key: cord-0859493-s2alwzov authors: Lebrasseur, Audrey; Fortin-Bédard, Noémie; Lettre, Josiane; Bussières, Eve-Line; Best, Krista; Boucher, Normand; Hotton, Mathieu; Beaulieu-Bonneau, Simon; Mercier, Catherine; Lamontagne, Marie-Eve; Routhier, François title: Impact of COVID-19 on people with physical disabilities: A rapid review date: 2020-11-01 journal: Disabil Health J DOI: 10.1016/j.dhjo.2020.101014 sha: 80c9b8d2fc8e02ee238bc5ea17b19d8b5ac4fb01 doc_id: 859493 cord_uid: s2alwzov BACKGROUND: The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic OBJECTIVE: This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities METHODS: A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language RESULTS: Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted CONCLUSIONS: Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers. transportation, have regular healthcare or rehabilitation appointments, need close contact from Given the need for rapid answers to support decision making of various stakeholders and public 72 policies, a rapid review was conducted. A rapid review is a knowledge synthesis that uses an 73 accelerated systematic review method, represented by limiting certain aspects of the 74 methodology in order to provide evidence in a policymaker's timeframe 19, 20 . The methodology 75 of this rapid review follows the Cochrane Rapid Reviews' guide 20 and the Practical guide for 76 rapid reviews to strengthen health policy and systems 21 . Our methods and results are reported 77 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 78 Statement 22 . To address the methodological challenges encountered in the conduct of rapid 79 reviews during COVID-19, suggestions and the eight-step knowledge synthesis proposed by 80 Tricco et al. were followed 23 . The protocol for this rapid review was registered with the 81 PROSPERO database (ID: CRD42020196330). To meet the collaborative recommendations for 82 the inclusion of key stakeholders in rapid reviews, the authors comprised interdisciplinary and 83 intersectoral rehabilitation researchers within a regional health authority 21 . 84 85 The International Classification of Functioning, Disability and Health (ICF) was used to identify 87 key terms and construct a search strategy with a unified and standard health language 24 . The 88 level of functioning is defined by the ICF as a dynamic interaction between the health conditions 89 of an individual and his contextual factors (personal and environmental). The term disability is 90 used to define impairments, activity limitations and participation restrictions, which result from a 91 non-optimal interaction between the health conditions, environmental factors, and personal 92 J o u r n a l P r e -p r o o f Nine of the eleven selected studies were cross-sectional studies 28, 29, 30, 31, 32, 33, 34, 35, 36 , one was a 182 prospective study 37 and one was a retrospective descriptive study 38 . Six studies were conducted 183 in Europe 28, 30, 31, 33, 35, 37 , one worldwide 29 , one in China 38 , one in the United States and Canada 32 , 184 J o u r n a l P r e -p r o o f one in Serbia 34 and one in Montenegro 36 . Regarding the diagnosis of the included populations, 185 three studies included stroke survivors 29, 31, 38 , one included individuals with amyotrophic lateral 186 sclerosis (ALS) 28 , four included individuals with multiple sclerosis 32, 34, 36, 37 , one included 187 individuals with chronic neurological diseases 30 , one included individuals with chronic pain 35 188 and one included individuals with neuromuscular disease 29, 31, 32, 33 . Four studies were focussed 189 on the perception of healthcare workers and health centers 29, 31, 32, 38 . 