Structure of the training program during the COVID-19 confinement in spanish professional football, a coach survey

OBJECTIVES

To describe and analyze the training programs carried out during the COVID-19 forced confinement in men´s professional football in Spain.

METHODS

Observational Study based on a telematic ad-hoc questionnaire developed to meet the objective of the study. The sample consisted of thirty-six coaches representing thirty-six professional men's soccer teams in the Spanish first and second division.

RESULTS

Training programs developed during confinement prioritized conditioning and functional emphasis, in addition to general and nonspecific resistance training, due to contextual limitations.

CONCLUSION

The structure of training during the COVID-19 confinement was limited by contextual circumstances. This study has made possible to record the training and strategies used in professional football during a confinement due to a worldwide state of alarm, with the aim of resuming competitive activity in the best possible conditions.

Effects of Tabata and HIIT Programs Regarding Body Composition and Endurance Performance among Female Handball Players

Background: The purpose of the study was to analyze the effect of two different training modes towards the development of body composition, aerobic and anaerobic endurance of female handball players aged 18-23, in COVID-19 pandemic. (2) Methods: 18 female handball players from the second division were divided into two groups: Group 1 subject-ed to Tabata Program (n=9) and Group 2 trained using HIIT Program (n=9). (3) Results: Paired Sample T-Test was carried in the statistical analysis and the significance level was determined (p < .005). The group subjected to HIIT training achieved greater increases in endurance performance than the group carrying out Tabata training (p < .005). (4) Conclusions: Different results were obtained when studying changes regarding segmental analysis of upper, lower limbs and trunk. Both groups undergoing Tabata and HIIT train-ing registered improvements. Keywords: COVİD-19 pandemic; handball game; aerobic and anaerobic endurance; fitness programs

Exploring the Unexpected Transition to Online Learning Due to the COVID-19 Pandemic in an Ethiopian-Public-University Context

In this paper, we present the initial changes and continuing challenges that are faced by teachers and students due to the unexpected transition to online learning from the COVID-19 pandemic at Bahir Dar University, Ethiopia. For this, the authors applied a phenomenological-case-study design, collecting qualitative data from purposively selected Ph.D. students (n = 10) and teachers (n = 4), examiners (n = 2), as well as the postgraduate coordinator. The results indicate that the teachers experienced some difficulties in effectively using learning technologies. Moreover, the students were overburdened with increased accountability and excessive challenges. However, the institutional capacity to support was relatively minimal. Despite these odds, the study participants showed higher levels of willingness and completed the program successfully. The study participants reported moderate satisfaction with their personal and professional experiences. The COVID-19 pandemic is an opportunity to remind universities and colleges about the essential skills that students need in this unpredictable world, for example, informed decision making, creative problem solving, and adaptability.

Can the immunological system of the upper respiratory tract, improved by physical exercise, act as a first immunological barrier against SARS-CoV-2?

INTRODUCTION

The main route of transmission of SARS-CoV-2 is the upper respiratory tract via cell membranes, including angiotensin-converting enzyme 2 (ACE2) and transmembrane host-associated serine protease transmembrane serine protease 2 (TMPRSS2). Both enzymes present in the nasal epithelium are the first direct point of contact for SARS-CoV-2. In this sense, the mucosal immune mechanisms of the upper respiratory tract, including immunoglobulin A (IgA), could be enhanced by physical exercise and be the first defense mechanism against the transmission and infection of SARS-CoV-2.

AREAS COVERED

The authors reviewed recent biomedical literature available in databases related to the effects of exercise and training modalities on IgA concentration levels in the upper respiratory tract in different populations.

EXPERT OPINION

: According to the biomedical literature reviewed, physical exercise can decrease or improve the level of IgA concentrations. However, it is important to take into account factors such as training load, recovery during the exercise session and between training, as well as the exercise modality. Furthermore, the characteristics of the target population should be taken into account to maximize the adaptive immune response to adequately strengthen the upper respiratory tract and potentially be a barrier against SARS-CoV-2 infection.

Physical Activity of Poles in the Care for Their Health Potential Before and During the COVID-19 Pandemic

OBJECTIVES

The aim of this study is to present the engagement of adult Poles in physical activity (PA) before and during the coronavirus pandemic, taking into consideration: frequency, duration, and types of the activity, depending on the gender and age of the participants.

METHODS

The study was conducted using an online survey questionnaire. A total of 688 residents of Poland aged 18 to 58 (28.61 ± 9.5) y participated in the study.

RESULTS

A statistically significant decrease in the frequency of PA was noted in the group of men (P = 0.0001) and in the age group of 39 to 58 y old. The analysis of the duration of a single PA before and during the pandemic has shown a statistically significant reduction in the workout time among both men and women and across all age groups (P = 0.05). There was a statistically significant increase in the frequency of women undertaking flexibility exercises, eg, yoga (P = 0.000), as well as a decrease in marching and walks (P = 0.003). Men significantly less frequently did strength exercises (P = 0.002).

CONCLUSIONS

During the pandemic, there was a statistically significant decrease in the frequency and duration of PA. The preferences of the participants as to the type of PA undertaken changed as well.

