Comparison of body mass index and physical fitness activity results of middle school students before and after the covid-19 pandemic and evaluation using survey results

Comparison of body mass index and physical fitness activity results of middle school students before and after the covid-19 pandemic and evaluation using survey results | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of body mass index and physical fitness activity results of middle school students before and after the covid-19 pandemic and evaluation using survey results Ekrem Albayrak, Idris Erdem, Havva Erdem, Handan Ankaralı This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8663497/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract BACKGROUND: This study aimed to examine changes in body mass index (BMI) and selected physical fitness parameters (push-ups, sit-ups, and right–left flexibility) among middle school students across three distinct periods; pre-pandemic, early post-pandemic, and late post-pandemicand to evaluate whether the negative effects of the COVID-19 pandemic persisted over time. Differences according to gender, grade level, and academic term were also analyzed, together with survey-based lifestyle indicators collected in the post-pandemic period. METHODS: A longitudinal observational design was used. Physical fitness test data obtained during Physical Education and Sports classes were retrospectively and prospectively analyzed for three academic years: 2017–2018 (pre-COVID period), 2021–2022 (early post-COVID period), and 2022–2023 (late post-COVID period). The sample consisted of 1,771 students aged 9–13 years from grades 5 to 8. Measurements included height, weight, BMI, push-up, sit-up, and right–left flexibility tests. In addition, a post-pandemic lifestyle survey was administered via Google Forms. Non-parametric statistical tests (Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank tests) were applied, with statistical significance set at p < 0.05. RESULTS: Significant differences were observed in physical fitness and anthropometric parameters across periods. Compared with the pre-pandemic period, students in the early post-pandemic period showed higher body weight and BMI values, alongside marked declines in muscular strength and flexibility. Although partial recovery was observed in the late post-pandemic period, most physical fitness parameters did not return to pre-pandemic levels. Survey findings indicated changes in dietary habits and physical activity patterns; however, no statistically significant association was found between fast-food consumption frequency and academic performance. CONCLUSIONS: The findings indicate that the COVID-19 pandemic had lasting negative effects on physical fitness and BMI among middle school students. Although some improvements were evident over time, recovery remained incomplete. These results highlight the importance of structured school-based physical activity programs and proactive planning to mitigate the adverse effects of potential future pandemics. COVID-19 Physical activity Body mass index Obesity Adolescents Figures Figure 1 Figure 2 Figure 3 Introduction The COVID-19 pandemic resulted in unprecedented public health measures, including prolonged school closures and restrictions on organized sports and recreational activities. These measures substantially altered daily routines of children and adolescents, leading to marked reductions in physical activity and increases in sedentary behaviors. Given that childhood and early adolescence represent critical periods for physical growth and neuromuscular development, disruptions during these stages may have long-term consequences for physical fitness and metabolic health. 1-4 Physical fitness components such as muscular strength, muscular endurance, flexibility, and healthy body composition are key determinants of both athletic performance and general health. Previous evidence has demonstrated that school-based physical education plays a central role in maintaining these components. However, during the pandemic, the suspension of face-to-face physical education and extracurricular sports limited opportunities for structured physical activity, potentially accelerating declines in fitness levels and increasing obesity risk. 5-8 Although several cross-sectional studies have examined the immediate effects of COVID-19 restrictions on physical activity and body weight, longitudinal evidence comparing pre-pandemic and post-pandemic periods within the same educational context remains limited. 9-11 Moreover, few studies have evaluated whether physical fitness levels recover following the resumption of in-person schooling. 10-12 Addressing this gap is particularly relevant for sports medicine and physical fitness research, as it informs both preventive strategies and rehabilitation-oriented interventions for youth populations. 10-12 Therefore, the primary aim of this study was to investigate changes in body mass index (BMI) and selected physical fitness parameters (push-ups, sit-ups, and flexibility) among middle school students across three distinct periods: pre-pandemic, early post-pandemic, and late post-pandemic. A secondary aim was to evaluate post-pandemic lifestyle behaviors using survey data. It was hypothesized that physical fitness would decline significantly during the early post-pandemic period and that recovery in the late post-pandemic period would remain incomplete. Material and Methods Study design This longitudinal observational study analyzed physical fitness data collected during Physical Education and Sports classes across three academic years. The study design and reporting were aligned with the principles commonly adopted in sports medicine research, emphasizing repeated measurements and within-group comparisons over time Ethical approval This research was conducted in accordance with the principles stated in the Helsinki Declaration. This research was carried out after obtaining approval from the Middle School Principal's Office, the District National Education Directorate, and the ethics committee (Ethical approval was obtained from the Clinical Research Ethics Committee of Samsun University (2024/3/12)). In order for students to participate in the research, consent was obtained from their parents by sending them an "Informed Consent Form" which provided detailed information about the research. Students who were approved by their parents and who also wished to participate were included in the study. Participants A total of 1,771 middle school students (grades 5–8; age range: 9–13 years) were included. Data were obtained from three academic periods: 2017–2018 (pre-pandemic), 2021–2022 (early post-pandemic), and 2022–2023 (late post-pandemic). Both male and female students were included, and analyses were conducted by grade level and academic term. Physical fitness assessment Anthropometric measurements included body height (cm) and body mass (kg), measured using standard school-based equipment. BMI was calculated as kg/m². Physical fitness was assessed using field-based tests commonly applied in youth sports medicine: push-up test (upper-body muscular endurance), sit-up test (abdominal muscular endurance), and right and left sit-and-reach tests (flexibility). Measurements were performed twice within each academic year (first and second semesters). Survey assessment A structured questionnaire was administered during the late post-pandemic period via Google Forms (table-I). The survey assessed dietary habits, physical activity participation, sleep patterns, family environment, and perceived academic performance.The questions were developed using similar publications in the literature. 