{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:51:07Z","timestamp":1789692667034,"version":"4.0.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic exacerbated mental health challenges among adolescents, yet the protective role of regular physical exercise (PE) in enhancing life satisfaction (LS) and quality of life (QOL) remains underexplored in this population. This study aimed to investigate the direct and indirect effects of PE on LS and QOL among Chinese adolescents during the pandemic, with a focus on its mediating pathways through alleviating depressive and anxious symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adolescents aged 12 to 17 seeking for psychological services at Shandong Provincial Hospital were recruited between June 2021 and May 2022. Using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), 6-items QOL questionnaire (QOL-6), and Adolescent Students\u2019 Life Satisfaction Scale (ASLSS), we assessed depressive symptoms, anxious symptoms, QOL, and LS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 392 adolescents (133 regular physical exercisers (PEs) vs. 259 non-regular physical exercisers (NPEs)) were included. Significant differences were observed in educational level, residence, general health status, and regular diet between PE and NPEs. A one-way ANOVA showed that PEs had significantly lower scores on GAD-7 and PHQ-9, higher QOL-6 scores, and greater LS across all six ASLSS dimensions compared to NPEs. The mediation analysis showed regular exercise indirect positive effects on QOL-6 and ASLSS 6 dimensions through the alleviation of anxious and depressive symptoms. Stepwise regression confirmed the significant positive effect of exercise on QOL, as well as LS with friendship, academic performance, and autonomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PE alleviates emotional distress and enhances subjective well-being in adolescents through dual pathways, underscoring its value as a low-cost intervention during public health crises. Findings advocate integrating structured physical activity into school-based mental health programs to foster resilience. Longitudinal studies are needed to validate causal mechanisms and optimize exercise protocols for diverse adolescent populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1692392","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:54:05Z","timestamp":1769064845000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Direct and indirect effects of physical exercise on life satisfaction and quality of life in Chinese adolescents during the COVID-19 pandemic"],"prefix":"10.3389","volume":"14","author":[{"given":"Liqiang","family":"Dou","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Qingdao University Medical College","place":["Qingdao, China"]},{"name":"Department of Psychiatry, Pingdu Mental Health Center","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Qingdao University Medical College","place":["Qingdao, China"]},{"name":"Department of Psychiatry, Qingdao Mental Health Center","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Qingdao University Medical College","place":["Qingdao, China"]},{"name":"Department of Psychiatry, Qingdao Mental Health Center","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghong","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Qingdao University Medical College","place":["Qingdao, China"]},{"name":"Department of Psychiatry, Qingdao Mental Health Center","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/s2215-0366(18)30227-x","article-title":"Association between physical exercise and mental health in 1\u00b72 million individuals in the USA between 2011 and 2015: a cross-sectional study","volume":"5","author":"Chekroud","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"110844","DOI":"10.1016\/j.isci.2024.110844","article-title":"Effect of physical activity on anxiety and depression in COVID-19 adults: a systematic review and meta-analysis","volume":"27","author":"Luo","year":"2024","journal-title":"iScience"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"714","DOI":"10.3390\/bs13090714","article-title":"The impact of regular exercise on life satisfaction, self-esteem, and self-efficacy in older adults","volume":"13","author":"Toros","year":"2023","journal-title":"Behav Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e1004384","DOI":"10.1371\/journal.pmed.1004384","article-title":"Physical activity across midlife and health-related quality of life in Australian women: a target trial emulation using a longitudinal cohort","volume":"21","author":"Nguyen","year":"2024","journal-title":"PLoS Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s12966-019-0901-7","article-title":"The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: a cohort study","volume":"16","author":"Bell","year":"2019","journal-title":"Int J Behav Nutrit Physical Activity"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.pneurobio.2011.11.007","article-title":"Cognitive and behavioural effects of physical exercise in psychiatric patients","volume":"96","author":"Kn\u00f6chel","year":"2012","journal-title":"Prog Neurobiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/eurpub\/cki159","article-title":"Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms","volume":"16","author":"Nabkasorn","year":"2006","journal-title":"Eur J Pub Health"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.2165\/00007256-198401020-00004","article-title":"Endorphins and exercise","volume":"1","author":"Harber","year":"1984","journal-title":"Sports Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12966-024-01676-6","article-title":"Physical activity and mental health: a systematic review and best-evidence synthesis of mediation and moderation studies","volume":"21","author":"White","year":"2024","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.jadohealth.2014.01.021","article-title":"The association between adolescent self-reported physical activity and wellness: the missing piece for youth wellness programs","volume":"55","author":"Rachele","year":"2014","journal-title":"J Adolesc Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.jadohealth.2019.09.017","article-title":"A longitudinal study of sport participation and perceived social competence in youth","volume":"66","author":"Bedard","year":"2020","journal-title":"J Adolesc Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1111\/sms.13957","article-title":"Association between pattern of team sport participation from adolescence to young adulthood and mental health","volume":"31","author":"Murray","year":"2021","journal-title":"Scand J Med Sci Sports"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"6616","DOI":"10.3390\/su15086616","article-title":"Physical activity and academic performance in school-age children: a systematic review","volume":"15","author":"Latino","year":"2023","journal-title":"Sustainability"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"664640","DOI":"10.3389\/fspor.2021.664640","article-title":"Effects of physical exercise interventions on spatial orientation in children and adolescents: a systematic scoping review","volume":"3","author":"Morawietz","year":"2021","journal-title":"Front