Prospective analysis of physical activity levels and associated fitness factors amid COVID-19 pandemic and social-distancing rules. A special focus on adolescents

Objective

Physical activity is a significant health determinant and is likely to be influenced by social-distancing rules imposed by authorities during the COVID-19 pandemic. This study explored gender-based differences in physical activity levels (PALs) and associated factors amid COVID-19 pandemic in adolescents.

Methods

In this prospective analysis, 112 healthy adolescents (15.63 ± 1.21 years) participated. They were assessed at the baseline (before the announcement of COVID-19 as a global pandemic) for anthropometry, fitness status, and PALs (baseline-PALs), and next at the follow-up (three months of imposed social-distancing rules) for PALs (follow-up-PALs) over an internet-based platform through the Physical Activity Questionnaire for Adolescents.

Results

A significant PALs decline was evidenced for the whole sample (P < .001) and such a decline was predominantly affected by significant PALs reduction among males (P < .001) rather than in females (P = .06). The fitness variables (explosive power, muscle endurance, flexibility, and aerobic endurance) were consistently positively correlated with the baseline- and follow-up-PALs in both genders with particularly prominent associations of PALs with explosive power and aerobic endurance.

Conclusion

Physical literacy is necessary for PALs preservation, given the remarkable PALs decreases among adolescents during challenging circumstances such as the COVID-19 pandemic.

The Impact of the COVID-19 Pandemic on Students' Body Posture During Online Learning Should not be Overlooked

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Physical activity on mental wellbeing in senior English Premier League soccer players during the COVID-19 pandemic and the lockdown

The COVID-19 pandemic and the subsequent lockdown created new stressors that could potentially attenuate mental wellbeing (MW) in athletes, who are already susceptible to poor MW. This study aims to describe fluctuations to MW during "lockdown" and subsequent "return to sport" protocols, in comparison to the normal "in-season" in professional soccer. Twenty-five English Premier League (EPL) soccer players completed the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) every two weeks, during the 2019/2020 season, and every week during "lockdown" and "return to training" for 28 weeks. The duration of each physical activity (PA) session completed was recorded. No significant differences were found for MW between time points (In-season, lockdown, return to training and the restart) (51.5 ± 5.6 vs. 50.7 ± 4.8 vs. 50.8 ± 5.7 vs. 50.7 ± 5.6 (p > 0.05)) respectively. Individually, differences were identified; in-season weekly session duration (243 ± 38 min) was higher than during lockdown (180 ± 62 min) (p < 0.05). During lockdown, weekly MW scores were related to the previous 7-day number of sessions (r = 0.151) and active min (r = 0.142) (p < 0.05). Furthermore, participants that exercised >250 min in lockdown, had higher MW scores (52.46 ± 4.65) than <250 min (50.35 ± 6.55) (p < 0.05). MW responses to lockdown were best understood on an individual basis. Additionally, PA only had a measurable effect on MW when >250 min. Further, stressors imposed upon players during an EPL season, are potentially greater than those inflicted by the lockdown. Implications for monitoring MW in EPL soccer players and the potential inclusion of an in-season break are discussed.Highlights Mental Wellbeing Responses, as measured by the Warwick-Edinburgh Mental Wellbeing scale did not change significantly at a group level across the four phases of the season. However, on an individual level changes were evident.There was a decline in the trend of wellbeing scores during in-season, return to training and the restart, but an increase in wellbeing scores during lockdown.Physical Activity had a measurable effect on wellbeing, when physical activity was >250 min during lockdown.These findings highlight the need for individual monitoring of wellbeing and longitudinal monitoring in sport to identify decline in wellbeing and implement intervention. In addition, the prescription of physical activity >250 min per week during lockdown in trained athletes may promote positive mental health.

Levels of physical activity in four domains and affective wellbeing before and during the Covid-19 pandemic

BACKGROUND

Latest studies indicated that the general mental health level is low during the pandemic. Probably, this deterioration of the mental health situation is partly due to declines in physical activity. The aim of this study was to investigate differences in and the association between affective wellbeing and levels of different domains of physical activity at three time points before and during the pandemic.

METHOD

We used a nationwide online panel with a trend data design encompassing a total sample of N = 3517, representing the German population (> 14 years). Four different activity domains (sport and exercise, light outdoor activity, housework/gardening, active travel) and affective wellbeing (positive and negative affect) were assessed at three time points before and during the Covid-19 pandemic (October 2019, March 2020, October 2020).

RESULTS

Multivariate analyses of variance (MANOVA) indicate differences regarding affective wellbeing over the three time points with the lowest values at the second time point. Levels of activity in the four domains differed significantly over time with the strongest decrease for sport and exercise from the first to the second time point. Partial correlations indicated that the relationships between sport and exercise and positive affect were most consistent over time.

CONCLUSIONS

Overall, our findings suggest that physical activity plays a particularly important role in the pandemic period as a protective factor against poor mental health. Especially sports and exercise seem to be supportive and should be encouraged, e.g. by providing additional support in finding adequate outdoor, home-based or digital substitutes.

