Multidimensional Factors Can Explain the Clinical Worsening in People With Parkinson's Disease During the COVID-19 Pandemic: A Multicenter Cross-Sectional Trial

Carla Silva-Batista; Daniel Boari Coelho; Renato Campos Freire Júnior; Lorena Rosa Almeida; Adriana Guimarães; Katia Cirilo Costa Nóbrega; Hugo Machado Sanchez; Ana Raquel Rodrigues Lindquist; Vera Lúcia Israel; Hélcio Kanegusuku; Rachel Guimarães; Nayanne Beckmann Bosaipo; Richelma Barbosa; Clynton Lourenço Correa; Maria José Finatto; Felipe Augusto Dos Santos Mendes; Maria Elisa Pimentel Piemonte

doi:10.3389/fneur.2021.708433

Multidimensional Factors Can Explain the Clinical Worsening in People With Parkinson's Disease During the COVID-19 Pandemic: A Multicenter Cross-Sectional Trial

Front Neurol. 2021 Jul 30:12:708433. doi: 10.3389/fneur.2021.708433. eCollection 2021.

Authors

Carla Silva-Batista¹, Daniel Boari Coelho², Renato Campos Freire Júnior³, Lorena Rosa Almeida^{4

5}, Adriana Guimarães⁶, Katia Cirilo Costa Nóbrega⁷, Hugo Machado Sanchez⁸, Ana Raquel Rodrigues Lindquist⁹, Vera Lúcia Israel¹⁰, Hélcio Kanegusuku¹¹, Rachel Guimarães¹², Nayanne Beckmann Bosaipo¹³, Richelma Barbosa¹⁴, Clynton Lourenço Correa¹⁵, Maria José Finatto¹⁶, Felipe Augusto Dos Santos Mendes¹⁷, Maria Elisa Pimentel Piemonte¹⁸

Affiliations

¹ Exercise Neuroscience Research Group, University of São Paulo, Sao Paulo, Brazil.
² Biomedical Engineering, Federal University of ABC, Sao Bernardo do Campo, Brazil.
³ Faculty of Physical Education and Physical Therapy, Federal University of Amazonas, Manaus, Brazil.
⁴ Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital/SESAB, Salvador, Brazil.
⁵ Motor Behavior and Neurorehabilitation Research Group, Bahiana School of Medicine and Public Health, Salvador, Brazil.
⁶ Department of Physical Education, State University of Santa Catarina, Florianópolis, Brazil.
⁷ Department of Physiotherapy, Federal University of Amapa, Macapa, Brazil.
⁸ Physical Therapy Department, Federal University of Jataí, Jataí, Brazil.
⁹ Graduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil.
¹⁰ Department of Physiotherapy, Federal University of Parana, Curitiba, Brazil.
¹¹ Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, Sáo Paulo, Brazil.
¹² Laboratory of Neuroimaging, University of Campinas, Sáo Paulo, Brazil.
¹³ Setor de Distúrbios do Movimento e Neurologia Comportamental do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Sáo Paulo, Brazil.
¹⁴ Department of Physiotherapy, University of Pará State, Santarém, Brazil.
¹⁵ Graduate Program of Physical Education, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
¹⁶ Department of Linguistics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
¹⁷ Graduate Program in Rehabilitation Sciences, Faculty of Ceilandia of University of Brasília, Brasília, Brazil.
¹⁸ Faculty of Medical Science of University of São Paulo, Sáo Paulo, Brazil.

Abstract

Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious. Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes. Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume. Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale-parts IB and II-emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05). Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.

Keywords: mental health; motor symptoms; non-motor symptoms; physical activity; social distancing.