Negative Effects of COVID-19 Stay-at-Home Mandates on Physical Intervention Outcomes: A Preliminary Study

Abstract

Background: Due to the COVID-19 pandemic, beneficial physical intervention classes for individuals with Parkinson’s disease (PD) were cancelled. Objective: To understand effects of the COVID-19 stay-at-home mandate and the inability to participate in recommended and structured physical interventions as a consequence of these mandates, specifically designed mobile assessments were used that collected both self-reporting information and objective task-based metrics of neurocognitive functions to assess symptom changes for individuals with PD. Methods: Self-reporting questionnaires focusing on overall quality of life (e.g., when individuals typically feel at their best, changes in activity levels, and symptom progression) were given to all individuals (n = 28). In addition, mobile-based neurocognitive assessments were administered to a subset of the population (n = 8) to quantitatively assess changes due to COVID-19 restrictions. Results: The highest self-reported factors in which individuals denoted feeling their best were after exercise (67.86%) and being in a comfortable and supportive environment (60.71%). Objective measures found overall duration of physical activity during the stay-at-home mandate decreased significantly (p = 0.022). With the lack of overall activity, 82.14%of individuals self-reported having at least one symptom that worsened moderately or higher. Further testing, using mobile-based assessments, showed average completion times of functional tasks increased, taking about 2.1 times longer, while accuracy metrics showed overall degradation. Conclusion: Although the COVID-19 stay-at-home mandate was intended to help protect individuals at high risk from coming into contact with the virus, it also prevented individuals from receiving recommended supervised exercise interventions resulting in significant negative effects in social well-being and across motor and speech neurocognitive tasks for individuals with PD.

Worsened Parkinson’s Disease Progression: Impact of the COVID-19 Pandemic

“…As physical daily activities and other contributing factors have not been measured in these patients, the study does not prove a causal link between confinement-dependent factors such as psychiatric status, activity level and worsened progression in PD. There is, however, evidence from qualitative studies suggesting an interrelation between physical activity and disease progression [14,17,19] and quantitative evidence that physical activity was significantly decreased during the stay-at-home mandate in PD-patients [5].…”

“…Additionally, data shows that COVID-19-dependent restrictions have negative effects on mental health [3] besides correlative evidence showing a worsening of non-motor features and potentially exacerbated motor symptoms in PD [4]. Further, a recent pilot study including mobile assessments to collect self-report data showed that it was physical activity that led to highest self-satisfaction in PD-patients during COVID-19 restrictions [5].…”

New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review

“…Moreover, the marked disturbances in the sleep/wake circadian rhythm as well as the behavioral changes in the home confinement period, determined the progressive decline in quality of lifestyle, satisfaction and mental wellbeing as affective disorders with depression, sadness, anxiety and feelings of loneliness that reflected lack of socialization from organized communities to emotional rehabilitation programs [40,41]. In addition to COVID-19 as a secondary stressor to the primary stressor, cognitive dysfunction, negative emotions, frustration and mental disorders had been exacerbated.…”

“…In a preliminary study on the stay at home mandate, a self-questionnaire was carried out with 36 patients by mobile based-neurocognitive assessment with PD, of which 53.6% were female and 46.4% were male, regarding physical activity/week, number of active days and average time allocated for physical exercise. Motor and neurocognitive patterns were quantified and performed by using the scales: MTA, MCA, NFI, SWCT and MMSE, which found decreases in motor skills, speech neurocognitive tasks and wellbeing life quality in approximately 80% of the patients with PD [40].…”

“…Motor and non-motor symptoms are related to PA in PD patients; PA involves a decrease in symptoms by 50% for PD patients [40]. PA influences mental wellbeing [41] by improving mood and physical health.…”