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The still ongoing COVID-19 pandemic has dramatically impacted athletes, and, in particular, para-athletes and athletes with disabilities. However, there is no scholarly appraisal on this topic. Therefore, a critical scoping review of the literature was conducted. We were able to retrieve sixteen relevant studies. The sample size ranged from 4 to 183. Most studies were observational, cross-sectional, and questionnaire-based surveys, two studies were interventional, and two were longitudinal. One study was a technical feasibility study. Almost all studies were conducted as single-country studies, with the exception of one multi-country investigation. Five major topics/themes could be identified: namely, 1) impact of COVID-19-induced confinement on training and lifestyles in athletes with disabilities/para-athletes; 2) impact of COVID-19-induced confinement on mental health in athletes with disabilities/para-athletes; 3) impact of COVID-19-induced confinement on performance outcomes in athletes with disabilities/para-athletes; 4) risk of contracting COVID-19 among athletes with disabilities/para-athletes; and, finally, 5) impact of COVID-19 infection on athletes with disabilities/para-athletes. The scholarly literature assessed was highly heterogeneous, with contrasting findings, and various methodological limitations. Based on our considerations, we recommend that standardized, reliable tools should be utilized and new, specific questionnaires should be created, tested for reliability, and validated. High-quality, multi-center, cross-countries, longitudinal surveys should be conducted to overcome current shortcomings. Involving all relevant actors and stakeholders, including various national and international Paralympic Committees, as a few studies have done, is fundamental: community-led, participatory research can help identify gaps in the current knowledge about sports-related practices among the population of athletes with disabilities during an unprecedented period of measures undertaken that have significantly affected everyday life. Moreover, this could advance the field, by capturing the needs of para-athletes and athletes with disabilities and enabling the design of a truly “disability-inclusive response” to COVID-19 and similar future conditions/situations. Furthermore, follow-up studies on COVID-19-infected para-athletes and athletes with disabilities should be conducted. Evidence of long-term effects of COVID-19 is available only for able-bodied athletes, for whom cardiorespiratory residual alterations and mental health issues a long time after COVID-19 have been described.

Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.

Objective: To investigate the effect of 1) lockdown duration and 2) training intensity on sleep quality and insomnia symptoms in elite athletes.Methods: 1,454 elite athletes (24.1 ± 6.7 years; 42% female; 41% individual sports) from 40 countries answered a retrospective, cross-sectional, web-based questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: 1) Pittsburgh sleep quality index (PSQI); 2) Insomnia severity index (ISI); bespoke questions about 3) napping; and 4) training behaviors. The association between dependent (PSQI and ISI) and independent variables (sleep, napping and training behaviors) was determined with multiple regression and is reported as semi-partial correlation coefficient squared (in percentage).Results: 15% of the sample spent < 1 month, 27% spent 1–2 months and 58% spent > 2 months in lockdown. 29% self-reported maintaining the same training intensity during-lockdown whilst 71% reduced training intensity. PSQI (4.1 ± 2.4 to 5.8 ± 3.1; mean difference (MD): 1.7; 95% confidence interval of the difference (95% CI): 1.6–1.9) and ISI (5.1 ± 4.7 to 7.7 ± 6.4; MD: 2.6; 95% CI: 2.3–2.9) scores were higher during-compared to pre-lockdown, associated (all p < 0.001) with longer sleep onset latency (PSQI: 28%; ISI: 23%), later bedtime (PSQI: 13%; ISI: 14%) and later preferred time of day to train (PSQI: 9%; ISI: 5%) during-lockdown. Those who reduced training intensity during-lockdown showed higher PSQI (p < 0.001; MD: 1.25; 95% CI: 0.87–1.63) and ISI (p < 0.001; MD: 2.5; 95% CI: 1.72–3.27) scores compared to those who maintained training intensity. Although PSQI score was not affected by the lockdown duration, ISI score was higher in athletes who spent > 2 months confined compared to those who spent < 1 month (p < 0.001; MD: 1.28; 95% CI: 0.26–2.3).Conclusion: Reducing training intensity during the COVID-19-induced lockdown was associated with lower sleep quality and higher insomnia severity in elite athletes. Lockdown duration had further disrupting effects on elite athletes’ sleep behavior. These findings could be of relevance in future lockdown or lockdown-like situations (e.g., prolonged illness, injury, and quarantine after international travel).

It is well-documented that changes in the rhythm of life during Ramadan affect sleep schedules (i.e., interruption of night sleep patterns) and are likely to have negative effects on physical and cognitive performances. The aim of the present study was to examine the effect of different naps opportunities’ durations during Ramadan on performance of short-duration repetitive maximal exercise and perception of effort. Fifteen physically active men (age: 21 ± 3 years, height: 177 ± 6 cm, body-mass: 73 ± 10 kg) performed a 6 × 30-s shuttle run test after a 25-min nap (N25), a 45-min nap (N45), and in a no-nap condition (NN) during three experimental periods: ∼2 weeks before Ramadan (BR), the last ten days of Ramadan (ER), and ∼3 weeks after Ramadan (AR). During the shuttle run test performed in the late afternoon, the greatest distance (GD), the total distance (TD) and a fatigue index (FI) were assessed. Rating of perceived exertion (RPE) was determined after each 30-s effort. Dietary intake and sleep quality were assessed in each of the three periods. Compared to BR, GD and TD were lower in the ER testing period (p = 0.005; d = 0.54) but returned to BR levels in the AR period. During ER, carbohydrate intake was lower (p = 0.04; d = 0.2), and sleep duration and sleep quality were reduced (d = 0.27 and 0.54, respectively), although other aspects of dietary intake and sleep pattern were not affected. Compared to NN, GD and TD were higher after N25 (d = 0.57 and 0.34, respectively) and N45 (d = 0.93 and 0.88 respectively). RPE was lower in N45 (p = 0.035, d = 0.84). N45 resulted in higher TD (p = 0.021, d = 0.13) and lower RPE (p = 0.004; d = 0.57) compared to N25 during ER. Taking a daytime nap benefits subsequent performance in a shuttle run test, whether sleep the previous night was normal (as in BR) or compromised (as in ER). The benefits of napping were greater after a 45-min nap opportunity than after a 25-min nap opportunity.

