Home Based Physical Exercise for Prevention and Management of COVID-19 Pandemic and for Its Associated Consequences
Background: Corona viruses are sort of viruses that are phenotypically and genotypically diverse. COVID-19 pandemic reported the first time on December 2019 in Wuhan, China. Mental and physical well-being are negatively affected by sedentary habits and positively affected by active lifestyle. Method: The research method of this article is a systematic review and Based on titles and abstracts, reference the articles were screened for eligibility, i.e. included publications regarding the effect of physical activity on Covid-19. search strategy by used terms in relation with physical activity and Covid-19. Results: The COVID-19 pandemic has forced many people around the world to stay at home and self-isolate for a long period of time. These leads to psychological outcomes such as depression, post-traumatic stress symptoms, panic, confusion, anger, fear, and substance misuse and develops Sedentary Death Syndrome and reduce individuals’ functional ability. Conclusion: Increased physical activity levels and fitness help alleviate or relieve Covid-19 associated health problems such as depression, anxiety and stress (mental health) and at this time if an individual follows a physically active lifestyle or participate regularly in home based physical activity, it has been found to be an effective way of improving fitness and overall health of individual. The effect of regular home based exercise training has a significant positive effect on overall health of individuals. Mental and physical well-being are negatively affected by sedentary habits and positively affected by active lifestyle.
Home Based Physical Exercise for Prevention and Management of COVID-19 Pandemic and for Its Associated Consequences, European Journal of Preventive Medicine.
Vol. 8, No. 6,
2020, pp. 97-105.
Parnell, D., Widdop, P., Bond, A., & Wilson, R. (2020). COVID-19, networks and sport. Managing Sport and Leisure, https://doi.org/10.1080/23750472.2020.1750100.
Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports, 25 (S3), 1–72. https://doi.org/10.1111/sms. 12581.
Powell, K. E., Paluch, A. E., & Blair, S. N. (2011). Physical activity for health: What kind? How much? How intense? On top of what? Annual Review of Public Health, 32 (1), 349–365. https://doi.org/10.1146/annurev-publhealth-031210-101151.
Chekroud, S. R., Gueorguieva, R., Zheutlin, A. B., Paulus, M., Krumholz, H. M., Krystal, J. H., &Chekroud, A. M. (2018). Association between phys-ical exercise and mental health in 1•2 million indi-viduals in the USA between 2011 and 2015: A cross-sectional study. The Lancet Psychiatry, 5 (9), 739–746. https://doi.org/10.1016/S2215-0366(18)30227-X.
Mathieu, R. A., Powell-Wiley, T. M., Ayers, C. R., McGuire, D. K., Khera, A., Das, S. R., & Lakoski, S. G. (2012). Physical activity participation, health per-ceptions, and cardiovascular disease mortality in a multiethnic population: The Dallas heart study. American Heart Journal, 163 (6), 1037–1040. https://doi.org/10.1016/j.ahj.2012.03.005.
Booth, F. W.; Roberts, C. K.; Thyfault, J. P.; Ruegsegger, G. N.; Toedebusch, R. G. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiol. Rev. 2017, 97, 1351–1402. [CrossRef] [PubMed].
Lee, I. M.; Shiroma, E. J.; Lobelo, F.; Puska, P.; Blair, S. N.; Katzmarzyk, P. T. E ect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet 2012, 380, 219–229. [CrossRef].
Lees, S. J.; Booth, F. W. Sedentary death syndrome. Can. J. Appl. Physiol. 2004, 29, 447–460. [CrossRef] [PubMed].
Castrogiovanni, P.; Trovato, F. M.; Szychlinska, M. A.; Nsir, H.; Imbesi, R.; Musumeci, G. The importance of physical activity in osteoporosis. From the molecular pathways to the clinical evidence. Histol. Histopathol. 2016, 31, 1183–1194. [PubMed].
