Unsupervised Walking Activity Assessment Reveals <scp>COVID</scp>‐19 Impact on Parkinson's Disease Patients

Vila-Viçosa, Diogo; Clemente, Ana Cristina Fernandes; Pona‐Ferreira, Filipa; Leitão, Mariana; Bouça‐Machado, Raquel; Kauppila, Linda Azevedo; Costa, Rui M.; Matias, Ricardo; Ferreira, Joaquim J.

doi:10.1002/mds.28514

Cited by 5 publications

(18 citation statements)

References 7 publications

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“…Pneumonia, another marker of disease progression ( 18 ), could be a direct consequence of motor impairment after a major injury [e.g., a fracture ( 31 )] and/or due to the reduction of primary care contacts ( 32 ). Some empirical data consistently show a reduction in the daily walking activity during the confinement period compared to the pre-confinement period ( 33 ), the reduction in the amount, duration, and frequency of exercise ( 34 , 35 ) and physiotherapy ( 20 ) in people with PD, with possible subjective and objective worsening of both motor and non-motor features ( 20 , 34 , 36 – 39 ).…”

Section: Discussionmentioning

confidence: 99%

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

et al. 2022

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BackgroundThe indirect impact of the COVID-19 epidemic on major clinical outcomes of people with Parkinson's disease (PD) or other parkinsonism is unknown.ObjectivesThe study aimed to (1) describe changes in healthcare services during the first epidemic bout in people with PD or parkinsonism; (2) compare the occurrence of hospitalization for any PD-related major clinical outcomes in 2020 with 2019; (3) investigate the factors, including changes in healthcare services, associated with major clinical outcomes and death.MethodsAll healthcare services of the province of Bologna and major clinical outcomes were assessed through a record linkage study (ParkLink Bologna) using clinical data and health databases. Same analyses were performed in a random cohort of controls matched for age, sex, district of residence, and comorbidities with the ParkLink cohort (ratio of 1:10).ResultsA cohort of subjects with PD (759) or other parkinsonism (192) was included together with a cohort of controls (9,226). All indicators of healthcare services dropped at least below 50% during the lockdown period in all cohorts, mostly impacting physiotherapy in people with PD (−93%, 95% CI 88–96%). In 2020, compared to 2019, a three-fold risk of major injuries (RR 3.0, 95% CI 1.5–6.2) and infections (RR 3.3, 95% CI 1.5–7.2), excluding COVID-19, was observed only in people with PD, and neither in people with parkinsonism nor in controls. Decreased physiotherapy was associated with the occurrence of at least one major clinical outcome (OR 3.3, 95% CI 1.1–9.8) in people with PD. Experiencing at least one major clinical outcome was the strongest risk factor for death (OR 30.4, 95% CI 11.1–83.4) in people with PD.ConclusionsDuring the first COVID-19 epidemic peak, healthcare services were drastically reduced in a province of northern Italy, regardless of the disease condition. However, compared to 2019, in 2020, only people with PD had a higher risk of major clinical outcomes, that were associated with higher mortality. Strategies to maintain physical activity in people with PD should be implemented in possible future health emergencies.

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Section: Discussionmentioning

confidence: 99%

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

et al. 2022

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“…However, compared to previous cohorts, physical activity in the present cohort was considerably lower (Mantri et al 2018(Mantri et al , 2019, which may partially reflect the impact of current public health restrictions, with several patients representing recent retirees or otherwise experiencing significantly impaired engagement in activities outside their residential place. Accordingly, the impact of the COVID-19 pandemic and associated lockdowns in PD has been recently quantified in the country, whereby the COVID-19 confinement translated into significantly decreased mobility (walking minutes/day) among PD patients (Vila-Viçosa et al 2021). Likewise, the COVID-19 lockdown has also been recently shown to lead to a dramatic reduction in physical activity as assessed by PASE scores among older adults (Huber et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Distinct gait dimensions are modulated by physical activity in Parkinson's disease patients

et al. 2022

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Parkinson's disease (PD) is the fastest growing neurodegenerative disease, but disease-modifying or preventive treatments are lacking. Physical activity is a modifiable factor that decreases the PD risk and improves motor symptoms in PD. Understanding which dimensions of gait performance correlate with physical activity in PD can have important pathophysiological and therapeutic implications. Clinical/demographic data together with physical activity levels were collected from thirty-nine PD patients. Gait analysis was performed wearing seven inertial measurement units on the lower body, reconstructing the subjects' lower body motion using 3D kinematic biomechanical models. Higher physical activity scores were significantly correlated with MDS-UPDRS part III scores (r = − 0.58, p value = 9.2 × 10 −5 ), age (r = − 0.39, p value = 1.5 × 10 −2 ) and quality-of-life (r = − 0.47, p value = 5.9 × 10 −3 ). Physical activity was negatively associated with MDS-UPDRS part III scores after adjusting for age and disease duration (β = − 0.08530, p value = 0.0010). The effect of physical activity on quality-of-life was mediated by the MDS-UPDRS part III (62.10%, 95% CI = 0.0758-1.78, p value = 0.022). The level of physical activity was correlated primarily with spatiotemporal performance. While spatiotemporal performance displays the strongest association with physical activity, other quality-of-movement dimensions of clinical relevance (e.g., smoothness, rhythmicity) fail to do so. Interventions targeting these ought to be leveraged for performance enhancement in PD through neuroprotective and brain network connectivity strengthening. It remains to be ascertained to which extent these are amenable to modulation.

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“…It was found that 103 PD patients reported four main problems in the first Italian lockdown: 1. fear of contracting corona, 2. reduction of physical activity, 3. not being able to access support services and clinics and 4. reduction of socialization [ 148 ]. There was an objective reduction of physical activity, measured by a smartphone application, as most PD patients failed to meet 30 min of activity per day [ 149 ]. This was aggravated further in 44% during confinement [ 149 ].…”

Section: Chaptermentioning

confidence: 99%

“…There was an objective reduction of physical activity, measured by a smartphone application, as most PD patients failed to meet 30 min of activity per day [ 149 ]. This was aggravated further in 44% during confinement [ 149 ]. It is well known that physical activity and training is an important treatment strategy in PD to maintain motor functions and independence, so the deprivation of physical activity during a lockdown can be suspected to lead to symptom progression and loss of independence [ 149 ].…”

Section: Chaptermentioning

confidence: 99%

Can SARS-CoV-2 Infection Lead to Neurodegeneration and Parkinson’s Disease?

et al. 2021

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The SARS-CoV-2 pandemic has affected the daily life of the worldwide population since 2020. Links between the newly discovered viral infection and the pathogenesis of neurodegenerative diseases have been investigated in different studies. This review aims to summarize the literature concerning COVID-19 and Parkinson’s disease (PD) to give an overview on the interface between viral infection and neurodegeneration with regard to this current topic. We will highlight SARS-CoV-2 neurotropism, neuropathology and the suspected pathophysiological links between the infection and neurodegeneration as well as the psychosocial impact of the pandemic on patients with PD. Some evidence discussed in this review suggests that the SARS-CoV-2 pandemic might be followed by a higher incidence of neurodegenerative diseases in the future. However, the data generated so far are not sufficient to confirm that COVID-19 can trigger or accelerate neurodegenerative diseases.

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Unsupervised Walking Activity Assessment Reveals COVID‐19 Impact on Parkinson's Disease Patients

Cited by 5 publications

References 7 publications

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

Distinct gait dimensions are modulated by physical activity in Parkinson's disease patients

Can SARS-CoV-2 Infection Lead to Neurodegeneration and Parkinson’s Disease?

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