RESUMEN
Multiple sclerosis (MS) is a chronic autoimmune neurodegenerative disease. This disease can manifest itself in many different neurological symptoms such as (gait and balance impairment, sensory deficits, muscle weakness, spasticity, bladder impairment, fatigue, cognitive impairment etc.). For successful disease management not only pharmacological treatment is important, but also a healthy lifestyle including regular physical activity. However, pandemic restrictions limited access to sport facilities and together with home-office regimen, increased the sedentary behaviour in all population. The pandemic level of physical activity in people with MS in the Czech Republic remains unclear. Therefore, using an online cross-sectional survey we aimed to evaluate physical activity (PA) level in people with MS during Covid-19 pandemic. Two hundred ninety-seven persons with MS filled out online survey, 83 % women, with a mean age 43.7 years (SD 11.3). Most respondents had mild to moderate disability (74 %). During pandemic year 2020, 23 % persons with MS ceased their PA, 18 % reduced their PA, 25 % continued their PA as before, 11 % increased their PA, and 20 % did not perform any PA in the past and did not do so during the pandemic. Aerobic activity was the main type of performed PA, followed by health exercise and yoga. Total of 37 % people reported that their fitness level had decreased during the pandemic. © Masaryk University. All Rights Reserved.
RESUMEN
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.
RESUMEN
Introduction: During the Covid-19 pandemic, the provision of rehabilitation care to people with MS was significantly reduced (in addition, many patients were afraid to visit medical and sports facilities). An alternative (in these cases) could be telerehabilitation (ie the provision of rehabilitation services at a distance). The aim of our pilot study was to evaluate the feasibility of this form of rehabilitation in people with MS with balance disorders. Method(s): Our pilot study included 20 patients with MS with balance disorders. The intervention lasted 12 weeks. The experimental group underwent individual telerehabilitation (twice a week, 45 individual telerehabilitation), which consisted of balance and strength exercises with a physiotherapist, using the Homebalance system and other simple tools). The control group received regular rehabilitation care (outpatient individual physiotherapy). Functional tests were selected to assess the gait and balance disorders: Timed Up and Go (TUG), TUG with dual cognitive task and Berg Balance Scale (BBS). Subjective perceptions of gait, balance and fatigue disorders were evaluated with standardized questionnaires: Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), Falls Efficacy Scale International (FES-I), Activity Balance Confidence Scale (ABC Scale ). Result(s): The mean age of participants was 51 years (34-65 years), with the mean disease duration was 17 years (4-29 years) with a median neurological disability EDSS 5 (3-6.5). There was a significant improvement in the experimental group in the functional mobility test-TUG (p=0.048), balance-BBS (p=0.002) and in the standardized ABC Scale questionnaire (p=0.041). Conclusion(s): The results of the pilot study suggest that individual telerehabilitation could be an alternative to routine rehabilitation care for the treatment of balance and mobility disorders in patients with MS (suitable, for example, for people with a more distant place of residence or in case of new pandemic restrictions).