Top

Journal of Medical Case Reports

Published in:

01-12-2021 | Multiple Sclerosis | Case report

The impact of a coronavirus disease 2019 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

Authors: Tobias Braun, Raphael Weidmann, Jens Carsten Möller, Anissa Ammann, Detlef Marks

Published in: Journal of Medical Case Reports | Issue 1/2021

Abstract

Background

Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders, such as Parkinson’s disease or multiple sclerosis, to constantly support patients and their proxies in disease management. Due to the coronavirus disease 2019 pandemic, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders to receive prescribed rehabilitation interventions.

Case presentation

A 67-year-old White Swiss man with two chronic neurological diseases, Parkinson’s disease and multiple sclerosis, underwent a 4-week inpatient rehabilitation in our hospital. The main rehabilitation goals were related to improvements of mobility and a decrease in the risk of falls. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a coronavirus disease 2019 pandemic-related interruption of the regular ambulatory rehabilitation for several weeks during the first coronavirus disease 2019 wave in Switzerland, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a prepandemic level.

Conclusions

The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.

Aisen ML. Justifying neurorehabilitation: a few steps forward. Neurology. 1999;52:8–10. https://doi.org/10.1212/wnl.52.1.8.CrossRefPubMed

Möller JC, Schweinfurther R, Oechsner M. Parkinson-Syndrome in der Neurorehabilitation. Ther Umsch. 2017;74:489–93. https://doi.org/10.1024/0040-5930/a000946.CrossRefPubMed

Gaber TA-ZK, Oo WW, Gautam V, Smith L. Outcomes of inpatient rehabilitation of patients with multiple sclerosis. NeuroRehabilitation. 2012;30:97–100. https://doi.org/10.3233/NRE-2012-0731.CrossRefPubMed

Keus S, Munneke M, Graziano M, Paltamaa J, Pelosin E, Domingos J, et al. European physiotherapy guideline for Parkinson’s disease. The Netherlands: KNGF/ParkinsonNet; 2014.

National Institute for Health and Care Excellence. Multiple sclerosis in adults: management. Clinical Guidelines (CG 186). London: NICE; 2014.

Řasová K, Freeman J, Cattaneo D, Jonsdottir J, Baert I, Smedal T, et al. Content and delivery of physical therapy in multiple sclerosis across Europe: a survey. Int J Environ Res Public Health. 2020. https://doi.org/10.3390/ijerph17030886.CrossRefPubMedPubMedCentral

Tomlinson CL, Herd CP, Clarke CE, Meek C, Patel S, Stowe R, et al. Physiotherapy for Parkinson’s disease: a comparison of techniques. Cochrane Database Syst Rev. 2014. https://doi.org/10.1002/14651858.CD002815.pub2.CrossRefPubMedPubMedCentral

Campbell E, Coulter EH, Mattison PG, Miller L, McFadyen A, Paul L. Physiotherapy rehabilitation for people with progressive multiple sclerosis: a systematic review. Arch Phys Med Rehabil. 2016;97:141-51.e3. https://doi.org/10.1016/j.apmr.2015.07.022.CrossRefPubMed

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.CrossRefPubMedPubMedCentral

10.

Pepe E, Bajardi P, Gauvin L, Privitera F, Lake B, Cattuto C, Tizzoni M. COVID-19 outbreak response, a dataset to assess mobility changes in Italy following national lockdown. Sci Data. 2020;7:230. https://doi.org/10.1038/s41597-020-00575-2.CrossRefPubMedPubMedCentral

11.

Sabat I, Neuman-Böhme S, Varghese NE, Barros PP, Brouwer W, van Exel J, et al. United but divided: policy responses and people’s perceptions in the EU during the COVID-19 outbreak. Health Policy. 2020. https://doi.org/10.1016/j.healthpol.2020.06.009.CrossRefPubMedPubMedCentral

12.

