Global Response to COVID-19

Resources on Sleep, exercise, and information resources in Flemish – translation may be available

As part of the program, two members of our team (Clara and Moran) made presentations on exercise and sleep hygiene during lockdown. This program was conducted in Dutch and can be found online at https://www.youtube.com/watch?time_continue=1936&v=YVV5LbPZrVQ&feature=emb_logo

(Segment on exercise with Clara begins at 32:18, demonstration at 41:44)

(Segment on sleep hygiene with Moran follows at 53:58 )

Further, there were possibilities for Q&A with the experts and these have been published at https://www.parkinsonliga.be/corona-vraag-en-antwoord

Speech therapy

LSVT patients' resources a lot, they are mostly free and now they have a Friday LOUD group  from all over the world: https://blog.lsvtglobal.com/lsvt-resources-for-people-with-pd/

Nursing
Regular communication forums – weekly and sharing telehealth guidelines

Speech Therapy

LSVT Global resources Including ongoing live webinars

COVID Panel Presentation	Resources for People with Parksinson's Disease	Resources for Faculty and Students

Physical Therapy

https://www.epda.eu.com/latest/resources/epda-exercisecast/

It is a free online video exercise project for people with Parkinson that started as an EPDA response to the lockdown situation created by the covid-19 pandemic. It includes instruction exercise videos  that are challenging and surprisingly fun by combining voice, movement and cognition all into one; and then its application to people with Parkinson invited to participate in live sessions.

The content page includes:

1. Episode 1 – The body speaks & spells
2. Episode 2 – What happened to Monday?
3. Episode 3 – Punchalicious! Can I punch you now?
4. Episode 4 – Moving for something new
5. Live sessions
6. What is the EPDA ExerciseCast project?
7. Why use a dual or multitask training approach?
8. Related reading

Exercise Resources

1. Parkinson Foundation
2. APDA - Online and Free Online Courses
3. APDA Wisconsin
4. APDA St. Louis
5. Michigan
6. European Parkinson's Disease Association
7. POWER FOR PARKINSONS
8. Dance for PD
9. Parkinson's Nebraska

Neuropsychology

Neuropsychology assessments transferred to telehealth, with supporting guidelines

Teleneuropsychology (TeleNP) in Response to COVID-19

https://www.the-ins.org/webinars/

Physiotherapy

http://www.cnscampus.com/en/noticias/resources-for-patients-and-caregivers

Developed exercise resources for patients and caregivers

Physiotherapy/Speech Therapy

A range of Multi-disciplinary  resources put together to support patients

Physiotherapy general:

The statement was developed by our hospital and was recently translated into English. It is also added to the website of the WCPT. 

https://www.kngf.nl/binaries/content/assets/kennisplatform/onbeveiligd/guidelines/kngf-position-statement_v1.0-final.pdf​

Speech-language therapy general:
Also from our hospital with the Dutch SLP Association, translated in English: https://www.nvlf.nl/stream/fact-sheet-covid-19

And also published on the covid website od the Dysphagia Research Society (DRS): https://www.dysphagiaresearch.org/page/COVID-19Resources

The Dutch Parkinson Association has a covid webpage with exercise videos: https://www.parkinson-vereniging.nl/corona-bewegen?fbclid=IwAR2m2i1F4v-83SBeAU815ODoXsW6bI-hTsgxQ_WJnDVC47hib0bwY7k_IiY

Nursing / NGO

https://www.parkinsonsvic.org.au/i-am/other/

https://www.parkinsonsvic.org.au/about-us/media-release/physical-activity-during-covid-19/

www.parkinsonsvic.org.au/about-us/media-release/coronavirus-covid-19/

developed a range of resources for people living with Parkinson’s ranging from information and assistance in staying safe. A key resource being information to support patients identify safe exercise resources when they are looking online. 

Physiotherapy

1. Planning therapeutic activities
1.1. Meeting of health professionals by video-conference using different platforms (Google Meet, Hangout, Jitsi, Skype, Zoom) in order to organize our therapeutic plans. 