Outdoor Physical Activity During the First Wave of the COVID-19 Pandemic. A Comparative Analysis of Government Restrictions in Italy, France, and Germany

Introduction: Mandated restrictions on outdoor physical activity (PA) during the coronavirus pandemic disrupted the lifeworld of millions of people and led to a contradictory situation. On the one hand, PA was perceived as risky behaviour, as it might facilitate transmission of the virus. On the other hand, while taking precautions, regular PA was an important tool to promote the population's health during the lockdown. Methods: This paper examines the differences in government restrictions on PA in France, Germany, and Italy during the first wave of the COVID-19 pandemic. We draw on techniques of qualitative content analysis and apply a critical theoretical framework to assess the countries' restrictions on PA. Results: Our analysis shows that the restrictions on PA varied in the three countries, in all three countries. This variance is attributed both to differences in the timing and severity of the pandemic in the countries analysed, as well as to the divergence in the relationships between the countries' sport and health systems. Conclusion: At the national level, the variance in restrictions on PA reflect the differences in the spread of the coronavirus and in the health systems' understanding of and approach to PA. The global scientific discourse on the pandemic represents a further key influencing factor. The management of the coronavirus pandemic has demonstrated that the extreme complexity of societies in terms of public health, politics, and the economy pose challenges and unsolvable contradictions.

Return-to-Play Considerations Following a COVID-19 Infection in Elite Athletes

The COVID-19 pandemic has created a unique challenge for sports medicine staffs as they are attempting to safely transition elite athletes into sport participation after a COVID-19 infection. Athletes must isolate for a period of time after testing positive for COVID-19 to prevent the spread of the virus within a community. After an isolation period, a battery of cardiac tests must be given to assess whether or not an athlete is ready to begin a reconditioning protocol. A return-to-play plan should be established to safely re-integrate high-level athletes into strength and conditioning, sport-specific drill work, and contact drill work. Elite athletes should also be gradually eased back into full training loads in order to avoid increases in orthopedic injuries after a prolonged absence from training.

Exercise in COVID-19: Intensity and Timing

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The Effect of Social Isolation on Physical Activity during the COVID-19 Pandemic in France

The objective of this cross-sectional study is to analyze the changes in physical activity (PA) practice of a sample of 2099 French adults, mostly females, who answered an online questionnaire during the first COVID-19 lockdown (March-May 2020). A descriptive analysis of participants was performed using relative frequencies. Chi-squared tests were performed to compare the responses of selected variables. Multinomial logistic regressions were performed to compare the variations of PA with all the variables identified. The age of participants ranged from 18 to 88. Among people who practiced PAs before the first lockdown, the probability to keep practicing PAs is higher among those with a lower level of education, among housewives and retirees and among those who lived in cities of 10,000-19,999 inhabitants. For those who did not practice PAs before the social distancing, the probability of starting to practice is greater in those with a lower level of education and for those who suffered from a chronic disease. Our results place the emphasis on the complexity and multifactoriality of the changes that emerged during the first lockdown. The "education" factor emerges, as a significant determinant of PA that should certainly be explored further.

Strange Days: Adult Physical Activity and Mental Health in the First Two Months of the COVID-19 Pandemic

Background: In addition to its physical health benefits, physical activity is increasingly recognized as a means to support mental health. Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental well-being, reduced likelihood of developing mental illness, and improved symptom management. Despite these benefits, most people fail to achieve minimum recommended levels of MVPA. Population levels of physical activity have further declined since the onset of the COVID-19 pandemic and implementation of public health measures (e.g., shelter-in-place protocols). The potential impact of this decline on mental heath outcomes warrants ongoing investigation. Purpose: To investigate associations between changes in MVPA and mental health (depressive symptoms, anxiety symptoms, and life satisfaction) in adults impacted by the COVID-19 pandemic. Method: Research followed a cross-sectional design. English-speaking adults were invited to complete an online questionnaire. MVPA was assessed retrospectively (before COVID-19) and currently (during COVID-19) with the International Physical Activity Questionnaire. Mental health was assessed with the Patient Health Questionnaire, 9-Item (PHQ-9), the Generalized Anxiety Disorder, 7-Item (GAD-7), and the Satisfaction with Life Scale (SWLS). Regression was used to assess relationships between MVPA and mental health. ANOVA with follow-up tests examined whether participants who differed in mental health status (e.g., no symptoms vs. severe symptoms) differed in their change in MVPA. T-tests were used to examine differences in mental health symptomatology between participants who were sufficiently (i.e., achieving MVPA guidelines of ≥ 150 min/week) vs. insufficiently active. Results: Prior to COVID-19, 68.2% of participants were classified as being sufficiently active, vs. 60.6% during COVID-19. The majority of participants reported experiencing some level of depressive symptoms (62.0%) or anxiety symptoms (53.7%). After controlling for covariates, changes in MVPA accounted for significant variability in the PHQ-9 (7.7%), GAD-7 (2.5%), and SWLS (1.5 %). Participants with clinically significant mental health symptomatology reported greater declines in MVPA than those who reported no symptoms. Conversely, participants who were sufficiently active during COVID-19 reported significantly lower depression and anxiety, and higher life satisfaction. Conclusion: Participants who experienced the greatest declines in MVPA reported relatively greater psychological distress and lower life satisfaction. While preliminary, these findings suggest the importance of maintaining and promoting physical activity during a period of pandemic.

