Abstract
Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious.Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes.Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume.Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale—parts IB and II—emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05).Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.
Highlights
The coronavirus disease 2019 (COVID-19) is an infectious disease of pandemic proportions, which is rapidly developing around the world
People with Parkinson’s disease (PD) living in Italy reported an acute clinical worsening in either motor disturbances or neuropsychiatric nonmotor symptoms due to lockdown and infection outbreak [2], consistent with clinical worsening in mental health and reduced physical activity level in people with PD living in Egypt [3], India [4], and Germany [5]
Perceptions of negative changes in daily routine, freezing of gait, fear of falling, and fear of the COVID19 pandemic have been observed during lockdown in people with PD [1, 4, 6], which are important aspects that may potentially lead to the worsening of motor and non-motor symptoms and mental health in this population
Summary
The coronavirus disease 2019 (COVID-19) is an infectious disease of pandemic proportions, which is rapidly developing around the world. The motor and non-motor symptoms of people with PD living in Italy significantly worsened in those infected by COVID-19 [7]. These studies showed a clinical worsening of PD during the COVID-19 pandemic in a small sample size (≤100 people with PD), there is no systematic data available [8]. Self-reported clinical worsening by people with Parkinson’s disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious
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