13,14 The survey was administered through a WhatsApp group including students, teachers, and parents. Only surveys that provided permission for use were considered for the responses. Institutional permission and ethical committee approval were also obtained. Statistical analysis Statistical analyses were conducted using SPSS version 22.0. Data distribution was assessed using descriptive methods, and non-parametric tests were applied where appropriate. The Wilcoxon signed-rank test was used for within-year comparisons, the Mann–Whitney U test for two-group comparisons, and the Kruskal–Wallis test for comparisons across periods. Results were considered statistically significant at p < 0.05. Results The analysis included repeated measurements from 1,771 students across three academic periods. Clear temporal differences were observed in both anthropometric and physical fitness variables (table II-IV). In the pre-pandemic period, students demonstrated expected age-related increases in height and body mass, accompanied by stable or improving physical fitness performance between semesters. In contrast, the early post-pandemic period was characterized by significant increases in body mass and BMI, together with marked declines in push-up, sit-up, and flexibility performances across most grade levels (Supplementary Table S1, S2). During the late post-pandemic period, partial recovery was observed in muscular endurance and flexibility. Sit-up and flexibility scores improved compared with the early post-pandemic period; however, these values generally remained below pre-pandemic levels. BMI values, although slightly reduced, remained elevated relative to the pre-pandemic period (Table S1, S2). Survey findings indicated increased fast-food consumption and reduced physical activity during the pandemic, with only partial normalization after the return to face-to-face education. No statistically significant association was identified between fast-food consumption frequency and perceived academic performance (figures 1-3). Discussion In this study, physical fitness parameters of secondary school students were examined in the PP, EPP and LPP periods. The findings revealed that the pandemic caused significant changes in students' living habits and had significant effects on students' physical activity levels and general health. A decline in physical fitness parameters has been observed, especially in the post-pandemic periods. This decline is observed in tables II-IV and Supplementary Table S1,S2. The main reasons for this decline were thought to be the closure of schools, social isolation and the effect of online education. Similar findings have been mentioned in the literature; Many studies have stated that the pandemic has reduced physical activity, causing an increase in obesity and general health problems. 11,12 The data obtained in this study show that the return to physical activity was slow in the post-pandemic period and the physical fitness levels of students decreased compared to previous periods. The fact that the data in EPP is lower than in PP proves this. As a result, it reveals the need to prepare for similar crises in the future and develop more sustainable solutions to protect children's health. Compared with the literature, the results of this study are similar to findings in other countries . 15 The COVID-19 pandemic has had a profound impact on both the lifestyles and educational lives of school-age children. In this study, the effects of the pandemic on fast food consumption, family life dynamics and school success were also observed in this study, as in the literature. In our study, according to the survey results (figures 1-3)it was seen that there was a significant change in the fast food consumption habits of the students. While the number of students consuming fast food 0-3 times a week before the pandemic was higher, there was an increase in the number of students consuming fast food 4-8 times a week during the pandemic. This situation suggested that spending more time at home during the pandemic caused an increase in the consumption of ready-made food and junk food. It is thought that the reason for this increase may be that the stress and anxiety brought by the pandemic may have triggered this change by increasing unhealthy nutrition choice. 9 Again, the increase in fast food consumption; It may also be related to families turning to outside orders during lockdown periods. At the same time, there was an increase in carbohydrate-based eating habits and a decrease in fresh fruit and vegetable consumption during the pandemic. These results suggested that the pandemic had negative effects on students' eating habits, and this could lead to health problems in the long term. In this study, physical activity and sleep patterns were examined, and it was observed that there was a decrease in students' physical activities and deterioration in their sleep patterns during the pandemic. According to the data obtained, students' return to sports activities remained limited in the post-pandemic period. This shows that the sedentary lifestyle that became a habit during the pandemic period may have long-term effects. Similarly, there are findings in the literature that the pandemic reduces children's physical activity levels, which may lead to health problems such as obesity. 10,11 In terms of academic success, it has been observed that the academic success of some students increased in the post-pandemic period, while the academic success of some students deteriorated. The weakening of motivation and discipline, especially during the home education process, has negatively affected students' study habits. However, it has been determined that family support and access to digital learning materials play a role in students increasing academic success in the post-pandemic period. These findings show that inequalities in education have deepened in the post-pandemic period. 