Musumeci, G. Sarcopenia and Exercise “The State of the Art”. J. Funct. Morphol. Kinesiol. 2017, 2, 40. [CrossRef].
Castrogiovanni, P.; Di Rosa, M.; Ravalli, S.; Castorina, A.; Guglielmino, C.; Imbesi, R.; Vecchio, M.; Drago, F.; Szychlinska, M. A.; Musumeci, G. Moderate Physical Activity as a Prevention Method for Knee Osteoarthritis and the Role of Synoviocytes as Biological Key. Int. J. Mol. Sci. 2019, 20, 511. [CrossRef] [PubMed].
Szychlinska, M. A.; Castrogiovanni, P.; Trovato, F. M.; Nsir, H.; Zarrouk, M.; Lo Furno, D.; Di Rosa, M.; Imbesi, R.; Musumeci, G. Physical activity and Mediterranean diet based on olive tree phenolic compounds from two di erent geographical areas have protective e ects on early osteoarthritis, muscle atrophy and hepatic steatosis. Eur. J. Nutr. 2019, 58, 565–581. [CrossRef] [PubMed].
World Health Organization. Physical activity, https://www.who.int/news-room/fact-sheets/detail/physical-activ ity (2018, accessed 12 March 2020).
Tiberi M and Piepoli MF. Regular physical activity only associated with low sedentary time increases survival in post myocardial infarction patient. Eur J PrevCardiol 2019; 26: 94–96.
Cheng W, Zhang Z, Cheng W, et al. Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J PrevCardiol 2018; 25: 1864–1872.
Engeseth K, Prestgaard EE, Mariampillai JE, et al. Physical ﬁtness is a modiﬁable predictor of early cardiovascular death: A 35-year follow-up study of 2014 healthy middle-aged men. Eur J PrevCardiol 2018; 25: 1655–1663.
Centers for Disease Control, 2009). Centers for Disease Control and Prevention. (2009). Obesity - Halting the epidemic by making health easier. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved fromhttp://www.cdc.gov/chronicdisease/index.htm.
Cline, K. P., Spradlin, T. E., &Plucker, J. P. (2005). Child obesity in Indiana: A growing public policy concern. Bloomington, IN: Center for Evaluation & Education Policy.
Summerbell CD, Waters E, Edmunds L, Kelly SAM, Brown T, & Campbell KJ. (2005). Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD001871. DOI: 10.1002/14651858.CD001871.pub2.
Harada, T., Okagawa, S., & Kubota, K. (2004). Jogging improved performance of a behavioralbranching task: implications for prefrontal activation. Neuroscience Research, 49 (3), 325-337. doi: 10.1016/j.neures.2004.03.011.
Sibley, B. A., & Etnier, J. L. (2003). The relationship between physical activity and cognition inchildren: a meta-analysis. Pediatric Exercise Science, 15, 243-256.
Haskell, W. L., I-Min Lee, F., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116 (9), 1081–1093.
US Department of Health. (1997). Physical Activity and Health: A Report of the Surgeon General. Atlanta: National Center for Chronic Disease Prevention and Health Promotion. (Biddle &Mutrie, 2008; Strôhle, 2009).
Biddle, S. J. H., &Mutrie, N. (2008). Psychology of Physical Activity: Determinants, Wellbeing and Interventions. (2nd ed.). New York: Routledge.
Lawlor & Hopker, 2001; Lawlor, D. A., &Hopker, S. W. (2001). The effectiveness of exercise as an intervention in the management of depression: Systematic review and meta-regression analysis of randomised controlled trials. British Medical Journal, 322 (7289), 763.
McDonald & Hodgdon, 1991; McDonald, D. G., & Hodgdon, J. A. (1991). The Psychological Effects of Aerobic Fitness Training Research and Theory. New York: Springer Verlag.
North, McCullagh, & Tran, 1990). North, T. C., McCullagh, P., & Tran, Z. V. (1990). Effect of exercise on depression. Exercise and Sport Sciences Reviews, 18 (1), 379–416.
