Training Conditions and Emotional Impact on Spanish Olympic Swimmers and Rowers in Social Isolation Due to COVID-19. Results of a Survey

Round 1

Reviewer 1 Report

Please refer to attached file. 

Comments for author File: Comments.pdf

Author Response

Dear reviewer

We appreciate the time you have spent on our article. We have considered all of your recommendations. All the authors have debated from our disciplines (psychology, sociology, statistics, methodology, etc.). We believe we have responded to all your comments. As a consequence, we have made important changes.

Do not forget that the changes you proposed extend the length of the article. We hope that the Editor is informed in this regard.

There are also changes in the manuscript that respond to the comments of the second reviewer. Please consider this situation.

We appreciate your collaboration, kind regards

The authors

1. The study aims to explore the impact of Covid-19 on the training habits, conditions, environments, and emotions of an elite group of athletes from one nation in two sports.

Exactly. This is the objective of the study

2. The study adds to a considerable amount of national and international research exploring the impact of Covid-19 on different aspects of sport. In this sense the study has the potential to add to our knowledge about this based upon the experiences of this population of athletes.

Thank you very much, we agree

3. The aims and objectives of the research are clear, the research process and explanation are adequate but please refer to minor reflections around the research process

Thanks. We are pleased to know that you believe that the purposes and objectives of the investigation are clear, and the investigation process and the explanation are adequate.

4. The article needs to be clearer about the key messages and potential contribution to knowledge – is this the first study to examine the impact of covid 19 on Spanish Olympic swimmers and rowers? What is the absolute unique benefit of this research?

In answer to the first question, yes, this is the first study to address the impact of the coronavirus-19 crisis on Spanish Olympic swimmers and rowers. We are not aware of any study on this population in other countries. For that reason, we have added a paragraph in the introduction and conclusions.

“The studies that we found were published between 2020 and 2021. However, there are also no specific studies on Olympic athletes in isolation contexts, this study being the first to analyze the training conditions and the emotional impact of Olympic swimmers and rowers in Spain”.

 “In this sense, the present study is the first to analyze the training conditions and the emotional impact among Olympic swimmers and rowers in Spain”.

Regarding the second question, as indicated in the conclusion of the article, the main benefit is that it provides valuable information for high-performance athletes, Olympic teams and sports federations. In this sense, some sentences have been incorporated in the last paragraph of the introduction and in the conclusions.

“The results of the study have served to issue a report that we have sent to the Higher Sports Council, the Spanish Olympic Committee and the Sports Federations of Swimming and Rowing. This report provides useful recommendations for the design of a protocol that serves Olympic athletes to improve training conditions and reduce emotional impact, in the face of future epidemiological crises. Among the main recommendations, three stand out. The first recommendation is that these athletes remain isolated in groups, not individually, with other athletes and with coaches, in high-performance centers and sports residences with appropriate facilities and equipment. The second recommendation is to reduce the use of social networks and the Internet and, instead, dedicate time to relaxing leisure activities (meditation, Pilates, mindfulness, yoga, reading etc.). The third recommendation is the importance of Olympic athletes having the support of psychologists in confinement situations”.

5. The article would benefit from further work – not a lot- which outlines (a) previous research around the impact of Covid 19 and sport or elite sport and (b) previous research that has considered the impact of pandemics upon mental health of athletes. This would necessitate a couple of paragraphs on each of these themes – maybe two on each. The essence of these paragraphs would be (i) The research to data around the impact of Covid 19 on sport has tended to reflect upon the following themes (i) the impact upon Covid 19 of grass roots participation in sport; (ii) the disproportionate impact of Covid-19 on certain populations involved in sport ; (iii) etc – maybe provide the reader with 5-8 core themes that have been researched already and name the studies i.e. Kidd and Donnelly - https://thecommonwealth.org/sites/default/files/inline/Commonwealth%20Moves_COVID19%20%26%20Community%20Sport%20Policy%20Analysis%20Toolkit.pdf

“As a consequence of the COVID-19 pandemic, recent research has warned about the effect of confinement and social isolation on athletes' physical activity and mental health [20]. Home confinement has meant a drastic change in athletes' training routines [19, 21], and although athletes attempted to maintain their physical activity during confinement, a reduction in training time and intensity was observed [21-23]. During the confinement period, the quality of athletes’ sleep was also reduced [24-25] and at the same time an increase in the number of sedentary activities was evident [23-28].

