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Original research
Impact of COVID-19 on the physical activity, quality of life and mental health of adolescent athletes: a 2-year evaluation of over 17 000 athletes
  1. Andrew Watson1,
  2. Kristin Haraldsdottir1,
  3. Kevin Biese2,3,
  4. Allison Schwarz1,
  5. Scott Hetzel4,
  6. Claudia Reardon5,
  7. M Alison Brooks6,
  8. David R Bell7,
  9. Timothy McGuine6
  1. 1 Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  2. 2 University of Wisconsin-Madison, Madison, Wisconsin, USA
  3. 3 Department of Kinesiology and Athletic Training, University of Wisconsin - Oshkosh, Oshkosh, Wisconsin, USA
  4. 4 Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
  5. 5 Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, USA
  6. 6 Orthopedics, University of Wisconsin-Madison, Madison, Wisconsin, USA
  7. 7 Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
  1. Correspondence to Dr Andrew Watson, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI 53705, USA; watson{at}ortho.wisc.edu

Abstract

Purpose To evaluate the changes in mental health, quality of life (QOL) and physical activity (PA) among adolescent athletes during the COVID-19 pandemic as organised sports resumed.

Methods Adolescent athletes completed surveys including demographic and sport participation information, 7-item Generalized Anxiety Disorder, 9-item Patient Health Questionnaire, Pediatric Quality of Life Inventory and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale in May 2020 following COVID-19-related sport cancellations (Spring20) and after returning to sports in May 2021 (Spring21). The groups were balanced by inverse propensity score weighting and compared using analysis of variance models and ordinal regression models.

Results 17 421 participants were included (Spring20=13 002; Spring21=4419; 16.2±1.2 years; 53% female). Anxiety was significantly lower (better) in Spring21 (Spring20=7.0, 95% CI 6.9 to 7.1; Spring21=4.9, 95% CI 4.8 to 5.0, p<0.001), as was the prevalence of moderate to severe anxiety (Spring20=29.4%, Spring21=17.1%, p<0.001). Depression was significantly improved in Spring21 (Spring20=7.6, 95% CI 7.5 to 7.7; Spring21=4.6, 95% CI 4.5 to 4.8, p<0.001), as was the prevalence of moderate to severe depression (Spring20=32.2%, Spring21=15.4%, p<0.001). Athletes in Spring21 reported higher QOL (Spring20=79.6, 95% CI 79.3 to 79.9; Spring21=84.7, 95% CI 84.4 to 85.0, p<0.001) and increased levels of PA (Spring20=13.8, 95% CI 13.6 to 13.9; Spring21=22.7, 95% CI 22.6 to 22.9, p<0.001).

Conclusion Early COVID-19 sports restrictions were associated with worsening mental health in adolescents. In 2021, after returning to sports, athletes reported significant improvements in mental health, QOL and PA, although mental health adversities remain an important priority.

  • Covid-19
  • adolescent
  • anxiety
  • depression
  • quality of life

Data availability statement

Data are available upon reasonable request.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bjsports-2022-105812

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Twitter @DrABrooksUWisc

    • Contributors All authors have contributed to the study development, data analysis, and approved the final version of the manuscript. AMW is responsible for the overall content as the guarantor.

    • Funding This study was partially funded by (2021 data collection only) the National Federation of State High School Associations.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.