Perception of COVID-19 Pandemic by Brazilian People With Parkinson's Disease and Multiple Sclerosis.

COVID-19 in Brazil is threatening, and it has forced the government to adopt partial lockdown as a strategy to stop the spread of the virus in the first wave of pandemic (March 2020). These preventive measures during the COVID-19 pandemic may affect the motor and non-motor symptoms in people with Parkinson's disease (PD) and Multiple sclerosis (MS). Thus, the purpose of this study was to investigate the perception during the first wave of COVID-19 pandemic lockdown on motor and non-motor symptoms, and also measure physical activity level, quality of life, and sleep quality in Brazilian people with PD and MS. One hundred and fifty-three participants (PD-97 and MS-56) answered an online survey to identify the perception of motor and non-motor symptoms, and characterize the physical activity level, and quality of life and sleep in these neurological Brazillian population. During the beginning of pandemic lockdown in Brazil, our results indicated that 69% of people with PD and 55% of people with MS reported worse on motor aspects and lower amount of physical activity performed. Also, 75.2% (PD) and 92.9% (MS) of our cohort were considered inactive or sedentary. Based on the perception and behavior of the population studied, people with PD and MS should be encouraged to perform more physical activity in order to reduce the effects of isolation in motor and non-motor aspects of the diseases. Teleinterventions, such as home-based exercise, should be included in the new routine of people with PD and MS to reduce the impacts of lockdown and to maintain quality of life at a good level.

Ankle muscle fatigability impairs body sway for more than 24 h.

This study aimed to investigate if the impairing in postural control, induced by ankle fatiguing exercise, remains after 24/48 h in young adults. Center of Pressure (CoP) was assessed in 16 participants (23 ± 3 years old) before, immediately after an ankle fatigability induction protocol (FI) and after 24 or 48 h of recovery using two 60-s trials with eyes open (EO) and closed (EC). The FI consisted of performing the ankle plantar flexion and dorsiflexion movement repeatedly (0.5 Hz). Ankle muscle fatigability increased CoP anterior-posterior (AP - p < 0.02) and medial-lateral (ML - p < 0.009) root mean square (RMS), and AP (p < 0.01) mean velocity immediately after compared to before FI. These effects remained after 24/48 h of recovery: higher CoP AP (p < 0.03) and ML (p < 0.009) RMS. No significant effects for detrend fluctuation analysis and entropy analysis among periods of postural evaluations was found. Fatigue*visual condition interaction revealed an increased AP median frequency (p < 0.001) during EC compared to EO only immediately after FI. Young adults' body sway remains impaired until 48 h, but not the postural control adaptability and complexity. Visual information may not attenuate the late deleterious ankle muscle fatigability effects. Individuals should be cautious during balance tasks and exercise after fatiguing exercise in the next 24/48 h, therefore avoiding unbalances and falls.

Cortical activity and gait parameter characteristics in people with multiple sclerosis during unobstructed gait and obstacle avoidance.

BACKGROUND: People with Multiple Sclerosis (PwMS) present higher cortical activity during walking. However, the cortical activity during gait while avoiding an obstacle is still not clear. OBJECTIVE: To investigate cortical activity and gait spatial-temporal parameters in PwMS during two different gait tasks (i.e., unobstructed and obstacle avoidance). METHOD: Fifteen PwMS and 15 healthy controls (CG) were recruited. Participants performed ten trials in each gait condition, wearing a 64-electrode cap electroencephalogram (EEG) at 1024 Hz. Kinematic data were obtained through 10 Vicon® cameras at 200 Hz. EEG was analyzed through four cortical areas (frontal, motor, parietal, and occipital cortex areas) and five frequency bands (delta, theta, alpha, beta, and gamma) obtained through the power spectral density. In addition, spatial-temporal gait parameters (e.g., step length and velocity) were measured. Two-way ANOVA (group x gait condition) and MANOVA (group x gait condition) were used to compare gait and EEG parameters, respectively. One-way ANOVA was used to compare groups in the crossing phase of the obstacle avoidance condition. RESULTS: PwMS presented lower step length and velocity, and higher cortical activity in frontal (beta and gamma) and parietal (gamma) cortical areas in both gait conditions compared to CG. Moreover, PwMS presented increased cortical activation (frontal and parietal) and decreased step length and velocity in obstacle avoidance compared with unobstructed gait. In addition, PwMS required more cortical resources (frontal and parietal) than CG to accomplish both gait conditions. During the obstacle avoidance task, it was further observed that PwMS positioned their feet closer to the obstacle, before and after the task, compared to CG. CONCLUSION: PwMS demand higher cortical resources to accomplish gait tasks, mainly when it is necessary to negotiate an obstacle in the pathway. This higher cortical activity may be a compensatory mechanism to deal with damage in subcortical structures caused by multiple sclerosis.