M.E. Pimentel Piemonte1, L. Rosa Santos de Almeida2, R. Paes Guimarães3, C. Lourenço Correa4, F. Augusto dos Santos Mendes5, V. Vera Lúcia Israel6, R. Campos Freire Júnior7, A. Raquel Rodrigues Lindquist8, N. Beckmann Bosaipo9, A. Coutinho de Azevedo Guimarães10, C. Braga Landre11, I. Almeida1
1Medical School of University of Sao Paulo, Physical Therapy, Sao Paulo, Brazil, 2Hospital Geral Roberto Santos, Salvador, Brazil, 3Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, Brazil, 4Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 5Faculdade de Ceilândia da Universidade de Brasília, Brasilia, Brazil, 6Universidade Federal do Paraná, Curitiba, Brazil, 7Universidade Federal do Amazonas, Manaus, Brazil, 8Universidade Federal do Rio Grande do Norte, Natal, Brazil, 9Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil, 10Universidade do Estado de Santa Catarina, Florianópolis, Brazil, 11Universidade Federal do Amapá, Macapa, Brazil

Background: Anxiety and depression are common non-motor alteration in PD, occurring in up to 30–40% of patients and are associated to more severe disease evolution. Increased levels of stress during the COVID-19 pandemic may have several short-term as well as long-term adverse consequences this population. Reduced physical activity during the pandemic may contribute to increase psychological stress, thereby further aggravates the worsening in quality of life.

Purpose: To investigate the impact of interruption in physical activities due to physical distancing during the COVID-19 pandemic on the worsening of the mental health and quality of life in people living with Parkinson's disease.

Methods: 463 individuals with confirmed PD diagnosis mean age of 67.2 years (SD=9.5), in stage 1 – 3 of disease evolution according to Hoehn and Yahr classification, living in 14 different cities representative of 5 different geo-economic regions, participated in the present study. After presenting the informed consent form, and expressing agreement to participate in the study, participants were asked to answer, through telephone interviews, a previously established questionnaire that investigates: (1) general information; (2) socio-economic status; (3) information associated with PD; (4) quality of life worsening; (5) health conditions related to COVID-19; (6) mental health worsening; (7) fear of falling; (8) level of physical activity; (9) cognitive health conditions and (10) motor and non-motor aspects of daily life experience. The participants were divided into two groups, according to their self-reported physical activity profile: PA group (PAG) with 327 participants, and no PA group (NPAG), with 136 participants. The comparison in  worsening severety of the mental health  and quality of life between the two groups (PAG and NPAG), was analyzed by ANOVA one-way.

Results: The groups were comparable in clinical aspects. The ANOVA showed a significant statistical difference between the groups for mental health worsening;  (F1, 461=5.95, p=.015, ES= .78), and quality of life worsening (F1, 461=8.1, p=.004, ES= .81). The Tukey post-hoc confirmed  a more  severe worsening of the mental health  and quality of life  for NPAG in comparison to  PAG. Besides, mental health worsening  and quality of life worsening was directly correlated (R=.49; p<.0001).

Conclusion(s): The interruption in PA due to physical distancing during the COVID19 pandemic caused more severe worsening in mental health condition and quality of life in people living with PD. Further  studies should investigate feasible and effective strategies to guarantee PA maintenance at home for this frail population, probably by telehealth.

Implications: The enlargement  of telehealth to avoid the interruption in PA is an urgent physical therapy service demand in order to reduce the impact of decreased PA on physical and mental health in people living with PD in all the world. That is particularly challenging for in-development countries where the remote access to patients is limited.

Funding, acknowledgements: This study is part of the activities of FAPESP Research, Innovation and Dissemination Center for Neuromathematics (grant #2013/ 07699-0, FAPESP).

Keywords: Physical activity, Physical distancing, Mental health

Topic: Neurology: Parkinson's disease

Did this work require ethics approval? Yes
Institution: Faculty of Medicine of the University of São Paulo
Committee: Ethics Committee of the General Hospital of FMUSP
Ethics number: 67388816.2.0000.0065

All authors, affiliations and abstracts have been published as submitted.

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