Eveland-Sayers, B. M., Farley, R. S., Fuller, D. K., Morgan, D. W., & Caputo, J. L.(2009). Physical fitness and academic achievement in elementary school children. Journal of Physical Activity and Health, 6, 99-104.
(Augestad, Slettemoen, & Flanders, 2008; Augestad, L. B., Slettemoen, R. P., & Flanders, W. D. (2008). Physical activity and depressive symptoms among Norwegian adults aged 20–50. Public Health Nursing, 25 (6), 536–545.
De Moor, Beem, Stubbe, Boomsma, & De Geus, 2006; De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: A population-based study. Preventive Medicine, 42 (4), 273–279. doi: 10.1016/j.ypmed.2005.12.002.
De Moor, Boomsma, Stubbe, Willemsen, & de Geus, 2008; De Moor, M. H. M., Boomsma, D. I., Stubbe, J. H., Willemsen, G., & de Geus, E. J. C. (2008). Testing causality in the association between regular exercise and symptoms of anxiety and depression. Archives of General Psychiatry, 65 (8), 897–905.
Goodwin, 2003; Goodwin, R. D. (2003). Association between physical activity and mental disorders among adults in the United States. Preventive Medicine, 36 (6), 698–703. doi: 10.1016/S0091-7435(03)00042-2.
Mutrie & Hannah, 2007; Mutrie, N., & Hannah, M. K. (2007). The importance of both setting and intensity of physical activity in relation to non-clinical anxiety and depression. International Journal of Health Promotion and Education, 45 (1), 24–32.
Harvey, Hotopf, Overland, &Mykletun, 2010; Harvey, S. B., Hotopf, M., Overland, S., &Mykletun, A. (2010). Physical activity and common mental disorders. The British Journal of Psychiatry, 197 (5), 357–364.
Mikkelsen et al., 2010; Mikkelsen, S. S., Tolstrup, J. S., Flachs, E. M., Mortensen, E. L., Schnohr, P., &FlensborgMadsen, T. (2010). A cohort study of leisure time physical activity and depression. Preventive Medicine, 51 (6), 471–475. doi: 10.1016/j.ypmed.2010.09.008.
Teychenne, Ball, & Salmon, 2008; Teychenne, M., Ball, K., & Salmon, J. (2008). Physical activity and likelihood of depression in adults: A review. [doi: DOI: 10.1016/j.ypmed.2008.01.009]. Preventive Medicine, 46 (5), 397-411.
Thorsen, L., Nystad, W., Stigum, H., Dahl, O., Klepp, O., Bremnes, R. M., et al. (2005). The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample. Supportive Care in Cancer, 13 (8), 637–646.
Bhaskarabhatla KV and Birrer R. Physical activity and diabetes mellitus. ComprTher 2005; 31: 291–298.
Lippi G and Sanchis-Gomar F. An estimation of the worldwide epidemiologic burden of physical inactivity- related ischemic heart disease. Cardiovasc Drugs Ther 2020; 34: 133–137.
Brooks SK, Webster RK, S mi th LE, e t al. The p sychological impact of quarantine an d h ow to re du ce it: R ap id review of the e vi de nce. Lancet 2 0 2 0; 3 9 5: 9 12–9 20.
Silvia Ravalliand Giuseppe Musumeci (2020). Coronavirus Outbreak in Italy: Physiological Benefits of Home-Based Exercise During Pandemic, J. Funct. Morphol. Kinesiol., 5, 31; doi: 10.3390/jfmk5020031.
Gasmi A, Noor S, Tippairote T, Dadar M. Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic. ClinImmunol. 2020; 7: 108409. DOI: 10.1016/j.clim.2020.108409.
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. ClinImmunol. 2020; 108427. DOI: 10.1016/j.clim.2020.108427.
Scavone C, Brusco S, Bertini M. Current pharmacological treatments for COVID-19: what's next? Br J Pharmacol. 2020. DOI: 10.1111/bph.15072.
