ORIGINAL RESEARCH published: 27 September 2021 doi: 10.3389/fpsyg.2021.736499 Effects of the COVID-19 Health Crisis on Sports Practice, Life Quality, and Emotional Status in Spanish High-Performance Athletes Elena Conde 1† , Luis Manuel Martínez-Aranda 1,2* † , Gema Sanz 3 , Cristina López de Subijana 4 , Antonio Sánchez-Pato 1,5 , Álvaro Díaz-Aroca 1 , Alejandro Leiva-Arcas 1,5 , Juan Alfonso García-Roca 1,5 , Yago Ramis 6 and Miquel Torregrossa 6 1 Faculty of Sport, San Antonio Catholic University (UCAM), Murcia, Spain, 2 Human Movement Neuroscience Research Group (Neuromove), (UCAM), Murcia, Spain, 3 Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden, 4 Instituto Nacional de Educación Física, Universidad Politécnica de Madrid, Madrid, Spain, 5 Faculty Edited by: of Sport, Olympic Studies Center, Catholic University of Murcia, Murcia, Spain, 6 Departament de Psicología Bàsica, Andrew M. Lane, Universitat Autònoma de Barcelona, Barcelona, Spain University of Wolverhampton, United Kingdom Spain is one of the many countries highly affected by the COVID-19 crisis, establishing Reviewed by: Tanja Kajtna, very restrictive measures with a complete lockdown for more than 3 months. This University of Ljubljana, Slovenia situation forced the complete closure of sport practice and national or international Ángel De-Juanas, competitions, leading to a negative impact on physical and psychological health of high- National University of Distance Education (UNED), Spain performance athletes. Therefore, the objectives of this study were (a) to determine the *Correspondence: effects of the COVID-19 health crisis on Spanish high-performance athletes in terms of Luis Manuel Martínez-Aranda sports practice, life quality, and emotional state and (b) to identify the profile with the lmmartinez2@ucam.edu greatest difficulties during and after the lockdown. A sample of 130 high-performance † These authors have contributed equally to this work and share the first athletes aged between 18 and 34 years (67 women and 63 men) participated in this authorship study (83.1% achieved a medal in National–International elite competitions; 86.9% were considered student-athletes). Measures included socio-demographic data through a 5- Specialty section: This article was submitted to dimension ad hoc survey: physical activity and exercise using an adapted version from Movement Science and Sport the International Physical Activity Questionnaire (IPAQ); health status and limitations Psychology, using an adapted version of SF-12 Health Questionnaire; Perceived stress (Short- a section of the journal Frontiers in Psychology PSS); and Mood States (29-item POMS). All participants have shown a significant Received: 05 July 2021 decrease pre–post-lockdown in both health and performance perception, especially Accepted: 23 August 2021 in women, individual athletes, medalists, and student-athletes. Strong limitations of Published: 27 September 2021 training, attention, and motivation as well as a moderate negative emotional state during Citation: Conde E, Martínez-Aranda LM, lockdown were reported, in women, individual athletes, medalists, and student-athletes. Sanz G, López de Subijana C, Even with an improved emotional state and energy level in the post-lockdown period, Sánchez-Pato A, Díaz-Aroca A, moderate-to-high stress scores were reported by women and medalists. Our findings Leiva-Arcas A, García-Roca JA, Ramis Y and Torregrossa M (2021) highlight the importance of paying attention to the physical and psychological health of Effects of the COVID-19 Health Crisis elite athletes on three profiles: team athletes (due to social distance), student-athletes on Sports Practice, Life Quality, and Emotional Status in Spanish (dual-career issues), and women athletes (prevalence of implicit gender inequalities in High-Performance Athletes. sport). Front. Psychol. 12:736499. doi: 10.3389/fpsyg.2021.736499 Keywords: COVID-19, elite athletes, lockdown, post-lockdown, sports performance, emotional state Frontiers in Psychology | www.frontiersin.org 1 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes INTRODUCTION of life, and emotional state. This experience could have a direct impact on their sporting performance and other dimensions In early 2020, a new viral outbreak began to spread related to their well-being, which is even more relevant given that internationally. On January 30, 2020, according to the the Olympic Games are coming up in July 2021 and international International Health Regulations (World Health Organization competitions are returning. from now on World Health Organization, 2020a), the outbreak In an athletic career, it is necessary to be aware of the was declared by World Health Organization (2020b) as “a transitions faced by the athlete (Stambulova and Wylleman, public health emergency of international concern present 2015). Special attention should be paid to the so-called non- in 18 countries, mainly in Europe.” Countries implemented normative transitions, due to the high level of uncertainty control measures to minimize the risk of transmission and involved, such as the situation of the COVID-19 pandemic, spread of the virus, such as closing schools, canceling the large and its consequences not expected. The effects that an meeting, suspending social and sporting events, and confining involuntary break can have on the professional life of athletes citizens to their homes. The effects of the epidemic caused by are similar to the effects of an injury (decreasing the health COVID-19 have been emerging as the situation evolved rapidly status, interruption of the athletic career, loss of professional (Epidemiology Working Group for NCIP Epidemic Response, status and economic income, and so on). It is a sport- Chinese Center for Disease Control and Prevention, 2020). inherent fact, whether it is experienced as a catastrophe, In Spain, on 13 March, 2 days after the WHO declared as a challenge, or sometimes as an avoiding mechanism COVID-19 a pandemic, the Council of Ministers decreed a from stressful situations or elevated competitive anxiety (De “state of alarm" for the entire national territory, provided by la Vega, 2003; Stambulova et al., 2020). Therefore, the the article 1,165 of the Constitution (Constitución española, health crisis situation experienced by COVID-19 represents a 1978). In this process, people were confined in their homes, challenging period for athletes, with possible effects on their away from the social environment for 99 days to limit the spread lives and professional career, potentially leading to changes in of the virus, as a crucial public health measure. The effects of several dimensions, such as physical and physiological, motor such lockdown raised significant mental health risks, due to an skills, psychosocial and self-identity, relationships, performance, uncertainty associated with increased negative feelings (Lades motivation and aspirations, organizational-occupational and et al., 2020), as well as high emotional impact (Lima et al., 2020; micro- and macro-cultural issues (Samuel et al., 2020). In Xiang et al., 2020). Previous studies in Spain found that between this line, the postponement of the Tokyo Olympic Games 15.8 and 21.6% of the general population showed depressive, has