Direct and indirect effects of physical exercise on life satisfaction and quality of life in Chinese adolescents during the COVID-19 pandemic.

Regular physical exercisers had significantly lower anxiety and depression scores compared to non-regular physical exercisers.

• Sample included 392 adolescents aged 12–17 seeking psychological services at Shandong Provincial Hospital, recruited between June 2021 and May 2022.
• 133 were classified as regular physical exercisers (PEs) and 259 as non-regular physical exercisers (NPEs).
• A one-way ANOVA showed that PEs had significantly lower scores on GAD-7 (anxiety) and PHQ-9 (depression) compared to NPEs.
• Assessments used the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Generalized Anxiety Disorder-7 (GAD-7) for anxious symptoms.

Regular physical exercisers had significantly higher quality of life and life satisfaction scores across all measured dimensions compared to non-exercisers.

• PEs had higher QOL-6 scores and greater life satisfaction across all six ASLSS dimensions compared to NPEs.
• Life satisfaction was measured using the Adolescent Students' Life Satisfaction Scale (ASLSS) and quality of life with the 6-item QOL questionnaire (QOL-6).
• Differences were assessed using one-way ANOVA.

Regular exercise had indirect positive effects on quality of life and all six life satisfaction dimensions through the alleviation of anxious and depressive symptoms.

• Mediation analysis demonstrated that the indirect pathway from regular exercise to QOL-6 and each of the six ASLSS dimensions was mediated by reductions in anxiety and depressive symptoms.
• Both anxious symptoms (GAD-7) and depressive symptoms (PHQ-9) served as mediators in these pathways.
• The mediation analysis identified dual mediating pathways—through alleviation of anxiety and through alleviation of depression—supporting a dual-pathway model.

Stepwise regression confirmed significant positive direct effects of exercise on quality of life and on specific life satisfaction dimensions including friendship, academic performance, and autonomy.

• Stepwise regression was used to confirm direct effects of regular exercise on outcomes after accounting for mediators.
• Significant direct effects were found for QOL-6, and for the ASLSS dimensions of friendship, academic performance, and autonomy.
• Not all ASLSS dimensions showed significant direct effects, suggesting some LS dimensions were influenced primarily through indirect (mediated) pathways.

Significant demographic and lifestyle differences existed between regular physical exercisers and non-regular physical exercisers in the sample.

• Significant differences were observed between PE and NPE groups in educational level, residence, general health status, and regular diet.
• The sample was drawn from adolescents aged 12–17 seeking psychological services, limiting generalizability to the broader adolescent population.
• Data collection occurred during June 2021 to May 2022, during the ongoing COVID-19 pandemic in China.