Siordia JA Jr. Epidemiology and clinical features of COVID-19: A review of current literature. J ClinVirol. 2020; 127: 104357. DOI: 10.1016/j.jcv.2020.104357.
Walsh NP, Gleeson M, Shephard RJ, et al. Position statement. Part one: Immune function and exercise. ExercImmunol Rev. 2011; 17: 6-63. DOI: 10.1002/eji.201040296.
Martin SA, Pence BD, Woods JA. Exercise and respiratory tract viral infections. Exerc Sport Sci Rev. 2009; 37 (4): 157-64. DOI: 10.1097/JES.0b013e3181b7b57b.
Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain Behav Immun. 2005; 19 (5): 377-80. DOI: 10.1016/j.bbi.2005.04.002.
Warren KJ, Olson MM, Thompson NJ. Exercise Improves Host Response to Influenza Viral Infection in Obese and Non-Obese Mice through Different Mechanisms. PLoS One. 2015; 10 (6): e0129713. DOI: 10.1371/journal.pone.0129713.
Sim YJ, Yu S, Yoon KJ, Loiacono CM. Chronic exercise reduces illness severity, decreases viral load, and results in greater anti-inflammatory effects than acute exercise during influenza infection. J Infect Dis. 2009; 200 (9): 1434-42. DOI: 10.1086/606014.
Davis JM, Kohut ML, Colbert LH. Exercise, alveolar macrophage function, and susceptibility to respiratory infection. J ApplPhysiol (1985). 1997; 83 (5): 1461-6. DOI: 10.1152/jappl.19188.8.131.521.
Murphy EA, Davis JM, Carmichael MD. Exercise stress increases susceptibility to influenza infection. Brain Behav Immun. 2008; 22 (8): 1152-5. DOI: 10.1016/j.bbi.2008.06.004.
Lowder T, Padgett DA, Woods JA. Moderate exercise early after influenza virus infection reduces the Th1 inflammatory response in lungs of mice. ExercImmunol Rev. 2006; 12: 97-111. DOI: 10.1016/j.bbi.2005.04.002.
Murphy EA, Davis JM, Brown AS, Carmichael MD, Van Rooijen N, Ghaffar A, Mayer EP. Role of lung macrophages on susceptibility to respiratory infection following short-term moderate exercise training. Am J PhysiolRegulIntegr Comp Physiol. 2004; 287 (6): R1354-8. DOI: 10.1016/j.bbi.2008.06.004.
Kohut ML, Davis JM, Jackson DA, Colbert LH, Strasner A, Essig DA, Pate RR, Ghaffar A, Mayer EP. The role of stress hormones in exercise-induced suppression of alveolar macrophage antiviral function. J Neuroimmunol. 1998; 81 (1-2): 193-200. DOI: 10.1016/s01655728(97)00179-3.
Kohut ML, Martin AE, Senchina DS, Lee W. Glucocorticoids produced during exercise may be necessary for optimal virus-induced IL-2 and cell proliferation whereas both catecholamines and glucocorticoids may be required for adequate immune defense to viral infection. Brain Behav Immun. 2005; 19 (5): 423-35. DOI: 10.1016/j.bbi.2005.04.006.
Nieman DC, Johanssen LM, Lee JW, Arabatzis K. Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness. 1990; 30 (3): 316-28. DOI: 10.1249/00005768-199402000-00002.
Nieman DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Exerc. 1994; 26 (2): 128-39. DOI: 10.1249/00005768-199402000-00002.
Svendsen IS, Hem E, Gleeson M. Effect of acute exercise and hypoxia on markers of systemic and mucosal immunity. Eur J Appl Physiol. 2016; 116 (6): 1219-29. DOI: 10.1007/s00421-016-3380-4.