190 The level of evidence of ten of the eleven studies was 4 on the CEBM levels of The outcomes of the selected studies mostly included environmental factors, specifically 205 regarding the services, systems and policies. Indeed, four out of the eleven studies' outcomes 206 were exclusively about healthcare access 29, 31, 32, 38 and four others included questions about this 207 element 28, 30, 34, 36 . Examples of barriers related to services addressed in studies were the cessation 208 of home-based physiotherapy 28 Regarding activities and participation, restrictions for the acquisition of goods and 220 services and limitations for the use of transportation were noted in the sections about barriers 221 from environmental factors. A reduction of physical activity was also reported, and the changes 222 were statistically significant in one study 33 and non-statistically significant in another 35 . Some 223 people also reported significant changes in their social and lifestyle habits and more difficulties 224 in their daily life 37 . 225 226 The objective of this paper was to review the impact of the COVID-19 pandemic and associated 228 isolation and protective measures on people with physical disabilities. Multiple studies have been 229 conducted since the start of this global pandemic, with more than 40 000 papers resulting from 230 people with visual and hearing impairments, may be less susceptible to medical complications 254 due to COVID-19 than people with neurological disabilities. This, in turn, might explain the lack 255 of published studies regarding non-neurological conditions. However, measures associated to the 256 pandemic, such as social isolation or generalized use of face masks, might have important social 257 impacts on these groups 44, 45 . Therefore, more studies are needed to address these questions, and 258 it is urgent that we get more insight on the experience of these marginalized but prevalent 259 subgroups of the population, to improve policies and procedures and to reduce potential 260 inequality in future crisis management. 261 Behavioral and sleep disturbances were also reported in people with ALS 28 and multiple 262 sclerosis 34, 36 , but it may be partially associated with the evolution of the diseases and not with 263 the COVID-19 pandemic. It is thus important to distinguish the impact of the pandemic of the 264 natural course of a disability to adjust care pathways regarding the needs of this population or to 265 plan healthcare services responses for such issues in the future. However, similar effects were 266 noted in studies about the general population 5, 46 , suggesting that sleep disturbances and mood 267 changes may be influenced or accentuated by the COVID-19 pandemic. 268 Reported higher satisfaction with sexual function in individuals with multiple sclerosis 37 269 also suggests there may be positive impacts of the COVID-19 pandemic on the population. Furthermore, available data regarding people with physical disabilities could not be 286 included in this rapid review because they were not yet published in a peer-reviewed paper. For 287 instance, preliminary results of a study regarding people with visual impairments 49 highlighted 288 potential problems in that population, such as people's fear of having a breakdown, increased 289 anxiety, and concerns about others assisting them in physical tasks like going to the grocery store 290 during the COVID-19 pandemic 50 . Such studies should therefore be kept in mind in order to keep 291 track of future papers that could help people understand the impacts and needs of people with 292 physical disabilities. 293 A major lack of evidence regarding the impacts on children with physical disabilities was 294 noted. Indeed, none of the selected papers included children, despite their vulnerability during 295 this crisis. The closure of schools may have stopped services, such as occupational therapy or 296 speech therapy, which are often delivered in class. The impacts on children with physical 297 disabilities should be assessed to assure an adequate response towards their needs and to 298 minimize possible developmental impacts. 