O impacto do isolamento social, devido a pandemia de covid-19, no desempenho funcional, risco de queda e marcha em pessoas com a doença de parkinson: uma revisão sistemática

Abstract

Parkinson's Disease (PD) is a progressive neurodegenerative condition, characterized by motor symptoms such as tremors, rigidity, and bradykinesia, which are often worsened by the reduction in regular physical activity, essential for maintaining motor function. During the pandemic, social distancing measures significantly reduced physical activity levels, which may have contributed to the worsening of these symptoms. The aim of this study was to evaluate the literature on the impact of social isolation during the COVID-19 pandemic on the deterioration of motor symptoms in patients with Parkinson's Disease. This systematic review was previously registered with the PROSPERO protocol (CRD42022369245). Searches were conducted in Embase, PubMed, Scopus, Web of Science, and the Cochrane Library. Keywords and synonyms related to Parkinson's Disease and the COVID-19 Pandemic were used in the search through the combination of Boolean operators. Eligibility criteria for the studies were defined based on the population of interest, exposure to social isolation, and observed motor outcomes. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Tools. After screening 1,534 studies, 34 articles were included in this systematic review, including 23 cross-sectional studies, 7 prospective longitudinal studies, 3 retrospective longitudinal studies, and 1 single-center qualitative study. Due to the social isolation restrictions, there was a reduction in physical activity levels. Consequently, there was a worsening of motor symptoms such as tremors, imbalance, bradykinesia, affecting functional performance, with increased fall risk and worsened gait. The methodological quality was classified as moderate to high in most studies. Social isolation and the consequent reduction in physical activity levels during the COVID-19 pandemic exacerbated motor symptoms in patients with Parkinson's Disease, highlighting the need for strategies to reduce this impact.