Objective: To examine changes in PD-patient reported outcomes during the COVID19 pandemic and the influence of changes in PA over the same period

Background: Exercise interventions have been shown to improve motor symptoms in PD. The COVID19 pandemic presented numerous challenges that could affect symptom progression in chronic conditions like PD. In particular, closure of gyms, group exercise classes and further limitations imposed by social distancing guidelines made it more difficult to exercise. Here, we examine changes in PD-patient reported outcomes during the COVID19 pandemic and the influence of changes in PA using a previously validated patient reported outcome scale (PRO-PD)(1)

Method: CAM Care PD’ is an ongoing internet-based natural history study attempting to identify modifiable variables associated with rate of PD progression(1). We analyzed paired data from 326 subjects who completed an assessment during the COVID19 pandemic and another within the prior 2 years (mean 1.1yr). PA was reported as days/week exercising more than 30 minutes. For group comparisons and visualization (Figure 1) we binned activity changes as decreased, stable (same level reported on both assessments) or increased. Relationships between changes in outcome variables (PRO-PD total, motor and nonmotor(NMS)) and changes in PA were assessed in linear regression models controlling for age, sex, disease duration, income, intra-assessment duration and baseline PRO-PD and activity.

Results: The cohort was comprised of 58% women. Mean(SEM) age and disease duration were 65.4(0.5) and 6.8(0.8) years, respectively. Average annualized change (worsening) in PRO-PD was 70(13) points, more than double the published historical average of 33 points(1). Worsening of PRO-PD was not significantly associated with age, disease duration, sex, income or education in multivariate models. Change in PA was significantly associated with change in PRO-PD total (beta, SEM; -27.3, 8.5, p=0.001), PRO-PD motor (-11.0, 3.4, p=0.001) and PRO-PD NMS (-13.1., 5.5, p=0.18) in linear regression models.

Conclusion: Worsening of PD patient reported outcomes was greater than historical averages during the COVID-19 pandemic. Stable or increased PA was associated with less worsening of motor and non-motor symptoms. Strategies to increase PA during the COVID19 pandemic and beyond are important to improve patient outcomes in PD.

References: 1) Mischley LK, Lau RC and Weiss NS. (2017) npj Parkinson’s Disease. 3:20

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MDS Abstracts - https://www.mdsabstracts.org/abstract/maintenance-of-physical-activity-pa-mitigates-worsening-of-patient-reported-outcomes-in-parkinsons-disease-pd-during-the-covid-19-pandemic/