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

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

doi:10.3389/fneur.2021.699884

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

Front Neurol. 2021 Aug 27:12:699884. doi: 10.3389/fneur.2021.699884. eCollection 2021.

Authors

Tom E Nightingale^{1

2}, Nicola R Heneghan³, Sally A M Fenton^{1

4}, Jet J C S Veldhuijzen van Zanten^{1

4}, Catherine R Jutzeler^{5

6}

Affiliations

¹ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
² International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
³ Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
⁴ Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, United Kingdom.
⁵ Department of Biosystems Science and Engineering, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland.
⁶ SIB Swiss Institute of Bioinformatics, Ecublens, Switzerland.

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.

Keywords: SARS-CoV-2; exercise; mental health; neurological disorders; pandemic; well-being.