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Título

Effects of telehealth on sleep and physical activity level in patients with parkinson’s disease during the pandemic

Resumo

Introduction: Telemedicine allows Parkinson’s Disease (PD) patients to overcome physical barriers of access to health care services and increases accessibility for people with mobility impairments. Studies have shown similar effectiveness of virtual consultations versus face-to-face appointments for the management of PD symptoms. Objective: This study aims to evaluate the feasibility of telehealth activity in the follow-up of patients with PD, focusing on its effects on sleep and physical activity level. Methods: This study was performed at a Neurology Outpatient Clinic in Fortaleza, from May 1st to December 31st, 2020. Inclusion criteria were PD diagnosis and consultation in the clinic in the last 12 months and exclusion criteria were non-adherence to consultations and lack of technology for communication. All participants signed a consent form. During the study, patients participated in a teleconsultation, answered to 3 questionnaires- Pittsburgh PSQI Quality Index; Epworth Sleepiness Scale; and International Physical Activity Questionnaire- Short Form (IPAQ-SF)- and received health education advice, such as on healthy eating, sleep hygiene, fall prevention and encouragement on doing physical activity at least 30 minutes 3 times per week. After 15 days, calls were made to reinforce the recommendations and, after 45 days, the 3 questionnaires were reapplied. Results: A total of 107 patients participated, 58.9% were male. The mean age was 65 and mean disease duration was 10 years. 8.6% of the patients were attending physical therapy sessions; 25.7% were engaged in physical activity at least 30 min 3 times per week; and 36.5% needed walking aids. Perceived functional decline and worsening parkinsonian symptoms during the pandemic were reported for 32.7% of the patients. Baseline IPAQ-SF classification was as follows: 41.4% sedentary; 10.3% insufficiently active A; 9.2% insufficiently active B; 34.5% active; and 4.6% very active. There were improvements in three PSQI components: perceived sleep duration, sleep disorders and daytime sleep disturbance with an average of 1.7, 2.3 and 1.7 respectively. As for the level of physical activity, there was an increase in the number of days of walking and the number of days of moderate activities for at least 10 continuous minutes. Conclusion:This telehealth intervention promoted positive effects on sleep and on physical activity level of PD patients and may have greater benefits in longitudinal application.

Palavras Chave

Parkinson Disease; Telemedicine; COVID-19