Medical recommendations for home-confined footballers' training during the COVID-19 pandemic: from evidence to practical application

Bodily Practices and Meanings Articulated in the Physical Exercise of Older Adults in Santiago de Chile Post-COVID-19

This article presents the results of almost nine months of ethnographic research on the relationship between physical exercise and health in older people in the post-COVID-19 context. Via exploratory-descriptive qualitative research and the use of a convenient sample, I shed light on this relationship using the stories and life experiences of 40 older people (10 men and 30 women, including two women instructors for senior classes) who exercise regularly. The meanings they attributed to physical exercise during COVID-19 and after it are explained, emphasising first that there is no health in a context of not feeling safe; once there is a feeling of security, the most relevant meanings can be exposed in three directions. First, exercise produces a sense of identity linked to "being an athlete" and "belonging to a group". Second, exercising is valued as participating in something meaningful (the meanings range from self-realisation, independence, and autonomy to feelings of happiness). Finally, and linked to the sense of identity, those who train alone show more commitment and total hours spent in physical exercise and physical activity than those who train in groups. Even though older people are not a homogeneous group, they generally faced the pandemic as an ageist situation that affected their lives and how they saw sports and health. This article describes the strategies they used during COVID-19 related to exercise and well-being and those used once the pandemic restrictions were no longer present. The qualitative aspects that physical exercise brings to this population are highlighted. The research results give voice to older people, showing their heterogeneity and the meanings and practices that unite them. These inputs are rich material for studies on physical activity, older people, and well-being.

The impact of COVID-19 on national hockey league players' return to play

OBJECTIVE

Evaluate the on-ice performance and return to play (RTP) rate following COVID-19 for National Hockey League (NHL) players during the 2020-21 season.

METHODS

Players with COVID-19 during the abbreviated 2020-21 season were identified using publicly accessible online sources. Demographics and on-ice metrics were accessed using the NHL's online statistics website. The length of time, rate of RTP, and games missed due to COVID-19 were analyzed. Primary outcomes included average time on ice (TOI) per game (TOI/G), average TOI per shift (TOI/S), and points per game (PPG) compared at different timepoints including pre- and post-COVID-19.

RESULTS

A total of 73 players (47 forwards, 18 defensemen, 8 goalies) had a documented COVID-19 diagnosis during the abbreviated 2020-21 season. Players missed an average of 5.6 games (14.7 days) due to COVID-19. The post-COVID-19 RTP rate was 97.3%, including playoffs. No differences were found in TOI/G between the pre- (15.7 ± 3.9 min) and post-COVID-19 (15.8 ± 3.4 min, p = 0.874) or in the first (15.8 ± 4.0 min) and second week (15.9 ± 3.8 min, p = 0.925) returned. TOI/shift did not change from pre- (45.6 ± 5.3 sec) to post-COVID-19 (46.7 ± 4.6 sec, p = 0.035) or in first (46.2 ± 5.4 sec) and second week post-COVID-19 (46.2 ± 4.8 sec, p = .854). No differences were identified for PPG between career, pre-COVID-19, and post-COVID-19 (0.44 vs 0.38 vs 0.41; p = 0.274).

CONCLUSION

RTP post-COVID was markedly high for NHL players. While the effects of COVID-19 on specific physiological measures remains to be elucidated, this study found NHL players do not have reduced performance following COVID-19.

Sport and academic engagement of 1,387 Slovenian dual-career athletes before and during COVID-19 lockdown-what did we learn?

Introduction

Since the coronavirus disease outbreak in 2019, there have been several preventive measures and restrictions applied to minimize the transmission of the virus. While lockdown has affected our everyday lives, it has negatively impacted sport and athletes as well.

Methods

1,387 Slovenian dual-career (DC) athletes (47.4% females, 52.6% males) participated in the 22-item questionnaire to gather information on their sports and academic engagement before and during COVID-19 lockdown period. Half of the athletes were enrolled in education at the secondary level (n = 819, aged 15-18  years), while the others were enrolled in primary (n = 301, 8-14 years) and tertiary (n = 267, 19-36  years) education. All participants in the current study have a valid athlete categorization by the Slovenian Olympic Committee and are competing at either junior (31.7%), national (26.9%), prospective (29.5%), international (8.5%), world (2.3%) or Olympic (1.2%) level.

Results

DC athletes spent less time on training (-4.7 h; p < 0.001), learning (-1.0 h; p < 0.001), exams (-0.9 h; p < 0.001), laboratory work (-0.6 h; p < 0.001), and other educational activities (-0.3 h; p < 0.001) during COVID-19 lockdown compared to period before the lockdown. Their training environment was changed so they trained either at home or outdoors. Results showed that indoor (-3.7 h; p < 0.001) and team sport athletes (-1.3 h; p < 0.001) trained less than outdoor and individual sports. Male athletes spent more time on training both before (1.3 h; p < 0.001) and during lockdown (1.3 h; p < 0.001) and other sport-related activities (1.3 h; p < 0.001). On the other hand, female athletes spent more time on studying both before (1.5 h; p < 0.001) and during lockdown (2.6 h; p < 0.001). Both sport and educational activities were influenced by athletes' age (p ≤ 0.017).

Conclusion

Indoor and team sport athletes were more affected by the governmental measures than outdoor and individual sport athletes. Male athletes experienced a greater decline in learning time compared to female athletes. DC is shown to be beneficial for athletes even in times of COVID-19 lockdown, as DC athletes report smaller decline in motivation, shifting attention from sport to study and having fewer mental problems due to uncertain sports future. The feedback of the preventive measures could serve to assist policy makers and athlete's support staff to form and apply preventive measures that are more effective for DC athletes' training and education.

Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The "Italian Injury Study" during the Serie a Championship

INTRODUCTION

Football was the first sport to resume competitions after the coronavirus disease 2019 (COVID-19) lockdown and promptly the hypothesis was raised of a potential relationship between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and musculoskeletal injuries in athletes. This study aimed to confirm the association between SARS-CoV-2 infection and muscle strain injury in a large population of elite football players and to investigate if the COVID-19 severity level could affect the risk of injury.

METHODS

A retrospective cohort study involving 15 Italian professional male football teams was performed during the Italian Serie A 2020-2021 season. Injuries and SARS-CoV-2 positivity data were collected by team doctors through an online database.

RESULTS

Of the 433 included players, we observed 173 SARS-CoV-2 infections and 332 indirect muscle strains. COVID-19 episodes mostly belonged to severity level I and II. The injury risk significantly increased after a COVID-19 event, by 36% (HR = 1.36, CI_95% 1.05; 1.77, p-value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI_95% 1.21; 2.86, p-value = 0.005) in the COVID-19 severity level II/III versus players without a previous SARS-CoV-2 infection, while level I (asymptomatic) patients showed a similar average burden (ratio = 0.92, CI_95% 0.54; 1.58, p-value = 0.77). A significantly higher proportion of muscle-tendon junction injuries (40.6% vs. 27.1%, difference = 13.5%, CI_95% 0.002%; 26.9%, p-value = 0.047) was found when comparing level II/III versus Non-COVID-19.