meant an important change and adjustment of their anxious, and/or post-traumatic symptoms during the first month planning for some athletes, being a good opportunity to of lockdown (González-Sanguino et al., 2020). From the physical further improve their performance or recover from injuries health point of view (Chen et al., 2020), this situation leads to they might have suffered (Stambulova et al., 2020; Taku and the appearance of negative effects associated with inactivity, Arai, 2020). Therefore, it is necessary to understand how sedentary lifestyles, increased consumption of high-calorie much the sporting practice of elite athletes has changed foods, and poor sleep quality, thereby favoring the physical and the impact this might have on both their physical and deconditioning of the general population (Mera et al., 2020). psychological well-being as a consequence of a prolonged From June 21, 2020, Spain ended the state of alarm and began to period of lockdown. live in the stage known as “new normality” or post-lockdown, a Scientific literature regarding elite athletes and their mental battery of measures to prevent, contain, and coordinate actions health during the period of social isolation (Di Fronso et al., to deal with the health crisis caused by COVID-19 (Royal 2020; Pons et al., 2020; Schinke et al., 2020; Stambulova Decree-Law 21/2020 of 9 June. BOE, 2020). et al., 2020) showed a high concern for athletes who planned The effects of lockdown in the new situation could be specific not only their training for the Olympic Games, but also for to elite athletes compared to the general population. Athletes other qualifying competitions. Researchers have questioned how who have reached a high level of professionalism (Brackenridge, uncertainty about missing their Olympic and other international 2004) are committed to sport up to 40 h per week, so that competitions may affect the mood of athletes (Samuel et al., sport practice has a fundamental role in their lives. Due to the 2020; Schinke et al., 2020). It is argued that these changes global public health circumstances caused by COVID-19, the increased the feeling of uncertainty, confusion, and frustration, Tokyo Olympic Games scheduled for July 2020, as well as all and made it difficult to set concrete goals (Taku and Arai, 2020). international competitions, had to be postponed [(Schinke et al., In countries like Italy, elite athletes (Di Fronso et al., 2020) 2020) and as (Evans et al., 2020), p. 90] noted, “There is little doubt showed that the pandemic had a strong negative impact on that the everyday lives and practices of sports participants, not least both perceived stress and psycho-biosocial states. These harmful athletes, have had to change, pause or even cease as a result of effects observed in both women and men were caused by the the pandemic.” The emergency health measures adopted in Spain unique characteristics and demands of the emergency period. In caused an important disruption in their sporting careers, training Spain, young athletes, mainly female athletes, suffered a negative plans, and competitions in a sudden and unforeseen manner. impact on their mental health during the COVID-19 lockdown Both the situation of lockdown experienced and the current (Pons et al., 2020). Also in Spain, a case study conducted situation, where the athletes had to adapt very quickly, could with a confined Paralympic athlete in an ultra-marathon event have caused significant changes in their sporting practice, quality did not show high levels of anxiety, revealing how dependent Frontiers in Psychology | www.frontiersin.org 2 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes it is on the context or reality where the athlete is involved MATERIALS AND METHODS (Belinchón de Miguel et al., 2019). Apparently, the loss of routines in lives of athletes has Participants affected both their mental and physical states (Taku and Arai, The participants were 130 high-performance athletes (67 women 2020). In addition, in order to stablish and maintain an optimal and 63 men) aged between 18 and 34 years. The 85.4% of the performance, preparatory, control, and official competitions are sample were considered top or elite athletes according to the an important tool (Mujika et al., 2018). Consequently, the Spanish government. The 29.2% had been in the elite for 0–3 absence of competitions has a negative impact on the athletic and years, 46.9% for 3–10 years, and 23.8% for more than 10 years competitive performance of athletes (Jukic et al., 2020). Although of their sporting life. The 83.1% of the participants had achieved most athletes continued their daily training, two out of three a gold, silver, or bronze medal in their sport discipline at least athletes trained individually or without professional coaching. once during their time competing internationally in the elite. In More than half of the athletes were training at a moderate exercise total, 54.6% of the athletes belonged to individual sports, while intensity, with a lower-than-normal training load, resulting in 45.4% belonged to team sports. Finally, 86.9% of the sample were deconditioning, being a challenge for subsequent reconditioning considered student-athletes. All of them gave their consent for in post-lockdown period (Pillay et al., 2020). In addition, their responses to be treated anonymously, and the University’s attending to the motor skills dimension and the detraining or Research Ethics Committee approved the study, which was partial losses in important adaptations, the training modifications conducted in accordance with the Declaration of Helsinki. could have led to reductions in speed, technical accuracy, sensorimotor coordination, and movement flow (Tran et al., Measures 2017; Desiderio and Bortolazzo, 2020; Jukic et al., 2020). Sociodemographic Data Concerning the well-being of athletes, it is necessary to An ad hoc survey was created in order to collect relevant highlight studies exploring the perceived impact on athletes due data according to the objectives of this study. This survey was to measures of social distancing and the emotional, mental, social, composed by items related to (a) gender, (b) best sporting and physical components related to well-being that may have result obtained (medalists, non-medalists), (c) sporting discipline been affected (Brooks et al., 2020; Gupta and McCarthy, 2021; practiced (individual-team sports), (d) student-athlete, and (e) Woodford and Bussey, 2021). The contribution of Woodford high-performance sporting expertise. and Bussey (2021) stated that the lockdown provided the athletes with a rest period, allowing them to think about their sporting Physical Activity and Exercise participation and make the necessary changes in their lives that All information related to the amount of physical activity and would protect their well-being during the lockdown and post- resting time performed by the participants was collected. For this lockdown periods. purpose, the short version proposed by the Junta de Andalucía of In this context, it is necessary to understand the impact the International Physical Activity Questionnaire (IPAQ; Mantilla of lockdown on the physical and mental health of athletes in and Gómez-Conesa, 2007) was used. This