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

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.

Gait-Adaptability Training in People With Hereditary Spastic Paraplegia: A Randomized Clinical Trial

“…Previous research from our group showed that, during the Covid-19 pandemic, people with HSP were generally less active, 28 a phenomenon that has also been reported in other neurological populations. 29 -34 In addition, we found that the relative inactivity during the Covid-19 lockdown negatively impacted on spasticity-related symptoms, including gait and balance impairments. Because—in the current study—the first assessments took place shortly after a period of generally reduced levels of physical activity, both groups may have increased their levels of activity and exercise in such a way that the added effects of gait-adaptability training were reduced.…”

Can telehealth increase physical activity in individuals with Rett syndrome? A multicentre randomized controlled trial

“…Reduced physical activity levels, mostly associated with reduced access to facilities, have been reported in children and adults with disabilities during this pandemic. 37,38 Reduced access to services and supports during a pandemic can persist outside periods of formal lockdown, despite telehealth. 39 One study of the lived experience of parent caregivers of adults with intellectual disability identified complex challenges during the pandemic, including lack of access to professional support leading to the parent needing to provide therapy, a reduced range of available activities and equipment, contracted social networks, exacerbation of behaviour problems, time pressures on parents, and lack of respite.…”

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic

“…Moreover, positive dose–response associations were found among LPA, VPA, and QoL in children and adolescents with IDs during the COVID-19 pandemic, which is consistent with previous studies. For example, Nightingale et al ( 2021 ) found a positive association between leisure-time PA and health-related QoL in individuals with IDs during the COVID-19 pandemic. Daytime activity was also found to be positively associated with QoL in people with IDs (Simões & Santos, 2017 ).…”

“…Previous studies examined the association between PA and mental health in ID populations before and during the COVID-19 pandemic. For example, PA was positively associated with physical QoL (Mensch et al, 2019 ) and emotional and psychological well-being (Puce et al, 2019 ) in children and adolescents with IDs before the pandemic, and health-related QoL in individuals with IDs during the pandemic (Nightingale et al, 2021 ). Meanwhile, MVPA and SC are fundamental components of adolescents’ QoL.…”