Physical activity recommendations during the COVID-19 pandemic: a practical approach for different target groups

Introduction

Ensuring health and well-being during this pandemic is essential according to the United Nations Sustainable Development Goals. Physical exercise has an important role in the preservation of the immune system, which is vital to prevent infections. To promote physical exercise and maintain a healthy status, recent studies have suggested general exercise routines to be implemented during the quarantine period. However, to improve the health-related physical fitness components, any specific prescription should include intensity, volume, duration, and mode. Controversy persists about which is the best intensity of physical activity, while performing exercise at a moderate intensity could bring important benefits to asymptomatic people. High intensity or unaccustomed exercise should be restricted for older people, and for people of all ages with chronic diseases or compromised immune system, obesity, or upper respiratory tract infection with limited symptoms. Besides, physical activity guidelines should be particular to each population group, giving special consideration to those vulnerable to COVID-19 who are much more likely to suffer more self-isolation. Therefore, the present study is to provide specific physical activity recommendations for different populations during this pandemic.

Early mobilization and physical exercise in patients with COVID-19: A narrative literature review

BACKGROUND

Currently, little is known about early mobilization and exercise in individuals with COVID-19.

OBJECTIVE

To describe the indication and safety of early mobilization and exercises in mild to severe COVID-19 patients and to investigate the use of telerehabilitation to deliver exercise programs to these patients.

METHODS

This narrative literature review was conducted performing a comprehensive search of databases.

RESULTS

32 articles met the established criteria and the main findings were summarized and described, including indication, contraindication and recommendation for early rehabilitation and exercises prescription.

CONCLUSIONS

The literature suggests that early mobilization and physical exercise are beneficial for individuals with COVID-19. However, much of what has been published is based on expert opinion due to a lack of randomized trials, which are needed.

Effects of High-Intensity Interval Training and Moderate-Intensity Training on Stress, Depression, Anxiety, and Resilience in Healthy Adults During Coronavirus Disease 2019 Confinement: A Randomized Controlled Trial

Objective: This study aimed to compare the effects of two intervention programs, (1) high-intensity interval training (HIIT) and (2) moderate-intensity training (MIT), on anxiety, depression, stress, and resilience during the confinement caused by the coronavirus disease 2019 (COVID-19) in healthy adults. Methods: A total of 67 adults who participated were randomly assigned to two groups: HIIT and MIT groups. The MIT group had to perform a home-based intervention based on aerobic exercises, whereas the HIIT group had to perform a home-based intervention based on HIIT exercises. The two groups (HIIT and MIT) had to complete the same physical exercise volume, 40 min per session (6 days per week) during the confinement period (6 weeks). Depression, anxiety, stress, and resilience were assessed before and after the intervention. Results: Results showed that HIIT and MIT significantly reduced the stress, anxiety, and depression as well as increase the resilience (p < 0.05). Moreover, the improvements obtained in the HIIT group seem to be greater than those of the MIT group in depression (p < 0.05). Conclusions: HIIT and MIT decreased anxiety, stress, and depression as well as increased resilience during the COVID-19 confinement. In addition, the HIIT intervention seemed to be more beneficial to reduce depression than the MIT intervention.

The Impact of the COVID-19 Pandemic on US College Students' Physical Activity and Mental Health

BACKGROUND

Investigating the impact of the COVID-19 pandemic on both physical activity (PA) and mental health is important to demonstrate the need for interventions. This study examined the apparent impact of the pandemic on college students' PA, perceived stress, and depressive symptoms.

METHODS

From 2015 through 2020, data were collected at the beginning and end of the spring semester at a large Northeastern US university via an online survey assessing student demographics, PA, perceived stress, and depressive symptoms. Mixed ANOVA examined differences in PA and mental health changes over the spring semester between "normal" and COVID-19 circumstances. Two-way ANOVA examined the interaction between circumstance and changes in PA in relation to changes in mental health.

RESULTS

Participants (n = 1019) were predominately women and non-Hispanic white. There was a significant decline in PA and an increase in perceived stress under COVID-19, but not normal, circumstances and a significant increase in depressive symptoms under COVID-19, but not normal, circumstances among women.

CONCLUSIONS

A significant decline in PA and mental health among college students occurred under COVID-19 circumstances, and PA did not appear to protect against deterioration in mental health. Proactive and innovative policies, programs, and practices to promote student health and well-being must be explored immediately.

Sports Medicine Considerations During the COVID-19 Pandemic

The outbreak of the novel coronavirus (COVID-19) has resulted in upward of 14 million confirmed cases and >597,000 deaths worldwide as of July 19, 2020. The current disruption in sports activities caused by COVID-19 presents a challenge to physicians, coaches, and trainers in discerning best practices for a safe return to sport. There is a distinct need to develop and adopt consistent measures for resumption of sports activities, including training and competition, in a way that places the health and well-being of athletes at the forefront while also protecting coaches, allied staff, and spectators. This article provides an overview of the effects of COVID-19 in the athletic population and presents considerations for training during the pandemic, as well as guidelines for return to sports as restrictions are lifted.

