Anxiety, insomnia, and depression during COVID-19 lockdown in elite individual and team sport athletes.

PURPOSE: Pandemic-induced lockdowns disrupted sport training and competition. We aimed to identify the impact on the mental health of high-level athletes and clarify whether the effects differ for team-based and individual athletes. METHODS: This cross-sectional survey, stratified by sex and sport type, collected demographic data and mental health measurements from 274 Brazilian high-performance athletes (142 from team sports and 132 from individual sports) involved with the Brazilian Olympic Committee program for the Tokyo Olympics 2021. Depression, disturbed sleep, and anxiety were assessed by the 9-Item Patient Health Questionnaire, 7-Item Insomnia Severity Index, and 7-Item Generalized Anxiety Disorder scale respectively. Responses were analyzed dichotomously according to published threshold values, characterizing the relative frequency distribution of prevalence (PCRS) or non-prevalence of clinically relevant symptoms (NPCRS). RESULTS: Out of all participants, 47 [17.1%], Z(274) = 15.38, p = .001, 32 [11.7%], Z(274) = 17.94, p = .001, and 49 [17.9%], Z(274) = 15.04, p = .001 had PCRS of anxiety, insomnia, and depression, respectively. There were no significant differences in the PCRS among genders. Compared with individual sport athletes, team sport athletes were more likely to report PCRS of insomnia (12 [37.5%] vs 20 [62.5%], Z(274) = -2.00, p = .046), and depression (18 [36.7%] vs 31 [63.3%], Z(274) = -2.63, p = .009) but not for anxiety. CONCLUSION: Athletes reported high levels of mental health problems during the lockdown. Team sport athletes reported worse symptoms of insomnia and depression than individual sport athletes, possibly due to the impact of unaccustomed social isolation and lack of social team activity. Therefore, it becomes relevant to consider psychological support to team sport athletes who for some reason, such as a pandemic, enduring crisis even injury rehabilitation needs to be isolated.

Usability of paper and electronic pain drawings in assessing musculoskeletal pain: a scoping review

BackgroundCOVID-19 has accelerated the implementation of online consultations thus creating the need to assess usability of electronic-pain-annotation tools. We aimed to learn from the pandemic and generate practice recommendations from assessing electronic-pain-annotation and pen-to-paper-annotation by producing a detailed usability framework.Materials and MethodsThis study followed the PRISMA scoping review guidelines. Online databases were searched from January 2015 to February 2021 for studies evaluating pain diagram usability in adults with musculoskeletal pain. Study quality was assessed using STROBE. An evidence gap map, framework and infographic were constructed.Results22 observational studies, 1 systematic review and 1 app review were included;of which 9 were high quality, 13 medium and 1 low (App review not assessed). 9 studies reviewed pen-to-paper-annotation, 14 reviewed electronic-pain-annotation and 1 both. Pen-to-paper-annotation and electronic-pain-annotations were found to be highly reliable (ICC 0.81–0.998), valid, and successful communication tools. Both had a positive relationship with outcome measures assessing psychological comorbidities, such as the widespread pain index. Gender specific electronic-pain-annotations enable better identification with the diagram and enhance communication about pain. Barriers involved lack of technology, interpretation, age, and pain experience. Automated weekly reminders were a completion facilitator. There were no studies directly comparing electronic-pain-annotation to pen-to-paper-annotation.ConclusionElectronic-pain-annotation and pen-to-paper-annotation were both effective at communicating pain with electronic-pain-annotation allowing for more accurate quantification of pain extent. Gender specific electronic-pain-annotation allowed for better reporting of pain. Gaps included responsiveness in both modes and usability in electronic-pain-annotations which needs to be addressed to optimise integration into electronic health records.

Embedding supervised exercise training for men on androgen deprivation therapy into standard prostate cancer care: a feasibility and acceptability study (the STAMINA trial).

Lifestyle interventions involving exercise training offset the adverse effects of androgen deprivation therapy in men with prostate cancer. Yet provision of integrated exercise pathways in cancer care is sparse. This study assessed the feasibility and acceptability of an embedded supervised exercise training intervention into standard prostate cancer care in a single-arm, multicentre prospective cohort study. Feasibility included recruitment, retention, adherence, fidelity and safety. Acceptability of behaviourally informed healthcare and exercise professional training was assessed qualitatively. Despite the imposition of lockdown for the COVID-19 pandemic, referral rates into and adherence to, the intervention was high. Of the 45 men eligible for participation, 79% (n = 36) received the intervention and 47% (n = 21) completed the intervention before a government mandated national lockdown was enforced in the United Kingdom. Patients completed a mean of 27 min of aerobic exercise per session (SD = 3.48), at 77% heart rate maximum (92% of target dose), and 3 sets of 10 reps of 3 resistance exercises twice weekly for 12 weeks, without serious adverse event. The intervention was delivered by 26 healthcare professionals and 16 exercise trainers with moderate to high fidelity, and the intervention was deemed highly acceptable to patients. The impact of societal changes due to the pandemic on the delivery of this face-to-face intervention remain uncertain but positive impacts of embedding exercise provision into prostate cancer care warrant long-term investigation.