CONCLUSIONS

This study confirms the correlation between SARS-CoV-2 infection and indirect muscle injuries and highlights how the severity of the infection would represent an additional risk factor.

Impact of the COVID-19 Pandemic on Injury Incidence in Japanese Male Professional Soccer Players

Background

The outbreak of the 2019 novel coronavirus disease (COVID-19) led to an enforced quarantine period and limited training and match activities for athletes.

Purpose

To report the influence of the COVID-19 pandemic on the occurrence of injury in Japanese male professional soccer players.

Study Design

Descriptive epidemiology study.

Methods

In total, 21 clubs in the 2019 season and 28 clubs in the 2020 season from the Japan Professional Football League were prospectively followed, and 16 clubs in 2019 and 24 clubs in 2020 were analyzed in this study. Individual training, match exposure, and time-loss injuries were recorded using an electronic data capture system. The influence of COVID-19-related suspension during the 2020 season was retrospectively investigated via comparisons with the 2019 season.

Results

Total activity time included 114,001 hours in training and 16,339 hours in matches in 2019 and 170,798 hours in training and 25,411 hours in matches in 2020. The mean training interruption period caused by COVID-19 in 2020 was 39.9 days (range, 3-65 days), and the mean game-interruption period was 70.1 days (range, 58-79 days). The total number of injuries was 1495 in 2019 and 1701 in 2020. The overall injury incidence per 1000 hours of exposure was 5.7 in 2019 and 5.8 in 2020. The overall injury burden per 1000 hours of exposure was 155.5 days in 2019 and 130.2 days in 2020. The muscle injury incidence was highest in May 2020, immediately after the suspension period.

Conclusion

The overall injury incidence did not differ between 2019 and 2020. However, muscle injury incidence notably increased in the 2 months after the COVID-19 pandemic suspension period.

Impact of the COVID-19 Pandemic on Sports Medicine Patient Care

The COVID-19 pandemic has necessitated new practices in sports medicine patient care. Telehealth has been validated as a reliable tool for consultations and physical examinations and increases access to care in a cost-efficient manner. Social distancing and avoiding team members who have tested positive are the most effective ways to reduce spread. For screening, daily self-reported symptom checklists and fever monitoring help identify potentially infected athletes who should be instructed to isolate and seek care. Polymerase chain-reaction (PCR) testing for the virus via nasopharyngeal swab is not recommended for screening and should be reserved for symptomatic individuals with fever, cough, or shortness of breath. Face masks and personal protective equipment (PPE) may be beneficial in high-risk settings, but there is little evidence to support use in athletic populations. Median return to play after COVID-19 in elite athletes has been reported as 18 days (range: 12 to 30), with 27% not fully available at 28 days. Chest pain at diagnosis was the only symptom associated with time loss longer than 28 days. Finally, canceled competitions or time loss results in grief, stress, and frustration for athletes, as well as loss of a social support network and routine training regimens. Mental health support services may be indicated.

Wearable technology in the sports medicine clinic to guide the return-to-play and performance protocols of athletes following a COVID-19 diagnosis

The coronavirus disease 2019 (COVID-19) pandemic has enabled the adoption of digital health platforms for self-monitoring and diagnosis. Notably, the pandemic has had profound effects on athletes and their ability to train and compete. Sporting organizations worldwide have reported a significant increase in injuries manifesting from changes in training regimens and match schedules resulting from extended quarantines. While current literature focuses on the use of wearable technology to monitor athlete workloads to guide training, there is a lack of literature suggesting how such technology can mediate the return to sport processes of athletes infected with COVID-19. This paper bridges this gap by providing recommendations to guide team physicians and athletic trainers on the utility of wearable technology for improving the well-being of athletes who may be asymptomatic, symptomatic, or tested negative but have had to quarantine due to a close exposure. We start by describing the physiologic changes that occur in athletes infected with COVID-19 with extended deconditioning from a musculoskeletal, psychological, cardiopulmonary, and thermoregulatory standpoint and review the evidence on how these athletes may safely return to play. We highlight opportunities for wearable technology to aid in the return-to-play process by offering a list of key parameters pertinent to the athlete affected by COVID-19. This paper provides the athletic community with a greater understanding of how wearable technology can be implemented in the rehabilitation process of these athletes and spurs opportunities for further innovations in wearables, digital health, and sports medicine to reduce injury burden in athletes of all ages.

A Study on the Injury Rate of Spanish Competitive Athletes as a Consequence of the COVID-19 Pandemic Lockdown

The COVID-19 lockdown may have had collateral effects on the conditions of athletes, with possible increases in injury risks upon the return to sports. Due to the existence of multiple factors of injury risks based on the lockdown and the return to sports, the aim of this study was to analyze the injury rates after the lockdown in competitive athletes. A non-experimental quantitative design based on a survey was carried out, and 94 athletes (42 males and 52 females; 23.57 ± 6.20 years) participated. Statistical analyses were carried out using non-parametric tests. Injury rates did not increase significantly after the lockdown, and there were no statistical differences between performance levels, types of sports, the design of a specific training program by sports professionals during the lockdown, the moment of injury, and the mechanism of injury. It is important to develop injury prevention protocols to prepare athletes after such a long period of detraining.

Efectos del COVID-19 en la carga externa en el fútbol de alto nivel

Analizamos el efecto del cese de la competición por COVID-19 en el rendimiento físico de jugadores de fútbol de la 1ª división española). La muestra se estratificó en tres grupos: rondas 1ª-3ª; 25ª-27ª y 28ª-30ª. Las comparaciones por pares fueron Student-t y Mann-Whitney U. Usamos un valor p de ?0.05 como criterio para la significación estadística. Los valores de umbral para evaluar las magnitudes del tamaño del efecto se realizaron a través (d de Cohen). Tras el parón, las distancias recorridas aumentaron en los equipos locales y visitantes. Hubo un ligero descenso de los esfuerzos de alta intensidad entre el post-confinamiento y las jornadas (25ª-27ª). Comparados el 1er y 3er periodo, los valores fueron ligeramente superiores (rondas 28ª-30ª). Eso mismo se observó en las de aceleraciones y desaceleraciones, con mayores diferencias entre los periodos (1º y 3º). Hubo diferencias, cuando se comparó la reanudación con las jornadas previas al parón.

Bio-secure bubble during the COVID-19 pandemic to host the Asian Football Confederation (AFC) Champions League: A retrospective observational study

Background and Aims

To describe the COVID-19 positivity rate among football players, team staff, and local organizing committee members participated in the Asian Football Confederation (AFC) Champions League (West) tournament organized with the Bio-secure bubble protocol in place.