16 When we look at the dynamics of family life, it has been determined that the majority of families are at home during the pandemic. This time spent at home can provide students with both academic and emotional support. As a matter of fact, the majority of participants stated that their school success increased after the pandemic. This shows that family support and time spent at home may have a positive impact on academic success. However, this increase was not observed in every student and it is thought that this effect may have been limited, especially in families with lower socioeconomic status. Socioeconomic status was not questioned in this study. In this study, physical fitness activities and BMI values of secondary school students were examined before and after the pandemic. The results show a significant decrease in students' physical fitness levels in the post-pandemic period. It was observed that the performance of the students decreased significantly, especially in push-ups, sit-ups and flexibility tests. This finding supports the negative impact of the obligation to stay at home and restriction of physical activity during the pandemic on children's physical development. Social restrictions and the distance education process implemented during the pandemic period have significantly limited children's physical activities. The decrease in participation in regular sports activities with the closure of schools is one of the main reasons for this decrease. In addition, children spending more time at home, increased screen time and adopting a sedentary lifestyle have reinforced this situation, which should be considered as an important risk factor for children's long-term health outcomes. In studies examining the impact of the COVID-19 epidemic on physical activity, changes in physical activity have also been noted. 17 A meta-analysis revealed a slightly negative global change in physical activity for children and adolescents. 17 There are some studies examining the impact of the COVID-19 pandemic and associated restrictions not only on physical activity but also on the physical fitness structure. 18,19 Despite different measurement methods and study participants, the studies all reported a trend towards a decrease in endurance. There appears to be less abundant and inconclusive evidence of declining power. 18,19 Data obtained according to the results of physical fitness tests conducted during and after the pandemic period show that there have been significant changes in students' physical activities and physical fitness levels. Especially in the early period after the pandemic (2021-2022), a remarkable increase was observed in variables such as students' weight gain, height and flexibility. However, although there was an improvement in some physical activities in the late post-pandemic period (2022-2023), it was observed that it was generally not possible to return to pre-pandemic levels. These results support that long-term restrictions and inactivity have negative effects on children's physical development. Especially during the pandemic, students staying at home has resulted in a decrease in physical activity levels, social isolation and weight gain. In the data in the study, there was a significant decrease in students' sit-up and push-up performances in the EPP (2021-2022), but a partial improvement in these values was observed in the LPP (2022-2023). This shows that the effects of the pandemic are long-term and it takes time for students to return to their previous performance levels. The main finding of this study is that the COVID-19 pandemic had a sustained negative impact on physical fitness and body composition in middle school students. The most pronounced declines were observed during the early post-pandemic period, highlighting the effects of prolonged inactivity and restricted access to organized physical activity. The reductions in muscular endurance and flexibility observed in this study are consistent with previous sports medicine research reporting declines in neuromuscular performance following periods of detraining. From a physiological perspective, reduced mechanical loading and movement variability during lockdowns may have contributed to decreased muscle endurance and joint mobility in youth. Although partial recovery was evident in the late post-pandemic period, the failure to return to pre-pandemic fitness levels suggests that passive recovery may be insufficient. These findings underscore the need for structured reconditioning and injury-prevention programs within school-based physical education following prolonged inactivity. The persistent elevation in BMI observed in the post-pandemic periods raises concerns regarding increased cardiometabolic risk. Changes in dietary behaviors, combined with reduced physical activity, likely contributed to this trend. From a sports medicine standpoint, early identification of excess weight gain is essential to prevent long-term musculoskeletal and metabolic complications. Limitations and practical implications This study did not include objective measures of physical activity intensity or socioeconomic status, which may have influenced recovery patterns. Future research should incorporate accelerometer-based activity monitoring and intervention-based designs. From a practical perspective, sports medicine professionals and physical education teachers should collaborate to implement progressive conditioning strategies following periods of prolonged inactivity. Conclusions The COVID-19 pandemic resulted in significant declines in physical fitness and unfavorable changes in BMI among middle school students. Although partial recovery occurred following the resumption of in-person education, physical fitness levels did not fully return to pre-pandemic values. These findings emphasize the importance of targeted, school-based physical activity and reconditioning programs to restore physical fitness and mitigate long-term health risks in youth populations. Declarations Disclosure Statement The authors have no competing interests to declare. Ethics, consent and permissions All participants provided written informed consent, and the study procedures were approved by the National Center for Health Statistics Research Ethics Review Board. Consent to publish Not applicable. Author contributions The authors’ responsibilities were as follows: İE, HE and EA: designed the research and hadprimary responsibility for the final content; HA, HE: conducted analyses and wrote the first draft of the paper; HA, HE, İE, EA: revised the manuscript; and all authors: read and approved the final manuscript and approved the final submitted version. Funding None References Fraiman YS, Litt JS, Davis JM, Pursley DM and the Pediatric Policy Council. Racial and ethnic disparities in adult COVID-19 and the future impact on child health. Pediatr Res. 2021;89:1052–1054. Christakis DA, Van Cleve W, Zimmerman FJ. Estimation of US children's educational attainment and years of life lost associated with primary school closures during the coronavirus disease 2019 pandemic. JAMA Network Open. 2020;3:e2028786 Van Lancker W, Parolin Z. COVID-19, school closures, and child poverty: a social crisis in the making. Lancet Public Health 2020;5: e243–e244. Hawrilenko M, Kroshus E, Tandon P, Christakis D. The Association Between School Closures and Child Mental Health During COVID-19. JAMA Netw Open. 2021;4(9):e2124092 Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732-7. C. Craggs, K. Corder, E. M. van Sluijs, and S. J. Griffin. Determinants of change in physical activity in children and adolescents: a systematic review. American Journal of Preventive Medicine. 