299 The impact of COVID-19 should be considered by governments and institutions when 300 taking actions and decisions about the healthcare access and the public health measures to 301 implement during the pandemic and during future health crisis. Mental health concerns have 302 been mostly reported among the elderly 51 , healthcare workers 52 and the youth 53 . People with 303 physical disabilities should not be forgotten, especially since they already face substantial 304 barriers in their everyday life 10 and have higher risks of mental health issues 11, 13 . 305 306 Our rapid review, performed and reported in accordance with PRISMA guidelines, is a starting 308 point for a more complete agenda of research in disability sciences. Its relevance for scientists, 309 clinicians and decision makers should be emphasized. However, some limitations might have 310 affected our conclusions. Studies about people with physical disabilities might have been 311 excluded because they did not provide specific descriptions of the assessed population. For 312 example, some studies did not differentiate people with strokes from those with diabetes and 313 hypertension in their analyses 54, 55 , or children with physical disability from children with 314 attention deficit disorder 56 , resulting in their exclusion from the review. Furthermore, letters to 315 the editor and position papers containing original data were excluded because of our eligibility 316 criteria 57, 58 . Only peer reviewed papers were included, therefore excluding grey literature. The 317 search strategy was limited in six online databases and was not conducted in trial registries. 318 Language restrictions (English or French) might also have resulted in the exclusion of important 319 data. Moreover, we decided to limit the review to people with physical disabilities. However, 320 impacts experienced by people with intellectual and developmental disabilities should also be 321 considered and assessed in future reviews, as they are also considered as a population vulnerable 322 to negative outcomes during this crisis 59, 60, 61 . Another limitation of this review is the lengthy 323 publishing process of some journals, which might result in a lack of studies about the impact of 324 COVID-19 on people with physical disabilities in the short term. Indeed, some medical journals 325 have accelerated their publishing process for studies about COVID-19, but it does not seem to be 326 the case for all rehabilitation journals, which generally publish studies about people with 327 physical disabilities. An update of this review will therefore be needed to confirm and expand the 328 results. 329 330 Results obtained with this rapid review have highlighted difficult access to services for people 332 with disabilities during the pandemic. It is of utmost importance to better understand the motives 333 under this situation (avoidance of services by users, difficulty accessing the services, etc.) to 334 rethink the question of access to rehabilitation services in context of crisis, such as pandemic, 335 war or natural disaster. Our review also underlines the lack of research about the impacts of the 336 COVID-19 pandemic on people with physical disabilities, a population that is too often forgotten 337 in governmental decisions 62 and that should be included in future crisis strategies and response 338 planning 63 . Studies with the main goal of investigating the impacts on this population should 339 therefore be conducted if we want to better respond to their specific and unique needs. Psychosocial, impact*, determinant*, outcome*, effect*, relation*, experience*, psycholog*, "mental health", "emotional well-being", anxiety, "social", environment, "self care", "self management support", activities of daily Living, leisure activities, participation, need* Psychosocial support systems, psychosocial deprivation, selfmanagement, psychology, mental health, activities of daily Living, leisure activities People with disabilities "people with limit*", "person with limit*", "disabilit*", "disabled", "physical limit*", "wheelchair user*", "diagnosis related