shortened version the post-lockdown period. Likewise, it is important to know consisted of seven items and provided information about the how these poor training conditions may have interfered with time respondents spent in moderate- and vigorous-intensity their sporting lives (Pillay et al., 2020), as well as the existence activities, walking, and resting. In this adapted version, several of uncertainty due to the cancelation or delay of important items were duplicated in order to collect data from pre-lockdown competitions (Samuel et al., 2020) and the social distancing from and post-lockdown periods. Additional items were included coaches and teammates (Graupensperger et al., 2020). for reporting the resting days and hours, since three time- Most of the studies in athletes published to date have been point (pre–during–post-lockdown) was collected. Therefore, a conducted during the lockdown period (Abenza-Cano et al., total of 18 items composed this adapted questionnaire to 2020; Corsini et al., 2020; Jukic et al., 2020; McGuine et al., 2021; the participants. The Cronbach’s alpha coefficient reported Samuel et al., 2020; Taku and Arai, 2020) and some of them, acceptable levels of reliability, with values ∼0.80. This instrument in the final period, when athletes were very close to reactivate allowed monitoring the physical activity prevalence of the adult their sporting activity (Pillay et al., 2020), but there is little population aged 18–65 years. scientific evidence on the consequences perceived by athletes in the post-lockdown period and the impact it may be having Health Status and Limitations Questionnaire on their physical and mental health and quality of life, taking An adapted questionnaire based on the original SF-12 Health into account the proximity of the Tokyo 2021 Olympic Games. Questionnaire (Ware et al., 1996; Gandek et al., 1998) translated Attending this need in the scientific literature, the main objectives into Spanish by Alonso et al. (1998) and Vilagut et al. (2005) in this study were (a) to determine the effects of the COVID- was used. This instrument consisted of 12 items from the eight 19 health crisis on Spanish elite athletes related to (a.1) sports dimensions of the original SF-36 (Ware and Sherbourne, 1992). practice, (a.2) health, life quality, and performance perception, For this occasion, an adapted questionnaire was expanded and (a.3) emotional state in the current situation of post-lockdown as applied in order to collect pre–post data (dimensions 1 and 2), well as (b) to identify the profile of the athletes with the greatest during and post-lockdown periods (dimensions 39), consisting difficulties in this period, to whom the necessary attention and in 20 items related to nine dimensions. The number of response help should be given. options assessing intensity or frequency ranged from three to Frontiers in Psychology | www.frontiersin.org 3 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes six, depending on the dimension: (1) health perception, (2) information about the process. Responses to the online performance perception (ranging both between 0 = bad and questionnaire by the athletes were provided in a single session 4 = excellent), (3) degree of limitation in training (from 0 = No, I and without any interruption until all the tests were completed. trained what I really wanted to 4 = Yes, I trained a way less than I The completion of the online survey was performed in a wanted to), (4-6) Limitations of training, attention and motivation controlled manner and in the presence of the respective coaches. due to negative emotional causes (Yes, No, Maybe), and finally, The athletes answered the IPAQ questionnaire according to (7-8) Positive-negative emotional state and (9) energy levels (from pre- and post-lockdown periods, except for resting days and 0 = never to 5 = always). Cronbach’s alpha coefficient reported hours with three time-point questions: (a) PRE (before the values of reliability between 0.78 and 0.96. This instrument lockdown); (b) DURING (during the lockdown period); and provided a profile of the health status of participants and is one (c) POST (after the lockdown). For the questionnaire related to of the most widely used generic scales in both descriptive and health status and limitations, only two points (pre vs. post or evaluative studies. during vs. post) were taken into consideration. The remaining questionnaires (perceived stress and mood states) were only Perceived Stress related to the post-lockdown period. Athletes who agreed to A shortened version of the Spanish version of the Perceived Stress participate were informed of the confidential and voluntary Scale (PSS; Cohen et al., 1983) designed by Remor and Carrobles nature of the study as well as the absence of any reward for (2001) was used. This scale is a self-report instrument that participation. When answering the questionnaire, all of them assesses the level of stress perceived during the last month. The had accumulated 99 days of lockdown. Finally, in appreciation shortened version used in this study has 12 items with a five-point of their collaboration, a final report was sent with the main scale response format (0 = never, 1 = hardly ever, 2 = occasionally, findings of the study. 3 = often, 4 = very often). The total PSS score is obtained by inverting the scores of items 4, 5, 6, 7, 9, and 11 (as follows: 0 = 4, Data Analysis 1 = 3, 2 = 2, 3 = 1, and 4 = 0) and then adding the 12 items Descriptive statistics were performed on all participants in the together. The direct score obtained indicates that a higher score study. A Lilliefors test of normality was applied (>50 samples), corresponds to a higher level of perceived stress. Cronbach’s alpha yielding non-normal results for all variables except Stress score. coefficient reported the values of reliability between 0.78 and 0.82. Median and interquartile ranges were used for non-normal The PSS was completed concerning the post-lockdown period. continuous variables, and mean (± standard deviation) was used for Stress score variable. The N and percentages were used Mood States for descriptive variables as well. Comparisons for each variable The Profile of Mood States (POMS) in its original reduced version type were assessed based on the following categorical variables: (McNair et al., 1992), composed of 29 items and validated gender, best result achieved, modality, student-athlete, and high- in Spanish by Fuentes et al. (1995), was used. This version performance expertise. Wilcoxon’s rank-sum test was used for includes a Likert-type scale with values ranging from 0 (not at continuous variables if non-normally distributed; otherwise, a all) to 4 (very much) to assess the factors Fatigue, Depression, t-test was applied. Additionally, paired Wilcoxon signed-rank test Tension, Hostility, and Vigor. The Cronbach’s alpha showed was used to assess changes within pre vs. during or during vs. values between 0.70 and 0.83. This instrument is useful for post and pre vs. post COVID-19 lockdown when available. Chi- assessing mood and its relationship to sport (Abenza et al., 2010). square test was used for categorical variables. Wilcoxon’s effect Participants completed the POMS questionnaire regarding the size (ES) was calculated