Sports in time of COVID-19: Impact of the lockdown on team activity

The COVID-19 pandemic has affected many sectors of our global society since its detection in Wuhan in December 2019, and team sports have been no stranger to this reality. This special article presents a review of the literature exposing the dangers for athletes of this virus, reporting the effects of the pandemic on competitive sport, and making evidence-based recommendations to avoid the consequences of detraining in confined athletes. Furthermore, we present the results of a survey with 361 answers computed from coaches and different staff members from 26 different countries, representing the activity of more than 4500 athletes from all over the world. The aim was to know more teams’ activity during this cessation period. Finally, the article outlines recommendations based on the answers to help teams if a second outbreak of the virus forces massive confinements again, guiding a safe return to sport at any competitive level.

Regular Sports Participation as a Potential Predictor of Better Clinical Outcome in Adult Patients With COVID-19: A Large Cross-Sectional Study

Purpose: To compare the severity outcomes of COVID-19 disease between patients with and without regular sports participation. Methods: In a cross-sectional study, the authors investigated all patients who visited the emergency department of Imam Khomeini hospital with signs and symptoms of COVID-19 from February 20 to April 20, 2020. Then the authors assessed all patient outcomes (outpatient vs hospitalization or death). Finally, the authors compared the outcomes between athletes with regular sports participation and others, adjusting for confounding factors of age and sex. Results: Of all 4694 adult patients, 249 individuals (137 males and 112 females with mean [SD] age of 36.45 [9.77] y) had regular participation in different sport disciplines. Overall, 30 (12%) athletes were hospitalized or died (30 and 0, respectively) compared with 957 (21.5%) nonathletes (878 and 79, respectively). Athletes with regular sports participation were 1.49 times less likely to be hospitalized (P = .044). Conclusions: Regular sports participation may positively affect the clinical outcome, regardless of confounding factors of age and sex. The probability of hospitalization in athletes with regular sports participation was 33% lower than nonathletes. However, more longitudinal studies are needed to determine the causal effects.

Physical Activity Recommendations during COVID-19: Narrative Review

Regular practice of physical activity plays a fundamental role in preventing and treating cardiovascular diseases such as obesity, hypertension, diabetes, and metabolic syndrome. During the pandemic caused by COVID-19 and the lockdown established, people have reduced considerably their mobility and motor activity, which has led to an increase in unhealthy lifestyle habits, raising the risk of suffering from diseases. This paper consists of reviewing the existing scientific literature on recommendations of physical activity during the pandemic and to establish specific guidelines according to the type of population to which the activity would be directed. A search strategy has been carried out in the different databases: Embase, PubMed, SCOPUS, SPORTDiscus, and Web of Science (WoS), including all the articles published until 14 May 2020, to find essays with recommendations on aerobic activity, muscle strengthening, flexibility-stretching, meditation-relaxation, and balance exercises. The articles found have been evaluated considering the following criteria: type of publication, proposals for physical exercise, language, and, if it appears, volume of activity, frequency, intensity, and rest. The results obtained 29 articles that discuss patterns of physical activity, although there is no common consensus on such recommendations during confinement, nor are they suitable for all people. From these results, we can conclude that physical activity is widely recommended during the confinement caused by COVID-19, mainly through the performance of aerobic, strength, flexibility, and balance exercises.

IASEM-TUMS COVID-19 Virtual Pulmonary Rehabilitation Framework; Exercise Prescription for Recovered COVID-19 Patients

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PERCEPTIVE CHANGES IN ENDURANCE ATHLETES DURING SOCIAL ISOLATION DUE TO COVID-19

ABSTRACT Introduction: The COVID-19 pandemic has led to social isolation measures in different contexts. In endurance sports, competitions worldwide have been canceled, affecting behavioral, psychological, and physical aspects. Objective: This study aimed to assess potential associations between stress, motivation, behavioral changes, and physical fitness in endurance athletes, and time in social isolation. Methods: A cross-sectional study with the participation of 201 athletes, including mountain bikers (n = 89), runners (n = 88) and triathletes (n = 24). Each participant answered questions about time spent in isolation; body weight; changes in training schedule during the isolation period; levels of motivation; stress levels; loss of physical fitness; what aspect of physical fitness was most jeopardized during the isolation period; alcohol consumption; quality of sleep; quality of diet; and whether they had been ill during the isolation period. Results: The results showed significant differences between the percentage of runners (4.5%) and triathletes (16.7%) who had been isolated from 1-10 days, and between the percentage of cyclists (41.6%) and runners (68.2%) in 11-20 days and >20 days (28.1% and 9.1%) respectively. Social isolation was significantly associated with at least one variable for the three groups of athletes; however, the runners were the most affected by the pandemic, presenting an association with low motivation, high stress, poorer quality of sleep, increased alcohol consumption, and loss of physical fitness. Conclusion: Our study showed that the period of social isolation, specifically over time > 10 days, generated significant changes in the perceptions of motivation, stress, alcohol consumption, and physical fitness of endurance athletes, with runners being the most affected group. Level of Evidence III; Diagnostic studies - Investigation of a diagnostic test; Study of non-consecutive patients, without a “gold standard” applied uniformly.