Methods

A retrospective observational study was carried out to include a total of 2184 participants during the AFC-West tournament in Qatar, which was a 3-week event (September 14-October 3, 2020). This event was undertaken under the Bio-secure bubble protocol, which was developed and implemented for sports events in Qatar during the pandemic. Within 72 h of departure and upon arrival in Qatar, all participants underwent reverse-transcriptase polymerase chain reaction testing (RT-PCR) to diagnose COVID-19. The test was considered positive based on the cycle threshold (cT) value which was <30, whereas, reactive if cT value was ≥30 and <40, and negative (cT > 40).

Results

Of the 2184 participants (528 players, 388 team staff, and 1268 local staff), 916 international participants were tested for COVID-19 PCR upon arrival at the Hamad International Airport, whereas the local staff (n = 1268) were tested 2 days before entering the bubble. The mean age of the players was 27.5 ± 9.8. Fifteen teams participated and as many as 60 matches were played over 3 weeks. Most participants tested negative (95.3%) and 3.9% tests were inconclusive. During the entire tournament, the positivity rate was 2.7% among all participants. Of the total positive cases, 0.8% were positive before entering the bubble system. The remaining (1.9%) tested positive during the tournament phase (19 players, 16 team officials, and 8 organizing committee staff).

Conclusion

Bio-secure bubble protocol operated in a controlled environment presents a minimal risk of COVID-19 infection for hosting international football events. This framework could be benchmarked to resume professional football competitions under unprecedented pandemic situations.

The effects of aerator masks and medical masks on oxygen saturation (SO2) on mentally retarded athletes

The study purpose was investigated the effect of aerator masks on the oxygen saturation (SO2) of mentally retarded athletes compared to medical masks. The researcher used a comparative study. Parametric test was used to test the difference in SO2 percent and evaluate the questionnaire in the two groups. The results showed after undergoing exercise, SO2 percent in participants was 94.60±0.55 for aerator masks and 96.60±0.55 for medical masks. The study also showed that there was no significant difference in SO2 percent of participants wearing aerator masks and medical masks. However, the decrease in oxygen saturation percent of participants wearing aerator masks experienced a lower decrease, 1.60±0.55 compared to medical masks of 2.00±1.00. On the other hand, wearing an aerator mask is better because it does not prevent maximum performance, better comfort, the mask material feels better on the skin, does not experience difficulties breathable, and suitable for exercise. An aerator mask is a mask with an adequate supply of oxygen so that every breath is maintained even when used during sports activities.

Psychological and Mental Sequelae in Elite Athletes with Previous SARS-CoV-2 Infection: A Systematic Review

During the COVID-19 pandemic, many athletes from several sporting disciplines were infected with the SARS-CoV-2. The aim of this systematic review is to summarize the current scientific evidence on the psychological sequelae and mental health of elite athletes who have been infected by the virus. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement; three databases were searched: PubMed, ISI Web of Knowledge, and Scopus. The initial search resulted in 2420 studies; after duplicate removal and screening by title and abstract, 41 articles were screened by full-text. A total of four eligible articles were included in the review. All included articles measured depression and anxiety in athletes who had suffered from COVID-19, while in three papers levels of stress were measured. Overall, the only two questionnaires used in more than one study were the DASS-21 and the APSQ. In our systematic review, we highlighted that mental and psychological health in elite athletes has the same importance as physical health. This statement suggests that these examinations should be introduced and performed during the competitive sports' medical examinations conducted at the start of the sporting season, which currently consists only of the examination of physical parameters. Due to lack of studies on the topic, the results of our review show that mental health in athletes with a history of SARS-CoV-2 infection is an issue that requires more investigation, considering the evidence of clinical consequences. The importance of post-infection psychological sequelae is significant in assessing possible repercussions on the athletes' sporting performance.

The Influence of COVID-19 on University Students' Well-Being, Physical Activity, Body Composition, and Strength Endurance

BACKGROUND

Very few scientific studies have simultaneously evaluated changes in well-being (WB), physical activity (PA), and strength endurance (SE) based on results from before and during the COVID-19 pandemic.

AIM

The aim of the study was to assess WB, PA, and SE levels, as well as body composition parameters in university students before and during the pandemic.

METHODS

The study included 30 males and 30 females (mean age: 21.7 ± 2.51 and 21.6 ± 2.34 years, respectively). Well-being using the Self-Perception Questionnaire (POMS), PA from the Polish regular version of the International Physical Activity Questionnaire (IPAQ), body composition parameters using the InBody 270 analyzer, and SE based on the results of a 12 min test involving a Concept 2PM-5 rowing ergometer were assessed before and during the pandemic.

RESULTS

An assessment of university students' WB revealed a significant increase in variables such as tension, depression, anger, confusion, and a significant decline in vigor (p < 0.05). In both sexes, PA and SE decreased significantly-from 2115.4 to 1822.8 METs-min/week and from 2184.5 to 2035 m, respectively, in males, and from 1793.5 to 1699.8 METs-min/week and from 2021.5 to 1943.8 m, respectively, in females. At the same time, body mass and BMI values increased significantly (p < 0.001) in both females and males.

CONCLUSIONS

The COVID-19 pandemic caused a significant decrease in WB, PA and SE levels in young females and males, and led to a significant increase in their body mass and BMI.

Flexibility of Ballet Dancers in COVID-19 Pandemic: A Prospective Observational Study in Portugal

The aim of this study was to verify how dancers’ flexibility work has developed during confinement through four assessment moments: before, during (two times), and after the lockdown period. The sample was formed by 18 dancers from the Porto Dance Conservatory (Portugal) with an average age of 11.4 ± 1.4 years and 1.4 ± 0.7 years of experience. To assess the passive and active flexibility level, we used seven of the International Gymnastics Federation’s recommended tests using main joints (i.e., hips and spine). The first evaluation was performed before the pandemic situation began in a training environment, and the second and third evaluation were performed during the lockdown, in home environment, and in virtual trainings. Finally, the last evaluation was carried out in a training environment after returning to face-to-face activities and with several rules such a social distancing and mask use. The results showed that significant improvements were verified in the flexibility level of the dancers from the first to the fourth moment of evaluation. In the current study, no statistical significance was noted for the decreased values of functional asymmetry between the preferred and non-preferred lower limbs. These differences may have substantial relevance for dancers’ harmonious body development.