group", "chronic condition*", "motor dysfunction", "chronic disease*", handicap*, "visual* impair*", blind, deaf, "hearing impair*", mobility limit*, stroke, traumatic brain injur*, amputee*, sclerosis OR 'hearing impaired person'/de OR 'visually impaired person'/de OR 'amputee'/de OR 'physically disabled person'/de OR 'walking difficulty'/de OR 'cerebrovascular accident'/de OR 'brain injury'/de #7 'disabilit*':ab,ti,kw OR 'motor dysfunction':ab,ti,kw OR 'people with limit*':ab,ti,kw OR 'person with limit*':ab,ti,kw OR 'disabled':ab,ti,kw OR 'diagnosis related group':ab,ti,kw OR 'wheelchair user*':ab,ti,kw OR 'physical limit*':ab,ti,kw OR 'chronic condition':ab,ti,kw OR 'chronic disease':ab,ti,kw OR 'handicap*':ab,ti,kw OR 'visual* impair*':ab,ti,kw OR 'blind':ab,ti,kw OR 'deaf':ab,ti,kw OR 'hearing impair*':ab,ti,kw OR 'mobility limit*':ab,ti,kw OR 'stroke':ab,ti,kw OR 'traumatic brain injur*':ab,ti,kw OR 'amputee*':ab,ti,kw OR "sclerosis":ab,ti,kw #6 = #4 OR #5 #5 'social psychology'/de OR 'social medecine' OR 'impacts of events scale' OR 'mental health'/de OR 'self care'/de OR 'self management support'/de OR 'social support'/de OR 'daily life activity'/de OR 'leisure'/de #4 psychosocial:ab,ti,kw OR impact*:ab,ti,kw OR determinant*:ab,ti,kw OR outcome*:ab,ti,kw OR effect*:ab,ti,kw OR relation*:ab,ti,kw OR experience*:ab,ti,kw OR psycholog*:ab,ti,kw OR 'mental health':ab,ti,kw OR 'emotional well-being':ab,ti,kw OR anxiety:ab,ti,kw OR 'self care':ab,ti,kw OR 'social':ab,ti,kw OR environment*:ab,ti,kw OR 'self management support':ab,ti,kw OR 'activities of daily living':ab,ti,kw OR 'leisure activit*':ab,ti,kw OR participation:ab,ti,kw OR need*:ab,ti,kw #3 = #1 OR #2 #2 'covid-19':ab,ti,kw OR 'sars-cov-2':ab,ti,kw OR 'coronavirus':ab,ti,kw OR 'severe acute respiratory syndrome':ab,ti,kw OR 'pandem*':ab,ti,kw OR 'severe acute respiratory syndrome coronavirus 2':ab,ti,kw OR 'epidemy' OR 'quarantine':ab,ti,kw OR epidemic:ab,ti,kw OR epidemies:ab,ti,kw OR '2019ncov':ab,ti,kw #1 'covid 19'/de OR 'sars coronavirus'/de OR 'severe acute respiratory syndrome'/de OR 'pandemic'/de People with disabilities disabilit*':ab,ti,kw OR 'motor dysfunction':ab,ti,kw OR 'people with limit*':ab,ti,kw OR 'person with limit*':ab,ti,kw OR 'disabled':ab,ti,kw OR 'diagnosis related group':ab,ti,kw OR 'wheelchair user*':ab,ti,kw OR 'physical limit*':ab,ti,kw OR 'chronic condition':ab,ti,kw OR "chronic disease":ab,ti,kw OR 'handicap*':ab,ti,kw OR "visual* impair*":ab,ti,kw OR 'blind':ab,ti,kw OR 'deaf':ab,ti,kw OR "hearing impair*":ab,ti,kw OR 'mobility limit*':ab,ti,kw OR 'stroke':ab,ti,kw OR 'traumatic brain injur COVID-19 or SARS-CoV-2 or coronavirus or "Severe Acute Respiratory Syndrome" or pandem*or "severe acute respiratory syndrome coronavirus 2" or epidemy or quarantine or epidemic or epidemies or "2019-nCoV" pandemics or epidemics ((((title: ("people with limit*"))) OR ((title: ("person with limit*"))) OR ((title: ("disabilit*"))) OR ((title: ("disabled"))) OR ((title: ("physical limit*"))) OR ((title: ("wheelchair user*"))) OR ((title: ("diagnosis related group"))) OR ((title: ("chronic condition*"))) OR ((title: ("motor dysfunction"))) OR ((title: ("chronic disease*"))) OR ((title: ("handicap*"))) OR ((title: ("visual* impair*"))) OR ((title: ("blind"))) OR ((title: ("deaf"))) OR ((title: ("hearing impair*"))) OR ((title: ("mobility limit*"))) OR ((title: ("stroke*"))) OR ((title: ("traumatic brain injur*"))) OR ((title: ("amputee*"))) OR ((title: ("sclerosis"))) OR ((abstract: ("people with limit*"))) OR ((abstract: ("person with limit*"))) OR ((abstract: ("disabilit*"))) OR ((abstract: ("disabled"))) OR ((abstract: ("physical limit*"))) OR ((abstract: ("wheelchair user*"))) OR ((abstract: ("diagnosis related group"))) OR ((abstract: ("chronic condition*"))) OR ((abstract: ("motor dysfunction"))) OR ((abstract: ("chronic disease*"))) OR ((abstract: ("handicap*"))) OR ((abstract: ("visual* impair*"))) OR ((abstract: ("blind"))) OR ((abstract: ("deaf"))) OR ((abstract: ("hearing