2. Communication
2.1. Intensifying our contact with PwP and their families/caregivers by WhatsApp (individual or group)
2.2. Therapy diary: we asked all patients to write down in a sheet, day, time and activities performed along day.
2.3. Stimulating social ties by video calls using WhatsApp. A challenge is use another platform for video and audio conferencing such as hangout or zoom to include more participants during video call. However our patients do not experience on handling these programs. 

3. Promoting Education in health for patients, caregivers and families
3.1. Nursing team made video explaining safe greetings and self-care
3.2. Translating educational materials from WHO
3.3. Online form to assess freezing of gait (FOG-Q) and quality of life (PDQ39). It is important to notice that all Portuguese-speaking patients can access this form. After fill out they receive the result via email. This strategy was primarily designed for our patients; however, we thought other PwP could benefit from this strategy. Thus, we disclose the form in the Brazilian territory as well as other Portuguese-speaking countries. The form is available at https://bit.ly/2WWGfhX

4. Activities involving executive functions
4.1. Reading books, newspapers, magazines
4.2. Listening and singing songs
4.3. Playing board games, when possible
4.4. Practicing manual activities (crafts, knitting, etc)
4.5. Learning a new language
4.6. Talking to family members

5. Physical Exercises
5.1. Mobility
5.2. Transfers
5.3. Muscle strength
5.4. Balance

DBS

• Surgery for DBS cancelled
• Review of existing patients In person or telehealth
• Battery replacements continue but need COVID 19 Screen

Speech Therapy

• Clinical assessment and meal time assessments conducted by Zoom
• The Sing for JoyChior runs on Zoom weekly

Nursing

Transferred clinical teaching and support to online forums

• MDS India- forum for Indian neurology education online teaching programme.
• Weekly academic teaching sessions for movement disorders specialist and health care professionals at King’s college Hospital London.( international participants including; Romania, Germany, India, US, Mexico).
• PD nurses support platform weekly meeting on Wednesdays to share information re Covid-19 and PD services in the UK. ( all PD nurses in the UK invited and this week PD nurses from China joining as well).Please see attached weekly program.
• Teaching session on fatigue and sleep in Parkinson’s for the Mexican in National Institute of Neurology and neurosurgery in Mexico.
• We shared our PD nurse phone consultation Nationally.  Please see attached.

Physiotherapy

Appointments mainly cancelled, some paper based resources provided. Telephone support for some patients

Some face to face appointments following strict Greek CDC guidelines

1. Appointments are spaced apart.
2. The patient enters the practice alone, I pick them up at the door, so as to avoid people gathering in the waiting room.
3. The patient wears a mask and uses hand sanitizer upon entering.
4. I wear a mask and gloves.
5. The room is disinfected after each patient.

Nursing

• Transferring face to face consultation to telehealth and video clinics- noted to be just at time consuming. Research all stopped

Social Work

• Have embarked on a program to match isolated patients with volunteer medical and health care students for regular contact (phone)

Medical

• Country wide strict lockdown measures has resulted in wide ranging medication shortages in including levo dopa

Medical

• Noted a step rise in the level of COVID 19 infections- people with PD actively avoiding attending clinic because of fear of becoming infected- there is no PPE available, masks being recycled by the Health care professionals

Physiotherapy

• Clinics transferred to telehealth and Physiotherapy gym closed- sessions for Physiotherapy provided by telehealth / webex

Nursing

• Service delivery and education pivoted to online delivery- Research currently suspended, however avenues to look at online delivery of RCT in to benefits of Dance and Singing being explored.  Most neurology clinics seeing reduced numbers of patients face to face ( usually only nee referrals) DBS and introduction of advanced therapies delayed for 8 weeks, with reduced numbers recommended 

Medical

• Normal service all suspended, and patients only seen as an emergency. Some patients are seen using social media platforms such as Viber and Facebook – which are readily used in the country. Strict screening of patients for infection before they able to access the neurology department.

• Services transferred to online, using multiple platforms- people unable to leave home due to strict lock down. Services include physiotherapy consultation to delivery of dance and exercise classes.