Consequences of the SARS-CoV-2 Infection on Anaerobic Performances in Young Elite Soccer Players

The COVID-19 pandemic required local confinement measures reducing sport practice with possible consequences on the athletes’ performances. Furthermore, anaerobic detraining was underestimated and poorly known in adolescents. This article aimed to assess the effects of SARS-CoV-2 infection and 1-month COVID-19 confinement on jump testing in young elite soccer players despite a 1-month multimodal training program followed by a 1-month soccer retraining period. Thirty-one elite soccer players aged 14 were included; 16 were infected by the SARS-CoV-2 and compared with 15 non-infected elite soccer players before and after 1 month of COVID-19 confinement, and after 1 month of a soccer retraining period. Squat jumps (SJ), countermovement jumps with (CMJs) and without arm swinging (CMJ) and multiple consecutive jumps (stiffness) were used to explore the anaerobic performances. Analysis of variance for repeated measures was used to compare the positive and negative SARS-CoV-2 groups, taking into account the confinement period (low training) and the retraining soccer period. The jump tests were not altered in the positive SARS-CoV-2 group compared to the negative SARS-CoV-2 group after confinement (SJ: 31.6 ± 5.6 vs. 32.7 ± 3.7; CMJ: 34.1 ± 6.9 vs. 34.2 ± 2.6; CMJs: 38.6 ± 6.8 vs. 40.3 ± 3.9; stiffness: 28.5 ± 4.3 vs. 29.1 ± 3.7) and at 1 month of this period (SJ: 33.8 ± 5.5 vs. 36.2 ± 4.6; CMJ: 34.7 ± 5.5 vs. 36.4 ± 3.5; CMJs: 40.4 ± 6.7 vs. 42.7 ± 5.5; stiffness: 32.6 ± 4.7 vs. 34.0 ± 4.3). The SARS-CoV-2 infection had no consequence on anaerobic performances assessed by jump tests in adolescent soccer players. The adolescents’ growth could explain the absence of alteration of jump performances during the COVID-19 confinement. These results can be useful to manage the recovery of the anaerobic fitness after SARS-CoV-2 infection occurring in adolescent athletes.

Influence of the COVID-19 Lockdown and Restart on the Injury Incidence and Injury Burden in Men's Professional Football Leagues in 2020: The UEFA Elite Club Injury Study

BACKGROUND

Studies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce.

OBJECTIVE

To describe the injury incidence and injury burden in men's professional football teams during the pandemic year of 2020.

METHODS

Nineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015-2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges.

RESULTS

There was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015-2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015-2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September-December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020.

CONCLUSIONS

There was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015-2019.

Strength Level of Professional Elite Soccer Players after the COVID-19 Lockdown Period: A Retrospective Double-Arm Cohort Study

Background

It is well known that periods of inactivity generate a loss of muscle strength, a fundamental component of sports performance in soccer. However, little information is available on the decrease in strength levels in professional soccer players after the quarantine lockdown that occurred during the COVID-19 pandemic.

Aim

To compare the isokinetic peak torque profiles of professional soccer players from different teams before and after the quarantine period generated by COVID-19.

Methods

A retrospective observational study was performed using data collected from two different professional elite-level soccer teams just before and immediately after the COVID-19 quarantine period. One team gave individual instructions to its players for conditioning maintenance at home during the quarantine period, while the other team used regular video calls to maintain the player's conditioning status on home training. The main outcomes were the mean peak torque of knee extensors and flexors, from concentric and eccentric contractions of each playing position. Analysis. A two-way ANOVA analysis was used to compare peak torque before and after the quarantine period and between both teams' strategies, showing a statistically significant reduction in eccentric knee flexor peak torque from the team that did not have remote monitoring.

Conclusions

Remote monitoring programs are recommended so that athletes are less affected by the deleterious effects of confinement.

LaLiga Lockdown: Conditioning Strategy and Adaptation to In-Game Regulations during COVID-19 Pandemic Prevented an Increase in Injury Incidence

The first division of Spanish professional football (LaLiga) was suspended for 12 weeks as part of the policies enforced by health authorities during the first wave of COVID-19. During this period, players were confined to home for 8 weeks, followed by a club-based retraining period of 4 weeks. Afterwards, LaLiga’s teams completed 11 matches, with approximately 3 days of recovery between matches, to finish the competition. The aim of this investigation was to determine whether there is a difference in mean injury incidence in LaLiga players between the pre-lockdown period and post-lockdown period. A total of 277 players belonging to 11 teams competing in LaLiga were monitored during the 2019–2020 season. Injury incidence in the 27 matchdays completed before the lockdown was compared to the last 11 matchdays completed after the resumption of the competition. In comparison to the period before the suspension, the resumption of the championship did not significantly affect the injury incidence (4.2 vs. 5.4 injuries per 1000 h of exposure, p = 0.338). Injury incidence before suspension and after resumption of the competition was similar for muscle (2.6 vs. 3.4 injuries per 1000 h of exposure, p = 0.152) and ligament injuries (0.8 vs. 0.4 injuries per 1000 h of exposure, p = 0.062). The resumption of the competition also did not modify the distribution of injury according to body location (p = 0.948), injury type (p = 0.766), mode of onset (p = 0.614), severity (p = 0.065), or player position (p = 0.295). In summary, mean injury incidence in LaLiga players was similar before and after the lockdown. It is probable that the conditioning strategy adopted by clubs before the resumption of LaLiga and the adaptation of some in-game regulations helped to avoid an increased injury rate after the lockdown.

Impact of COVID-19 lockdown on professional soccer players' match physical activities

AIM

The COVID-19 pandemic forced the 2019-20 Italian Serie A competition to stop and players went into lockdown. During lockdown, players only trained at home, likely having a detrimental effect on players' physical fitness and capacity. This study investigated the effect of the COVID-19 lockdown on professional soccer players' match physical activities.

METHODS

Match activities of 265 male professional soccer players were assessed in two periods prior to (PRE1 and PRE2) and one period following the lockdown (POST) using a video tracking system. Linear mixed models were used to examine differences between-periods in total (TD), very high-speed (VHS), sprint (SPR), high-acceleration (ACC) and high-deceleration (DEC) distances, considering full match data and data from six 15-min intervals.

RESULTS

TD and VHS during POST were lower than the two other competitive periods (p < 0.001, d small-moderate). SPR did not show differences between periods (p > 0.636). ACC and DEC during POST were lower than PRE2 (p < 0.015, d small). Declines in most 15-min intervals after lockdown were observed in TD and VHS.

CONCLUSIONS

There were small differences in the temporal distribution of SPR, ACC and DEC at POST. After the COVID-19 lockdown, soccer players' higher-intensity running activities were similar to those of games played before the lockdown, but TD and VHS decreased, both considering the entire match and 15-min intervals. The temporal distribution of running activities was mostly stable throughout the season.

