Table 2 Summary of findings

Total physical activity

14 studies [24, 25, 29, 30, 34, 35, 40, 41, 43, 45, 48, 49, 55, 71]

All studies: -0.57, -0.95 to -0.20

‘Some concerns RoB’ studies: -0.47, -0.95 to -0.20

Total physical activity among children and adolescents in Europe decreased significantly during the COVID-19 pandemic. Analysis revealed indications that stringent school closures (partially or fully closed schools) were associated with a higher decline in TPA compared with schools where there were either no restrictions or only a small number of restrictions.

Since 47% of the studies had a high or very high RoB, a high degree of heterogeneity was present and a publication bias can be assumed, we downgraded the results to ‘low certainty of evidence’.

⊕⊕⊝⊝

Low^a,b,c

Moderate-to-vigorous physical activity

12 publications [31,32,33, 35, 37, 39, 42, 43, 45, 50, 54, 55] (data from two publications [31, 32] of the same study population with different measuring time points were aggregated)

All studies: -0.43, -0.75 to -0.10

‘Some concerns RoB’ studies: -0.43, -0.84 to -0.02

Moderate-to-vigorous physical activity among children and adolescents in Europe decreased significantly during the COVID-19 pandemic. Analysis revealed indications that stringent school closures (partially or fully closed schools) were associated with a higher decline in MVPA compared with schools where there were either no restrictions or only a small number of restrictions.

Due to the high degree of heterogeneity and an indicated publication bias, we downgraded the results to ‘low certainty of evidence’.

⊕⊕⊝⊝

Low^b,d

Sporting activity

3 publications [31, 32, 51]

No pooling occurred

Sporting activity decreased significantly in each of the three publications.

As one of the three studies had a high RoB and inconsistency of the data can be suspected, we downgraded the results to ‘low certainty of evidence’.

⊕⊕⊝⊝

Low^e,f