2011; 40(6). 645–658. Van Dyck D, De Bourdeaudhuij I, Deliens T, Deforche B. Can changes in psychosocial factors and residency explain the decrease in physical activity during the transition from high school to college or university? Int J Behav Med. 2015 ;22(2):178-86. Nooijen CF, Galanti MR, Engström K, Möller J, Forsell Y. Effectiveness of interventions on physical activity in overweight or obese children: a systematic review and meta-analysis including studies with objectively measured outcomes. Obes Rev. 2017;18(2):195-213. Mason TB, Barrington-Trimis J, Leventhal AM. Eating to cope with the COVID-19 pandemic and body weight change in young adults. J Adolesc Health.2021;68:277–83. Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic Obes Res Clin Pract. 2020; 14:210–6. Flanagan EW, Beyl RA, Fearnbach SN, Altazan AD, Martin CK, Redman LM. The impact of COVID-19 stay-at-home orders on health behaviors in adults. Obesity. 2021;29:438–45 Violant-Holz V, Gallego-Jiménez MG, González-González CS,Muñoz-Violant S, Rodríguez MJ, Sansano-Nadal O, et al. Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review. Int. J.Environ. Pic. Public Health 2020;17: 9419 Doyan S, Alpat İ, Ersoy G.A definitional study on nutrition and physical activity behaviors of nutrition and dietetics students during quarantine due to covid-19 pandemic . Zeugma Health Res. 2021;3(2-3):94-103. Zaccagni L, De Luca F, Rinaldo N, Mazzoni G, Mandini S, Gualdi-Russo E. The COVID-19 Experience in Adolescents: Emotional and Behavioral Recall at the End of the Pandemic. Diseases. 2024;12(6):116. Ripley-Gonzalez JW, Zhou N, Zeng T, You B, Zhang W, Liu J, et al. The long-term impact of the COVID-19 pandemic on physical fitness in young adults: a historical control study. Sci Rep. 2023;13(1):15430. Chaabane S, Doraiswamy S, Chaabna K, Mamtani R, Cheema S. The Impact of COVID-19 School Closure on Child and Adolescent Health: A Rapid Systematic Review. Children (Basel). 2021;8(5):415. Wunsch K, Kienberger K, Niessner C. Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(4):2250. Jarnig G, Jaunig J, van Poppel MNM. Association of COVID-19 Mitigation Measures With Changes in Cardiorespiratory Fitness and Body Mass Index Among Children Aged 7 to 10 Years in Austria. JAMA Netw Open. 2021;4(8):e2121675. Chambonnière C, Fearnbach N, Pelissier L, Genin P, Fillon A, Boscaro A, Bonjean L, Bailly M, Siroux J, Guirado T, Pereira B, Thivel D, Duclos M. Adverse Collateral Effects of COVID-19 Public Health Restrictions on Physical Fitness and Cognitive Performance in Primary School Children. Int J Environ Res Public Health. 2021;18(21):11099. Tables Table I. Demographic characteristics of participants by year and grade. Year Grade N Age (mean ± SD) Sex (B/G) 2017–2018 5–8 623 11.4 ± 1.2 317/306 2021–2022 5–8 505 11.3 ± 1.1 244/261 2022–2023 5–8 643 11.5 ± 1.1 310/333 Note: Values are presented as mean ± SD. Table II. Changes in anthropometric variables across periods. Period Weight (kg) Height (cm) BMI (kg/m²) Pre-pandemic 45.3 ± 11.2 150.4 ± 9.1 29.8 ± 6.4 Early post-pandemic 48.9 ± 12.3 152.6 ± 8.7 31.5 ± 6.9* Late post-pandemic 47.6 ± 11.8 153.2 ± 8.5 30.7 ± 6.6* Note: *p < 0.05 vs pre-pandemic period. Table III. Changes in physical fitness parameters across periods. Period Push-up (reps) Sit-up (reps) Right flexibility (cm) Left flexibility (cm) Pre-pandemic 5.1 ± 6.2 14.8 ± 11.3 21.4 ± 6.5 21.2 ± 6.6 Early post-pandemic 3.2 ± 5.4* 11.9 ± 10.6* 18.2 ± 7.1* 18.4 ± 7.0* Late post-pandemic 4.6 ± 6.7* 15.6 ± 13.9 20.9 ± 6.8 21.0 ± 6.9 Note: Values are mean ± SD. *p < 0.05 vs pre-pandemic period. Table IV is not available with this version. Additional Declarations No competing interests reported. Supplementary Files supplementaryY.docx titlepageSTROBEStatement.docx CONSORT2025Y.docx survey.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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results","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe COVID-19 pandemic resulted in unprecedented public health measures, including prolonged school closures and restrictions on organized sports and recreational activities. These measures substantially altered daily routines of children and adolescents, leading to marked reductions in physical activity and increases in sedentary behaviors. Given that childhood and early adolescence represent critical periods for physical growth and neuromuscular development, disruptions during these stages may have long-term consequences for physical fitness and metabolic health.\u003csup\u003e1-4\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003ePhysical fitness components such as muscular strength, muscular endurance, flexibility, and healthy body composition are key determinants of both athletic performance and general health. Previous evidence has demonstrated that school-based physical education plays a central role in maintaining these components. However, during the pandemic, the suspension of face-to-face physical education and extracurricular sports limited opportunities for structured physical activity, potentially accelerating declines in fitness levels and increasing obesity risk.\u003csup\u003e5-8\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eAlthough several cross-sectional studies have examined the immediate effects of COVID-19 restrictions on physical activity and body weight, longitudinal evidence comparing pre-pandemic and post-pandemic periods within the same educational context remains limited. \u003csup\u003e9-11\u003c/sup\u003eMoreover, few studies have evaluated whether physical fitness levels recover following the resumption of in-person schooling. \u003csup\u003e10-12\u0026nbsp;\u003c/sup\u003eAddressing this gap is particularly relevant for sports medicine and physical fitness research, as it informs both preventive strategies and rehabilitation-oriented interventions for youth populations.\u003csup\u003e10-12\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eTherefore, the primary aim of this study was to investigate changes in body mass index (BMI) and selected physical fitness parameters (push-ups, sit-ups, and flexibility) among middle school students across three distinct periods: pre-pandemic, early post-pandemic, and late post-pandemic. A secondary aim was to evaluate post-pandemic lifestyle behaviors using survey data. It was hypothesized that physical fitness would decline significantly during the early post-pandemic period and that recovery in the late post-pandemic period would remain incomplete.