Prvu Bettger J, Thoumi A, Marquevich V, de Groote W, Rizzo Battistella L, Imamura M, et al. COVID-19: maintaining essential rehabilitation services across the care continuum. BMJ Glob Health. 2020. https://doi.org/10.1136/bmjgh-2020-002670.CrossRefPubMedPubMedCentral

13.

Der Schweizerische Bundesrat. Verordnung 2 über Massnahmen zur Bekämpfung des Coronavirus (COVID-19) - (COVID-19-Verordnung 2); 13. März 2020.

14.

Gutenbrunner C, Stokes EK, Dreinhöfer K, Monsbakken J, Clarke S, Côté P, et al. Why rehabilitation must have priority during and after the COVID-19-pandemic: a position statement of the global rehabilitation alliance. J Rehabil Med. 2020. https://doi.org/10.2340/16501977-2713.CrossRefPubMedPubMedCentral

15.

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. The CARE guidelines: consensus-based clinical case report guideline development. J Clin Epidemiol. 2014;67:46–51. https://doi.org/10.1016/j.jclinepi.2013.08.003.CrossRefPubMed

16.

Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17:427–42.CrossRefPubMed

17.

Johnston M, de Morton N, Harding K, Taylor N. Measuring mobility in patients living in the community with Parkinson disease. NeuroRehabilitation. 2013;32:957–66. https://doi.org/10.3233/NRE-130919.CrossRefPubMed

18.

Braun T, Schulz R-J, Reinke J, van Meeteren NL, de Morton NA, Davidson M, et al. Reliability and validity of the German translation of the de Morton Mobility Index (DEMMI) performed by physiotherapists in patients admitted to a sub-acute inpatient geriatric rehabilitation hospital. BMC Geriatr. 2015;15:1660. https://doi.org/10.1186/s12877-015-0035-y.CrossRef

19.

Braun T, Marks D, Thiel C, Grüneberg C. Reliability and validity of the de Morton Mobility Index in individuals with sub-acute stroke. Disabil Rehabil. 2019;41:1561–70. https://doi.org/10.1080/09638288.2018.1430176.CrossRefPubMed

20.

de Morton NA, Davidson M, Keating JL. The de Morton Mobility Index (DEMMI): an essential health index for an ageing world. Health Qual Life Outcomes. 2008;6:63. https://doi.org/10.1186/1477-7525-6-63.CrossRefPubMedPubMedCentral

21.

Braun T, Rieckmann A, Grüneberg C, Marks D, Thiel C. Hierarchical assessment of balance and mobility—German translation and cross-cultural adaptation. Z Gerontol Geriatr. 2016;49:386–97. https://doi.org/10.1007/s00391-016-1026-0.CrossRefPubMed

22.

MacKnight C, Rockwood K. Rasch analysis of the hierarchical assessment of balance and mobility (HABAM). J Clin Epidemiol. 2000;53:1242–7.CrossRefPubMed

23.

Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMed

24.

Braun T, Thiel C, Schulz R-J, Grüneberg C. Reliability of mobility measures in older medical patients with cognitive impairment. BMC Geriatr. 2019;19:20. https://doi.org/10.1186/s12877-019-1036-z.CrossRefPubMedPubMedCentral

25.

Holden MK, Gill KM, Magliozzi MR, Nathan J, Piehl-Baker L. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Phys Ther. 1984;64:35–40.CrossRefPubMed

26.

Enright PL, McBurnie MA, Bittner V, Tracy RP, McNamara R, Arnold A, Newman AB. The 6-min walk test: a quick measure of functional status in elderly adults. Chest. 2003;123:387–98.CrossRefPubMed

27.

Bohannon RW, Crouch R. Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract. 2017;23:377–81. https://doi.org/10.1111/jep.12629.CrossRefPubMed

28.

Bohannon RW. Population representative gait speed and its determinants. J Geriatr Phys Ther. 2008;31:49–52.CrossRefPubMed

29.

Bohannon RW, Glenney SS. Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review. J Eval Clin Pract. 2014;20:295–300. https://doi.org/10.1111/jep.12158.CrossRefPubMed

30.

