Stress Impact of COVID-19 Sports Restrictions on Disabled Athletes

Pandemic-specific coping, anxiety, and depression across multiple waves of COVID-19 in elite athletes with disabilities

Objectives

Competitive athletes have faced many of the same mental health challenges experienced by the general population during the COVID-19 pandemic. The purpose of the current study was to examine the extent to which pandemic-specific coping predicted anxiety and depression over and above general coping styles in elite athletes with disabilities across multiple waves of the COVID-19 pandemic.

Methods

Participants were 91 athletes (60 men and 31 women) in the Polish Paralympic Preparation Program before the 2020 Tokyo Summer Paralympic Games and 2022 Beijing Winter Paralympic Games. The Coping Inventory for Stressful Situations and an open-ended item asking participants to describe coping resources they had used to overcome stressful situations caused by the pandemic were administered in April 2021, and the Hospital Anxiety and Depression Scale was administered in April, July, and November of 2021.

Results

General coping styles were not significantly associated with pandemic-specific coping, anxiety, or depression in the July and November 2021 assessments. Pandemic-specific coping was related prospectively to both anxiety and depression across the July and November 2021 assessments when controlling for age, gender, general coping styles, and April 2021 anxiety and depression, respectively.

Conclusion

The findings suggest that elite athletes with disabilities may cope with pandemic-related stress differently from how they cope with stress in general and that pandemic-specific coping may be relevant to mental health outcomes during the COVID-19 pandemic. This information may be useful in the development of interventions to assist elite athletes with disabilities cope with pandemics and other atypical stressors.

Psychological changes in athletes infected with Omicron after return to training: fatigue, sleep, and mood

Background

This study aims to analyze the changes of approximately 1 month in fatigue, sleep, and mood in athletes after returning to training following infection with the COVID-19 Omicron strain and provide recommendations for returning to training after infection.

Methods

Two hundred and thirty professional athletes who had returned to training after being infected with COVID-19 in December 2022 were recruited to participate in three tests conducted from early January 2023. The second test was completed approximately 1 week after the first, and the third was completed about 2 weeks after the second. Each test consisted of completing scales and the exercise-induced fatigue measure. The scales included a visual analog scale, the Athens Insomnia Scale for non-clinical application, and the Depression-Anxiety-Stress scale. The exercise task was a six-minute stair climb test, and athletes evaluated subjective fatigue levels before and after exercise using another Visual Analog Scale and the Karolinska Sleepiness Scale.

Results

After returning to training, athletes' physical fatigue decreased initially but increased as training progressed. Cognitive fatigue did not change significantly. The exercise task led to elevated levels of physical fatigue after a longer duration of training. Sleep quality problems decreased rapidly after the start of training but remained stable with prolonged training. Depression levels continued to decline, while anxiety levels only reduced after a longer duration of training. Stress levels decreased rapidly after the start of training but did not change with prolonged training.

Conclusion

Athletes who return to training after recovering from COVID-19 experience positive effects on their fatigue, sleep, and mood. It is important to prioritize anxiety assessment and interventions during the short period after returning and to continue monitoring fatigue levels and implementing recovery interventions over a longer period of time.

Impact of Prolonged Cessation of Organized Team Training Due to the COVID-19 Pandemic on the Body Composition of Japanese Elite Female Wheelchair Basketball Athletes

Studies on the effects of training confinement on athletes with physical impairments are limited. Hence, in this retrospective cohort study, we aimed to investigate the impact of prolonged cessation of organized team training due to the coronavirus disease 2019 pandemic on the body composition of elite female Japanese basketball athletes. Fourteen female wheelchair basketball athletes (aged ≥20 years) were enrolled. The primary outcomes were lean and adipose indices measured using whole-body dual-energy X-ray absorptiometry. The impact of prolonged organized team training cessation on body composition was investigated by comparing the body composition at baseline and post-training confinement. A reduced whole-body lean mass (p = 0.038) and percent lean mass (p = 0.022), as well as an increased percent body fat (p = 0.035), were observed after the confinement period. The regional analysis revealed reduced percent lean and increased percent fat masses in the trunk (p = 0.015 and p = 0.026, respectively) and upper limbs (p = 0.036 and p = 0.048, respectively). In conclusion, prolonged organized team training cessation reduced lean mass and increased body fat percentage, primarily in the trunk and upper limbs. Individualized training programs targeting these body regions should be implemented to improve body composition and physical conditions in athletes during and after prolonged cessation of organized team training.

Impact of COVID-19 Infection on Cardiorespiratory Fitness, Sleep, and Psychology of Endurance Athletes-CAESAR Study

COVID-19 has a deteriorating impact on health which is especially important for endurance athletes (EAs) who need to maintain continuity of training. The illness affects sleep and psychology, which influence sport performance. The aims of this study were: (1) to assess the consequences of mild COVID-19 on sleep and psychology and (2) to assess the consequences of mild COVID-19 on cardiopulmonary exercise test (CPET) results. A total of 49 EAs (males = 43, 87.76%; females = 6, 12.24%; age = 39.9 ± 7.8 years; height = 178.4 ± 6.8 cm; weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m^-2) underwent a maximal cycling or running CPET pre- and post-COVID-19 and completed an original survey. Exercise performance deteriorated after COVID-19 (maximal oxygen uptake, VO_2max = 47.81 ± 7.81 vs. 44.97 ± 7.00 mL·kg·min^-1 pre- and post-infection, respectively; p < 0.001). Waking up at night affected the heart rate (HR) at the respiratory compensation point (RCP) (p = 0.028). Sleep time influenced pulmonary ventilation (p = 0.013), breathing frequency (p = 0.010), and blood lactate concentration (Lac) (p = 0.013) at the RCP. The maximal power/speed (p = 0.046) and HR (p = 0.070) were linked to the quality of sleep. Stress management and relaxation techniques were linked with VO_2max (p = 0.046), maximal power/speed (p = 0.033), and maximal Lac (p = 0.045). Cardiorespiratory fitness deteriorated after mild COVID-19 and was correlated with sleep and psychological indices. Medical professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.