Social distancing is another potential stressor due to home confinement caused by COVID-19 [20]. Reduced social relationships and companionship in sport practice is associated with a longer period of sedentary activities and reduced well-being (Lorenzo [29-31]. In addition, due to confinement, athletes perceived a deprivation of personal contact with their coaches and psychological support, thereby increasing symptoms of mental illness such as stress and depression [32-35]”.

6. Do the same couple of paragraphs on Covid-19, Sport and Mental Health?

We appreciate your drawing our attention to this point and therefore the following paragraphs have been added to the introduction:

“Some authors [18-19] suggested that the effect of the COVID-19 pandemic is associated with mental and physical health challenges in athletes; and periods of inactivity, isolation from athletic teams, distance from the athletic community, less qualified interactions with athletic coaches, and lack of social support, have also been shown to cause emotional distress and psychological disorders in athletes”

“Some meta-analyses have shown that the COVID-19 crisis has had negative effects on the mental health of the general population [38-40]. Some risk factors for suffering from these negative psychological symptoms have been lacking support networks during confinement, excessive media exposure to information about the incidence of COVID-19, and uncertainty about employment [39].

 Numerous studies have shown that due to COVID-19 confinement an inverse association has been observed between reduced physical activity and well-being in the general population [41-42] and especially with negative consequences for mental health, increasing symptoms of stress and depression due to lack of physical activity [43-45]. Athletes are an especially at-risk group for suffering these negative psychological consequences of the confinement period; reduced physical activity has had a negative effect on their sport performance and, with it increased their stress and negative mood states [46-50].”

7. Should the conclusions take the research back into some of the previous research and comment upon how this study adds to previous knowledge?

Thank you for pointing out this gap in the conclusions, following the reviewer's recommendation the following paragraphs have been added:

“Our study shows that physical activity and training during confinement was associated with the mental health of Spanish swimmers and rowers. Similar results have been observed in samples of athletes from other disciplines in the same conditions of confinement established by the Spanish government. García-Tascón et al. [24] in a large sample of Spanish athletes from different disciplines observed that confinement due to COVID-19 entailed a decrease in physical activity and intensity of training with a negative effect on health in Spanish athletes. Mon-López et al. [25] observed in a sample of Spanish handball players that during confinement the reduction in the amount and intensity of training was associated with worse sleep quality, and negative emotional states.

A conclusion that we can reach from the results obtained in our study and others is that, in situations of confinement, such as those produced by the confinement due to the COVID-19 pandemic in Spain, maintaining physical activity and having adequate training conditions are protective factors for the mental health of athletes. Lorenzo Calvo et al. [29] showed in Spanish professional basketball players during the confinement period that negative emotional states were associated with lower training frequency and sleep quality. Pons et al. [34] in a sample of young Spanish athletes found that young people with worse training conditions suffered greater mental health problems. The relationship between sport, physical activity and mental health has been observed worldwide as a consequence of confinement conditions similar to those in Spain [66-70]. This relationship between mental health and physical activity can go both ways, Chirico et al. [62] observed in a sample of Italian athletes during confinement for COVID-19 that anxiety negatively influenced the intention to do physical activity. A lesson learned for future similar crises is that to protect the mental health of athletes, sport organizations should implement psychological support programs combined with promotion of training conditions and maintenance of physical activity [7].”

Apart from the key feedback as above the reviewers would like the authors to consider:

We have tried to follow the following guidelines to improve the original manuscript

9. Change the title to be more precise i.e., Olympic Swimmers and Rowers rather than athletes

Thanks for the recommendation. We agree with the need to specify in the title. Following your suggestions, we have adapted the title, specifying that Olympic athletes are "swimmers and rowers." And we have also done so in the abstract and the keywords.