Sports Act Living"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1186\/s12889-024-18822-1","article-title":"Trends of physical activity and recreational screen time among Chinese children and adolescents: a national study from 2017 to 2019","volume":"24","author":"Guo","year":"2024","journal-title":"BMC Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.15585\/mmwr.mm7344a5","article-title":"QuickStats: percentage* of children and adolescents aged 12-17 years who participated in 60 minutes of physical activity Most days or every day,(\u2020) by daily hours of screen time use(\u00a7) - United States, July 2021-December 2023","volume":"73","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2985","DOI":"10.3390\/nu14142985","article-title":"The impact of digital screen time on dietary habits and physical activity in children and adolescents","volume":"14","author":"Rocka","year":"2022","journal-title":"Nutrients"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e29719","DOI":"10.7759\/cureus.29719","article-title":"The impact of COVID-19 on the behaviors and attitudes of children and adolescents: a cross-sectional study","volume":"14","author":"Annam","year":"2022","journal-title":"Cureus"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"930","DOI":"10.3390\/nu13030930","article-title":"Lifestyle changes and determinants of children's and adolescents' body weight increase during the first COVID-19 lockdown in Greece: the COV-EAT study","volume":"13","author":"Androutsos","year":"2021","journal-title":"Nutrients"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2470","DOI":"10.3390\/ijerph18052470","article-title":"Impact of COVID-19 on mental health in adolescents: a systematic review","volume":"18","author":"Jones","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s00787-021-01856-w","article-title":"The impact of COVID-19 lockdown on child and adolescent mental health: systematic review","volume":"32","author":"Panchal","year":"2023","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1186\/s12888-023-04813-w","article-title":"The relationship between depressive and anxious symptoms and school attendance among adolescents seeking psychological services in a public general hospital in China: a cross-sectional study","volume":"23","author":"Zhao","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e74","DOI":"10.1192\/bjo.2025.22","article-title":"Examining the relationships of happiness and emotional symptoms, regular exercise and demographic characteristics among adolescents seeking psychological services: cross-sectional study with mediation analysis","volume":"11","author":"Yin","year":"2025","journal-title":"BJPsych Open"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1016\/s0140-6736(02)11681-3","article-title":"Risk factors for suicide in China: a national case-control psychological autopsy study","volume":"360","author":"Phillips","year":"2002","journal-title":"Lancet"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.jpsychires.2021.03.063","article-title":"Predictors and moderators of quality of life in patients with major depressive disorder: an AGTs-MDD study report","volume":"138","author":"Yang","year":"2021","journal-title":"J Psychiatr Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.3969\/j.issn.1671-6981.2004.05.067","article-title":"Adolescent students\u2019life satisfaction: its construct and scale development","volume":"27","author":"Zhang","year":"2004","journal-title":"Psychol Sci"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1037\/1040-3590.6.2.149","article-title":"Preliminary development and validation of a multidimensional life satisfaction scale for children","volume":"6","author":"Huebner","year":"1994","journal-title":"Psychol Assess"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1080\/17437199.2015.1022901","article-title":"A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations","volume":"9","author":"Rebar","year":"2015","journal-title":"Health Psychol Rev"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1136\/bjsports-2011-090185","article-title":"Physical activity and mental health in children and adolescents: a review of reviews","volume":"45","author":"Biddle","year":"2011","journal-title":"Br J Sports Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jshs.2020.01.002","article-title":"The mirror's curse: weight perceptions mediate the link between physical activity and life satisfaction among 727,865 teens in 44 countries","volume":"10","author":"Meyer","year":"2021","journal-title":"J Sport Health Sci"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1010194","DOI":"10.3389\/fpubh.2022.1010194","article-title":"Physical activity, sleep quality and life satisfaction in adolescents: a cross-sectional survey study","volume":"10","author":"Cao","year":"2022","journal-title":"Front Public Health"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.3390\/nu16101484","article-title":"Determinants of weight status and body, health and life satisfaction in young adults","volume":"16","author":"Suwalska","year":"2024","journal-title":"Nutrients"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"121","DOI":"10.3390\/bs11090121","article-title":"The role of physical activity in the relationship between satisfaction with life and health-related quality of life in school-age adolescents","volume":"11","author":"Villafaina","year":"2021","journal-title":"Behav Sci"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.3109\/00048674.2011.621063","article-title":"Don't worry, be active: positive affect and habitual physical activity","volume":"45","author":"Pasco","year":"2011","journal-title":"Aust N Z J Psychiatry"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4088\/pcc.v06n0301","article-title":"The benefits of exercise for the clinically depressed prim care companion","volume":"6","author":"Craft","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e33475","DOI":"10.7759\/cureus.33475","article-title":"Role of physical activity on mental health and well-being: a review","volume":"15","author":"Mahindru","year":"2023","journal-title":"Cureus"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/1479-5868-10-98","article-title":"A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport","volume":"10","author":"Eime","year":"2013","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1479-5868-7-40","article-title":"Systematic review of the health benefits of physical activity and fitness in school-aged children and youth","volume":"7","author":"Janssen","year":"2010","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1016\/j.jpeds.2005.01.055","article-title":"Evidence based physical activity for school-age youth","volume":"146","author":"Strong","year":"2005","journal-title":"J Pediatr"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1692392\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:43:56Z","timestamp":1771919036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1692392\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":41,"alternative-id":["10.3389\/fpubh.2026.1692392"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1692392","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]},"article-number":"1692392"}}