Is Being Physically Active Enough or Do People with Parkinson's Disease Need Structured Supervised Exercise? Lessons Learned from COVID-19.

Josefa Domingos,Júlio Belo Fernandes,Carlos Família,Catarina Godinho,John Dean

doi:10.3390/ijerph19042396

Abstract

Social isolation imposed by the COVID-19 pandemic negatively impacted people’s lifestyles and daily activities. In this work we compared pre- and post-pandemic clinical outcomes in people with Parkinson’s disease, to assess differences according to the type of behaviour and exercise habits adopted by participants. After two months of COVID-19 lockdown, we assessed: changes in exercise behaviour; motor and non-motor aspects of daily life experiences (MDS-UPDRS I & II); activities of daily living (The Schwab & England scale); quality of life (Parkinson Disease Questionnaire); sleep (Parkinson Disease Sleep Scale); falls; and Clinical Global Impression Change. Twenty-seven individuals aged between 57 and 92 years old participated; from these, ten individuals (37%) completely interrupted physical activities, while seventeen (63%) maintained some level of active lifestyle. Regardless of whether they remained active or not, all participants perceived a significant worsening of their clinical condition, reporting an increase in difficulties completing daily activities or chores (37%) and worsening of their health condition (51.8%). The quantifiable influence of exercise habits was borderline for the group who kept active. The active group seem to have a better self-perception of their health condition, although it was not enough to show a clear benefit. People with Parkinson’s disease should be informed that being physically active may not be enough and more structured exercise could be needed.

Highlights

Introduction published maps and institutional affilThe social isolation imposed by the novel coronavirus 2 (COVID-19 pandemic) caused a significant negative impact on people’s lifestyles and daily activities around the world [1].Health care systems internationally rapidly implemented infection and environmental control strategies to control COVID-19
For people with Parkinson’s disease (PD), these changes led to reduced physical activity and worsening social isolation, resulting in several negative impacts upon symptoms of the disease in addition to lower overall health status [3]
Our goal was to assess changes in several measures of disability, independence in activities of daily living (ADL), motor and non-motor symptoms, quality of sleep, self-perception of disease severity, and occurrence of falls after two months of social isolation associated with the COVID-19 lockdown, according to type of exercise behaviour

Summary

Introduction

Introduction published maps and institutional affilThe social isolation imposed by the novel coronavirus 2 (COVID-19 pandemic) caused a significant negative impact on people’s lifestyles and daily activities around the world [1].Health care systems internationally rapidly implemented infection and environmental control strategies to control COVID-19. The social isolation imposed by the novel coronavirus 2 (COVID-19 pandemic) caused a significant negative impact on people’s lifestyles and daily activities around the world [1]. While quarantine was considered a highly-efficacious, widely-implemented strategy to minimize exposure risk and reduce the spread of the disease [2], it imposed severe sudden changes in daily routines. For people with Parkinson’s disease (PD), these changes led to reduced physical activity and worsening social isolation, resulting in several negative impacts upon symptoms of the disease in addition to lower overall health status [3]. Even before COVID restrictions were imposed, people with PD are on average 29% less physically active than age-matched healthy controls, in the presence of greater disease severity, gait impairment and more disability in daily living [3,4].

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