22 Chapter 2 Abstract Objective Hereditary spastic paraplegia (HSP) is characterized by progressive spasticity of both lower extremities. Spasticity-related symptoms are common, and thought to be positively influenced by physical activity, and negatively by psychological stress. The lockdown due to the COVID-19 pandemic created an opportunity to explore its impact on symptom severity in HSP. Methods During the fifth week of the partial lockdown in the Netherlands, fifty-eight pure HSP patients rated possible changes in levels of physical activity, psychological stress and symptom severity via a web-based questionnaire. Results The partial lock-down reduced the physical activity in 74% of patients with HSP, whereas 43% reported an increase in psychological stress. Reduced physical activity was associated with increased muscle stiffness, pain, physical fatigue and gait impairments, whereas increase psychological stress was independently associated with increased mental fatigue. Conclusions Our results underscore the potential impact of physical activity on symptom severity in people with HSP.
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