Isolation Related to the COVID-19 Pandemic in People Suffering from Parkinson's Disease and Activity, Self-Assessment of Physical Fitness and the Level of Affective Disorders.

BACKGROUND: Staying at home for long periods and limiting various types of activities and social contacts due to the COVID-19 pandemic may have negative consequences for health. This is especially true for people suffering from chronic diseases, in whom an appropriate level of activity and social contacts delay the progress of the disease. This group includes people diagnosed with Parkinson's disease-PD. AIM: It was decided to investigate the effect of COVID-19 isolation related to self-assessment of physical fitness, physical activity, and the level of anxiety and depression in people with PD. METHODS: The study included 30 patients diagnosed with Parkinson's disease. We compared the results of the pre-pandemic questionnaire and the telephone interview with the same questions-after the period of isolation due to COVID-19. The questionnaire included questions about physical activity and fitness self-assessment. The level of affective disorders was tested using HADS. RESULTS: There was a statistically significant decrease in the physical activity of the respondents after isolation related to COVID-19 (p < 0.05). Self-assessment of physical fitness also decreased, but the differences were not statistically significant. In the post-isolation study, only 50% of the respondents had normative values for anxiety and only 40% for depression. The analysis showed that the level of physical activity-the independent variable, explains anxiety in 30% and depression in 27%. CONCLUSIONS: Pandemic isolation has significantly reduced physical activity in PD patients. There was a certain drop in the self-esteem of physical fitness in these people. Physical fitness is an important predictor of preventing the affective disorders of anxiety and depression. The effects of isolation due to COVID-19 require further research.

Kinesiophobia in Stroke Patients, Multiple Sclerosis and Parkinson's Disesase.

BACKGROUND: Stroke (S), multiple sclerosis (MS), Parkinson's disease (PD) are chronic neurological diseases that are a challange for public health and represent a real social problem. Physical activity (PA) improves functional performance, reduces various symptoms in PD and MS, in stroke- reduced neurological impairment of patients and provides a chance for independence. One of the main obstacles in successful rehabilitation is patients' movement passivity. The reason might be the psychological aspects, in particular fear of movement-kinesiophobia. Aim: To determine how many patients with S, MS, and PD suffer from kinsiophobia and what factors influence this process. METHODS: Fifty patients after stroke, eighty one MS patients and sixty one PD patients were consecutively recruited from hospital and outpatients clinics. The sociodemographic data, self- assesment of fitness, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK) and The Modified Baecke Questionnarie for Older Adults for physical activity were collected. A score >37 was considered to indicate a high level of kinesiophobia according to the TSK. RESULTS: High level of kinesiophobia was shown in 66.67% of the subjects. TSK medians in particular illnesses were above the cut-off score and amounted: S-42.50 points; MS-38 points; PD-42.00 points. Regression showed 15% of fluctuation of variance (R2 = 0.1498; p < 0.0001), where regression factor showed: for mobility self-assessment: b = -0.2137 and for the age b = 0.0065. CONCLUSIONS: Kinesiophobia among the patients suffering from S, MS and PD concerns most of the subjects. Predictors of kinesiophobia are: limitations connected with functioning and age. The meaning of kinesiophobia in neurological disorders requires further research.

Effectiveness of 6-Week Nordic Walking Training on Functional Performance, Gait Quality, and Quality of Life in Parkinson's Disease.

Background and objectives: Motor rehabilitation improves physical mobility and quality of life in Parkinson's disease (PD). As specialized rehabilitation is expensive and resource-consuming, there is a need for simpler, cost-effective methods. The purpose of the study was to determine whether Nordic Walking (NW) training may support the management of motor disability in PD. Materials and Methods: Forty patients (median age 64.0 years, range 50-75 years) with idiopathic PD, Hoehn and Yahr stages II-III, were randomly assigned to NW or standard rehabilitation (SR) programs, comprising twelve rehabilitation sessions conducted bi-weekly throughout the 6-week study period. Results: Median Unified Parkinson's Disease Rating Scale part III scores were significantly reduced with NW, by 8.5, and with SR, by 6.0 points (both p < 0.001), with significantly greater improvement with NW than with SR (p = 0.047). Gait quality and balance control, measured using the Dynamic Gait Index, improved with NW by a median of 8.0 and with SR by 5.5 points (both p < 0.001), with slightly greater improvement with NW, compared to the SR group (p = 0.064). Quality of life, assessed using the Parkinson's Disease Questionnaire (PDQ-39), improved with NW by a median of 15 and with SR by 12 points, p = 0.001 and p = 0.008, respectively. Conclusions: The 6-week Nordic Walking program improves functional performance, quality of gait, and quality of life in patients with PD and has comparable effectiveness to standard rehabilitation.

Affective Disorder and Functional Status as well as Selected Sociodemographic Characteristics in Patients with Multiple Sclerosis, Parkinson's Disease and History of Stroke.

The main arguments in support of researching anxiety and depression in patients with chronic somatic diseases are the prevalence of affective disorders in the population, somatic conditions as risk factors of affective disorders and the search for effective preventative and therapeutic strategies. The aim of the study was to determine the association between the functional status, selected sociodemographic characteristics and prevalence as well as severity of anxiety and depression in patients with multiple sclerosis (MS), Parkinson's disease (PD) and history of stroke (S). Material and methods: Eighty participants (44 women and 36 men) with MS (n = 22), PD (n = 31) and history of stroke (n = 27) were enrolled. All participants completed a questionnaire consisting of metrics, the Katz Index of Independence in Activities of Daily Living and the Hospital Anxiety and Depression Scale (HADS). Results: Fifty-five per cent of all participants did not present with anxiety or depression, 20% scored above the diagnostic threshold on the anxiety scale and 26% scored above the diagnostic threshold on the depression scale. Subgroup analysis revealed that anxiety and depression sufferers were 13.64% and 13.64% of MS patients, respectively; 22.58% and 35.48% of PD patients, respectively; and 22.22% and 25.93% of stroke survivors, respectively. There was a significant correlation between depression and independence level in the entire group and between depression and marital status in stroke survivors. Conclusions: Although depression and anxiety are highly prevalent in patients with neurological conditions, the disorder has a very individual nature and is not associated with the patient's age, duration of a condition or concomitant diseases. Screening for depression and anxiety as a part of comprehensive approach may increase treatment efficacy in neurological patients.