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003eStudy design\u003c/p\u003e\n\u003cp\u003eThis longitudinal observational study analyzed physical fitness data collected during Physical Education and Sports classes across three academic years. The study design and reporting were aligned with the principles commonly adopted in sports medicine research, emphasizing repeated measurements and within-group comparisons over time\u003c/p\u003e\n\u003cp\u003eEthical approval\u003c/p\u003e\n\u003cp\u003eThis research was conducted in accordance with the principles stated in the Helsinki Declaration. This research was carried out after obtaining approval from the Middle School Principal's Office, the District National Education Directorate, and the ethics committee (Ethical approval was obtained from the Clinical Research Ethics Committee of Samsun University (2024/3/12)). In order for students to participate in the research, consent was obtained from their parents by sending them an \"Informed Consent Form\" which provided detailed information about the research. Students who were approved by their parents and who also wished to participate were included in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants\u003c/p\u003e\n\u003cp\u003eA total of 1,771 middle school students (grades 5–8; age range: 9–13 years) were included. Data were obtained from three academic periods: 2017–2018 (pre-pandemic), 2021–2022 (early post-pandemic), and 2022–2023 (late post-pandemic). Both male and female students were included, and analyses were conducted by grade level and academic term.\u003c/p\u003e\n\u003cp\u003ePhysical fitness assessment\u003c/p\u003e\n\u003cp\u003eAnthropometric measurements included body height (cm) and body mass (kg), measured using standard school-based equipment. BMI was calculated as kg/m². Physical fitness was assessed using field-based tests commonly applied in youth sports medicine: push-up test (upper-body muscular endurance), sit-up test (abdominal muscular endurance), and right and left sit-and-reach tests (flexibility). Measurements were performed twice within each academic year (first and second semesters).\u003c/p\u003e\n\u003cp\u003eSurvey assessment\u003c/p\u003e\n\u003cp\u003eA structured questionnaire was administered during the late post-pandemic period via Google Forms (table-I). The survey assessed dietary habits, physical activity participation, sleep patterns, family environment, and perceived academic performance.The questions were developed using similar publications in the literature.\u003csup\u003e13,14\u003c/sup\u003e The survey was administered through a WhatsApp group including students, teachers, and parents. Only surveys that provided permission for use were considered for the responses. Institutional permission and ethical committee approval were also obtained.\u003c/p\u003e\n\u003cp\u003eStatistical analysis\u003c/p\u003e\n\u003cp\u003eStatistical analyses were conducted using SPSS version 22.0. Data distribution was assessed using descriptive methods, and non-parametric tests were applied where appropriate. The Wilcoxon signed-rank test was used for within-year comparisons, the Mann–Whitney U test for two-group comparisons, and the Kruskal–Wallis test for comparisons across periods. Results were considered statistically significant at p \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe analysis included repeated measurements from 1,771 students across three academic periods. Clear temporal differences were observed in both anthropometric and physical fitness variables (table II-IV).\u003c/p\u003e\n\u003cp\u003eIn the pre-pandemic period, students demonstrated expected age-related increases in height and body mass, accompanied by stable or improving physical fitness performance between semesters. In contrast, the early post-pandemic period was characterized by significant increases in body mass and BMI, together with marked declines in push-up, sit-up, and flexibility performances across most grade levels (Supplementary Table S1, S2).\u003c/p\u003e\n\u003cp\u003eDuring the late post-pandemic period, partial recovery was observed in muscular endurance and flexibility. Sit-up and flexibility scores improved compared with the early post-pandemic period; however, these values generally remained below pre-pandemic levels. BMI values, although slightly reduced, remained elevated relative to the pre-pandemic period (Table S1, S2).\u003c/p\u003e\n\u003cp\u003eSurvey findings indicated increased fast-food consumption and reduced physical activity during the pandemic, with only partial normalization after the return to face-to-face education. No statistically significant association was identified between fast-food consumption frequency and perceived academic performance (figures 1-3).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, physical fitness parameters of secondary school students were examined in the PP, EPP and LPP periods. The findings revealed that the pandemic caused significant changes in students\u0026apos; living habits and had significant effects on students\u0026apos; physical activity levels and general health. A decline in physical fitness parameters has been observed, especially in the post-pandemic periods. This decline is observed in tables II-IV and Supplementary Table S1,S2. The main reasons for this decline were thought to be the closure of schools, social isolation and the effect of online education. Similar findings have been mentioned in the literature; Many studies have stated that the pandemic has reduced physical activity, causing an increase in obesity and general health problems.\u003csup\u003e11,12\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe data obtained in this study show that the return to physical activity was slow in the post-pandemic period and the physical fitness levels of students decreased compared to previous periods. The fact that the data in EPP is lower than in PP proves this. As a result, it reveals the need to prepare for similar crises in the future and develop more sustainable solutions to protect children\u0026apos;s health. Compared with the literature, the results of this study are similar to findings in other countries .\u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe COVID-19 pandemic has had a profound impact on both the lifestyles and educational lives of school-age children. In this study, the effects of the pandemic on fast food consumption, family life dynamics and school success were also observed in this study, as in the literature.\u003c/p\u003e\n\u003cp\u003eIn our study, according to the survey results\u0026nbsp;(figures 1-3)it was seen that there was a significant change in the fast food consumption habits of the students. While the number of students consuming fast food 0-3 times a week before the pandemic was higher, there was an increase in the number of students consuming fast food 4-8 times a week during the pandemic. This situation suggested that spending more time at home during the pandemic caused an increase in the consumption of ready-made food and junk food. \u0026nbsp;It is thought that the reason for this increase may be that the stress and anxiety brought by the pandemic may have triggered this change by increasing unhealthy nutrition choice.