Impact of Prolonged Absence of Organized Training on Body Composition, Neuromuscular Performance, and Aerobic Capacity: A Study in Youth Male Soccer Players Exposed to COVID-19 Lockdown

The aim of this study is to examine how physical performance has changed after 15 weeks (109 days) long-term absence of organized training in youth soccer players imposed by the stay at home orders. A total of sixty-eight young male soccer players from different age categories (U15, U16, U17 and U19) voluntarily participated in the prospective cohort study. Body fat percentage (BF%), counter-movement jump (CMJ), 30 m sprint, change-of-direction (COD) and yo-yo intermittent recovery test level-1 (YYIRTL-1) were evaluated twice (before and after the detraining period). Subsequently, 2 × 2 repeated measures ANOVA was used to investigate group and time differences in repeated measurements. A significance level of p < 0.05 was implemented. CV and SWC values were calculated to test the reliability of the tests performed at different times. Statistical analysis was performed using the IBM SPSS statistics software (v.25, IBM, New York, NY, USA). Significant increments in BF%, 30 m sprint, and COD (left and right), and also significant decrements in CMJ and YYIRTL-1, were found after the detraining period. A long-term detraining period due to the stay at home orders has a detrimental effect on body composition, neuromuscular performances, and aerobic capacity in youth soccer players.

Organising football matches with spectators during the COVID-19 pandemic: What can we learn from the Amir Cup Football Final of Qatar 2020? A call for action

The COVID-19 pandemic is a potential threat to professional sporting events when they eventually return to their usual calendar with spectators’ capacity of football stadiums usually exceeding 40,000 seats for important events. Hence, a strategy for safe return to sporting events is needed in the COVID-19 pandemic to pave the way towards a new normalcy. We reviewed the guidelines and policies implemented in organising the Amir Cup Football Final of Qatar, which hosted about 20,000 fans. The authors evaluated the publicly available information on the official websites of the various organizations involved and highlight the importance and usefulness of the Covid-19 Rapid Antigen Assay-Kit as a tool for screening sports spectators as well as the importance of a rigorous spectator pathway, including their accurate traceability thanks to a specific mobile phone application. Despite the surging of COVID-19 all over the world, a big football event with around 20,000 spectators in the same stadium has been hosted under strongly controlled preventative measures. These preventative measures show that it is possible to organize a major football match held outdoors, with the presence of thousands of supporters. This article is a call for action for the organisers of such events where the supporters’ health status is traceable to provide the scientific community with actual data of post-event infection rates. Therefore, it is suggested to consider using procedures like the ones described in the present article as a potential model in the process of organizing big sporting events with spectators in times of COVID-19.

The effects of COVID-19 lockdown on jumping performance and aerobic capacity in elite handball players

The aim of this research was to analyse the capacity of a home-based training programme to preserve aerobic capacity and jumping performance in top-level handball players during the COVID-19 lockdown. Eleven top-level male handball players from the same team participated in the study. A submaximal shuttle run test and a counter-movement jump test were used to measure the players’ aerobic fitness and lower limb explosive strength, respectively. A 9-week home-based training programme was followed during lockdown. Pre-test measurements were assessed before the pandemic on 29 January 2020 and ended on 18 May 2020. Moderate significant mean heart rate increases were found in the late stages of the submaximal shuttle run test after the lockdown (stage 5, 8.6%, P = 0.015; ES = 0.873; stage 6, 7.7%, P = 0.020; ES = 0.886; stage 7, 6.4%, P = 0.019; ES = 0.827). Moderate significant blood lactate increases were observed immediately after the submaximal shuttle run test following the lockdown (30.1%, P = 0.016; ES = 0.670). In contrast, no changes were found in jump performance. A structured home-based training programme during the COVID-19 lockdown preserved lower limb explosive strength but was an insufficient stimulus to maintain aerobic capacity in top-level handball players.

The impact of COVID-19 lockdown on professional soccer players' body composition and physical fitness

During the COVID-19 lockdown, professional soccer players ceased their regular team training sessions and were provided with exercise programs to follow independently. This investigation assessed the impact of a 7-week COVID-19 lockdown and home-based individual physical training on professional soccer players’ body composition and physical fitness. The study consisted of nineteen division 1 elite soccer players (age 27.68 ± 5.99 years, height 178.47 ± 5.44 cm) and compared the anthropometric and physical fitness parameters obtained post-transition period to those obtained post-COVID-19 lockdown. The statistical analysis indicated that body fat percentage was significantly higher after the lockdown period [t(18) = -5.59, p < 0.01, d = 0.56]. Furthermore, VO_2max [t(17) = -11.54, p < 0.01, d = 0.57] and running time [t(17) = 3.94, p < 0.01, d = 0.76] values were significantly higher after the COVID-19 lockdown than those obtained after the transition period. In addition, significantly higher level of performance was demonstrated on squat jump [t(18) = -4.10, p < 0.01, d = 0.30], countermovement jump [t(18) = -7.43, p < 0.01, d = 1.11] and sit and reach tests [t(19) = -5.33, p < 0.01, d = 0.32]. Concurrently, lower body strength was indicated to be significantly greater (p < 0.01) following the COVID-19 lockdown. The training protocol provided during the confinement, due to the COVID-19 outbreak, was effective in keeping physical fitness at a significantly higher level compared to the transition period. Coaches and trainers are encouraged to examine the effectiveness of this protocol, as it may help them develop effective periodization programs during the transition period. This protocol may aid in the development of effective periodization programs that require minimal equipment and can be followed in similar situations.

Decision-Making in Sport During a Pandemic

OBJECTIVE

The COVID-19 pandemic has affected all elements of global society, and sport is not exempt. Many sporting events have been either postponed or canceled, and national sporting organizations have had to make highly complex decisions in the face of scientific uncertainty and risk. This article applies these lessons to the world of sport with the goal of assisting sporting organizations to make sound and reasoned decisions during a pandemic.

DATA SOURCES

A narrative approach using both academic literature sources and live examples from the authors' experience. We use Daniels and Sabin's accountability for reasonableness framework to facilitate decision-making in the face of such uncertainty.

MAIN RESULTS

Decision-making in the context of uncertainty has the potential to create conflict and disengagement from key stakeholders. Evidence from recent pandemics has illustrated that an ethical approach to decision-making results in reasoned decision-making and confers a legitimacy to decisions that ultimately supports engagement and satisfaction from stakeholders.

CONCLUSIONS

The incorporation of ethical considerations into risk assessment and management when making complex decisions, which incorporate high levels of uncertainty, will assist sporting organizations have positive outcomes.

Impact of COVID-19 lockdown on the epidemiology of soccer muscle injuries in Italian Serie A professional football players

OBJECTIVE

To evaluate the influence that COVID-19 lockdown had on the epidemiology of soccer musculoskeletal injuries during 2019/2020 Italian First Football League Serie A in professional football players.

METHODS

In this retrospective study we analyzed records from media-based platform (Trasfermarkt, https://www.transfermarkt.com), describing the epidemiology of muscle injuries before and after the first COVID-19 lockdown phases in Italian professional football players. We also classified the severity of the injury as the number of missing days from participation.

RESULTS

We assessed a lower prevalence of post-lockdown injuries, albeit showing a similar injury rate at 1000 game-hours (pre-lockdown: 16.9 [13.0-20.7], post-lockdown: 15.5 [9.9-21.1]; RR: 0.92 [0.46-1.8]). All risk ratios for injury rate were not significantly different (p> .05) between pre- and post-lockdown.

