From the end of 2019 onwards, the COVID-19 pandemic caused by the SARS CoV-2 (Severe Acute Respiratory Syndrome Coronavirus) has affected all spheres of human activity, its influence felt most in spheres of economy, tourism, education and sport. Geographically, the pandemic has impacted most regions of the world. By mid-March 2020, Europe had become the epicenter of the epidemic, reporting over 40% of globally confirmed cases; as of 28 April 2020, 63% of global demises attributable to the virus were reported from this WHO Region (1). In Poland, the government data for the period between March 20 and April 30, 2020 record 14826 diagnosed COVID-19 cases and 714 resultant deaths (Fig. 1). Many European countries introduced diverse countermeasures against the spread of infection, including the so-called lockdowns of variable severity. In early April 2020, the extent of lockdown measures varied from country to country, with some banning any kind of interhousehold mingling and outdoor activities, some allowing certain types of activities (e.g. Poland, Germany and the UK) and some merely recommending precautionary social distancing measures (Sweden) (2).
The introduction of countermeasures against the spread of COVID-19 and fear linked with the pandemic resulted in cancellation or suspension of almost all sport activities and events around the world, including the 2020 Olympic and Paralympic Games in Tokyo. In effect, the pandemic negatively impacted sport from grassroots physical activity to elite sport events (3). The limits imposed on physical activity are predicted to negatively impact the health and future performance of athletes living under lockdowns. The enforced isolation is expected to lead to cessation of organized training/competitive activities and prolonged periods of inactivity, broken up by rare training sessions in suboptimal conditions (no or limited access to training facilities and equipment). Team relationships will likely deteriorate due to limited socializing opportunities between athletes, coaches and team support networks. Finally, the limits imposed on travel will further impact athletes with disabilities who were already suffering from mobility issues attributable to inadequate public transport infrastructure designed to accommodate people with disabilities (4, 5).
Scholarly reports published so far on the pandemic’s impact have assessed the influence of COVID-19 on the performance of athletes, underlining the need for regular physical activity during the period of social isolation (6–8). Other studies indicate that the decreased level of physical activity of children and adults living under lockdowns may expose them to an increased risk of obesity, associated with various immediate and long-term comorbidities, such as sleep apnea, hypertension, type 2 diabetes, heart disease, stroke and reduced immunity (7, 9). The psychophysiological conditions of life under lockdown and in quarantine may negatively affect the activity of the sympathetic nervous system: the uncertainty and isolation may result in abnormally prolonged release of cortisol and catecholamine, potentially leading to different pathologies and psychopathologies, such as anxiety, depression, loneliness or sleep disorders (4, 10).
Considering social repercussions of the COVID-19 pandemic, persons with disabilities constitute a distinct group in regard to their health risks (1). The studies demonstrate that people with specific comorbidities associated with disabilities (e.g. impaired immune function, either by disease or medication, renal/hepatic dysfunction, cardiovascular diseases, lung conditions) may exhibit more serious symptoms when suffering from the COVID-19 (11) and therefore require additional safety measures, such as stringent social isolation. Nevertheless, it is well known that physical activity, sport and socializing play a key role in physical rehabilitation of people with disabilities (12). Participation in physical activity and sport measurably increases their self-sufficiency and psychophysical resilience. Benefits of physical activity are often not deemed significant enough to justify relaxing social distancing rules in the context of the perceivably greater threat of COVID-19. The above holds especially true for athletes with disabilities who train for competitions under the lockdown.
Despite the fact that some athletes may find ways to train at home, we can reliably predict that the pandemic will negatively impact the athletes' performance. During March and June 2020 in Poland, all sports facilities and gyms were closed due to governmental mitigation measures (social isolation and social distancing). In result, athletes could only train outdoors, most often individually, often without any direct input from their coach. Since persons with disabilities often need support of their caregivers, athletes with disabilities face unique difficulties when forced to train individually.
In light of the situation described above, the main aim of the study was to assess the situation of athletes with disabilities preparing for the Tokyo 2021 Paralympic Games during the lockdown period (from March 20 to April 30, 2020) in Poland. We were particularly interested in necessary modifications in training caused by the governmental countermeasures against the COVID-19 pandemic.