ABSTRACT
Introduction: Restrictions aiming to slow down the spread of COVID-19 had consequences on the amount and content of physical activity in persons with multiple sclerosis (PwMS). Objectives & Aims: To investigate the impact of the COVID-19 pandemic on physical activity in PwMS. Method(s): An online survey was distributed during May - July 2021 in 11 countries. The survey gathered various metrics of physical activity (e.g. type, intensity, use of technology) performed prior to (2019) and during the pandemic (2021). Factors associated with stopping physical activity were also investigated. Result(s): The survey was completed by 3725 PwMS. Prepandemic 83% of the respondents reported being physically active, whereas during the pandemic 75% reported being physically active. Concern of contracting COVID-19 and loss of support were highly predictive factors associated with stopping physical activity. The decrease in physical activity was significant for both moderate and high intensity physical activity (p<.0001). Prior to the pandemic, 66% of the respondents reported physical activity behaviour indicating that they met the physical activity guidelines, while during the pandemic the respondents meeting the physical activity guidelines was 50%. The proportion of respondents meeting the guidelines decreased with increasing disability (Pre/during-pandemic: mild: 64%/ 55%;moderate: 52%/ 43%;severe: 39%/ 30%). Walking was the most frequent activity pre-pandemic (27%) and during the pandemic (33%). Of the 25% respondents who were inactive during the pandemic, 31% reported no interest in changing their physical activity behaviours, and 44% expressed a preference for a face-to-face format to conduct physical activity after the pandemic. During the pandemic, the most used technology (24%) were wearables (e.g. smart watch). Conclusion(s): Physical activity was reduced in PwMS from before to during the pandemic. Concerns of contracting COVID-19 and a loss of support were highly associated with reduced physical activity. There is a need to support PwMS aiming to increase physical activity. Physical activity programmes which address walking (the most frequent), disability and the use of wearable technology may be preferable.
ABSTRACT
Introduction: The COVID-19 pandemic has placed a strain on healthcare services worldwide with a highly heterogeneous impact. Therefore, the Special Interest Group for Mobility (SIG Mobility) of the European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation (RIMS) decided to examine the impact of the COVID-19 outbreak on physiotherapy services in people with multiple sclerosis (pwMS). Objective(s): To describe the impact of the pandemic on physiotherapy practice from the perspective of physiotherapists (PTs) by investigating changes in rehabilitation methods, organizational framework, and technology usage. Method(s): An online survey was developed by RIMS SIG Mobility and distributed to PTs in 9 countries (Australia, Belgium, Czech Republic, Ireland, Israel, Italy, Norway, Spain, and Turkey) from December 2020 to July 2021. Result(s): 215 PTs participated in the study. The therapy most affected during the pandemic was aerobic training/conditioning exercises;33.5% reported that these activities were either reduced or unavailable. In contrast, 15% reported increased use of relaxation/ mind-body techniques and/or fatigue management programs. Frequency, total number, and duration of sessions decreased significantly during the pandemic compared to before the pandemic (p<0.001). Physiotherapy service delivery (accessibility) and effectiveness for pwMS were significantly decreased (p<0.001). There was a 10% decrease in the use of hands-on techniques and a 10% increase in the use of oral instructions when treating pwMS having moderate or severe disability during the pandemic compared to before. PTs increased use of telerehabilitation applications during the pandemic (p<0.001): app usage increased significantly from 37% to 56%, use of recorded videos from 38% to 55%, use of physiotherapy exercise websites from 33% to 52%, and use of exercise classes on TV from 7% to 20%. The top 4 challenges faced in telerehabilitation were limitations of assessment (54%), difficulties with equipment (43%), difficulties with understanding the patient's body language (35%), and not being able to use proprioceptive cues (35%). Conclusion(s): The COVID-19 pandemic has notably affected physiotherapy services for pwMS internationally in terms of content, frequency of use, format, accessibility, and effectiveness. The long-term consequences of these changes should be investigated.
ABSTRACT
Introduction: The general recommendation of health regulatory authorities worldwide is that people with MS (PwMS) should be vaccinated for Covid-19. However, no data has been documented as to how the MS population has responded to this recommendation. Objective: In this special report, we present novel information as to the compliance, beliefs and attitudes towards Covid-19 vaccines in PwMS. Methods: Following an online educational programme including updated information on the Covid-19 infection and the administration of the vaccination to PwMS, an open online survey of 14 questions was distributed. The survey was open for a 25-day period during January 2021. The participants reported if they had been or are presently infected with Covid-19. If yes, participants were asked to report the severity and length of the symptoms. If no, they were asked to report if they had received or intended to receive the Covid-19 vaccine. Additional questions focused on their decision to receive or not receive the vaccine. Only completed questionnaires were analyzed. Results: The sample included 204 PwMS;63.6% were females with a mean age of 45.5 (S.D.=14.0). Ten patients have been infected and 2 were hospitalized due to the virus. Regarding the Covid-19 vaccine, 37.1% (n=72) responded that they had already been vaccinated;122 who had as yet not been vaccinated, 70.5% (n=86) replied that they were planning to receive the vaccine. Thirty-six (29.5%) PwMS responded that they did not intend to take the vaccine. Major reasons for Covid-19 vaccination refusal were fear of disease worsening and/or MS relapse (n=14), and doubts that the vaccine was safe or beneficial (n=6). Nevertheless, 79.5% (29/36) reported that in the event of obtaining new medical information on the efficacy of the vaccine or a recommendation by their treating neurologist, they would reconsider and agree to be vaccinated. Seven (out of 36, 20.5%) responded that they were determined not to receive the Covid-19 vaccine, irrespective, of any advice. Conclusions: We suggest that medical professionals involved in MS patient care, also be involved in Covid-19 related educational programs, specifically, on the issue of vaccination. The ability to enhance patient's knowledge, behaviors, and attitudes can certainly produce a change and increase patient compliance, confidence and receptivity to receive the Covid-19 vaccine and prevent health complications caused by this destructive virus.