impair*"))) OR ((abstract: ("mobility limit*"))) OR ((abstract: ("stroke*"))) OR ((abstract: ("traumatic brain injur*"))) OR ((abstract: ("amputee*"))) OR ((abstract: ("sclerosis"))) OR ((MeSH: ("Physical Disorders"))) OR ((MeSH: ("hearing impaired"))) OR ((MeSH: ("blind"))) OR ((MeSH: ("deaf"))) OR ((MeSH: ("Cerebrovascular Accidents"))) OR ((MeSH: ("Traumatic Brain Injury")))) AND ((((title: (Psychosocial))) OR ((title: (impact*))) OR ((title: (anxiety))) OR ((title: (self care))) OR ((title: (social))) OR ((title: (environment))) OR ((title: (self management support))) OR ((title: (determinant*))) OR ((title: (outcome*))) or ((title: (effect*))) or ((title: (relation*))) or ((title: (experience*))) OR ((title: (psycholog*))) OR ((title: ("mental health"))) OR ((title: ("emotional wellbeing"))) OR ((title: ("activit* of daily Li*"))) OR ((title: ("leisure activit*"))) OR ((title: ("participation"))) OR ((title: ("need*"))) OR ((abstract: (Psychosocial))) OR ((abstract: (impact*))) OR ((abstract: (anxiety))) OR ((abstract: (self care))) OR ((abstract: (social))) OR ((abstract: (environment))) OR ((abstract: (self management support))) OR ((abstract: (determinant*))) OR ((abstract: (outcome*))) or Impacts Psychosocial or impact* or determinant* or outcome* or effect* or relation* or experience* or psycholog* or "mental health" or "emotional well-being" or anxiety or self care or social or environment or self management support or activities of daily Living or leisure activities or participation or need "psychosocial development" or "psychosoc ial assessment" or "psychosocia l factors" or "mental health" or activities of daily living or leisure time People with disabilities "people with limit*", "person with limit*", "disabilit*", "disabled", "physical limit*", "wheelchair user*", "diagnosis related group", "chronic condition*", "motor dysfunction", "chronic disease*", handicap*, "visual* impair*", blind, deaf, "hearing impair*", mobility limit*, stroke, traumatic brain injur*, amputee*, sclerosis "Physical Disorders", hearing impaired, blind, deaf, Cerebrovascular Accidents, Traumatic Brain Injury ((abstract: (effect*))) or ((abstract: (relation*))) or ((abstract: (experience*))) OR ((abstract: (psycholog*))) OR ((abstract: ("mental health"))) OR ((abstract: ("emotional well-being"))) OR ((abstract: ("activit*of daily Li*"))) OR ((abstract: ("leisure activit*"))) OR ((abstract: ("participation"))) OR ((abstract: ("need*"))) OR ((MeSH: ("psychosocial development"))) OR ((MeSH: ("psychosocial factors"))) OR ((MeSH: ("mental health"))) OR ((MeSH: ("activities of daily living "))) OR ((MeSH: ("leisure time")))) AND ((((title: (COVID-19) )) OR ((title: (SARS-CoV-2))) OR ((title: (coronavirus))) OR ((title: ("Severe Acute Respiratory Syndrome"))) OR ((title: (pandem*))) OR ((title: ("severe acute respiratory syndrome coronavirus 2"))) OR ((title: (epidemy))) OR ((title: (quarantine))) OR ((title: (epidemic))) OR ((title: (epidemies))) OR ((title: ("2019-nCoV")))) OR ((abstract: (COVID-19) )) OR ((abstract: (SARS-CoV-2))) OR ((abstract: (coronavirus))) OR ((abstract: ("Severe Acute Respiratory Syndrome"))) OR ((abstract: (pandem*))) OR ((title: ("severe acute respiratory syndrome coronavirus 2"))) OR ((abstract: (epidemy))) OR ((abstract: (quarantine))) OR ((abstract: (epidemic))) OR ((abstract: (epidemies))) OR ((abstract: ("2019-nCoV"))) OR ((MeSH: (pandemics))) OR ((MeSH: (epidemics))))) AND Year: 2019 To 2020 CINA HL VIA EBSC OHOS T COVID-19 or SARS-CoV-2 or coronavirus or "Severe Acute Respiratory Syndrome" or pandem*or "severe acute respiratory syndrome coronavirus 2" or epidemy or quarantine or epidemic or epidemies or "2019-nCoV" (MM "SARS Virus") OR (MM "Coronavirus") (TI (covid-19 or "2019-nCoV" or covid or coronavirus or sars-cov-2 or quarantine or pandemic or epidemy or epidemies or epidemic) OR AB ( covid-19 or "2019-nCoV" or covid or coronavirus or sarscov-2 or quarantine or pandemic or epidemy or epidemies or epidemic) OR MM ("SARS Virus" or "Severe Acute Respiratory Syndrome")) AND (TI ( ''psychosocial'' or "emotional well-being" or ''mental health'' or "impact*" or "psycholog*" or determinant* or outcome* or effect* or relation* or experience*or anxiety or "self care" or social or environment or "self management support" or "activities of daily living" or "leisure activities" or participation or need*) OR AB ( ''psychosocial'' or "emotional well-being" or "impact*" or "psycholog*" or "mental health" or determinant* or outcome* or effect* or relation* or experience* or "social" or "self care" or environment or anxiety or "self management support" or "activities of daily living" or "leisure activities" or participation or need*) OR (MM "Psychosocial Aspects of Illness") OR (MM "Diagnosis, Psychosocial") OR (MM "Support, Psychosocial") OR (MM "activities of daily living") OR (MM "leisure activities")) AND ( TI ("people with limit*" or "person with limit*" or "disabilit*" or "disabled" or "physical limit*" or "wheelchair user*" or "diagnosis related group" or "chronic condition*" or "motor dysfunction*" or "chronic disease*" or handicap* or "visual* impair*" or blind or deaf or "hearing impair*" or "mobility limit*" or stroke or "traumatic brain injur*" or "amputee*" or sclerosis) ) OR ( AB ("people with limit*" or "person with limit*" or "disabilit*" or "disabled" or "physical limit*" or "wheelchair user*" or "diagnosis related group" or "chronic condition*" or "motor dysfunction*" or "chronic disease*" or handicap* or "visual* impair*" or blind or deaf or "hearing impair*" or "mobility limit*" or stroke or "traumatic brain injur*" or "amputee*" or sclerosis)) OR ((MM "Disabled") OR (MM "Hearing Disorders") OR (MM "vision disorders") OR (MM "amputees") OR (MM "stroke") OR (MM "brain injuries")) AND Year: 2019 To 2020 Impacts Psychosocial or impact* or determinant* or outcome* or effect* or relation* or experience* or psycholog* or "mental health" or "emotional well-being" or anxiety or self care or social or environment or self management support or activities of daily Living or leisure activities or participation or need* (MM "Psychosocial Aspects of Illness") OR (MM "Diagnosis, Psychosocial") OR (MM "Support, Psychosocial") or activities of daily living or leisure activities People with disabilities "people with limit*", "person with limit*", "disabilit*", "disabled", "physical limit*", "wheelchair user*", "diagnosis related group", "chronic condition*", "motor dysfunction", "chronic disease*", handicap*, "visual* impair*", blind, deaf, "hearing impair*", mobility limit*, stroke, traumatic brain injur*, amputee*, sclerosis (MM "Disabled"), Hearing Disorders, vision disorders, amputees, stroke, brain injuries AGELI NE VIA EBSC OHOS T COVID-19, SARS-CoV-2, coronavirus, "Severe Acute Respiratory Syndrome", pandem*, "severe acute respiratory syndrome coronavirus 2", epidemy, quarantine, epidemic, epidemies, "2019-nCoV" N/A (TI (covid-19 or "2019-nCoV" or covid or coronavirus or sars-cov-2 or quarantine or pandemic or epidemy or epidemies or epidemic) OR AB ( covid-19 or "2019-nCoV" or covid or coronavirus or sarscov-2 or quarantine or pandemic or epidemy or epidemies or epidemic)) AND TI ( ''psychosocial'' or "emotional well-being" or ''mental health'' or "impact*" or "psycholog*" or determinant* or outcome* or effect* or relation* or experience* or anxiety or "self care" or social or environment or "self management support" or "activit* of daily living" or "leisure activit*" or participation or need*) OR AB ( ''psychosocial'' or "emotional well-being" or "impact*" or "psycholog*" or "mental health" or determinant* or outcome* or effect* or relation* or experience* or "social" or "self care" or environment or anxiety or "self management support" or "activit* of daily living" or "leisure activit*" or participation or need*) OR (MM "Psychosocial needs") OR (MM "Social needs") OR (MM "Emotional needs") OR (MM "Mental health") OR (MM "Psychological well being") OR (MM "activities of daily