10. Include recommendations for further research or systemic changes

We have expressed some limitations and recommendations for future studies in the last paragraph of the conclusions

“We want to present several limitations. In turn, these limitations suggest several recommendations:

1.- It would have been advisable to ask about the training conditions and the subjective perception of their emotional state under normal conditions, not only during confinement. This would have made it possible to contrast the responses in two different situations: normal and in confinement. Hence, the results of this study should not be interpreted in causal terms, but this cross-sectional analytical study can provide information on the association between risk factors and psychological health outcomes as other studies have done. Therefore, we recommend future researchers to take this possible improvement into account. Future research would require a longitudinal study to analyze changes in emotional states and—more importantly its connection with athletic performance.

2.- Another limitation of this study is the absence of data on Olympic athletes from other sport disciplines, both individual (athletics, cycling, climbing, etc.) and collective (soccer, rugby, basketball, etc.). Hence, the results of this study should not be interpreted in causal terms, but this cross-sectional analytical study can provide information on the association between risk factors and psychological health outcomes as other studies have done. Future research should compare the psychological and emotional effects of confinement on individual and team athletes, as well as the differences between different sport specialties, in search of an evidence-based set of interventions for each one.

Despite these limitations, we believe that the methodological decisions ensured as much as possible the proper conduct of the study in such a complex context, thanks to the multidisciplinary work of sociologists, psychologists, specialists in survey techniques and statisticians.”

11. The 43-question survey tool was designed around 5 key theme areas; therefore, the introduction could be organized around a background to these 5 topic areas and include seminal works in each area.

We understand your reasoning. We consider the description of the blocks of the questions more appropriate in point 2. Methodology and, within this, in 2.1. Questionnaire. However, following your prompts and the directions of the second reviewer, we address some of the additional aspects on this issue in the introduction. We have added new paragraphs and a new bibliographical review.

12. The conclusion would benefit from a short paragraph which says the key take way messages from this study are – and list them.

We have taken this into consideration. You can see it in the conclusions. Let's hope we understood what you wanted us to do.

13. Olympians are naturally under pressure to maintain a positive image of strength and represent their country in a positive manner. How does being an Olympian effect the selfreported responses to the questionnaire?

According to some Olympics athlete feedback, completing the questionnaire has been hard because question after question, item after item they have realized how much the COVID19 pandemia has negatively affected their lives, but in their daily lives, athletes have learned to deal successfully with adversity.

14. The article talks about material and social conditions, but it is equally important to reflect upon material and social backgrounds of the athletes as well.

We share this reflection. For this reason we have incorporated a comment in the conclusions. We consider this to be a limitation of our study. For this reason, we make a recommendation for future studies.

15. The article would benefit from a considerable degree of polishing – it is never good to have two spelling errors in the title – Olympic and Athletes and in general the article needs some robust proof reading before publishing- see some minor suggestions in terms of feedback.

You are totally right. We admit that we have made an English translation error. We apologize. We have reviewed the new version of the manuscript with more attention. Thanks for letting us know. We have had the help of an official translator.

16. Minor amendments and reflections:

We have considered all comments and made the suggested minor changes

• Title correct spelling errors

We have corrected the misspelling of the title. We have also modified the title according to the suggestion made in point 9.

• Line 63-70: Sources to back up these statements?

The sources supporting these statements have been added:

“During the months of confinement, these Spanish Olympic athletes were training in their homes and suffering a great deal of anxiety for their future, given the fact that the opportunity cost of a sport career is high (at the personal, family, educational and professional level outside the field of sport) [7, 37].”

• Line 93-95 source of this quote?

Reference is added to support the proposed statement:

“This survey was designed and administered using the Google Form tool, which is a safe tool because access to the data base generated is limited to the users who administer the questionnaire [52].”

• Line 146: Mentions that the survey was validated, but no details included on how the research team executed a validation process for the survey tool they designed. The science seems hazy – specific details needed to create clarity. Line 146-148 mentions pilot-testing. Were any adjustments made after the pilot testing phase?

