Wellness Questionnaires for Athlete Monitoring

Wellness questionnaires, also called Athlete Self Report Measures (ASRM), are an important part of an athlete monitoring system. They capture the subjective response to the athlete's training load. But do they actually work, and if so, how can you best implement them?

Athlete wellness questionnaires are now commonplace across various sporting environments. These simple tools aim to capture the athlete's perception of their readiness and recovery status across a number of different wellness constructs, such as sleep, mood, fatigue, and soreness. Such data can inform training decisions, thereby seeking to improve athlete performance and minimise injury risk. This post delves into the efficacy of these self-report measures, explores key research findings, outlines the type of questions to include, and provides guidance on data analysis and implementation.

Do Athlete Self-Report Wellness Questionnaires Work?

Athlete self-report measures have been the subject of extensive research, with studies highlighting their effectiveness. One pivotal study conducted by Anna Saw and colleagues (2016) in the British Journal of Sports Medicine (BJSM), conducted a systematic review of both objective and subjective markers of athlete response.

The study concluded that subjective measures — those that ask athletes about their feelings — demonstrate superior sensitivity and consistency in reflecting both acute and chronic training loads compared to their objective counterparts, such as hormonal changes or athletic task performance.

The Value of Subjective Measures

While objective measures are essential, the consistency and sensitivity of subjective athlete self-report questionnaires make them invaluable. It also provides athlete with a means of communicating their experience of the training programme, thereby giving them a voice on their training programme.

Of course, we shouldn't only rely on the measures collected in questionnaires. Observing body language can provide another means of subjective response information. For example, Carl Foster's anecdote about the "hair in the yogurt" test illustrates how simple observations of athletes' behaviour can provide meaningful insights into their fatigue and wellness.

Crafting Effective Athlete Wellness Questionnaires

Creating a meaningful questionnaire requires balancing the need for comprehensive data with the practical constraints of time and effort for athletes and staff. We keep coming back to this balance in the form of the Value Burden Matrix.

The Value Burden Matrix

As discussed in the video above, the RESTQ-Sport tool provides an array of valuable information for research with 76 items included on the questionnaire. However, that is far too high of a burden to ask of our athletes to complete regularly. So we need to reduce the burden but still maintain value in our athlete questionnaires.

Key Constructs to Measure

The questionnaire should focus on major constructs that reflect an athlete's wellness.

Five key constructs include:

- Fatigue

- Sleep quality

- Muscle soreness

- Stress

- Mood

Blake McLean’s study in 2010 used a wellness questionnaire for Australian Rugby League players that included these five key constructs assessed on a one-to-five scale. Additionally, incorporating a body map for athletes to report specific areas of pain or soreness (two different constructs themselves!) can provide further data.

Questionnaires should be tailored to the specific context and population of your athletes. So there may be importance constructs not mentioned above, that are valuable in your setting. For instance, in a college setting, capturing data on academic stress might be relevant, whereas in sports with high travel demands, measuring travel fatigue is crucial.

Similarly, appropriately capturing menstrual cycle symptoms may be worthwhile in female athletes when used as part of an education programme relating to female athlete health.

Avoiding Bias in Responses

To ensure unbiased responses, avoid using emojis or smiley faces in your questionnaires. Neutral colouring and clear descriptors help in maintaining the objectivity of the responses. I understand it can be tempting to include such emojis, especially with younger generations, but these can be interpreted differently.

Analysing Wellness Data

Since wellness and training responses are highly individualised, comparing an athlete’s responses over time against their own data set is crucial. Using Z-scores can aid in this process by standardising data to highlight significant deviations from an individual athlete's norms.

For instance, comparing an athlete's current data against a 28-day rolling dataset and flagging anything beyond ±1.5 standard deviations can identify potential issues. For more on calculating z-scores, read this post: Mastering Z-score and T-score Statistics in Sports Science.

Significant deviations in wellness metrics should trigger a conversation rather than immediate action. Engaging with athletes to understand the context behind the data can lead to more informed decisions and interventions.

Keys to Successful Implementation

Successful implementation of athlete wellness questionnaires hinges on three foundational keys: communication, consistency, and coach support.

Communication

Educate athletes about the importance of the data collection and how it benefits them. Transparency about how the data will be used helps in gaining their honest and active participation. Education is a key pillar to developing buy-in to the wellness questionnaire process (Saw et al., 2015).

Consistency

Consistent data collection processes ensure reliability. Whether it's filling out questionnaires at home or using an iPad upon entering the facility, maintaining consistency helps athletes develop routine compliance... but only when it works!. Athletes have admitted to lying on wellness questionnaires when they face technological difficulties (Coventry et al., 2023).

Coach Support

The support of coaches is crucial for the success of these measures. Programs that have strong coach backing see higher compliance rates from athletes. Thus, educating coaches about the importance and use of wellness data is essential.

FAQs on Athlete Wellness Questionnaires

What are Athlete Self-Report Wellness Measures?

These are questionnaires that ask athletes about their current state regarding key constructs such as fatigue, sleep quality, muscle soreness, stress, and mood to gauge their overall wellness.

Should You Use Subjective Measures Over Objective Ones?

Research indicates that subjective measures often provide greater sensitivity and consistency in reflecting changes in training loads and athlete wellness compared to objective measures. Ultimately however, a combination of both should be used as part of a multivariate, holistic athlete monitoring system.

What is a Z-Score and How Does it Apply Here?

A Z-score standardises an individual’s data point against their mean data, helping to identify significant deviations from their typical values. This is particularly useful for monitoring personalised wellness responses.

How Should We Implement Wellness Questionnaires?

Successful implementation involves clear communication about the purpose, consistent data collection processes, and ensuring coach support to encourage athlete compliance. The frequency of data collection should be tailored to your specific environment but should be consistent. Some programmes opt for daily check-ins, while others may do so less frequently depending on the needs and constraints of the sport and athletes involved.

Final Thoughts

Athlete wellness questionnaires are a powerful tool in the sports scientist’s toolbox. By carefully designing, implementing, and analysing these self-report measures, we can gain vital insights into the athlete's training response, and ultimately safeguard athlete health and performance.

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Interested in learning more? Check out my course, in partnership with Sport Horizon, the Fundamentals of Load Monitoring. This unique course blends scientific theory with practical data viz application in Microsoft Power BI.

For more information on wellness questionnaires and athlete monitoring, check out the Global Performance Insights YouTube channel’s Load Monitoring playlist.

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