will be online and some will be a hybrid model.  However, how many of them will actually include physical education classes?  With the requirements of social distancing, it may not be feasible for some districts.  For the online models, they may provide virtual gym class.  But, how often will that happen per week?  Will it be enough to make an impact?  Per the CDC, “children and adolescents ages 6 through 17 years should do 60 minutes (1 hour) or more of moderate-to-vigorous intensity physical activity each day, including daily aerobic – and activities that strengthen bones (like running or jumping) – 3 days each week, and that build muscles (like climbing or doing push-ups) – 3 days each week.”

This is our call to action! As therapists we have the knowledge and expertise to help these kids get moving. 

Depending on the regulations of your area, you may be able to offer socially distanced, in person wellness classes for kids, or you could even open them up to families.  If space allows, you could complete them in your clinic or find a nice outdoor space, weather permitting.  If it is still not safe to congregate in person, go virtual.  There are many platforms you could use including Zoom or Google Meet.  

Whether you are offering these classes in person or virtually, you can market these classes directly to the schools.  Work with the physical education teachers and the PTA to get the word out to the parents and the kids.  You may even be able to form a revenue share with the schools.  If doing the classes in-person, the school may be able to provide an aide to assist.  This would help you, as well as, offer an employment opportunity to someone whose working hours may have been decreased.  Take advantage of your current and past patient list.  If your EMR has the capability, like OptimisPT, you can send a mass email advertising this great opportunity.  You will probably be surprised how many of your patients have children or grandchildren that would be interested in participating.  Don’t forget to also reach out to the pediatric physicians in your area.  You don’t want to overlook what could be a great referral base.  As physicians, they are well aware of the many benefits of keeping kids active.

Once you have interest built up and a list of participants, now it’s time to really get to work.  Make the sessions fun for the kids.  The goal is to get them moving and teach them that exercise can be fun.  If you are able to have the sessions in person, for inside instruction find a large gymnasium or recreation center that will allow the kids to be spaced out at least 6 feet apart.  You can have different stations and move the kids through a circuit spending a minute at each station.  They can then repeat the circuit, but complete an alternate activity at each one.  If you have access to any equipment you could use that as long as you either have time between kids to properly clean the equipment or have enough equipment so each child has their own.   Some activity ideas include using a medicine ball, ladder drills, burpees, bear crawls, squats, and high knees.  Running a lap around the room could also be an option.

If you are conducting the classes virtually, you can complete a similar circuit, except the kids would be doing it in their own space.  The exercises should be done without the use of equipment since most kids may not have access to equipment.  However, that does not make it any less challenging.  Body weight is a fantastic means of resistance.  Push ups, lunges, squats, and all varieties of planks are fantastic to build strength. You can add some cardio to the routine with jumping jacks, high knees, and mountain climbers.  Don’t forget to start and end each session with some stretching activities.

Another option to in person or live virtual classes would be to establish a daily workout program that the kids can access through an app at their convenience.  If you currently use OptimisPT, then you have free access to our OptimumMe App.  This is the perfect platform for kids to be able to access their program.   As the therapist, you can set up a fitness circuit that the kids can complete, like their very own bootcamp.  Establish a list of dynamic exercises to do.  These can include such things as jumping jacks, push ups, burpees, squats and planks.  Include pictures of the activities with instructions, or even better, include a short video clip of a child performing the activity that allows them to follow along.  You can create a different custom circuit for each day.  Everyday they complete their circuit they will be awarded a badge within the system.  After they collect a certain number of badges, you could offer some type of reward. Some reward ideas that clinics have used include a complimentary sports screening, a certificate to a local frozen yogurt shop (support local businesses at the same time), clinic logo pedometers, jump ropes, sports balls or gift cards to Amazon or a local sporting goods store. 

Keeping kids active is not just important for physical health, it also plays a major role in good mental health.   Exercise is a great way to relieve stress.  Kids, just like adults, could benefit from stress relief during these unprecedented times.  In a study published in Sports Medicine, “there is sufficient evidence to conclude that interventions targeting increases in physical activity, and decreases in sedentary behavior, are justified and will support the current and future mental health of children and adolescents.”  (Rodriguez-Ayllon, M., et. al., Sports Medicine, Vol. 49, No. 9, 2019)

With the uncertainty of the availability of physical education classes and sports programs we, as physical therapists, need to take this opportunity to get involved with the health of the kids in our community.  Whether in person, virtually, or independently using an app to complete the workout, the method may vary depending on the circumstances in your region, but the result should be the same…. Get these kids moving!

OptimisPT is doing a pilot program with our owned and operated clinics.  We are working with schools and our community to establish fitness programs for kids.  Stay tuned for updates and results of the program over the next couple months