Thank you for your comment on the validation process and pilot study. The questionnaire used in this survey is part of a larger study for which reference is added describing the validation process:

“The questionnaire was initially tested on a sample of 10 athletes to determine that it was appropriate and understandable. Four coaches and four sport psychologists, blinded to the study objectives, were recruited for validation as recommended by Osterlind [62], with a Likert scale to assess the comprehension and adequacy of the items. The questionnaire measurement model was validated using a Confirmatory Factor Analysis (CFA) in a sample of 1248 Spanish athletes reaching acceptable model fit and reliability indicators [37].”

• Line 166-167: we think we understand what this is saying – something along the lines of, “the data was sorted and evaluated against inclusion criteria to obtain the final data sample for analysis”. Original text: The data obtained through the survey were processed following a scrupulous delimitation process of the resulting sample. Would add strength to describe the requirements for data inclusion and rationale for the inclusion criteria chosen

We believe that the phrase was not well understood, because there has been a translation problem. The original sentence is not correct: "The data obtained through the survey were processed following a scrupulous process of delimiting the resulting sample." The correct thing would be to say: "The data obtained through the survey were processed following a scrupulous process of cleaning the matrix."

As it is due to a translation error, we consider that it is not necessary to clarify the second question, because no record (n) has been deleted. Where we said "delimitation of the sample" we meant "purification of the matrix". It was an error of expression. It has only been verified that all the filters have been fulfilled and that there is no data that is not valid; a common statistical operation with data matrices. The sample is of 88 people and this represents 100% of the population.

In the new version of the article we have expressed it correctly.

• Line 304-306: Pragmatic approach taken to research design – hypothesis made, and research questions asked after data collection - this should probably be mentioned in methodology section with a short rationale/explanation for undertaking this approach

Thanks. We agree with the suggestion. We have tried to respond to this recommendation in section 2.4.

• Line 353-394: CATPCA analysis tool. Has this been validated in athletic populations? Why was this tool chosen to measure emotional well-being? What other tools were considered?

Taking into account your doubts, we have decided to add some clarifications in section 2.4.

The CatPCA is not a scale and it is not the tool to measure wellness. The CatPCA is defined as Categorical Principal Component Analysis. It is a statistical information reduction technique. In our article, it served to summarize the information contained in 36 variables into only 2 dimensions. We have used this statistical technique because it can be used with all kinds of variables: nominal, ordinal, and continuous; however, the PCA can only be used with continuous variables. For this reason, although its use was valued, finally the PCA was not used; since not all the variables were continuous.

What was validated is the questionnaire used in this survey, which is the one that provided us with the analyzed data, as explained in section 2.1. Questionnaire: Emotional and Adaptive Reactions to Covid-19 Confinement (REACOVID-19).

17. Overview – An article that has the potential to add further to our knowledge about the impact of Covid-19. The key messages get lost in the text and the authors should reflect more upon the structure of the article, the key messages, what we knew before this study and what we now because of this study. The article would be stronger if the findings actually talked further to existing research

We agree with this proposal for improvement. We have tried to contrast the results of this study with previous studies, both in the introduction and in the conclusions. In the conclusions, we have also listed the key messages of the study. You can check the changes made to the introduction and conclusions

18. The article needs quite a bit of polishing and attention to detail, spelling etc

You are absolutely right. We have checked the spelling and some expressions in the text. We hope the new version of the manuscript is much improved.

Author Response File: Author Response.pdf

Reviewer 2 Report

In this study, the Authors conducted a structured survey on the effects COVID-19 confinement on Spanish Olympic athletes. The topic is of interest and must be thoughtfully compared to the extant literature to gain insight on this field. Some issues were raised and need to be adequately addressed, appended below.

1/  Neither the abstract nor the title address properly the design type of this investigation.The design should be highlighted as well as the dates of the timeframe should be specified either in the abstract or in the methods section.

2/ The general weakeness (which should be acknowledged) relates to the fact that all responses are subjective, and all subjects completed the survey at one timepoint, so the findings are subject to recall bias.

