"Every Day Is a Battle": The Impact of COVID-19 on Physical Activity Behavior Among a Group of Rural Older Adults Living with Parkinson's Disease.

Abstract

Background: The closure of fitness and rehabilitation centers during the COVID-19 pandemic significantly impacted the rural Parkinson's disease (PD) population, a population already vulnerable due to limited access to healthcare, rehabilitation services, and social support. Objective: This study aimed to assess the psychological, social, and physical impact of COVID-19 restrictions on older adults living with PD in a rural region of the southeastern US to better inform future practices. Methods: Participants (5 female, 6 male, age 78.7 ± 2.3 years) were recruited from PD support groups in rural communities across northwestern North Carolina, USA. Structured interviews focused on the impact of COVID-19 on daily physical activity (PA), quality of life, mental health, and social support. Thematic analysis was used to identify key themes. Results: Seven main themes emerged: mental health, life changes, the importance of group/social support, motivation for PA, COVID-19 adaptations/impact on PA, and functioning. These themes reflected increased social isolation, reduced motivation for PA, and negative impacts on quality of life. Conclusions: The study underscores the challenges faced by rural PD communities during isolation events and emphasizes the need for programs that prioritize social interactions to support physical and mental health, with plans to maintain these connections during future isolations.