Bradykinin System: A Therapeutic Goal for COVID-19

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Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic.

How children and young people can stay physically active during the novel coronavirus pandemic while take into account safety measures and precautions

The novel coronavirus (COVID-19) outbreak has caused major public concern and posed challenges to societies across the globe. The COVID-19 pandemic might have implications for health-related behaviors, such as physical activity, among people in different age groups. Lately, a number of papers have offered suggestions and recommendations on how to stay physically active during the novel coronavirus pandemic while take into account safety measures and precautions. Many of these suggestions and recommendations might be relevant for health professionals and health practitioners working to facilitate physical activity, health, and well-being among children and young people. In light of the COVID-19pandemic, this paper provides an overview of (a) suggestions and recommendations on physical activities; and (b) safety measures and precautions while being physically active.

Recommendations for the management of patients with systemic rheumatic diseases during the coronavirus disease pandemic

Patients with systemic rheumatic diseases (SRD) are vulnerable for coronavirus disease (COVID-19). The Korean College of Rheumatology recognized the urgent need to develop recommendations for rheumatologists and other physicians to manage patients with SRD during the COVID-19 pandemic. The working group was organized and was responsible for selecting key health questions, searching and reviewing the available literature, and formulating statements. The appropriateness of the statements was evaluated by voting panels using the modified Delphi method. Four general principles and thirteen individual recommendations were finalized through expert consensus based on the available evidence. The recommendations included preventive measures against COVID-19, medicinal treatment for stable or active SRD patients without COVID-19, medicinal treatment for SRD patients with COVID-19, and patient evaluation and monitoring. Medicinal treatments were categorized according to the status with respect to both COVID-19 and SRD. These recommendations should serve as a reference for individualized treatment for patients with SRD. As new evidence is emerging, an immediate update will be required.

The Effect of COVID-19 Confinement in Behavioral, Psychological, and Training Patterns of Chess Players

The outbreak of COVID-19 has triggered a pandemic, jeopardizing global health. The sports world is also suffering enormous consequences, such as the suspension of the Olympic Games in Tokyo or, in chess, the cancelation of the World Candidates Tournament 2020. Chess is a sport characterized by high psychophysiological demands derived from long training durations, tournaments, and games, leading to mental, emotional, and physical stress. These characteristics could provide chess players a certain advantage in facing quarantine situations. This study aimed to analyze the effect of COVID-19 confinement on behavioral, psychological, and training patterns of chess players based on their gender, level of education, and level of chess played. We analyzed chess players (N: 450; age = 38.12 ± 14.01 years) in countries where confinement was mandatory: Professional players (N: 55; age = 43.35 ± 13), high-performance players (N: 53; age = 38.57 ± 13.46), competitive players (N: 284; age = 36.82 ± 13.91), and amateur players (N: 58; age = 39.10 ± 14.99). Results showed that chess players significantly decreased physical activity per day while increased chess practise during the confinement period. However, anxiety levels remained moderate despite the anti-stress effects of physical activity. Amateur players showed a significantly higher level of social alarm than professional and high-performance players. Moreover, professional players showed higher values of extraversion than high-performance players and amateur players. In neuroticism, professional players showed higher values than high-performance players. In addition, the professional players showed higher scores in psychological inflexibility than competitive players. Finally, chess players with the highest academic level showed higher levels of personal concern and anxiety due to COVID-19 as well as lower psychological inflexibility compared to those with a lower academic level. In conclusion, chess players, especially those with a higher academic level, might have adapted their psychological profile to fit confinement situations and the worrying levels of physical inactivity.

Coronavirus (COVID-19), Coagulation, and Exercise: Interactions That May Influence Health Outcomes

The proinflammatory cytokine storm associated with coronavirus disease 2019 (COVID-19) negatively affects the hematological system, leading to coagulation activation and endothelial dysfunction and thereby increasing the risk of venous and arterial thrombosis. Coagulopathy has been reported as associated with mortality in people with COVID-19 and is partially reflected by enhanced D-dimer levels. Poor vascular health, which is associated with the cardiometabolic health conditions frequently reported in people with severer forms of COVID-19, might exacerbate the risk of coagulopathy and mortality. Sedentary lifestyles might also contribute to the development of coagulopathy, and physical activity participation has been inherently lowered due to at-home regulations established to slow the spread of this highly infectious disease. It is possible that COVID-19, coagulation, and reduced physical activity may contribute to generate a “perfect storm,” where each fuels the other and potentially increases mortality risk. Several pharmaceutical agents are being explored to treat COVID-19, but potential negative consequences are associated with their use. Exercise is known to mitigate many of the identified side effects from the pharmaceutical agents being trialled but has not yet been considered as part of management for COVID-19. From the limited available evidence in people with cardiometabolic health conditions, low- to moderate-intensity exercise might have the potential to positively influence biochemical markers of coagulopathy, whereas high-intensity exercise is likely to increase thrombotic risk. Therefore, low- to moderate-intensity exercise could be an adjuvant therapy for people with mild-to-moderate COVID-19 and reduce the risk of developing severe symptoms of illness that are associated with enhanced mortality.

