Figure 5
The flow begins at the top centre with an image showing a woman seated on a sofa, holding a remote control in a relaxed position inside a text box labeled “Physical inactivity or sedentary lifestyle”. Above her, four text boxes are shown arranged horizontally and labeled from left to right as follows: “Ignorance”, “Overprotection”, “Self-isolation”, and “Fear”. From these four boxes, a downward arrow arises labeled “Independent effects?”, pointing to “Physical inactivity or sedentary lifestyle”. From “Physical inactivity or sedentary lifestyle”, a downward arrow arises and points to the bottom centre, where an image shows a woman bent forward while holding her knees, symbolizing pain. Next to this woman, a text box labeled “Systemic dysfunction” is shown. From “Systemic dysfunction”, an upward arrow labeled “Direct (for example, joint pain) or indirect (for example, dyslipidaemia) effects” is shown pointing back to “Physical inactivity or sedentary lifestyle”. Below “Systemic dysfunction”, five text boxes are shown arranged horizontally and labeled from left to right as follows: “Low self-esteem or poor quality of life”, “Poor quality of life”, “Symptoms worsening”, “Deconditioning”, and “Metabolic disturbances”. From these five boxes, an upward arrow arises and points to “Systemic dysfunction”.Vicious cycle of physical inactivity and systemic function (Gualano et al., 2017)