Physical Activity and Health-Related Quality of Life in Adults With a Neurologically-Related Mobility Disability During the COVID-19 Pandemic: An Exploratory Analysis.

Jet J C S Veldhuijzen Van Zanten,Tom E Nightingale,Catherine R Jutzeler,Nicola R Heneghan,Sally A M Fenton

doi:10.3389/fneur.2021.699884

Abstract

Background: During the coronavirus-19 (COVID-19) pandemic various containment strategies were employed. Their impact on individuals with neurological conditions, considered vulnerable to COVID-19 complications, remains to be determined.Objective: To investigate associations between physical activity and health-related quality of life outcomes in individuals with a neurological condition during government mandated COVID-19 restrictions.Methods: An e-survey assessing fear of COVID-19, physical activity level and health-related quality of life outcomes (functional disability and pain, anxiety and depression, loneliness, fatigue, and vitality) was distributed to individuals with a neurologically-related mobility disability living in the United Kingdom. Open-ended questions were also included to contextualize barriers and facilitators to engage in physical activity during the COVID-19 pandemic. Gamma-weighted generalized linear models and tree-structured regression models were employed to determine the associations between physical activity and health-related quality of life.Results: Of 199 responses, 69% reported performing less physical activity compared to pre-pandemic. Tree-structured regression models revealed that lower leisure-time physical activity was significantly associated (p ≤ 0.009) with higher depression and fatigue, but lower vitality. The closure of leisure facilities and organized sport (27%) was the most commonly cited barrier to engage in physical activity, while 31% of participants mentioned concerns around their physical and mental health as a facilitator.Conclusion: Our analysis identified homogenous subgroups for depression, fatigue, and vitality based specifically on leisure-time physical activity cut points, irrespective of additional demographic or situational characteristics. Findings highlight the importance of and need to safely promote leisure-time physical activity during the COVID-19 pandemic in this at-risk population to help support health-related quality of life.

Highlights

The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is the causative agent of the serious life-threatening coronavirus disease of 2019 (COVID-19)
Almost half of the participants reported to be in self-imposed isolation/shielding (n = 99, 49.7%), while the remainder were practicing social distancing (n = 66, 33.2%), were in isolation due to government legislation (n = 25, 12.6%), or reported none/other measure (n = 9, 4.5%)
Using a comprehensive battery of valid and reliable patient reported outcome measures (PROMs) we revealed that leisure time physical activities (LTPA) was significantly associated with health-related quality of life (HRQoL) outcomes

Summary

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is the causative agent of the serious life-threatening coronavirus disease of 2019 (COVID-19). Individuals with a neurologically-related mobility disability present with a heightened prevalence of comorbidities (e.g., respiratory dysfunction, cardio- and cerebrovascular diseases, systemic immune depression, and chronic inflammation and obesity), which can predispose them to poorer outcomes (e.g., mortality and mechanical ventilation) after developing SARS-CoV-2 [3]. As such, those who were deemed vulnerable due to underlying health conditions were advised to shield (i.e., not to leave their home at all). During the coronavirus-19 (COVID-19) pandemic various containment strategies were employed Their impact on individuals with neurological conditions, considered vulnerable to COVID-19 complications, remains to be determined

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Discussion

Conclusion