CONCLUSIONS

The incidence of muscle injuries has not significantly changed after the first COVID-19 lockdown in Italian professional soccer players. Recognizing injury rates might be crucial for physician to evaluate adequate preventive measures.

Eccentric Hamstring Muscle Strength during Home Confinement Due to the COVID-19 Pandemic, and Football Competition Resumption in Professional Football Referees: A Prospective Observational Study

The COVID-19 pandemic has produced a major disruption for professional football leagues that has affected the physical preparation of both football players and referees. In Spain, health authorities decreed home confinement for eight weeks, supressing the normal training routines of professional referees. After home confinement, referees had four weeks to retrain as the national football league was set to resume matches to complete the 11 games remaining. The aim of the present investigation was to assess changes in eccentric hamstring muscle strength during football competition suspension/resumption due to the COVID-19 pandemic in 21 professional football referees (mean ± SD, age: 33.4 ± 5.1 years; height: 182.4 ± 5.0 cm; body mass: 75.1 ± 4.4 kg). Eccentric hamstring muscle strength was measured with the Nordic hamstring exercise at four time points. During home confinement, referees presented the lowest value of bilateral eccentric muscle strength (300 ± 14 N). Eccentric muscle strength increased by 13.2 ± 3.7% one week after the end of home confinement (339 ± 16 N; p = 0.001, effect size (ES) = 2.8) and remained stable before the first match (343 ± 17 N; p = 0.001, ES = 3.1) and after the end of the national league (328 ± 13 N; p = 0.001, ES = 2.0). In summary, home confinement produced detraining effects in professional football referees associated with hamstring muscle weakness. In this regard, strength-based activities with body loads may be insufficient to avoid muscle weakness and other means (e.g., weights) may be necessary to maintain muscle strength. However, the 4-weeks retraining period was sufficient to resolve hamstring muscle weakness induced by the restrictions of home confinement. This information may be helpful in the case of future sport competition suspension or home quarantine due to new waves of COVID-19 pandemic.

Sports Training during COVID-19 First Lockdown—A Romanian Coaches’ Experience

COVID-19 restrictions impacted sports training and its human resources. The purpose of this study was to highlight the difficulties faced by Romanian coaches while carrying out online training during the first lockdown. It was assumed that the training coordinates were significantly influenced by distance coaching and that the coaches’ self-perceived efficacy was related to their digital skills. The study involved 407 coaches (62.16% men, 37.84% women), with a mean age of 41.7 ± 10.01 years, who completed an online questionnaire with 16 items. The statistics analysis was both quantitative and qualitative, with a significance level of 95%. T test was used for the training duration and for the differences between the coaches’ seniority. Chi-squared test was applied between sports branches and Anova for the non-parametric data. Correlations and regression model were performed to estimate the relationship between variables. It was revealed that 87.22% of the coaches adjusted their initial objectives and that the IT tools were provided through coaches’ own financial resources for 83.05% of them. Overall, 51.84% of the coaches failed to engage all athletes in online training; for the rest of them, an association with their professional experience and sports branches was demonstrated (χ2(8) = 34.688, p = 0.001). ANOVA confirmed that the ability to use IT tools influenced online training efficiency at p < 0.005. The results emphasized that Romanian coaches encountered difficulties related to training programming, IT use, with consequences on their professional self-efficacy.

Soccer in the time of COVID-19: 1 year report from an Italian top league club, March 2020-February 2021

We report the events of an Italian top league soccer club that took place in 1 year (from March 2020 to February 2021) at the time of coronavirus disease 2019 (COVID-19) pandemic. In early March 2020, just before sport competitions were called off due to the national lockdown in Italy, the team, which included 27 players and 26 staff at the time, faced a COVID-19 outbreak, with 16 confirmed and seven probable cases, including three staff members who had to be hospitalised. In May 2020, at the resumption of the training sessions, a high prevalence of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G positivity (35/53, 66%) was detected among the members of the group. In the following months, sport activities were organised behind closed doors with stringent risk mitigation procedures in place. As of February 2021, only two new cases of SARS-CoV-2 infection were detected within the group, against more than 3500 nasopharyngeal swabs and 1000 serological tests.

Impact of the SARS-CoV-2 Coronavirus Pandemic on Physical Activity, Mental Health and Quality of Life in Professional Athletes-A Systematic Review

Due to the rapid rate of spread of the SARS-CoV-2 coronavirus, a number of restrictions have been introduced into public spaces, including those related to the operation of sports facilities, compounding the difficulty for athletes to conduct appropriate forms of training. The aim of this study was to review current scientific reports assessing the impact of the pandemic on the physical activity, mental state, and quality of life of professional athletes. Popular scientific databases—PubMed, Scopus, and Embase—were systematically searched from the beginning of the pandemic until 12 July 2021. According to the adopted criteria, 14 articles were included in the review. Ten of the qualified studies determined the impact of the pandemic on the physical activity of athletes. The authors of 11 papers assessed the mental state and quality of life of athletes during the pandemic. The studies showed negative effects of the pandemic: a decrease in overall physical fitness and number of days and hours of training, as well as an increase in the occurrence of negative emotions (stress, fatigue, and depression) and a decrease in sleep quality. Changes in physical activity had an impact on overall well-being ratings, which depended on the sex of the subjects. Women were more likely to experience negative emotions compared to men. The mental state of the athletes affected the quality of sleep. This review summarises the negative effects of the SARS-CoV-2 coronavirus pandemic on the physical and mental health of professional athletes.

Home-based training program during the SARS-CoV- 2 quarantine: training load, motivation, and wellbeing in professional elite female basketball players

BACKGROUND

due to the quarantine caused by the Coronavirus disease 2019 (COVID-19), professional team-sports adapted their training routine to maintain the athletes' performance and minimize the negative emotional effects. The purpose of the present study was to describe a home-based training program and extra-activities applied during the quarantine in elite professional female basketball players, and to compare the internal training load (ITL), session rating of perceived exertion (s-RPE), motivation, and wellbeing responses before and during the quarantine.

METHODS

nine female elite players (25.7 ± 7.0 years; 180.0 ± 8.0 cm; 79.0 ± 11.0 kg) belonging to a professional basketball team performed a home-based training program during the quarantine. ITL, s-RPE, training motivation, and wellbeing were examined before (phase 1), at the beginning (phase 2), and during (phase 3) of the quarantine.

RESULTS

ITL was higher (main effect) in phase 1 (449.5 ± 62.8 a.u.) compared to phase 2 (265.5 ± 39.0 a.u.) and phase 3 (423.1 ± 18.7 a.u.); s-RPE was higher in phase 1 (4.50 ± 0.63 a.u.) compared to phase 2 (3.8 ± 0.6 a.u.), but not to phase 3 (4.37 ± 0.79 a.u.). Motivation was higher in phase 1 (3.6 ± 0.3 a.u.) compared to phase 2 (2.3 ± 0.6 a.u.) and phase 3 (2.4 ± 0.5 a.u.).