3/ The manuscript should provide more information about the measures and the measured constructs in more general terms. What is the theoretical framework behind the developed questionnaire (e.g. Is it reliable? How can we be sure about what is realiabily mesured by the questionnaire? is there any unitary construct behind it ?).

• The description of the methods: more information is needed about the reliability of the measures.

4/  The theoretical framework would benefit from citing key studies on the same topic. Please see:

• DOI: 10.23736/S0022-4707.21.12715-X
• DOI: 10.3389/fpsyg.2020.02100

- also in the discussion, it might be fruitful covering and comparing the Authors'results with the extant literature.

Minor

The limitations of the study refer to the web-survey. In fact, this type of survey administration could limit the application, since its accessibility is linked to own internet connection.

Author Response

Dear reviewer

We appreciate the time you have devoted to our manuscript. We have taken into account all your recommendations. We believe we have responded to all of your comments and have made significant changes as a result.

Note that another reviewer has also proposed changes. These changes have also been incorporated into the manuscript.

Without further ado, we thank you for your collaboration, best regards

The authors

In this study, the Authors conducted a structured survey on the effects COVID-19 confinement on Spanish Olympic athletes. The topic is of interest and must be thoughtfully compared to the extant literature to gain insight on this field. Some issues were raised and need to be adequately addressed, appended below.

1/  Neither the abstract nor the title address properly the design type of this investigation.The design should be highlighted as well as the dates of the timeframe should be specified either in the abstract or in the methods section.

The date appears at the end of the section "2.2. Administration of the survey". However, as you requested, we have also included it in the abstract of the article.

2/ The general weakeness (which should be acknowledged) relates to the fact that all responses are subjective, and all subjects completed the survey at one timepoint, so the findings are subject to recall bias.

The substantive debate raised by his comment has been analyzed in the work of García Ferrando, Ibáñez and Alvira "The analysis of social reality. Research Methods and Techniques" (Alianza Editorial, 2007). During this time, much progress has been made in the analysis of subjective responses in surveys. In any case, directly in sciences such as psychology and sociology, we aspire to know people’s subjective responses. And this is done through an adequate methodological design, sample design and analysis of the responses.

In this respect, some strategies have been applied in this research. For example, the discussion and validation of the emotions questionnaire that is used has been evaluated by peers and published in a scientific journal (Andrade, E.; Arce, C.; De Francisco, C.; Torrado, J.; Garrido, J Short version in Spanish of the POMS questionnaire for adult athletes and the general population. RPD 2013; 22, 1; 95-10). The questionnaire has also been discussed among prestigious specialists, such as Dr. Trujillo, Professor of Psychiatry at New York University and Chief of Psychiatry at Bellevue Hospital, an expert in this type of situation. The method of administration of the survey has also been discussed with experts from the Higher Council for Scientific Research (CSIC), at the Spanish Ministry of Science, such as Dr. Juan Antonio Domínguez (expert in the field). And finally, a large sample has been used (88 subjects, a sample that represents 100% of the population under study), which offers high response reliability.

3/ The manuscript should provide more information about the measures and the measured constructs in more general terms. What is the theoretical framework behind the developed questionnaire (e.g. Is it reliable? How can we be sure about what is realiabily mesured by the questionnaire? is there any unitary construct behind it?). The description of the methods: more information is needed about the reliability of the measures.

Thank you for your comment on the validation process and pilot study. The questionnaire used in this survey is part of a larger study for which reference is added describing the validation process:

“The questionnaire was initially tested on a sample of 10 athletes to determine that it was appropriate and understandable. Four coaches and four sport psychologists, blinded to the study objectives, were recruited for validation as recommended by Osterlind [62], with a Likert scale to assess the comprehension and adequacy of the items. The questionnaire measurement model was validated using a Confirmatory Factor Analysis (CFA) in a sample of 1248 Spanish athletes reaching acceptable model fit and reliability indicators [37].”