for non-normal variables; otherwise, post-lockdown period. Cohen’s D was used. Differences at p < 0.05 level were considered statistically significant. All statistical analyses and plots were Procedure performed using the packages nortest (Gross and Ligges, 2015) After obtaining the approval of the Ethics Committee of the and rstatix (R version 4.0.3) (Kassambara, 2021). Correlation University, the online tool was designed through the Google analyses were performed using the R “rquery. cormat”1 function Forms platform using all the aforementioned questionnaires. and corrplot package (Wei and Simko, 2017). The online survey was sent by email following a convenience sampling strategy, to 2,136 athletes from different sports disciplines being registered in the COE (Spanish Olympic RESULTS Committee). In total, 130 elite athletes (83.1% won international medals) completed the whole online survey agreeing to The descriptive data from all the variables are shown in participate in the present study. Through human resources Supplementary Table 1. These results are presented as N contact, coaches from multiple sports disciplines were and percentages, median and interquartile range, or mean and encouraged to discuss with their athletes the importance of standard deviation, depending on the type of variable. Five conducting this type of study and to raise awareness of the comparative categorical groups were established for analyzing all difficulties that elite athletes have experienced both physically the results in this study: gender, modality, best result achieved, and psychologically, during this unusual and uncertain period. student-athlete, and high-performance expertise. During 5 weeks, the project team was in contact with the supervisor for the athlete recruitment in order to receive 1 http://www.sthda.com/upload/rquery_cormat.r Frontiers in Psychology | www.frontiersin.org 4 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes Days and Hours Limitations of Training, Attention, and Pre-(during)–Post-lockdown: Training, Motivation Due to Negative Emotional Moderate Physical Activity, Walking, and Causes Resting A chi-squared test found that there was a statistically significant A paired Wilcoxon signed-rank test revealed significant association between the limitations of training [χ2 (2) = 36.847, differences in days of resting in pre vs. during and during p < 0.001], attention [χ2 (2) = 25.469, p < 0.001] as well as vs. post for all of the groups analyzed (p < 0.001). Attending motivation [χ2 (2) = 50.730, p < 0.001] due to negative emotional to the categorical variables, men increased from 2 to 6 days causes, and the lockdown status. A higher number of participants of rest during the lockdown, and then returned at 2–3 days reported limitations during lockdown period but not after. in the post-lockdown period. Team sports use more resting days in each pre–during–post stage compared to individual Positive/Negative Emotional State and sports (p < 0.01). Student-athletes increased resting days Energy Levels During–Post-lockdown during lockdown to a lower extent compared to non-athletes, Concerning the negative emotional state, Figures 2A–E show regained their pre-lockdown habits later on (p < 0.01). From intermediate levels during lockdown, dropping significantly to a general perspective, sportsmen and women belonging to lower levels in the post-lockdown period for both genders team sports and with lower competitive level retained 1 day (female–male, p < 0.001, moderate ES, being more pronounced more for resting in the post-lockdown period compared in men); both modalities (individual-team; p < 0.001, moderate to pre-lockdown. ES and p < 0.001, small ES, respectively); best result (podium- Concerning hours of training and moderate physical activity, rest; p < 0.001, small ES and p < 0.01, large ES, respectively); changes were observed in medalist athletes (podium) (p = 0.008), student-athletes (p < 0.001, moderate ES, significantly higher in individual sports (p = 0.003), and in athletes with medium- during lockdown compared to non-student-athletes), and broad expertise in elite (p = 0.032), significantly decreasing short and medium high performance (HP) sporting expertise their daily and weekly training hours between pre- and (p < 0.001, large ES and p < 0.01, small ES, respectively). post-lockdown. The positive emotional state was moderate to high, increasing Significant differences for hours of resting pre vs. during, in the post-lockdown compared to lockdown for only male during vs. post and pre vs. post, were reported for the whole (p < 0.01, small ES); student-athletes (p < 0.001, small ES, sample and by subcategories, especially for both genders, significantly lower during lockdown compared to non-student- medalist athletes, both individual and team sports, student- athletes); and athletes with (medium) 3–10 years of experience in athletes, and athletes with 3–10 years of experience in the elite the elite (p < 0.05, small ES) (Figures 2A–E). (p < 0.001). The aforementioned samples considerably increased The participants in this study also showed moderate energy the hours of rest per day during lockdown, where the intervals levels during lockdown, increasing significantly to higher levels of 3–5 h and +5 h per day were greatly increased. In the post- in the post-lockdown for both genders (p < 0.05 and p < 0.001, lockdown period, the resting hours were generally somewhat small ES, for female and male, respectively); individual and team higher than those shown in the pre-lockdown period. athletes (p < 0.01, small ES); medalists (p < 0.001, small ES); student-athletes (p < 0.001, moderate ES); and short sporting Health and Performance Perception experience (p < 0.001, large ES) (Figures 2A–E). Regarding the health perception in the post-lockdown period, significant differences between genders were revealed, where Stress and Mood States women’s score was significantly lower than men (p = 0.02, A t-test revealed significant differences between genders for stress small ES). Both genders, male (p = 0.02, small ES), and female scores (p = 0.001, moderate ES) and in medalists, with higher (p = 0.001, moderate ES), showed a significant decrease in the scores compared to non-medalists (p = 0.01, moderate ES). When performance perception pre–post-lockdown (Figure 1A). combining both variables, women still show significantly higher Athletes competing in individual sports, the group of levels, but only within those competitors with the best result medalists, student-athletes, and those with 3–10 years of expertise (podium) (p = 0.001, moderate ES). In addition, women showed have shown a significant decrease in both health perception higher scores compared to men in team sports (p = 0.008), (p = 0.02, small ES; p = 0.01, small ES; p = 0.003, small ES; p = 0.02, student-athletes (p = 0.004), and medium sporting expertise small ES, respectively) and performance perception (p < 0.001, (3–10 years) (p = 0.002) (Figures 3A–C). moderate ES; p < 0.001, small ES; p < 0.001, small ES; p < 0.001, By combining best result and HP sporting expertise, the moderate ES, respectively) pre–post-lockdown (Figures 1B–E). medalists with 0–3 years of expertise showed higher stress scores compared to non-medalists (p = 