CONCLUSIONS

in conclusion, the results of the study demonstrated that extra-activities involving online athletes' socialization were implemented to rouse the motivation, but the quarantine period induced a reduction in ITL and influenced the player's training motivation.

Training in Rhythmic Gymnastics During the Pandemic

The pandemic caused by the COVID 19 Virus creates an unprecedented situation of global confinement altering the development of competition and sports training at all levels of participation and in all sports, including rhythmic gymnastics (RG). To avoid possible effects of physical, technical and psychological detraining, coaches looked for home training alternatives. The objectives of the study were to know how rhythmic gymnastics training developed during the lockdown period (the conditions, type of training, performance monitoring means, and determinants of gymnasts’ participation) and to provide recommendations for a possible future lockdown. Three hundred and two RG coaches from twenty-six different countries throughout the five continents and four professional levels took part in the study: national team (28), international (26), national (172) and regional (75). The data collection tool was a questionnaire consisting of 39 closed questions structured in three dimensions: identification data of the coaches, training data during confinement and gymnast participation data. The independent variable was the gymnasts’ performance levels and the dependent variables organized in four categories: the technical media used to conduct and monitor the training sessions, the type of training done, the mechanisms for monitoring training performance and the aspects that determined participation. Most coaches kept their gymnasts training during confinement, although 76.5% confirm abandonment of any of their gymnasts. The main means used were real-time video conferencing, although at the lower practice levels the media stand out in deferred time. The contents of the training were mainly body technique, physical preparation and body difficulties. For performance monitoring, challenges, physical, and technical tests were predominant. The determinants for the development of training in the confinement vary depending on the level of the gymnasts, connectivity and electronic resources at the highest level, and the availability of spaces and social distancing at lower levels. For future lockdowns, it is necessary to review the content of the trainings, as well as the performance evaluation and the means necessary for it.

Dual Careers of Athletes During COVID-19 Lockdown

This study aimed to investigate the student-athletes' capability to face the academic, sport, and social challenges during the coronavirus disease 2019 (COVID-19) lockdown and to disclose novel aspects of dual careers. A 32-item online survey encompassing demographic characteristics, sport and university engagement, support and dual-career benefits, physical activity, sitting time, and the time deemed necessary to recover the previous level of performance was developed. Four hundred sixty-seven student-athletes (males: 57%, females: 43%) from 11 countries, competing in 49 different sports (individual: 63.4%, team: 36.6%) at regional (17.5%), national (43.3%), and international (39.2%) levels, and enrolled at high school (21.9%) and university (78.1%) levels completed the survey. During the lockdown, the respondents decreased the time dedicated to sport and academics, although they maintained an active lifestyle. Student-athletes from countries under severe contagion were more likely to train at home, dedicate to academics, and receive support from the coach but less likely receive support from their teachers. With respect to their team sport counterparts, athletes competing in individual sports trained more and were more likely to receive support from their coaches. International athletes showed the highest training time and support from their coaches and as student-athletes. High school students received more support from their coaches and teachers, whereas university students were more likely considering dual careers useful to cope with the COVID-19 pandemic. This study substantiates the relevant role of competitive sports participation in the maintenance of active lifestyles, with student-athletes considering home training and e-learning valuable resources during the lockdown. Furthermore, their sport and academic commitments helped student-athletes cope with the emergency of the COVID-19 pandemic.

Comparative Analysis of Soccer Performance Intensity of the Pre-Post-Lockdown COVID-19 in LaLiga™

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) forced a stoppage in the 2019/2020 season of LaLiga™, possibly influencing performance indicators in the return to competition. Therefore, here, we evaluated whether the stoppage due to the coronavirus 2019 disease (COVID-19) lockdown influenced physical performance compared to the start of LaLiga^TM in terms of high-intensity efforts. Using a semi-automatic, multiple-camera system, running activities during 22 matches were analyzed. We compared the first 11 matches of the season (pre-lockdown) with the 11 matches just after the restart of LaLiga™ (post-lockdown). The results showed higher (p < 0.05) performance in the pre-lockdown period compared with the post-lockdown period, including in medium-speed running (14.1–21 km/h), high-speed running (21.1–24 km/h), and sprinting speed running distances (>24 km/h). However, the number of accelerations/min and decelerations/min were significantly higher during the post-lockdown period. Therefore, we conclude that the stoppage due to the COVID-19 lockdown generated lower physical performance in the post-lockdown period compared with the pre-lockdown period, most likely due to the accumulation of matches (congested schedules).

The Use of Online Training Tools in Competition Cyclists During COVID-19 Confinement in Spain

COVID-19 confinement has supposed a challenge to the whole wide world, especially in athletes that have frustrated their expectations about training programs and competitions. Specifically, competition cyclists during confinement had lot of difficulties to train due to the need to train outside their homes. However, the increase of online training sessions, or virtual training tools could help to overcome training difficulties due to confinement although there are not studies that analyse the effects of using these types of tools in cyclists. This study aims to test how the use of online training tools in competition cyclists during confinement is related to training frequency and duration, and emotions. 329 cyclists filled an online questionnaire about feelings during confinement and the use of online training tools, before and during confinement. Results showed that the use of online training tools was associated with higher frequency and duration of trainings. Moreover, those who used these tools felt more positively about their future and preparation to compete, feeling more energy than those who did not used online tools. In addition, cyclists that started using these online tools (including virtual roller training) during confinement increased the frequency of training. In conclusion the use of online training tools for cycling could be appropriate to maintain training levels and energy and positive feelings about their future.

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.

Impact of COVID-19 Lockdown on Serie A Soccer Players' Physical Qualities

In March 2020, the COVID-19 pandemic forced most activities in Italy, including soccer, to cease. During lockdown, players could only train at home, with limited evidence regarding the effect of this period. Therefore, this study aimed to investigate the effect of COVID-19 lockdown on professional soccer players' physical performance. Aerobic fitness and vertical jump were assessed before and after four periods in two different seasons: COVID-19 lockdown, competitive period before lockdown, competitive period and summer break of the 2016-2017 season. Linear mixed models were used to examine within-period changes and between-period differences in changes observed during COVID-19 lockdown and the three other periods. Within-period changes in aerobic fitness showed a significant improvement following COVID-19 lockdown (p<0.001) and a significant decline during summer break (p<0.001). Between-period differences were significant in the comparison of COVID-19 lockdown with both the competitive 2019-2020 season (p<0.01) and summer break (p<0.001). For the vertical jump, only the between-period comparison revealed significant differences as the changes associated with COVID-19 lockdown were worse than those of the two competitive periods, for both absolute (p<0.05; p<0.001) and relative peak power (p<0.01; p<0.001). Home-based training during lockdown was effective to improve aerobic fitness, although it did not allow players to maintain their competitive period's power levels.