Learmonth YC, Dlugonski D, Pilutti LA, Sandroff BM, Klaren R, Motl RW. Psychometric properties of the fatigue severity scale and the modified fatigue impact scale. J Neurol Sci. 2013;331:102–7. https://doi.org/10.1016/j.jns.2013.05.023.CrossRefPubMed

31.

Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N. The Parkinson’s Disease Questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing. 1997;26:353–7. https://doi.org/10.1093/ageing/26.5.353.CrossRefPubMed

32.

Allen NE, Sherrington C, Suriyarachchi GD, Paul SS, Song J, Canning CG. Exercise and motor training in people with Parkinson’s disease: a systematic review of participant characteristics, intervention delivery, retention rates, adherence, and adverse events in clinical trials. Parkinsons Dis. 2012;2012: 854328. https://doi.org/10.1155/2012/854328.CrossRefPubMed

33.

Hayes S, Galvin R, Kennedy C, Finlayson M, McGuigan C, Walsh CD, Coote S. Interventions for preventing falls in people with multiple sclerosis. Cochrane Database Syst Rev. 2019;11: CD012475. https://doi.org/10.1002/14651858.CD012475.pub2.CrossRefPubMed

34.

Rae-Grant AD, Turner AP, Sloan A, Miller D, Hunziker J, Haselkorn JK. Self-management in neurological disorders: systematic review of the literature and potential interventions in multiple sclerosis care. J Rehabil Res Dev. 2011;48:1087–100. https://doi.org/10.1682/jrrd.2010.08.0159.CrossRefPubMed

35.

Covid-19: Call for a rapid forward looking review of the UK’s preparedness for a second wave—an open letter to the leaders of all UK political parties. BMJ. 2020. https://doi.org/10.1136/bmj.m2866.

36.

Smith EE, Mountain A, Hill MD, Wein TH, Blacquiere D, Casaubon LK, et al. Canadian stroke best practice guidance during the COVID-19 pandemic. Can J Neurol Sci. 2020;47:474–8. https://doi.org/10.1017/cjn.2020.74.CrossRefPubMed

37.

Yang Y-C, Chou C-L, Kao C-L. Exercise, nutrition, and medication considerations in the light of the COVID pandemic, with specific focus on geriatric population. J Chin Med Assoc. 2020. https://doi.org/10.1097/JCMA.0000000000000393.CrossRefPubMedPubMedCentral

38.

Werner C, Rosner R, Wiloth S, Lemke NC, Bauer JM, Hauer K. Time course of changes in motor-cognitive exergame performances during task-specific training in patients with dementia: identification and predictors of early training response. J Neuroeng Rehabil. 2018;15:100. https://doi.org/10.1186/s12984-018-0433-4.CrossRefPubMedPubMedCentral

39.

Cavallieri F, Sireci F, Fioravanti V, Toschi G, Rispoli V, Antonelli F, et al. Parkinson’s disease patients’ needs during the COVID-19 pandemic in a red zone: a framework analysis of open-ended survey questions. Eur J Neurol. 2021. https://doi.org/10.1111/ene.14745.CrossRefPubMedPubMedCentral

Title: The impact of a coronavirus disease 2019 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report
Authors: Tobias Braun
Raphael Weidmann
Jens Carsten Möller
Anissa Ammann
Detlef Marks
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Multiple Sclerosis
COVID-19
Parkinson's Disease
Neurorehabilitation
Published in: Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-021-03119-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The impact of a coronavirus disease 2019 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Complete remission of advanced low-grade endometrial stromal sarcoma after aromatase inhibitor therapy: a case report

Lymphoid interstitial pneumonitis in a newly diagnosed late presenter of human immunodeficiency virus infection: a case report

Neuromyelitis optica and concomitant pulmonary tuberculosis: a case report

Basilar artery occlusion presenting as sudden bilateral deafness: a case report

Late presentation of a cauda equina lesion with a vulval abscess: a case report

Transient complete atrioventricular block and ST-segment elevation induced by coronary vasospasm due to iatrogenic hyperkalemia: a case report