0.01, large ES). In general terms, Degree of Limitation in Training as sporting expertise increases, the differences between medalists During–Post-lockdown and non-medalists equalize and become non-significant after The degree of limitation in training was compared during 3–10 years of experience in the elite (Figure 3D). and post-lockdown for all the categorical variables. A paired Concerning the mood states by gender, a Wilcoxon signed- Wilcoxon signed-rank test indicated that these differences were rank test revealed significant differences in depression (p = 0.04) significant (p < 0.001, large ES). and fatigue (p = 0.003) with higher scores for women, and Frontiers in Psychology | www.frontiersin.org 5 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes FIGURE 1 | (A–E) Health and performance perception by gender, best result achieved, modality, and student-athlete condition. Data presented as mean ± SD. *Significant at level 0.05; **significant at level 0.01; ***significant at level 0.001. vigor with higher scores for men (p = 0.008). Those with DISCUSSION better results have a slightly more negative profile, showing higher levels of tension (p = 0.02) and hostility (p = 0.04) The health crisis caused by COVID-19 raised a series of hitherto than non-medalists. They generally score a little higher on unknown circumstances in the world of elite sport, as the the negative dimensions of the profile and lower on vigor population had to be confined to their homes (for more than compared to non-medalists. No significant differences were 3 months, in the case of Spain). It also meant the delay found for any factor regarding other categorical variables and/or cancelation of sporting events all over the world, with (Figures 4A,B). the postponement of the Olympic Games for the first time in its history, being an example of the magnitude of this crisis Correlational Study worldwide. A large number of retrospective studies were carried The 30 most relevant ranked cross-correlations are shown in out during the lockdown period, trying to understand the Figure 5 and Supplementary Figure 1. Mood states, positive problems athletes were facing and how they could affect their and negative emotional states, energy levels, stress scores, health- physical and mental health. To complement these studies and performance perception, and degree of limitation in training the problems that have become evident, it is necessary to know were the variables yielding the most significant negative–positive what consequences have been produced on the lives months of correlations for all participants. athletes after exceptional circumstances. For this purpose, the Frontiers in Psychology | www.frontiersin.org 6 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes FIGURE 2 | (A–E) Emotional and energy state by gender, modality, student-athlete condition, and high-performance expertise. Data presented as mean ± SD. *Significant at level 0.05; **significant at level 0.01; ***significant at level 0.001. present results extend previous knowledge on the consequences to rest around 1 day more than pre-lockdown period, indicating of the COVID-19 pandemic by providing new evidence on the that certain habits are not recovered quickly or possibly that physical status, quality of life, and mental health of Spanish top- the return to training has been carried out in a progressive and level athletes who, after a long lockdown period, had to return to scheduled manner by the trainers, aware that after a quarantine, their sporting lives in a new context. athletes are more likely to get injured (Jukic et al., 2020). In Attending to physical health, the major increase in the resting this line, studies focused on young athletes in the United States time that Spanish athletes dedicated during the lockdown period reported that women were less physically active than men during seems to be a relevant aspect to be taken into account. According the lockdown period and had more sedentary behaviors, which to previous studies with elite athletes (Pillay et al., 2020), a could be related to factors such as lack of social interaction, significant increase in rest time during lockdown characterized by increased economic uncertainty (McGuine et al., 2021), as well as sedentary activities is claimed. Although athletes were assigned to the existence of implicit gender inequalities during the pandemic individual training plans during the lockdown, they reduced and (Evans et al., 2020). adapted those training in order to accommodate self-isolation It should also be noted the rest days of team sports athletes, and due to the closure of sports facilities and gyms (Mohr et al., which were longer compared to individual sports athletes during 2020). In this case, both genders significantly increased their rest the lockdown period, coinciding with the study by Pons et al. days in the lockdown period compared to the previous period. (2020) focused on young athletes in Spain. Lower levels of In post-lockdown period, it is observed that athletes, due to the physical activity were observed in favor of sedentary activities, progressive incorporation to their daily activities, even with a due to greater limitations for practicing, as well as the possibility decrease in rest days compared to those in lockdown, continued that individual sports athletes could continue to participate in Frontiers in Psychology | www.frontiersin.org 7 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes FIGURE 3 | (A–D) Stress scores by gender, best result achieved, and high-performance expertise. Data presented as mean ± S D. *Significant at level 0.05; **significant at level 0.01; ***significant at level 0.001. their sports when physical distance restrictions were established recommendations to exercise at home during the lockdown, and, therefore, were not affected to the same extent as team but similar to the results of the present research, the sedentary sports athletes. activities could be related to increasing the time dedicated to Also, noteworthy are the results in student-athletes, studies, with the aim of synchronizing the learning processes in characterized by pursuing academic studies at the same their future profession. time as their sporting careers and are framed within the so-called On the contrary, these statements would disagree with the dual career (Pallarés et al., 2011), where a high level of effort results reported by Izzicupo et al. (2021), a study carried out and many hours of dedication are required to achieve such a during lockdown in several European countries focused on conciliation. Student-athletes maintain a complex relationship student-athletes. An overall reduction in study time was observed between studies and sport, maintaining a special organization during the lockdown, even though student-athletes living in to achieve academic and sporting goals simultaneously (Álvarez countries under severe contagion (as is the case in Spain) Pérez and López Aguilar, 2012; López de Subijana et al., 2015; were more involved in studies than those living in countries Blanco García and Burillo Naranjo, 2017). During the lockdown, experiencing mild contagion, a reduction that the authors they also spent more time on rest-related activities (days and found