Physical activity and nutrition guidelines to help with the fight against COVID-19

As the world is witnessing the epidemic of coronavirus disease 2019, emerging genetics and clinical pieces of evidence suggest a similar immunopathology to those of severe acute respiratory syndrome and Middle East respiratory syndrome. Staying at home to prevent the spread of the virus and consequently being largely inactive is associated with unintended consequences. These can actually enhance the infection risk and exacerbate poor health conditions including impaired immune function. Physical activity is a feasible way of improving health, particularly physical and mental health in a time of social isolation. However, people with certain health conditions in these circumstances may need a special physical activity programme in addition to any exercise they may already be performing via online programmes. This review aims to provide practical guidelines during the COVID-19 quarantine period. We suggest performing aerobic, resistance training, respiratory muscle training and yoga in the healthy, and in those with upper respiratory tract illness, patients with lower respiratory tract illness should be restricted to respiratory muscle training and yoga. In addition, vitamins D and C, omega-3 fatty acids, and regular consumption of fruit and vegetables might be considered as nutritional aids to support the immune system in those affected by COVID-19.

The Relationship between Health Consciousness and Home-Based Exercise in China during the COVID-19 Pandemic

During the COVID-19 pandemic, people have reduced the frequency of going out, and need to engage in health behaviors at home. Home-based exercise has aroused people's attention. This paper aims to examine the influencing mechanism of health consciousness on home-based exercise during the COVID-19 pandemic. A questionnaire method was used to select 449 Chinese respondents on an online platform; the questionnaire includes a health consciousness scale, health life goal scale, perceived behavioral control scale, and the home-based exercise scale. A T-test was used to conduct differential analysis. The hierarchical regression analysis method was used to examine the relationship between health consciousness and home-based exercise, and the Hayes' SPSS PROCESS macro was used to test mediating effect. The results show that there are significant differences in home-based exercise with respect to gender, age, and marital status. Health consciousness has a significant positive effect on home-based exercise. Perceived behavioral control acts as the mediator between health consciousness and home-based exercise. Health consciousness can influence home-based exercise through health life goals and perceived behavioral control in turn. This paper takes a home-based exercise survey, and expands the theoretical research of home-based exercise. The findings suggest that people should pay attention to promoting the transformation of health consciousness into home-based exercise. It provides enlightenment for people to adopt health behaviors during the COVID-19 pandemic.

Modulators of the Personal and Professional Threat Perception of Olympic Athletes in the Actual COVID-19 Crisis

The COVID-19 pandemic is now a major global health issue, affecting world population and high-performance athlete too. The aim of the present research was to analyze the effect of psychological profile, academic schedule, and gender in the perception of personal and professional threat of Olympic and Paralympic athletes facing the 2021 Tokyo Olympiad in the actual COVID-19 crisis. We analyzed in 136 Olympic (26.4 ± 6.2 years) and 39 Paralympic athletes (31.8 ± 9.3 years) academic and sport variables, individual perceptions about COVID-19 crisis, personality, loneliness, psychological inflexibility, and anxiety. Paralympic athletes perceived higher negative impact in their training and performance by the confinement than Olympic athletes (+24.18, p < 0.005, r = 0.60). Neuroticism and psychological inflexibility presented the greatest negative feelings for female athletes (+32.59, p < 0.000, r = 0.13) and the perception that quarantine would negatively affect their sports performance. Finally professional athletes showed lower values in personality tests (Agreeableness factor) about COVID-19 crisis than non-professionals (−40.62, p < 0.012, r = 0.88).

Physical activity in periods of social distancing due to COVID-19: a cross-sectional survey

Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.

Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium

Countries all over the world implemented lockdowns to counteract COVID-19. These lockdowns heavily limited people’s exercise possibilities. At the same time, experts advocated to remain physically active to prevent future health problems. Based on an online survey, this study examines adults’ exercise levels and patterns during the COVID-19 lockdown in Belgium. Ordinal logistic regression analyses of 13,515 valid and population-weighted responses indicate a general increase in exercise frequencies, as well as in sedentary behavior. Except for people aged 55+, previously low active adults self-reported to exercise more during the lockdown. Among the people who were already high active before COVID-19, those above 55 years old, those with low education, those used to exercise with friends or in a sport club, and those who were not using online tools to exercise, self-reported to exercise less during the lockdown. Having less time, sitting more, and missing the familiar way and competitive element of exercising were the main reasons for a self-reported exercise reduction. Given the health risks associated with physical inactivity, results imply that governments should consider how those who were not reached can be encouraged to exercise during a lockdown. After all, additional COVID-19 lockdowns might be implemented in the future.

COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted "stay in place" or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.