“The show must go on”: How Paralympic athletes safeguarded their mental well-being and motivation to train for the postponed Tokyo 2020 games

Introduction

After the decision to postpone the Tokyo 2020 Games due to the COVID-19 pandemic, athletes had to adjust to a novel situation with feelings of uncertainty and insecurity. Grounded in Self-Determination Theory, this study was the first to examine whether different motivational profiles among Paralympic athletes can be identified, and to link these profiles with the athletes’ emotional, cognitive, and performance-related outcomes in times of a pandemic.

Methods

Five months before the start of the Paralympic Games, the participants (N = 32; mean age = 33.2 ± 6.8 years) completed an online questionnaire measuring their demographics, basic psychological needs, perceived stress, depressive symptoms, general well-being, and motivational self-regulation strategies. Two months after the Games, they completed a second online questionnaire measuring their actual and perceived performance at the past Games.

Results

Through K-means cluster analysis, three distinct clusters were identified based on the athletes’ dominant type of motivation, these are, dominantly amotivated (n = 11), autonomously motivated (n = 12), and controlled motivated (n = 9). Comparisons of athletes’ emotional, cognitive, and performance-related outcomes depending on their motivational profile revealed that the athletes with a dominantly amotivated profile had the least adaptive outcomes (i.e., low need satisfaction, high need frustration, and more depressive symptoms). Athletes with a dominantly autonomously motivated profile made less use of controlling self-motivating strategies compared to the other two profiles. Moreover, their actual performance at the Paralympic Games was better.

Discussion

Although none of the athletes were at severe risk for depression or showed extremely high levels of stress, these results confirm that improving the quality of athletes’ motivation can safeguard their well-being and enhance performance in Paralympic Sports.

Psychological Wellbeing and Perceived Fatigue in Competitive Athletes after SARS-CoV-2 Infection 2 Years after Pandemic Start: Practical Indications

The COVID-19 pandemic deeply affected sports and athletes, influencing performance and psychological wellbeing. In order to provide useful guidelines for coaches, a web-based survey was conducted. Three web-based questionnaires were administered during the last phase of the Omicron wave to a total of 204 Italian athletes (age 24.96 ± 9.82): an informative questionnaire to collect sociodemographic data and infection symptoms information, the Fatigue Severity Scale (FSS) and the General Health Questionnaire-12 (GHQ-12). No differences between infection sequels of different variant typologies were found over the long term after the infection. The most frequently declared symptoms included cough (50%), muscular skeletal impairments (48%) fatigue (43%) and fever (43%). Results showed that female athletes have a higher risk of developing post-COVID-19 symptoms, GHQ-12 worse results (p = 0.005) and greater fatigue (p = 0.0002) than males. No significant difference in infection incidence between high- and low-level athletes was found. Endurance athletes showed greater perceived fatigue than anaerobic sports athletes (p = 0.045). Conclusions: These results suggested the need for specific approaches and continuous updating to differentiate training programs for different athletes during the return to play. Medical controls and daily monitoring of athletes of all levels after the infection could be advisable.

A tale of two stories: COVID-19 and disability. A critical scoping review of the literature on the effects of the pandemic among athletes with disabilities and para-athletes

The still ongoing COVID-19 pandemic has dramatically impacted athletes, and, in particular, para-athletes and athletes with disabilities. However, there is no scholarly appraisal on this topic. Therefore, a critical scoping review of the literature was conducted. We were able to retrieve sixteen relevant studies. The sample size ranged from 4 to 183. Most studies were observational, cross-sectional, and questionnaire-based surveys, two studies were interventional, and two were longitudinal. One study was a technical feasibility study. Almost all studies were conducted as single-country studies, with the exception of one multi-country investigation. Five major topics/themes could be identified: namely, 1) impact of COVID-19-induced confinement on training and lifestyles in athletes with disabilities/para-athletes; 2) impact of COVID-19-induced confinement on mental health in athletes with disabilities/para-athletes; 3) impact of COVID-19-induced confinement on performance outcomes in athletes with disabilities/para-athletes; 4) risk of contracting COVID-19 among athletes with disabilities/para-athletes; and, finally, 5) impact of COVID-19 infection on athletes with disabilities/para-athletes. The scholarly literature assessed was highly heterogeneous, with contrasting findings, and various methodological limitations. Based on our considerations, we recommend that standardized, reliable tools should be utilized and new, specific questionnaires should be created, tested for reliability, and validated. High-quality, multi-center, cross-countries, longitudinal surveys should be conducted to overcome current shortcomings. Involving all relevant actors and stakeholders, including various national and international Paralympic Committees, as a few studies have done, is fundamental: community-led, participatory research can help identify gaps in the current knowledge about sports-related practices among the population of athletes with disabilities during an unprecedented period of measures undertaken that have significantly affected everyday life. Moreover, this could advance the field, by capturing the needs of para-athletes and athletes with disabilities and enabling the design of a truly "disability-inclusive response" to COVID-19 and similar future conditions/situations. Furthermore, follow-up studies on COVID-19-infected para-athletes and athletes with disabilities should be conducted. Evidence of long-term effects of COVID-19 is available only for able-bodied athletes, for whom cardiorespiratory residual alterations and mental health issues a long time after COVID-19 have been described.