Although the return to sports during COVID-19 has been associated with improvements in quality of life (QOL) and mental health, it is unknown whether these benefits are primarily due to increases in physical activity (PA).


The purpose of this study was to determine whether PA increases were responsible for the improvements in mental health and QOL among adolescents who returned to sport during the COVID-19 pandemic.




Wisconsin secondary schools


559 adolescent athletes (15.7+1.2 yrs., female = 43.6%) from 44 schools completed a survey in October 2020.

Main Outcome Measures

Demographic information, whether they had returned to sport participation (no [DNP], yes [PLY]), school instruction type, anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), QOL (Pediatric Quality of Life Inventory 4.0), and PA (Hospital for Special Surgery Pediatric Functional Activity Brief Scale). Mediation analysis assessed whether the relationship between sport status and anxiety, depression, and QOL was mediated by PA.


Of the 559 total athletes included, 171 (31%) athletes had returned to play, while 388 had not. PLY athletes had significantly lower anxiety (3.6±0.4 v 8.2±0.6, p<0.001) and depression (4.2±0.4 v 7.3±0.6, p<0.001), and significantly higher QOL (88.1±1.0 v 80.2±1.4, p<0.001) and PA (24.0±0.5 v 16.3±0.7, p<0.001). PA explained a significant, but small proportion of the difference in depression (22.1%, p=0.02) and QOL (16.0%, p=0.048) between PLY and DNP athletes, but not anxiety (6.6%, p=0.20).


Increased PA is only responsible for a small portion of the improvements in depression and QOL among athletes who returned to sports. This suggests that most of the mental health benefits of sport participation for adolescents during the COVID-19 pandemic are independent of the benefits of increased PA.

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