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.

Playing Non-Professional Football in COVID-19 Time: A Narrative Review of Recommendations, Considerations, and Best Practices

The coronavirus disease (COVID-19) pandemic in 2020 resulted in widespread interruption of team sports training and competitions. Our aim was to review the recommendations and best practices in return to play in non-professional football after activity lockdown. The authors searched two electronic databases (PubMed, Web of Science) to extract studies published before September 15 2020. Twenty studies explained recommendations, considerations, or best practices in return to play in football, and all of them were clustered into three groups: (1) training load management (n = 10), (2) medical recommendations (n = 9), and (3) recovery related issues (n = 5). The way to establish a progression in training process should be based on training load management and managing the number of stimuli per time. Following the studies, this training process should be divided into three phases: phase 1-physical distancing should be maintained; phases 2 and 3-group training should start. Medical considerations were clustered into different groups: general, pre- and post- training, during training, education, planning to return to competition, and suggestions for post confinement weeks. In particular, social issues, strict hygiene questions, and continuous PCR testing should be considered in return to play over football season. Finally, since a correlation has been found between high-intensive training loads and immunoglobulin A, nutritional and lifestyle recovery strategies should be performed. Moreover, since immunosuppression has been related to congested schedules (<72 h between matches), football federations should avoid this situation.

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.

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.

Studies of Physical Activity and COVID-19 During the Pandemic: A Scoping Review

BACKGROUND

This scoping review aimed to identify the available evidence related to physical activity (PA) and the coronavirus disease (COVID-19) pandemic.

METHODS

A search in 6 databases (PubMed, Embase, SPORTDiscus, Scopus, Web of Science, and CINAHL) was conducted on July 23, 2020. Medical subject headings and keywords related to PA and COVID-19 were combined to conduct the online search, which covered the period from January to July 2020.

RESULTS

Overall, 1784 articles were retrieved. After duplicate removal and title, abstract, and full-text screening, 41 articles were included. Most of the included studies were quantitative and collected data through online interviews/questionnaires, with sample sizes larger than 100 and composed by adults and older adults. Changes in PA levels due to the COVID-19 pandemic were the most assessed outcome, followed by the association between mental health issues and PA. Only 2 studies assessed the direct effects of PA on COVID-19.

CONCLUSION

Most of the evidence identified a decrease in PA levels due to social distancing measures and that PA might help to decrease the mental health burden related to the COVID-19 outbreak.

The Impact of Covid-19 and the Effect of Psychological Factors on Training Conditions of Handball Players

The spread of COVID-19 has altered sport in Spain, forcing athletes to train at home. The objectives of the study were: (i) to compare training and recovery conditions before and during the isolation period in handball players according to gender and competitive level, and (ii) to analyse the impact of psychological factors during the isolation period. A total of 187 participants (66 women and 121 men) answered a Google Forms questionnaire about demographics, training, moods, emotional intelligence, and resilience sent using the snowball sampling technique. T-test and analysis of variance (ANOVA) were used to compare sport level and gender differences. Linear regressions were used to analyse the psychological influence on training. Handball players reduced training intensity (in the whole sample; p = 0.44), training volume (especially in professional female handball players; p < 0.001), and sleep quality (especially in professional male handball players; p = 0.21) and increased sleep hours (especially in non-professional female players; p = 0.006) during the isolation period. Furthermore, psychological factors affected all evaluated training and recovery conditions during the quarantine, except for sleep quantity. Mood, emotional intelligence, and resilience have an influence on physical activity levels and recovery conditions. In addition, training components were modified under isolation conditions at p < 0.001. We conclude that the COVID-19 isolation period caused reductions in training volume and intensity and decreased sleep quality. Furthermore, psychological components have a significant impact on training and recovery conditions.

Return to football training and competition after lockdown caused by the COVID-19 pandemic: medical recommendations

The lockdown caused by the COVID-19 pandemic represents a great unknown regarding the physiological changes induced in elite football players. Although it will differ from country to country, the return to sport for professional football players will follow a forced lockdown never experienced and longer than the normal annual season break. Moreover, in addition to an obvious decrease in performance, the lockdown will possibly lead to an increase of the injury risk. In fact, preseason is always a period with a specific football injury epidemiology, with an increase in the incidence and prevalence of overuse injuries. Therefore, it seems appropriate to recommend that specific training and injury prevention programmes be developed, with careful load monitoring. Training sessions should include specific aerobic, resistance, speed and flexibility training programmes. The aerobic, resistance and speed training should respect some specific phases based on the progressiveness of the training load and the consequent physiological adaptation response. These different phases, based on the current evidence found in the literature, are described in their practical details. Moreover, injury prevention exercises should be incorporated, especially focusing on overuse injuries such as tendon and muscle lesions. The aim of this paper is to provide practical recommendations for the preparation of training sessions for professional footballers returning to sport after the lockdown.

Players' physical performance in LaLiga across the season: insights for competition continuation after COVID-19

Due to the COVID-19 outbreak, professional football players competing in LaLiga were confined at home for ~8 weeks and then they were allowed to train to prepare the first competitive match for 4 weeks. As the duration of summer break in the prior four seasons of LaLiga (from 2015-2016 to 2018-2019) was of similar length to the suspension of the championship due to COVID-19 (~12 weeks), we have analysed the running performance of teams competing in LaLiga in these four seasons to anticipate players’ physical performance after the resumption of the competition. The analysis includes the average running distance per game for each of the 38 matchdays that compose LaLiga. One-way ANOVA revealed that there was a main effect of the matchday on total running distance per match (p = 0.001), and in the distance covered between 14.0 and 20.9 km/h (p < 0.001), between 21.0 and 23.9 km/h (p < 0.001) and at above 24.0 km/h (p < 0.001). Overall, the post-hoc analysis revealed that the running patterns progressively increased during the first 8-10 matchdays and then reached a plateau which was significantly different to matchday-1 (p < 0.05). This analysis reveals that, in the prior four competitive seasons of LaLiga, players’ physical performance was lower at the beginning of the season and the teams needed approximately 8-10 matchdays to reach a steady state running performance. These data suggest that football players will progressively increase their performance across the 11 matchdays remaining to complete LaLiga.

Season Suspension and Summer Extension: Unique Opportunity for Professional Team-Sport Athletes and Support Staff During and Following the COVID-19 Crisis

Given the emergence of the COVID-19 outbreak, the official declaration of a global pandemic by the World Health Organization, and its consequential disruptions on the professional team sports landscape, it is the main objective of this brief opinion to help ensure that professional team-sport athletes and support staff remain aware as a society of some of the potential pitfalls - illustrated via negative but plausible detrimental scenarios. Finally, new ideas are introduced and evidence-based hypotheses are presented on the following five themes: periodization, exploration, virtual (at-home) training, player monitoring, and continued education, including return-to-competition preparation strategies following these exceptional times of uncharted territory.