The purpose of this study was to assess oxidative stress biomarkers prior to and following different forms of exercise. Ten elite male judokas (age: 18.1 ± 1.7 years, athletic experience: 6 years with a training frequency of 6 Judo-sessions/week) performed three cycle ergometry sessions comprising a 30 s Wingate test (MAX), 30 min at 60% maximal-aerobic-power-output (LOW) or these two exercise protocols combined (COMBINED) in a repeated-measures design. Venous blood-samples were collected before, and 0(P0), 5(P5), 10(P10) and 20(P20) min after each exercise protocol and assessed for malondialdehyde concentration ([MDA]), glutathione peroxidase (GPX), superoxide dismutase (SOD) and glutathione reductase (GR) content, and total-antioxidant-status (TAS). Plasma [MDA] was found to be increased above baseline at P0 and P5 in the MAX, LOW and COMBINED conditions (p < 0.05), but was greater at P10 and P20 in the LOW condition compared to MAX and COMBINED conditions (p < 0.05). Blood GPX and SOD content increased above baseline at P0 in MAX and COMBINED and at P5 in LOW (p < 0.05), with GR content being similar between groups at P0 and P5 (p > 0.05). 20 min post-exercise, GPX, SOD, GR content and TAS were lower in the MAX compared to the LOW and COMBINED conditions (p < 0.05). In conclusion, the findings from this study reveal that redox-related biomarkers exhibited divergent response dynamics following different forms of exercise, which might have implications for understanding the mechanisms of exercise-induced skeletal muscle fatigue and adaptive remodeling.

PurposeTo compare the effect of different durations of nap opportunity during the daytime on repeated high-intensity short-duration performance and rating of perceived exertion (RPE).MethodsSeventeen physically active men (age: 21.3 ± 3.4 years, height: 176.7 ± 5.9 cm, body mass: 71.8 ± 10.2 kg) performed a 5 m shuttle run test [to determine best distance (BD), total distance (TD), and fatigue index (FI)] under four conditions: a 25 min nap opportunity (N25), a 35 min nap opportunity (N35), a 45 min nap opportunity (N45), and control condition (no-nap) (N0). The sleep quality of each nap opportunity was evaluated using a scale ranging from 0 “no sleep” to 10 “uninterrupted, deep sleep throughout.” The four conditions were performed in a random order. RPE was recorded after each repetition of the 5 m shuttle run test and the mean score was calculated.ResultsBD increased after N25 (+6%) and N45 (+9%) compared to N0 (p < 0.05) and was significantly higher after N45 compared to N35 (p < 0.05). Compared to N0, the three nap opportunity durations enhanced TD (p < 0.05) with greater enhancement after N45 compared to N25 (+8% vs. +3%) and N35 (+8% vs. +3%). For FI, no-significant differences were observed between the three nap opportunity durations and N0. The mean RPE score was significantly higher after N25 (+20%) and N0 (+19%) compared to N45 (p < 0.05). All participants were able to fall asleep during each nap condition with a sleep quality score of 6.9 ± 1.0, 7.0 ± 0.7, and 7.1 ± 0.8 for N25, N35, and N45.ConclusionA nap opportunity during the daytime was beneficial for physical performance and perceived exertion with the N45 being the most effective for improving performance and reducing fatigue during the 5 m shuttle run test. The implication of the present study is that athletes might benefit from a nap opportunity of 25, 35 or 45 min before practice or before a competition.

Objectives: The aim of this study was to examine the effect of time of day on short-term repetitive maximal performance and psychological variables in elite judo athletes.Methods: Fourteen Tunisian elite male judokas (age: 21 ± 1 years, height:172 ± 7 cm, body-mass: 70.0 ± 8.1 kg) performed a repeated shuttle sprint and jump ability (RSSJA) test (6 m × 2 m × 12.5 m every 25-s incorporating one countermovement jump (CMJ) between sprints) in the morning (7:00 a.m.) and afternoon (5:00 p.m.). Psychological variables (Profile of mood states (POMS-f) and Hooper questionnaires) were assessed before and ratings of perceived exertion (RPE) immediately after the RSSJA.Results: Sprint times (p > 0.05) of the six repetition, fatigue index of sprints (p > 0.05) as well as mean (p > 0.05) jump height and fatigue index (p > 0.05) of CMJ did not differ between morning and afternoon. No differences were observed between the two times-of-day for anxiety, anger, confusion, depression, fatigue, interpersonal relationship, sleep, and muscle soreness (p > 0.05). Jump height in CMJ 3 and 4 (p < 0.05) and RPE (p < 0.05) and vigor (p < 0.01) scores were higher in the afternoon compared to the morning. Stress was higher in the morning compared to the afternoon (p < 0.01).Conclusion: In contrast to previous research, repeated sprint running performance and mood states of the tested elite athletes showed no-strong dependency of time-of-day of testing. A possible explanation can be the habituation of the judo athletes to work out early in the morning.