{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:24:49Z","timestamp":1753889089557,"version":"3.41.2"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":333,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Translational Sports Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Protracted return to sport (RTS) following COVID\u201019 is common due to long\u2010term cardiopulmonary symptoms and persistent fatigue. In athletes, low exercise tolerance may result in emotional distress. The aim of this study is to assess the symptom severity, the management thereof and the impact on quality of life (QOL) as endurance athletes return to their preillness level of sports participation. A cross\u2010sectional survey\u2010based mixed methods study of long\u2010distance athletes was performed. Quantitative data included sport and disease characteristics, fatigue score and management of persistent symptoms. A total of 295 survey responses were included. The mean age was 45.1 (10.2) years and 54.7% were male. Barriers to exercise included tachycardia (72%), fatigue (72%), dyspnoea (58%) and inability to exercise at high intensities (75%). High physical and mental fatigue scores were found, the former significantly predicting return to sport. Qualitative data were collected through open\u2010ended questions exploring challenges faced when returning to sport post\u2010COVID\u201019 convalescence and the impact on their QOL. Biopsychosocial well\u2010being constituted three themes: Physical, Psychological and Social. Categories with high code frequencies included persistent cardiopulmonary symptoms, physical fatigue, emotional distress and social disengagement. Mixing the methods revealed that the athletes\u2019 QOL deteriorated due to protracted RTS after COVID\u201019. A multidisciplinary approach to management may be required by endurance athletes.<\/jats:p>","DOI":"10.1155\/2024\/1506534","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T12:48:30Z","timestamp":1732884510000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Every Run Is Hard\u2019: Endurance Athletes\u2019 Experiences of Return to Sports Participation After COVID\u201019\u2014A Mixed Methods Study"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5392-512X","authenticated-orcid":false,"given":"Cheryl Anne","family":"Haley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1926-4690","authenticated-orcid":false,"given":"Helena","family":"Van Aswegen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9287-8301","authenticated-orcid":false,"given":"Benita","family":"Olivier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.5114\/biolsport.2021.106147"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.611261"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103259"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246300"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2021.04.005"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/sms.14265"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajp.v80i1.2063"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.02.003"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0277984"},{"key":"e_1_2_12_10_2","unstructured":"National Institute for Health and Care Excellence Covid19 Rapid Guideline: Managing the Long-Tern Effects of COVID-19 2021 https:\/\/www.nice.org.uk\/guidance\/ng188."},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056366"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2007.143834"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192416377"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20136308"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.975992"},{"key":"e_1_2_12_16_2","unstructured":"WHO Quality of Life 2012 https:\/\/www.who.int\/tools\/whoqol."},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2020.05.016"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.736499"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-40821-2"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179423"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa605"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v6i1.640"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.1037\/e566732013-001"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2007.007074"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06244-7"},{"key":"e_1_2_12_27_2","unstructured":"FAIR FAIR Principles 2016 https:\/\/www.go-fair.org\/fair-principles\/."},{"key":"e_1_2_12_28_2","unstructured":"NCBI COVID-19 Treatment Guidelines 2023. 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