Gleeson M, Bishop N, Oliveira M, McCauley T, Tauler P, Muhamad AS. Respiratory infection risk in athletes: association with antigen-stimulated IL-10 production and salivary IgA secretion. Scand J Med Sci Sports. 2012; 22 (3): 410-7. DOI: 10.1111/j.1600-0838.2010.01272.x.
Rooney BV, Bigley AB, LaVoy EC et al. Lymphocytes and monocytes egress peripheral blood within minutes after cessation of steady state exercise: A detailed temporal analysis of leukocyte extravasation. Physiol Behav. 2018; 194: 260-267. DOI: 10.1016/j.physbeh.2018.06.008.
Simpson RJ, Campbell JP, Gleeson M, et al. Can exercise affect immune function to increase susceptibility to infection? ExercImmunol Rev. 2020; 26: 8-22.
Weidner TG, Cranston T, Schurr T, et al. The effect of exercise training on the severity and duration of a viral upper respiratory illness. Med Sci Sports Exerc. 1998; 30 (11): 1578-83. DOI: 10.1097/00005768-199811000-00004.
Vassilakopoulos T, Petrof BJ. Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med.2004; 169 (3): 336-341. DOI: 10.1164/rccm.200304-489CP.
McKenzie DC. Respiratory physiology: adaptations to high-level exercise. Br J Sports Med. 2012; 46 (6): 381-384. DOI: 10.1136/bjsports-2011-090824.
Powers SK, Bomkamp M, Ozdemir M, et al. Mechanisms of exercise-induced preconditioning in skeletal muscles. Redox Biol. 2020; 101462. DOI: 10.1016/j.redox.2020.101462.
Morton AB, Smuder AJ, Wiggs MP, et al. Increased SOD2 in the diaphragm contributes to exercise-induced protection against ventilator-induced diaphragm dysfunction. Redox Biol. 2019; 20: 402-413. DOI: 10.1016/j.redox.2018.10.005.
Smuder AJ, Min K, Hudson MB, et al. Endurance exercise attenuates ventilator-induced diaphragm dysfunction. J Appl Physiol. 2012; 112 (3): 501-510. DOI: 10.1152/japplphysiol.01086.2011.
Smuder AJ, Morton AB, Hall, S E, et al. Effects of exercise preconditioning and HSP72 on diaphragm muscle function during mechanical ventilation. J Cachexia Sarcopenia Muscle. 2019; 10 (4): 767-781. DOI: 10.1002/jcsm.12427.
Bowden Davies KA, Pickles S, Sprung VS, Kemp GJ, Alam U, Moore DR, Tahrani AA & Cuthbertson DJ. Reduced physical activity in young and older adults: metabolic and musculoskeletal implications. Ther Adv Endocrinol Metab. 2019; 10: 2042018819888824. DOI: 10.1177/2042018819888824.
Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018; 32019: 2020-2028. DOI: 10.1001/jama.2018.14854.
Anderson E, Durstine JL. Physical activity, exercise, and chronic diseases: a brief review. Sports Med Health Sci. 2019; 1 (1): 3-10. DOI: 10.1016/j.smhs.2019.08.006.
World Health Organization. Global Strategy on Diet, Physical Activity and Health. 2011 a; https://www.who.int/dietphysicalactivity/factsheet_adults/en/.
World Health Organization. Global Strategy on Diet, Physical Activity and Health. 2011b; dations-5-17years.pdf?ua=1" https://www.who.int/dietphysicalactivity/publications/physical-activity-recommendations-517years.pdf?ua=1.
Norton S, Matthews FE, Barnes DE, et al. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol.2014; 13: 788-794. DOI: 10.1016/S1474-4422(14)70136-X.
Liguori G. ACSM's Guidelines for Exercise Testing and Prescription. 11th ed. Philadelphia, PA: Wolters Kluwer; 2017.
World Health Organization. (2010). Global recommen-dations on physical activity for health.
Bangsbo, J., Mohr, M., Poulsen, A., Perez-Gomez, J., &Krustrup, P. (2006). Training and testing the elite athlete. Review. Journal of Exercise Science and Fitness, 4 (1), 1–14.