contradictory when considering the greater availability hours) compared to the pre-lockdown normality. Similar of time at home. studies (Meza and López, 2020) also stated that student-athletes Related to progressively returning to sport, it is observed that during lockdown significantly decreased their physical activity there are differences between the hours that athletes dedicated (33.6%) in favor of more sedentary activities compared to the to training before the lockdown and in the post-lockdown. The pre-lockdown physical activity. athletes with the highest competitive level, in individual sports In any case, they duplicated the practice of physical activity and with medium and broad experience in the elite, significantly compared to non-athlete university students. Apparently, despite reduced their daily and weekly training hours after the lockdown the loss of physical activity, the student-athletes followed the by returning to training. For this reason, the main responsible Frontiers in Psychology | www.frontiersin.org 8 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes FIGURE 4 | (A,B) Profile of mood states by gender and best result achieved. Data presented as mean ± SD. *Significant at level 0.05; **significant at level 0.01. for the athletes’ return to training and competitions should have youth athletes (McGuine et al., 2021), states that female athletes specific knowledge of the different profiles and how the COVID- described lower life quality levels than males. In addition, 19 health emergency situation may have influenced their lives. following the study by Bowes et al. (2020), it seems that the gender Along the same lines, Desiderio and Bortolazzo (2020) stated that should be considered in those periods, as women perceived to “activity must be resumed slowly and by listening to the athlete, have less access to sports equipment than men and were also more as there is still uncertainty as to whether we will return to the old affected by reduced or even suspended salaries, affecting their habits of the old ‘normality,’ or whether the pandemic will give rise life quality and performance perception. According to Baldwin to a new stage with new lifestyles that will define the future” (p. 54). (2020), the pandemic has had a disproportionate impact on The health perception of athletes in the post-lockdown elite sport of women and has increased inequality, with possible period after the difficulties experienced during the lockdown spillover effects for the future. Therefore, it seems necessary period, is a factor that has been taken into account through to increase the number of studies focused on the problems two summary components: physical and psychological (Vilagut experienced by female athletes during lockdown and the post- et al., 2008). Accordingly, differences were found between lockdown period. genders, with women scoring significantly lower than men, Considering the competitive level of athletes, those with compared to their perception in pre-lockdown. Related to the higher level (medalists) reported a significant decrease in the performance perception, both genders, but more pronounced health and performance perception compared to pre-lockdown. in females, showed a significant decrease comparing pre–post It could be interpreted that these athletes were those who had lockdown periods. Olympic qualification as one of their next objectives. Therefore, Although the health and performance perception in athletes after 4 years of preparation, the postponement was an added after the lockdown period has not yet been extensively studied, stressor. In this line, studies affirm that this situation could cause a study carried out during lockdown with more than 13,000 a loss of concentration, motivation, and the desire to continue Frontiers in Psychology | www.frontiersin.org 9 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes FIGURE 5 | Top 30 ranked cross-correlations for the stress, POMS, emotional state and energy level, health and performance perception, and limitation in training variables. Red and blue colors correspond to positive and negative correlations, respectively. Size of the bar and color intensity are proportional to the correlation coefficients. preparing for the Olympics with the same energy as before, Focusing on the post-lockdown period, differences between affecting, among other variables, their health and performance the limitations experienced in training during lockdown (high perception (Clemente-Suárez et al., 2020). It should be noted degree) and the post-lockdown (low degree) were observed that individual-sports athletes perceived themselves to be less for both genders, also reported by medalists, individual sports, healthy than team sports athletes. Student-athletes also perceived student-athletes, and those with more experience in the elite. It a decrease in the health and performance perception, as well as seems clear then the importance of maintaining adequate levels of athletes with an average experience (3–10 years in elite sport). physical activity in professional athletes, as in addition to positive The health of athletes was possibly also influenced by physiological effects, sports practice enhances psychological well- emotional problems experienced during the lockdown period, the being. Moreover, strategies should be incorporated to reduce reduced time dedicated to training, and the training performance stress and anxiety about returning to competition, respecting with less attention and motivation compared to pre-lockdown. each individual’s own time, avoiding injuries and frustrations Social distancing seems to be one of the main reasons for to quickly reach the competitive level they showed prior to the appearance of such problems (Burgos et al., 2020). Studies lockdown (Olmedilla et al., 2014; Kalazich Rosales et al., 2020; performed during lockdown (Graupensperger et al., 2021) affirm Mera et al., 2020). Regarding emotional state of athletes for the relevance of the social connection and support of teammates the entire sample (both genders; medalists or non-medalists; in the emotional state of athletes and its relation to sport identity, individual-team sports; short and medium sporting experience), understood as the strength that makes people identify with and moderate values in the negative emotional state during the accept their role as athletes (Brewer et al., 1993). lockdown period were found, being positively correlated with the This perceived loss of social connection and support (Brewer levels of tension, depression, and stress reported later on. Despite et al., 2010) could increase the risk of depression (Sanders and this, they maintained moderately high levels of positivity and Stevinson, 2017), by threatening their identity. Chilean cyclists energy, possibly due to the novelty of the situation in the first 5– during lockdown (Burgos et al., 2020) emphasized the anxiety 6 weeks, the increased time dedicated to entertainment and the caused by being unable to train on a regular basis, leading them release from work responsibilities in many cases. to implement strategies to generate motivation and not lose the These negative emotional values decreased significantly competitive level they already had. in the post-lockdown