Covid-19 Restrictions and the Effects of Physical Activity on Mental Health in Midwestern Adolescent Adaptive Athletes

BACKGROUND: The COVID-19 pandemic and related lockdowns in 2020 negatively impacted high school students, with increased depression and anxiety especially in athletes who participated in team sports. For adolescents with disabilities, physical activity provides physical and mental health benefits; however, the impact of COVID-19 related adaptive sports cancellations have not been thoroughly investigated. HYPOTHESIS: Adaptive athletes with lower activity levels during a period of COVID-19 related restrictions will have worse scores of depression, anxiety, and quality of life. METHODS: Institutional Review Board (IRB) exemption was granted. Adaptive athletes ages 12-21 were identified through Midwestern adaptive athletic associations. Athletes completed a survey between June 2020 and January 2021 including Patient Health Questionairre-9 Item (PHQ-9) for depression, General Anxiety Disorder-7 Item (GAD-7) anxiety, Pediatric Functional Activity Brief Scale (PFABS) for activity level, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. PFABS and PedsQL were modified as appropriate to adaptive athletes. Univariate analysis was performed using chi-square tests to assess the association between activity and mental health. Student T-tests were used for multivariate analysis to assess the role of sex, grade in school, and individual vs team sport participation on quality of life. RESULTS: Twenty-four respondents completed the survey in its entirety, with majority from Wisconsin, Minnesota, and Illinois. Demographics are shown in Table 1. There was no significant association between physical activity levels and GAD-7 (R(2)=-0.040), PHQ-9 (R(2)=-0.020) or PedsQL (R(2)=-0.043). Activity levels of adaptive sports athletes did not differ by gender, sport type or school grade (Table 1). DISCUSSION: Unlike previous work in able-bodied adolescents, we found no correlation between physical activity and scores related to depression and anxiety among adolescent adaptive sports athletes during COVID-19. Additionally, there were no difference in activity levels nor mental health scores by gender, sport type nor school grade, a proxy for age. While, the sample size in this study was a fraction of those used in previous work, adaptive athletes are a small proportion of adolescent athletes. Adaptive athletes, who face greater challenges in society on a daily basis, may have had lower quality of life measures at baseline or more sophisticated coping mechanisms already in place providing fortitude in mental health in the face of the pandemic. CONCLUSION: In a small cohort of adaptive athletes in the Midwest region of the USA, sport related cancellations had no association with mental health scores from June 2020 to January 2021.