4/  The theoretical framework would benefit from citing key studies on the same topic. Please see:

DOI: 10.23736/S0022-4707.21.12715-X

DOI: 10.3389/fpsyg.2020.02100

-also in the discussion, it might be fruitful covering and comparing the Authors'results with the extant literature.

Thanks for this remark, following the reviewer's suggestion, the following paragraphs have been added to the discussion:

“Our study shows that physical activity and training during confinement was associated with the mental health of Spanish swimmers and rowers. Similar results have been observed in samples of athletes from other disciplines in the same conditions of confinement established by the Spanish government. García-Tascón et al. [24] in a large sample of Spanish athletes from different disciplines observed that confinement due to COVID-19 entailed a decrease in physical activity and intensity of training with a negative effect on health in Spanish athletes. Mon-López et al. [25] observed in a sample of Spanish handball players that during confinement the reduction in the amount and intensity of training was associated with worse sleep quality, and negative emotional states.

A conclusion that we can reach from the results obtained in our study and others is that, in situations of confinement, such as those produced by the confinement due to the COVID-19 pandemic in Spain, maintaining physical activity and having adequate training conditions are protective factors for the mental health of athletes. Lorenzo Calvo et al. [29] showed in Spanish professional basketball players during the confinement period that negative emotional states were associated with lower training frequency and sleep quality. Pons et al. [34] in a sample of young Spanish athletes found that young people with worse training conditions suffered greater mental health problems. The relationship between sport, physical activity and mental health has been observed worldwide as a consequence of confinement conditions similar to those in Spain [66-70]. This relationship between mental health and physical activity can go both ways, Chirico et al. [62] observed in a sample of Italian athletes during confinement for COVID-19 that anxiety negatively influenced the intention to do physical activity. A lesson learned for future similar crises is that to protect the mental health of athletes, sport organizations should implement psychological support programs combined with promotion of training conditions and maintenance of physical activity [7].”

Minor

The limitations of the study refer to the web-survey. In fact, this type of survey administration could limit the application, since its accessibility is linked to own internet connection.

We believe that these limitations do not exist because we contact athletes directly through their federations and 100% of the population has responded to the survey.

Surveys administered over the Internet are becoming more and more common in the field of social research. Given that the ways of life of contemporary society have changed, and people spend less and less time at home, the use of the survey through the Internet has been progressively and intensely spreading. According to the National Institute of Statistics (INE) —which carries out the Survey on Equipment and Use of Information and Communication Technologies in Homes— the use of this medium in 2020 was almost universal among those under 24 years of age (99, 8%) —which is the range of the population on which this work is based—.

(https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=estadistica_C&cid=1254736176741&menu=ultiDatos&idp=1254735976608).

Different Spanish methodologists have analyzed the use of the survey through the Internet in recent years (Díaz de Rada et al., 2019; Díaz de Rada and Domínguez, 2017; Díaz de Rada, 2011 and 2012). These authors state that "a retrospective view of the evolution in the collection of information by means of a survey reveals that the computer questionnaire (CAI) is gradually replacing the traditional face-to-face survey" (Díaz de Rada and Domínguez, 2017: 138). These research methods have been reported as – valid and reliable (Díaz de Rada Igúzquiza et al., 2019).

In the field of psychology, a revision on COVID19 research published, data were collected via an online survey (Chirico, Lucidi, Galli, Giancamilli, Vitale, Borghi, La Torrenand Codella (2020) among many other references: Chirico A, Lucidi F, Galli F, Giancamilli F, Vitale J, Borghi S, La Torre A and Codella R (2020). COVID-19 Outbreak and Physical Activity in the Italian Population: A Cross-Sectional Analysis of the Underlying Psychosocial Mechanisms. Front. Psychol. 11:2100. doi: 10.3389/fpsyg.2020.02100 2). It was necessary to use internet and mainstream media, including WhatsAppTM, because of the mobility and personal access limitations imposed during the testing period by the pandemic control efforts.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Dear Authors,

Thank you very much for your thoughtful handling of the comments. The manuscript has improved considerably due to the extensive consideration of the editor's and the reviewers' comments.

Overall, I think the manuscript adds knowledge to the extant body of literature.