period, especially in men, medalists, Frontiers in Psychology | www.frontiersin.org 10 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes student-athletes, both modalities (individual-team), and athletes Student-athletes have reported higher values of negative with 0–3 years of experience. This correlates with a decrease in emotional state during the lockdown, similarly to Toresdahl training limitations, and an inverse correlation in the positive and Asif (2020) who stated that the cancelation of training emotional state and energy level, both increasing significantly in and competitions could cause pain, stress, anxiety, frustration, the post-lockdown period. This is possibly linked to being able and sadness in athletes, where students in countries with to get back to socializing, training again with the opportunity to severe contagion, as in the case of Spain, may have increased compete in a short-term period, resuming studies and leading a vulnerability and support needs to cope with distance education regular life after months of lockdown. and digital skills (Izzicupo et al., 2021). Furthermore, it is important to highlight those fluctuations The results on stress and mood of athletes in the post- in stress and modifications in exercise routines, especially when lockdown period showed significant differences between genders drastic, could result in sports injuries or illnesses (Brink et al., and best sporting results. Women showed higher levels of 2010; Wadey et al., 2013; Ivarsson et al., 2017). According to these depression and fatigue, as well as higher levels of stress, especially statements, studies on the effect on the athletes’ emotional state of those sportswomen with better results. On the other hand, men unforeseen events that can slow down a sports career, such as an had higher values for vigor. Once again, the present study injury (Olmedilla et al., 2014) or an involuntary lockout (Samuel shows that women experienced more negative consequences of et al., 2020), affirm that injuries negatively affect the mood, lockdown, possibly affecting their mental health and, therefore, causing important changes and limiting sports competence and their personal life and sporting performance in the period of the derived performance (Montero et al., 2014). post-lockdown. Clarkson et al. (2020) suggest that the pressure The so-called Coronavirus experience (Samuel et al., 2020) on women’s sport during the pandemic is different compared is understood as a longitudinal, multifaceted, unpredictable, to men and that the lack of financial security, as well as and uncontrolled change event where athletes may experience feelings of threat and uncertainty, was widespread for players various emotional responses (positive, negative, and/or neutral). at all levels of women’s football. Completing these findings, Therefore, it seems necessary to study the emotional state Bowes et al. (2020) affirm that the negative impact felt by of athletes and related issues, even a period after the female athletes is not a direct result from those alongside whom lockdown. Likewise, other studies argue that the pandemic they work (coaches, psychologists, and larger support networks) and associated effects must be looked at in a complex and but from the broader sport structures, historically rooted in multidisciplinary way, not focusing exclusively on a biomedical gender inequality. approach and the responsibility of each country’s health According to Rowe (2020), the virus did not cause sporting ministries, as only one of the dimensions affecting athletes inequalities, but has exacerbated them across gender lines. In will be addressed (Burgos et al., 2020; Stambulova et al., Spain, the study conducted by Pons et al. (2020) with young 2020). student-athletes also states that the group of female athletes As discussed above, and now related to the emotional state, suffered a greater impact, especially those in higher academic student-athletes should be particularly considered since their courses, with a lower socioeconomic status and worse training behavior is different compared to other athletes not combining conditions during confinement. Di Fronso et al. (2020) suggest academic and sporting life. Significant differences were reported future research lines to be explored, since they have revealed in the negative emotional state, with student-athletes showing a more negative impact of COVID-19 confinement on Italian a worse baseline level during lockdown, suggesting a worse female athletes. The sporting level (medalist athletes) seems to be post-lockdown emotional state, but actually the results showed another indicator to be considered in the profiles of athletes with a significant drop afterward, correlating with the increase in more difficulties, experiencing higher stress levels and hostility positivity and energy. These results could mean that the student than non-medalists. athletes took advantage of the lockdown period, to spend more time than usual on their studies instead of training, whereas, after return to training, they experienced a better emotional RESEARCH LIMITATIONS state, as they can continue their normal academic activity as well as training and competition, feeling more competent and Carrying out a cross-sectional study to find out the situation controlling the situation. In fact, non-student-athletes showed of athletes at different times of the health crisis could find an inverse behavior, being affected by the situation to a greater limitations in the results obtained, because the responses were extent, maintaining their emotional state unchanged in the post- obtained in the post-confinement period. A longitudinal study lockdown period. could have been presented for the most appropriate in this case, As highlighted by other studies (Samuel et al., 2020; but the uncertainty in the duration of the periods lived, as well Stambulova et al., 2020), COVID-19 lockdown can place as the difficulties that the athletes were facing, were the reason unexpected demands on athletes who combine an academic and for carrying out the study once the confinement had passed and sporting career and, therefore, have negative consequences on efforts were being made to regain normalcy, even with a large their emotional state. This can be explained in our sample by number of limitations. the stress levels reported, probably due to the new challenge In addition, other limitations to consider would be the of restarting all the activity again, taking into account their inclusion of the questionnaires used in the present study in a dual career status. single survey, which could mean that it was too long for the Frontiers in Psychology | www.frontiersin.org 11 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes athletes to answer, as well as the inability to take the data in time on their academic careers, leading to an increase in more person due to mobility limitations that characterized the post- sedentary activities, with possible implications for their sports confinement stage in Spain. performance on the one hand, but advances for their lives outside of sport as well. CONCLUSION DATA AVAILABILITY STATEMENT This study shows how the health crisis caused by COVID- 19 altered the sporting practice, life quality, and