key: cord-1009254-w2m3cqlx authors: Vancini, Rodrigo Luiz; de Lira, Claudio Andre Barbosa; Andrade, Marília Santos; Arida, Ricardo Mário title: CoVID-19 vs. epilepsy: It is time to move, act and encourage physical exercise’? date: 2020-05-03 journal: Epilepsy Behav DOI: 10.1016/j.yebeh.2020.107154 sha: ad88f6de8203b9efd502db7d6c8ddf122466074f doc_id: 1009254 cord_uid: w2m3cqlx nan J o u r n a l P r e -p r o o f sedentary and have worse levels of physical fitness [10] [11] [12] [13] [14] [15] , which could be worse in this scenario. Considering the current perspective and the recommendation from local and global health authorities for social isolation and quarantine, the aim of this article is to present the practice of physical activity as an alternative strategy with which to cope with the pandemic of CoVID-19 for people with epilepsy and the health professionals who take care of them. The pandemic of CoVID-19 is frightening the world due to its potential for transmission-dissemination-hospitalization-lethality among more vulnerable populations, such as elderly people [6, [16] [17] [18] [19] . This could include people with epilepsy because the prevalence of epilepsy is higher in elderly people. Furthermore, many people with epilepsy have other comorbidities (depression, anxiety, hypertension and obesity) and risk factors (low levels of physical activity) associated or not with the side effects of anti-epileptic drugs [20] . In addition, quarantine and social isolation, associated with the CoVID-19 pandemic, could impact negatively on the lifestyles (physical activity and diet) and health status (mental health) of health people and those with chronic diseases/morbidities [21] . Li et al. [22] Recently, an interesting article was published on this topic entitled "A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another?" In this article, Hall et al. [21] highlight that the drastic change in people's daily lives (due to the recommendation for social isolation and quarantine) around the world, associated with the pandemic caused by CoVID-19, could negatively impact physical activity habits and emphasize sedentary behaviors. It is clear that there is a need for a change in the way that health systems are conducted and in strategies for health/education promotion that include changes in lifestyle (encourage the practice of physical exercise) around the world in order to face and cope better with scenarios of this type. In this regard, a physical inactivity pandemic is a real fact and the practice of physical activity by people with epilepsy could improve their physical and mental health [24] [25] [26] [27] [28] . Coping with the CoVID-19 pandemic and the great emotional stress would make society (individually and collectively) stronger. Coping is described as behavioral efforts (positive and/or negative) to deal with situations of harm and problem-solving techniques that are utilized to reduce psychological and emotional burden. Strategies of coping may include emotional support, meditative techniques, and religiosity/spirituality and physical exercise practice [29] [30] [31] . Emotional and psychological stress before, during and after the CoVID-19 pandemic could include fear, change in sleep patterns, eating, physical inactivity, difficulty in concentration, worsening of chronic health problems and mental health conditions, and increased use of alcohol, tobacco, or other illicit drugs [16, 17] . In such a J o u r n a l P r e -p r o o f "Physical exercise is medicine" for many diseases [25] [26] [27] , such as neurological (dementia), metabolic (obesity), cardiovascular (hypertension), pulmonary (asthma), musculoskeletal disorders (osteoporosis), and psychiatric (depression) conditions and also for epilepsy [25] [26] [27] [28] . However, people with epilepsy are known to have low levels of physical activity [32] , which can negatively impact their overall health status, physical fitness and mental health [32] [33] [34] [35] [36] . In this period of necessary social isolation and quarantine it is likely that the already low level of physical activity in people with epilepsy will further deteriorate and sedentary behaviors will increase. Therefore, strategies are needed to at least maintain mental health and physical fitness in a safe way, such as practicing light and homebased physical exercises. This practice needs to be adapted to the home environment and directed by skilled health professionals; people with epilepsy should be guided/advised in practicing home-based exercise, which should include aerobic exercises, muscle strength exercises and flexibility exercises [21, 37] . Thus, it is necessary to outline effective education and health strategies [37, 38] in the short, medium and long term in order to minimize the negative impact of social isolation and quarantine caused by CoVID-19 for the general population and people with epilepsy. "Physical exercise is medicine and recommended for people with epilepsy" [27, 28] and the general population. There are sufficient evidences that physical exercise produces positive effects on physical fitness, mental health, and lifestyle. The advice of the Epilepsy Society [2020] is to "Try to keep healthy by following a nutritious diet and taking light exercise" during the CoVID-19 pandemic. The most prudent thing to do is to respect social isolation and quarantine and seek alternative strategies, such as home-J o u r n a l P r e -p r o o f 6 based physical exercise, which may include popular social networks (Instagram), video and information search sites (YouTube) for health promotion among the general population and people with epilepsy. Authors have no competing interests to declare. ILAE official report: a practical clinical definition of epilepsy Epilepsy Society. Epilepsy and The Coronavirus (COVID-19) FAQs Comorbidities of epilepsy: current concepts and future perspectives Atherosclerosis in epilepsy: its causes and implications World Health Organization (WHO). (2020a). 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