Supplementary Material for: Physical Exercise as a Resilience Factor to Mitigate COVID-Related Allostatic Overload

<b><i>Introduction:</i></b> The long-lasting threat of COVID-19 makes it necessary to explore strategies to improve coping skills which enable us to master a balanced life in the face of adversity. <b><i>Objective:</i></b> To unravel the most challenging aspects of COVID-19 in a nonclinical adult population and identify predictors of lost balance and consequent allostatic overload (AO). We examined the role of regular, moderate-intensity formula aerobic exercise (312 meridian exercise) in preventing allostatic overload through increasing well-being. <b><i>Methods:</i></b> An online survey was conducted to measure CO­VID-related allostatic overload according to clinimetric criteria. The Psychosocial Index (PSI), Kellner’s Symptom Questionnaire (KSQ), short Depression Anxiety Stress Scales (DASS-21), Public Health Surveillance Well-Being Scale ­(PHS-WB), and Whiteley-7 were used to explore mental health characteristics. Univariate statistics logistic regression analysis and a general linear model were used. <b><i>Results:</i></b> According to 442 valid answers, 217 adults practiced physical exercise (PE) frequently (fPE, 3–5 times/every day) while 120 did it less regularly (1–2 times/week), and 105 did not exercise/practiced irregularly (controls). Restriction-related stressors were most challenging, resulting in AO in 29% (<i>n</i> = 128) of the sample. The main predictors were additional stressors (<i>p</i> = 0.005) and anxiety symptoms (<i>p</i> &lt; 0.001). The prevalence of AO was lower (<i>p</i> = 0.018) in the fPE group when compared to controls. KSQ distress symptoms were also lower in fPE (<i>p</i> &lt; 0.0001), while total well-being was increased (<i>p</i> &lt; 0.001) after adjusting for sex, age, and number of chronic diseases. According to the PHS-WB, both physical and mental well-being were higher (<i>p</i> = 0.003 and <i>p</i> = 0.004, respectively) in fPE. <b><i>Conclusions:</i></b> Frequent moderate exercise is associated with better mental and physical well-being and a lower prevalence of AO.

**引言**：新冠疫情（COVID-19）的长期威胁使得探索提升应对能力的策略成为必要，该能力可帮助我们在逆境中维持平衡的生活状态。
**研究目的**：旨在阐明非临床成年人群体中新冠疫情带来的最具挑战性的方面，并识别平衡失调及后续稳态负荷（allostatic overload, AO）的预测因子。本研究探讨了规律、中等强度的配方有氧运动（312经络锻炼法）通过提升幸福感以预防稳态负荷的作用。
**研究方法**：本研究通过线上问卷调查，依据临床测量标准评估与新冠相关的稳态负荷。采用社会心理指数（Psychosocial Index, PSI）、凯尔纳症状问卷（Kellner’s Symptom Questionnaire, KSQ）、抑郁焦虑压力简化量表（short Depression Anxiety Stress Scales, DASS-21）、公共卫生监测幸福感量表（Public Health Surveillance Well-Being Scale, PHS-WB）以及Whiteley-7量表探究心理健康特征。统计分析采用单变量logistic回归分析及一般线性模型。
**研究结果**：本次研究共回收442份有效问卷，其中217名成年人频繁进行体育锻炼（PE），属于高频体育锻炼组（fPE，每日3~5次），120名锻炼频率较低（每周1~2次），另有105名未进行规律锻炼或锻炼无规律（对照组）。与疫情管控相关的应激源是最具挑战性的因素，29%的受试者（n=128）出现了稳态负荷。主要预测因子为额外应激源（p=0.005）与焦虑症状（p<0.001）。与对照组相比，高频体育锻炼组的稳态负荷患病率更低（p=0.018）。高频体育锻炼组的凯尔纳症状问卷困扰症状评分也更低（p<0.0001）；在校正性别、年龄及慢性病数量后，总体幸福感显著提升（p<0.001）。依据公共卫生监测幸福感量表结果，高频体育锻炼组的躯体幸福感与心理幸福感均显著更高（分别为p=0.003与p=0.004）。
**研究结论**：规律的中等强度运动与更佳的躯体及心理幸福感、更低的稳态负荷患病率显著相关。