\u003csup\u003e9\u003c/sup\u003e Again, the increase in fast food consumption; It may also be related to families turning to outside orders during lockdown periods. At the same time, there was an increase in carbohydrate-based eating habits and a decrease in fresh fruit and vegetable consumption during the pandemic. These results suggested that the pandemic had negative effects on students\u0026apos; eating habits, and this could lead to health problems in the long term.\u003c/p\u003e\n\u003cp\u003eIn this study, physical activity and sleep \u0026nbsp;patterns were examined, and it was observed that there was a decrease in students\u0026apos; physical activities and deterioration in their sleep patterns during the pandemic. According to the data obtained, students\u0026apos; return to sports activities remained limited in the post-pandemic period. This shows that the sedentary lifestyle that became a habit during the pandemic period may have long-term effects. Similarly, there are findings in the literature that the pandemic reduces children\u0026apos;s physical activity levels, which may lead to health problems such as obesity.\u003csup\u003e10,11\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eIn terms of academic success, it has been observed that the academic success of some students increased in the post-pandemic period, while the academic success of some students deteriorated. The weakening of motivation and discipline, especially during the home education process, has negatively affected students\u0026apos; study habits. However, it has been determined that family support and access to digital learning materials play a role in students increasing academic success in the post-pandemic period. These findings show that inequalities in education have deepened in the post-pandemic period.\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eWhen we look at the dynamics of family life, it has been determined that the majority of families are at home during the pandemic. This time spent at home can provide students with both academic and emotional support. As a matter of fact, the majority of participants stated that their school success increased after the pandemic. This shows that family support and time spent at home may have a positive impact on academic success. However, this increase was not observed in every student and it is thought that this effect may have been limited, especially in families with lower socioeconomic status. Socioeconomic status was not questioned in this study.\u003c/p\u003e\n\u003cp\u003eIn this study, physical fitness activities and BMI values of secondary school students were examined before and after the pandemic. The results show a significant decrease in students\u0026apos; physical fitness levels in the post-pandemic period. It was observed that the performance of the students decreased significantly, especially in push-ups, sit-ups and flexibility tests. This finding supports the negative impact of the obligation to stay at home and restriction of physical activity during the pandemic on children\u0026apos;s physical development.\u003c/p\u003e\n\u003cp\u003eSocial restrictions and the distance education process implemented during the pandemic period have significantly limited children\u0026apos;s physical activities. The decrease in participation in regular sports activities with the closure of schools is one of the main reasons for this decrease. In addition, children spending more time at home, increased screen time and adopting a sedentary lifestyle have reinforced this situation, which should be considered as an important risk factor for children\u0026apos;s long-term health outcomes.\u003c/p\u003e\n\u003cp\u003eIn studies examining the impact of the COVID-19 epidemic on physical activity, changes in physical activity have also been noted.\u003csup\u003e17\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;A meta-analysis revealed a slightly negative global change in physical activity for children and adolescents.\u003csup\u003e17\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThere are some studies examining the impact of the COVID-19 pandemic and associated restrictions not only on physical activity but also on the physical fitness structure.\u003csup\u003e18,19\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eDespite different measurement methods and study participants, the studies all reported a trend towards a decrease in endurance. There appears to be less abundant and inconclusive evidence of declining power.\u003csup\u003e18,19\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eData obtained according to the results of physical fitness tests conducted during and after the pandemic period show that there have been significant changes in students\u0026apos; physical activities and physical fitness levels. Especially in the early period after the pandemic (2021-2022), a remarkable increase was observed in variables such as students\u0026apos; weight gain, height and flexibility. However, although there was an improvement in some physical activities in the late post-pandemic period (2022-2023), it was observed that it was generally not possible to return to pre-pandemic levels. These results support that long-term restrictions and inactivity have negative effects on children\u0026apos;s physical development.\u003c/p\u003e\n\u003cp\u003eEspecially during the pandemic, students staying at home has resulted in a decrease in physical activity levels, social isolation and weight gain. In the data in the study, there was a significant decrease in students\u0026apos; sit-up and push-up performances in the EPP (2021-2022), but a partial improvement in these values was observed in the LPP (2022-2023). This shows that the effects of the pandemic are long-term and it takes time for students to return to their previous performance levels.\u003c/p\u003e\n\u003cp\u003eThe main finding of this study is that the COVID-19 pandemic had a sustained negative impact on physical fitness and body composition in middle school students. The most pronounced declines were observed during the early post-pandemic period, highlighting the effects of prolonged inactivity and restricted access to organized physical activity.\u003c/p\u003e\n\u003cp\u003eThe reductions in muscular endurance and flexibility observed in this study are consistent with previous sports medicine research reporting declines in neuromuscular performance following periods of detraining. From a physiological perspective, reduced mechanical loading and movement variability during lockdowns may have contributed to decreased muscle endurance and joint mobility in youth.\u003c/p\u003e\n\u003cp\u003eAlthough partial recovery was evident in the late post-pandemic period, the failure to return to pre-pandemic fitness levels suggests that passive recovery may be insufficient. These findings underscore the need for structured reconditioning and injury-prevention programs within school-based physical education following prolonged inactivity.