emotional The original contributions presented in the study are included state of Spanish elite athletes during the lockdown and in the article/Supplementary Material, further inquiries can be in the subsequent post-lockdown period. Concerning the directed to the corresponding author/s. sporting practice, even with the advice of coaches during the lockdown, there were modifications due to the restrictions and the closure of sports facilities. After returning to the new ETHICS STATEMENT situation, sporting activity did not return to normal levels The studies involving human participants were reviewed and immediately, since training was carried out in a progressive approved by the San Antonio Catholic University (UCAM), and scheduled manner by professionals, well aware that training Murcia, Spain. The patients/participants provided their written had to be adapted to the circumstances. The health and informed consent to participate in this study. performance perception were other altered factors in the athletes, especially in student-athletes and women groups. In addition, athletes with a higher competitive level suffering AUTHOR CONTRIBUTIONS greater uncertainty due to the postponement of competition had an important decrease in both perceptions that should EC, CLdS, and MT participated in the design of the research be considered. Furthermore, the health of athletes was also project. EC, LMMA, CLdS, and MT participated in the survey influenced by emotional problems, leading them to perform design and adjustments. ASP, AL, and JAGR participated in the their training sessions with less attention and motivation subject recruiting and data collection process. LMMA and GS compared to before the health crisis. However, the post- participated in the data analysis and results. EC, LMMA, GS, and confinement period led to a decrease in the negative emotional ADA participated in the preparation of the original manuscript. state of the athletes, while at the same time increasing their EC, LMMA, GS, YR, CLdS, and MT participated in the revised positive emotional state and energy level in order to face version of the manuscript. All authors contributed to the article their tasks. On the other hand, the stress level remained and approved the submitted version. moderately high, due to the workload to be recovered, especially concerning the competitive and academic field for student-athletes. FUNDING We highlight the identification of profiles of different athletes to be considered, due to the consequences and difficulties This work belongs to the “Efectos de la nueva normalidad caused by the health crisis on their lives. First, Spanish women por crisis sanitaria COVID-19 en la práctica deportiva, la athletes could be a group to be specifically approached that calidad de vida y el estado emocional de los deportistas de might indicate the prevalence of implicit gender inequalities in élite en España, EASED (CoV-19)” project, supported by San sport, becoming even more evident in a global crisis situation. Antonio Catholic University (UCAM) (Plan Propio, PMAFI- Our findings could be related to less support received from COVID19/19), Murcia, Spain. organizations, as well as to other gender-related difficulties (less access to sports equipment, reduction or suspension of salaries, and so on) that should be further studied. Considering the ACKNOWLEDGMENTS physical and emotional health of female athletes, it appears We thank all the participants in this study as well as the to have been impaired, potentially affecting their lives and coaches/technical staff and other collaborators in the sports performance. During the last two Olympic Games, data collection process. In addition, the authors would Spanish women have won more medals (52.4 and 64.7% like to thank the Spanish Olympic Committee for their in London and Rio, respectively). Therefore, it would be involvement in the dissemination of the online survey and their necessary to increase the research, in order to know the support for this study. real impact of the pandemic on the elite sport of women in Spain, as well as the current and future consequences of the pandemic. Second, Spanish athletes who practiced team SUPPLEMENTARY MATERIAL sports had more limitations when training both during and in post-lockdown periods, mainly due to the social distance, The Supplementary Material for this article can be found online something that should clearly be considered. Third, student- at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021. athletes, who found the lockdown an opportunity to focus more 736499/full#supplementary-material Frontiers in Psychology | www.frontiersin.org 12 September 2021 | Volume 12 | Article 736499 Conde et al. COVID-19 Crisis on Spanish Athletes REFERENCES Corsini, A., Bisciotti, G. N., Eirale, C., and Volpi, P. (2020). Football cannot restart soon during the COVID-19 emergency! A critical perspective from the Italian Abenza, L., Olmedilla, A., Ortega, E., Ato, M., and García-Más, A. (2010). Análisis experience and a call for action. Br. J. Sports Med. 54, 1186–1187. de la relación entre el estado de ánimo y las conductas de adherencia en Constitución española (1978). Constitución Española. Madrid: Constitución deportistas lesionados. An. Psicol. 26, 159–168. Española. Abenza-Cano, L., Leiva-Arcas, A., Vaquero-Cristóbal, R., García-Roca, J. A., De la Vega, R. (2003). 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Ansiedad Publisher’s Note: All claims expressed in this article are solely those of the authors Estrés 7, 195–201. and do not necessarily represent those of their affiliated organizations, or those of Rowe, D. (2020). Subjecting pandemic sport to a sociological procedure. J. Sociol. the publisher, the editors and the reviewers. Any product that may be evaluated in 56, 704–713. doi: 10.1177/1440783320941284 this article, or claim that may be made by its manufacturer, is not guaranteed or Samuel, R. D., Tenenbaum, G., and Galily, Y. (2020). The 2020 coronavirus endorsed by the publisher. pandemic as a change-event in sport performers’ careers: conceptual and applied practice considerations. Front. Psychol. 11:567966. doi: 10.3389/fpsyg. Copyright © 2021 Conde, Martínez-Aranda, Sanz, López de Subijana, Sánchez- 2020.567966 Pato, Díaz-Aroca, Leiva-Arcas, García-Roca and Ramis and Torregrossa. This is an Sanders, G., and Stevinson, C. (2017). Associations between retirement reasons, open-access article distributed under the terms of the Creative Commons Attribution chronic pain, athletic identity, and depressive symptoms among former License (CC BY). The use, distribution or reproduction in other forums is permitted, professional footballers. Eur. J. Sport Sci 17, 1311–1318. doi: 10.1080/17461391. provided the original author(s) and the copyright owner(s) are credited and that the 2017.1371795 original publication in this journal is cited, in accordance with accepted academic Schinke, R. J., Papaioannou, A., Maher, C., Parham, W. D., Larsen, C. H., Gordin, practice. No use, distribution or reproduction is permitted which does not comply R., et al. (2020). Sport psychology services to professional athletes: working with these terms. Frontiers in Psychology | www.frontiersin.org 14 September 2021 | Volume 12 | Article 736499