living") OR (MM "leisure activities")) AND ( TI ("people with limit*" or "person with limit*" or "disabilit*" or "disabled" or "physical limit*" or "wheelchair user*" or "diagnosis related group" or "chronic condition*" or "motor dysfunction*" or "chronic disease*" or handicap* or "visual* impair*" or blind or deaf or "hearing impair*" or "mobility limit*" or stroke or "traumatic brain injur*" or "amputee*" or sclerosis) ) OR ( AB ("people with limit*" or "person with limit*" or "disabilit*" or "disabled" or "physical limit*" or "wheelchair user*" or "diagnosis related group" or "chronic condition*" or "motor dysfunction*" or "chronic disease*" or handicap* or "visual* impair*" or blind or deaf or "hearing impair*" or "mobility Impacts Psychosocial or impact* determinant* or outcome* or effect* or relation* or experience* or psycholog* or "mental health" or "emotional well-being" or anxiety or self care or social or environment or self management support or activities of daily Living or leisure activities or participation or need* Psychosocial needs, social needs, emotional needs, mental health, psychological well being, activities of daily living, leisure activities People with disabilities "people with limit*", "person with limit*", "disabilit*", "disabled", "physical limit*", "wheelchair user*", "diagnosis related group", "chronic condition*", "motor dysfunction", "chronic disease*", handicap*, "visual* disabled, physically disabled, visually disabled, disabilities, stroke, hearing impairment impair*", blind, deaf, "hearing impair*", mobility limit*, stroke, traumatic brain injur*, amputee*, sclerosis limit*" or stroke or "traumatic brain injur*" or "amputee*" or sclerosis)) OR ((MM "Disabled") OR (MM "Physically disabled") OR (MM "visually disabled") OR (MM "disabilities") OR (MM "stroke") OR (MM "hearing impairment")) AND Year: 2019 To 2020 People with physical disabilities, defined with an impairment of sensory functions and pain, voice and speech functions, or neuromusculoskeletal and movement-related functions; or of the structures of the nervous system, the eye, ear and related structures, the structures involved in voice and speech, or the structures related to movement. COVID-19 and associated isolation and protective measures Comparator (C) General population, other populations or none Changes in body functions or structures, limitations, restrictions, capacity or performance regarding the component activities and participation, or facilitators or barriers from environmental factors. 43.1% of patients answered that they were sleeping worse than before the pandemic. 45.7% of patients did not experience any change in their daily activities. 43.6% reported that they were concerned they would experience some difficulties in medication availability and 72.4% were concerned they could not go to the hospital as usual. Patients who would not go to the hospital and try to find their doctor stated the fear of getting infected as the main reason (85.5%). 163 participants with chronic conditions such as chronic neck pain (n=14) and chronic low back pain (n=18). Time of moderate-intensity PA in minutes/day was 109.3 ± 126.10 before and 77.5 ± 57.5 after COVID-19 in participants with chronic neck pain and was 106.1 ± 70.9 before and 87.7 ± 63.2 after COVID-19 in patients with chronic low back pain. Time of vigorous-intensity PA in minutes/day was 41.8 ± 46.4 and 40.4 ± 36.8 before and after COVID-19 in participants with chronic neck pain and was 61.1 ± 48.5 and 51.4 ± 40.8 before and after COVID-19 in patients with chronic low back pain. However, no decreases were statistically significant. None 4 Abuse, self-harm and suicidal ideation in the UK during the COVID-19 pandemic Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond. 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Exceptional Parent Will participation restrictions related to the COVID-19 lockdown boost inclusivity? Wrong study design Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?