\u003c/p\u003e\n\u003cp\u003eThe persistent elevation in BMI observed in the post-pandemic periods raises concerns regarding increased cardiometabolic risk. Changes in dietary behaviors, combined with reduced physical activity, likely contributed to this trend. From a sports medicine standpoint, early identification of excess weight gain is essential to prevent long-term musculoskeletal and metabolic complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations and practical implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not include objective measures of physical activity intensity or socioeconomic status, which may have influenced recovery patterns. Future research should incorporate accelerometer-based activity monitoring and intervention-based designs. From a practical perspective, sports medicine professionals and physical education teachers should collaborate to implement progressive conditioning strategies following periods of prolonged inactivity.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe COVID-19 pandemic resulted in significant declines in physical fitness and unfavorable changes in BMI among middle school students. Although partial recovery occurred following the resumption of in-person education, physical fitness levels did not fully return to pre-pandemic values. These findings emphasize the importance of targeted, school-based physical activity and reconditioning programs to restore physical fitness and mitigate long-term health risks in youth populations.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclosure Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Ethics, consent and permissions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided written informed consent, and the study procedures were approved by the National Center for Health Statistics Research Ethics Review Board.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors\u0026rsquo; responsibilities were as follows: İE, HE and EA: designed the research and hadprimary responsibility for the final content; HA, HE: conducted analyses and wrote the first draft of the paper; HA, HE, İE, EA: revised the manuscript; and all authors: read and approved the final manuscript and approved the final submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFraiman YS, Litt JS, Davis JM, Pursley DM and the Pediatric Policy Council. Racial and ethnic disparities in adult COVID-19 and the future impact on child health. Pediatr Res. 2021;89:1052\u0026ndash;1054. \u003c/li\u003e\n\u003cli\u003eChristakis DA, Van Cleve W, Zimmerman FJ. Estimation of US children\u0026apos;s educational attainment and years of life lost associated with primary school closures during the coronavirus disease 2019 pandemic. JAMA Network Open. 2020;3:e2028786\u003c/li\u003e\n\u003cli\u003eVan Lancker W, Parolin Z. COVID-19, school closures, and child poverty: a social crisis in the making. Lancet Public Health 2020;5: e243\u0026ndash;e244.\u003c/li\u003e\n\u003cli\u003eHawrilenko M, Kroshus E, Tandon P, Christakis D. The Association Between School Closures and Child Mental Health During COVID-19. JAMA Netw Open. 2021;4(9):e2124092\u003c/li\u003e\n\u003cli\u003eStrong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732-7. \u003c/li\u003e\n\u003cli\u003eC. Craggs, K. Corder, E. M. van Sluijs, and S. J. Griffin. Determinants of change in physical activity in children and adolescents: a systematic review. American Journal of Preventive Medicine. 2011; 40(6). 645\u0026ndash;658. \u003c/li\u003e\n\u003cli\u003eVan Dyck D, De Bourdeaudhuij I, Deliens T, Deforche B. Can changes in psychosocial factors and residency explain the decrease in physical activity during the transition from high school to college or university? Int J Behav Med. 2015 ;22(2):178-86. \u003c/li\u003e\n\u003cli\u003eNooijen CF, Galanti MR, Engstr\u0026ouml;m K, M\u0026ouml;ller J, Forsell Y. Effectiveness of interventions on physical activity in overweight or obese children: a systematic review and meta-analysis including studies with objectively measured outcomes. Obes Rev. 2017;18(2):195-213. \u003c/li\u003e\n\u003cli\u003eMason TB, Barrington-Trimis J, Leventhal AM. Eating to cope with the COVID-19 pandemic and body weight change in young adults. J Adolesc Health.2021;68:277\u0026ndash;83. \u003c/li\u003e\n\u003cli\u003eZachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic Obes Res Clin Pract. 2020; 14:210\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eFlanagan EW, Beyl RA, Fearnbach SN, Altazan AD, Martin CK, Redman LM. The impact of COVID-19 stay-at-home orders on health behaviors in adults. Obesity. 2021;29:438\u0026ndash;45\u003c/li\u003e\n\u003cli\u003eViolant-Holz V, Gallego-Jim\u0026eacute;nez MG, Gonz\u0026aacute;lez-Gonz\u0026aacute;lez CS,Mu\u0026ntilde;oz-Violant S, Rodr\u0026iacute;guez MJ, Sansano-Nadal O, et al. Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review. Int. J.Environ. Pic. Public Health 2020;17: 9419\u003c/li\u003e\n\u003cli\u003eDoyan S, Alpat İ, Ersoy G.A definitional study on nutrition and physical activity behaviors of nutrition and dietetics students during quarantine due to covid-19 pandemic\u003cem\u003e.\u003c/em\u003e Zeugma Health Res. 2021;3(2-3):94-103. \u003c/li\u003e\n\u003cli\u003eZaccagni L, De Luca F, Rinaldo N, Mazzoni G, Mandini S, Gualdi-Russo E. The COVID-19 Experience in Adolescents: Emotional and Behavioral Recall at the End of the Pandemic. Diseases. 2024;12(6):116. \u003c/li\u003e\n\u003cli\u003eRipley-Gonzalez JW, Zhou N, Zeng T, You B, Zhang W, Liu J, et al. The long-term impact of the COVID-19 pandemic on physical fitness in young adults: a historical control study. Sci Rep. 2023;13(1):15430. \u003c/li\u003e\n\u003cli\u003eChaabane S, Doraiswamy S, Chaabna K, Mamtani R, Cheema S. The Impact of COVID-19 School Closure on Child and Adolescent Health: A Rapid Systematic Review. Children (Basel). 2021;8(5):415. \u003c/li\u003e\n\u003cli\u003eWunsch K, Kienberger K, Niessner C. Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(4):2250.\u003c/li\u003e\n\u003cli\u003eJarnig G, Jaunig J, van Poppel MNM. Association of COVID-19 Mitigation Measures With Changes in Cardiorespiratory Fitness and Body Mass Index Among Children Aged 7 to 10 Years in Austria. JAMA Netw Open. 2021;4(8):e2121675.\u003c/li\u003e\n\u003cli\u003eChambonni\u0026egrave;re C, Fearnbach N, Pelissier L, Genin P, Fillon A, Boscaro A, Bonjean L, Bailly M, Siroux J, Guirado T, Pereira B, Thivel D, Duclos M. Adverse Collateral Effects of COVID-19 Public Health Restrictions on Physical Fitness and Cognitive Performance in Primary School Children. Int J Environ Res Public Health. 2021;18(21):11099. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable I. Demographic characteristics of participants by year and grade.