Relationships Between Physical Activity, Sedentary Behavior and Anxiety in Chinese Children with Visual Impairment: A Cross-lagged Analysis

Background Children with visual impairment (VI) tend to maintain the insufficient physical activity (PA) engagement and excessive sedentary behavior (SB) that could elevate health risks of various domains. Anxiety have been shown to correlate with PA and SB in general population, whereas the longitudinal or temporal relationships between PA, SB, and anxiety have yet to be examined in children with VI. Therefore, the primary purpose of this study is to investigate the bidirectional relationships between these variables over time. Methods 72 Chinese children with VI (mean age = 14.65 +/- 3.34 years) recruited from a special school for individuals with VI participated in this study. Moderate-to-vigorous physical activity (MVPA) and SB were assessed using ActiGraph GT3x + accelerometers across seven consecutive days. Anxiety was assessed by a self-reported questionnaire. Cross-lagged panel models were employed to examine the potential bidirectional relationships between PA, SB, and anxiety at baseline (T1) and 12-week follow-up (T2). Results T1 anxiety significantly predicted T2 MVPA only in children with low vision (beta= -0.30, p = 0.01). In additional, children with blindness showed a cross-lagged effect of T1 MVPA on T2 anxiety (beta=-0.29, p = 0.02). Lastly, anxiety significantly predicted T2 SB in the total sample (beta = 0.21, p = 0.04) and children with low vision (beta = 0.42, p < 0.01). Conclusion The relationships between PA, SB and anxiety were not bidirectional in children with VI. It is suggested that higher anxiety predicted less PA and more SB in children with low vision.