Prospective Analysis of Levels and Correlates of Physical Activity during COVID-19 Pandemic and Imposed Rules of Social Distancing; Gender Specific Study among Adolescents from Southern Croatia

Background: Due to the COVID-19 pandemic, global authorities have imposed rules of social distancing that directly influence overall physical activity in populations. The aim of this study was to evaluate the trends of changes in physical-activity levels (PALs) in adolescents and factors that may be associated with PALs among the studied boys and girls. Methods: Participants in this prospective study comprised 388 adolescents (126 females; mean age: 16.4 ± 1.9 years) from southern Croatia who were tested at a baseline (before the imposed rules of social distancing) and at a follow-up measurement (three weeks after the initiation). Baseline testing included anthropometric variables, variables of fitness status (done at the beginning of the school year), and PALs. At the follow-up, participants were tested on PALs. PALs were evaluated over an online platform using the Physical Activity Questionnaire for Adolescents. Results: A significant decrease of PALs was evidenced for the total sample (t-test = 3.46, p < 0.001), which was primarily influenced by a significant decrease of PALs in boys (t-test = 5.15, p < 0.001). The fitness status (jumping capacity, abdominal strength, aerobic endurance, and anaerobic endurance) was systematically positively correlated with PALs at the baseline and follow-up among boys and girls, with the most evident association between aerobic and anaerobic endurance capacities and PALs. Correlations between anthropometric and fitness variables with changes in physical activity (e.g., the difference between baseline and follow-up PALs) were negligible. Conclusions: Differences in PAL changes between genders were probably related to the fact that PALs among boys were mostly related to participation in organized sports. Correlations between baseline fitness status and PALs indicated the importance of overall physical literacy in preserving PALs in challenging circumstances, such as the COVID-19 pandemic observed here.

COVID-19 immune system and exercise

COVID-19, which became a current issue as a result of the pneumonia cases with unknown etiology in Wuhan City, Hubei Province of China on December 31, 2019, has started to spread throughout the world and deaths related to it have increased rapidly. Isolation, which is an important step in the control of this disease, has many physiological and psychological effects. Initiating a sudden quarantine situation means a radical change in the lifestyle of the population. Changing lifestyles and behaviours may result in insufficient levels of physical activity and inadequate movement, which increases the risk of developing conditions such as diabetes, hypertension, cardiovascular diseases and respiratory diseases. During quarantine, it is essential to stay active and maintain a physical exercise routine for mental and physical health. It is very important people should continue their active lives at home so that their lifestyles do not change and their health conditions do not deteriorate. The aim of the study is to determine the exercises that can be done during the COVID-19 outbreak and the points to be considered during the exercises. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Çin’in Hubei Eyaleti, Vuhan Şehrinde, 31 Aralık 2019’da etiyolojisi bilinmeyenpnömoni vakaları ile gündeme gelen COVID-19 dünyaya yayılmaya başlamış ve buna bağlı ölümler hızla artmıştır. Bu hastalığın kontrolünde önemli basamak olan izolasyonun fizyolojik ve psikolojik birçok etkisi vardır. Ani bir karantina durumunun başlatılması, nüfusun yaşam tarzında radikal bir değişiklik anlamına gelmektedir. Değişen yaşam biçimleri ve davranışları, yetersiz fiziksel aktivite seviyesi ve yetersiz hareket ile sonuçlanabilir ve bu durum diyabet, hipertansiyon, kardiyovasküler hastalıklar, solunum yolu hastalıkları gibi durumların oluşma riskini artırır. Karantina sırasında, zihinsel ve fiziksel sağlık için aktif kalmak ve fiziksel bir egzersiz rutini korumak esastır. İnsanların yaşam tarzlarının değişmemesi ve sağlıklarının bozulmaması için evde aktif yaşama devam etmeleri çok önemlidir. Yapılan çalışmanın amacı, COVID-19 salgını esnasında yapılabilecek egzersizler ve egzersiz esnasında dikkat edilmesi gereken hususların belirtilmesidir.

Impact of Sedentary Behavior on Bodily Pain While Staying at Home in COVID-19 Pandemic and Potential Preventive Strategies

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Strategies and Solutions for Team Sports Athletes in Isolation due to COVID-19

In December of 2019, there was an outbreak of a severe acute respiratory syndrome caused by the Coronavirus 2 (SARS-CoV-2 or COVID-19) in China. The virus rapidly spread into the whole World causing an unprecedented pandemic and forcing governments to impose a global quarantine, entering an extreme unknown situation. The organizational consequences of quarantine/isolation are: absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, inappropriate training conditions. Based on the current scientific, we strongly recommend encouraging the athlete to reset their mindset to understand quarantine as an opportunity for development, organizing appropriate guidance, educating and encourage athletes to apply appropriate preventive behavior and hygiene measures to promote immunity and ensuring good living isolation conditions. The athlete's living space should be equipped with cardio and resistance training equipment (portable bicycle or rowing ergometer). Some forms of body mass resistance circuit-based training could promote aerobic adaptation. Sports skills training should be organized based on the athlete's needs. Personalized conditioning training should be carried out with emphasis on neuromuscular performance. Athletes should also be educated about nutrition (Vitamin D and proteins) and hydration. Strategies should be developed to control body composition. Mental fatigue should be anticipated and mental controlled. Adequate methods of recovery should be provided. Daily monitoring should be established. This is an ideal situation in which to rethink personal life, understanding the situation, that can be promoted in these difficult times that affect practically the whole world.

Stadiums as Possible Hot Spots for COVID-19 Spread

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