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGrade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge (mean ± SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSex (B/G)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2017–2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5–8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.4 ± 1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317/306\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2021–2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5–8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e505\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.3 ± 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e244/261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2022–2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5–8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.5 ± 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e310/333\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Values are presented as mean ± SD.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u0026nbsp;Table II. Changes in anthropometric variables across periods.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePeriod\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWeight (kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHeight (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBMI (kg/m²)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.3 ± 11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e150.4 ± 9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29.8 ± 6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEarly post-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48.9 ± 12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e152.6 ± 8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.5 ± 6.9*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLate post-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47.6 ± 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e153.2 ± 8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30.7 ± 6.6*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: *p \u0026lt; 0.05 vs pre-pandemic period.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u0026nbsp;Table III. Changes in physical fitness parameters across periods.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePeriod\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePush-up (reps)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSit-up (reps)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRight flexibility (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft flexibility (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.1 ± 6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.8 ± 11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.4 ± 6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.2 ± 6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEarly post-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.2 ± 5.4*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.9 ± 10.6*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.2 ± 7.1*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.4 ± 7.0*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLate post-pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.6 ± 6.7*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.6 ± 13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.9 ± 6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.0 ± 6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Values are mean ± SD. *p \u0026lt; 0.05 vs pre-pandemic period.\u003c/p\u003e\n\u003cp\u003eTable IV is not available with this version.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"COVID-19, Physical activity,Body mass index, Obesity, Adolescents","lastPublishedDoi":"10.21203/rs.3.rs-8663497/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8663497/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBACKGROUND: This study aimed to examine changes in body mass index (BMI) and selected physical fitness parameters (push-ups, sit-ups, and right–left flexibility) among middle school students across three distinct periods; pre-pandemic, early post-pandemic, and late post-pandemicand to evaluate whether the negative effects of the COVID-19 pandemic persisted over time. Differences according to gender, grade level, and academic term were also analyzed, together with survey-based lifestyle indicators collected in the post-pandemic period.\u003c/p\u003e\n\u003cp\u003eMETHODS: A longitudinal observational design was used. Physical fitness test data obtained during Physical Education and Sports classes were retrospectively and prospectively analyzed for three academic years: 2017–2018 (pre-COVID period), 2021–2022 (early post-COVID period), and 2022–2023 (late post-COVID period). The sample consisted of 1,771 students aged 9–13 years from grades 5 to 8. Measurements included height, weight, BMI, push-up, sit-up, and right–left flexibility tests. In addition, a post-pandemic lifestyle survey was administered via Google Forms. Non-parametric statistical tests (Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank tests) were applied, with statistical significance set at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eRESULTS: Significant differences were observed in physical fitness and anthropometric parameters across periods. Compared with the pre-pandemic period, students in the early post-pandemic period showed higher body weight and BMI values, alongside marked declines in muscular strength and flexibility. Although partial recovery was observed in the late post-pandemic period, most physical fitness parameters did not return to pre-pandemic levels. Survey findings indicated changes in dietary habits and physical activity patterns; however, no statistically significant association was found between fast-food consumption frequency and academic performance.\u003c/p\u003e\n\u003cp\u003eCONCLUSIONS: The findings indicate that the COVID-19 pandemic had lasting negative effects on physical fitness and BMI among middle school students. Although some improvements were evident over time, recovery remained incomplete. These results highlight the importance of structured school-based physical activity programs and proactive planning to mitigate the adverse effects of potential future pandemics.\u003c/p\u003e","manuscriptTitle":"Comparison of body mass index and physical fitness activity results of middle school students before and after the covid-19 pandemic and evaluation using survey results","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-05 03:56:33","doi":"10.21203/rs.3.rs-8663497/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"271cef74-d131-4833-822c-fd5f7ce668b3","owner":[],"postedDate":"March 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-01T04:24:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-05 03:56:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8663497","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8663497","identity":"rs-8663497","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}