Fox et al., 1971; Fox, S. M. 3rd., Naughton, J. P., & Haskell, W. L. (1971). Physical activity and the prevention of coronary heart disease. Annals of Clinical Research, 3 (6), 404–432. PMID: 4945367.
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., Nieman, D. C., & Swain, D. P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in appar-ently healthy adults: Guidance for prescribing exer-cise SPECIAL COMMUNICATIONS: POSITION STAND. Medicine & Science in Sports & Exercise, 43 (7), 1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb.
Barene, S., Krustrup, P., Jackman, S. R., Brekke, O. L., &Holtermann, A. (2014). Do soccer and Zumba exer-cise improve fitness and indicators of health among female hospital employees? A 12-week RCT. Scandinavian Journal of Medicine & Science in Sports, 24 (6), 990–999. https://doi.org/10.1111/ sms.12138.
Connolly, L. J., Scott, S., Morencos, C. M., Fulford, J., Jones, A. M., Knapp, K., Krustrup, P., Bailey, S. J., & Bowtell, J. L. (2020). Impact of a novel home-based exercise intervention on health indicators in inactive premenopausal women: A 12-week randomised controlled trial. European Journal of Applied Physiology, Mar 19. [Epub ahead of print]. https://doi.org/10.1007/s00421-020- 04315-7.
Alpert, P. T. (2011). The health benefits of dance. Home Health Care Management & Practice, 23 (2), 155–157. https://doi.org/10.1177/1084822310384689.
Hernandes, J. C., Di Castro, V. C., Mendonça, M. E., & Porto, C. C. (2018). Quality of life of women who practice dance: A systematic review protocol. Systematic Reviews, 7 (1), 92. https://doi.org/10.1186/s13643-018-0750-5\.
Connolly, L. J., Bailey, S. J., Krustrup, P., Fulford, J., Smietanka, C., & Jones, A. M. (2017). Effects of self-paced interval and continuous training on health markers in women. European Journal of Applied Physiology, 117 (11), 2281–2293. https://doi.org/10.1007/s00421-017-3715-9.
AmriHammami, BasmaHarrabi, Magni Mohr & Peter Krustrup (2020): Physicalactivity and coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training, Managing Sport and Leisure, 10. DOI: 1080/23750472.2020.1757494.
Tanaka, H., Monahan, K. D., & Seals, D. R. (2001). Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology, 37 (1), 153–156. https://doi.org/10.1016/S0735-1097(00)01054-.
Harrison, J. S. (2010). Bodyweight training: A return to basics. Strength and Conditioning Journal, 32 (2), 52–55. https://doi.org/10.1519/SSC.0b013e3181d 5575c.
Jönhagen, S., Ackermann, P., & Saartok, T. (2009). Forward lunge: A training study of eccentric exer-cises of the lower limbs. Journal of Strength and Conditioning Research, 23 (3), 972–978. https://doi.org/10.1519/JSC.0b013e3181a00d98.
Kikuchi, N., &Nakazato, K. (2017). Low-load bench press and push-up induce similar muscle hypertro-phy and strength gain. Journal of Exercise Science & Fitness, 15 (1), 37–42. https://doi.org/10.1016/j.jesf. 2017.06.003.
Watanabe, Y., Tanimoto, M., Oba, N., Sanada, K., Miyachi, M., & Ishii, N. (2015). Effect of resistance training using bodyweight in the elderly: Comparison of resistance exercise movement between slow and normal speed movement. Geriatrics Gerontology International, 15 (12), 1270– 1277. https://doi.org/10.1111/ggi.12427.
Lipecki, K., &Rutowicz, B. (2015). The impact of ten weeks of bodyweight training on the level of phys-ical fitness and selected parameters of body com-position in women aged 21-23 years. Polish Journal of Sport and Tourism, 22 (2), 64–68. https://doi.org/10.1515/pjst-2015-0014.