**1. Introduction**

A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease called COVID-19, detected in China in December 2019, managed to affect over 200 countries in just 6 months, reporting over 10 million illnesses and over half a million deaths. The World Health Organization (WHO) declared a global pandemic in March 2020, thus causing worldwide concern. Therefore, all societies affected by the SARS-CoV-2 infection have gradually declared social distancing and home-confinement to prevent the spread of the new infection. According to Tondo et al. [1], the COVID-19 pandemic generates substantial changes in routine activities, restrictions of movement and has a considerable impact on people's psychological and cognitive levels. Furthermore, it

Marin, M.; Rusu, M.R.; Rusu, L. New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review. *J. Clin. Med.* **2022**, *11*, 597. https://doi.org/10.3390/ jcm11030597

**Citation:** Bacanoiu, M.; Danoiu, M.;

Academic Editors: Michele Roccella and Cristoforo Comi

Received: 16 December 2021 Accepted: 20 January 2022 Published: 25 January 2022

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**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

creates challenges for the healthcare system. The main problems in dementia during this pandemic period are related to an increase of sufferers of cognitive impairment [1].

Under these conditions, the most drastic quarantine measures in human history were imposed [2]. This situation, imposed to slow the spread of COVID-19, has had negative effects on the quality of life, psychosocial and emotional behavior of individuals, even whether apparently healthy or with various associated diseases.

Due to social isolation and lack of direct communication, changes in emotional status have been reported, with the appearance of emotional disorders by way of feelings of loneliness, decreased personality (e.g., frustration, boredom, delusions, inadequate supplies) and distrust of peers [3–5].

Infection with SARS-CoV-2, which has caused severe acute respiratory syndrome and other distress for multiple organ failure, has affected a substantial number of patients with other comorbidities (such as Myasthenia Gravis, Vascular dementia) associated with neurodegenerative diseases, such as Parkinson's disease (PD), Alzheimer's disease, Frontotemporal dementia and Lewy body disease. Lack of therapeutic interventions, limiting access to specialized treatments, decreasing physical activity and help from caregivers and family during this period has aggravated functional abilities, cognitive impairments and behavioral disturbances [6].

During the isolation at home imposed by the COVID-19 pandemic, the needs for social assistance intervention increased, putting pressure on professional healthcare and home caregivers for patients with dementia [5]. Therefore, the imposed home confinement considerably restricted access to social and health services, which led to a worsening of behavioral and neuropsychological symptoms for them [6]. At the same time, a decrease in physical activity and limit of activity daily living (ADL), generate a change of lifestyle and life quality.

From this point of view, the promotion of a mental health and wellbeing lifestyle, involves continuing physical training. This means supporting movement skills, improving gait, increasing muscle strength and endurance, and prevents the progression of the disease in mild cognitive impairments (MCI). The challenge identified in the literature is that the COVID-19 outbreak has limited access to these activities due to isolation at home [7]. Hence, other interventions, such as aerobic exercises and home dance training had to be implemented to counteract the progressive deficiencies of patients with PD [8,9].

In addition to worsening motor and cognitive functions, the COVID-19 quarantine also impaired sleep quality, eating behavior affected mental wellbeing and induced depressive symptoms [10].

In the context of the COVID-19 outbreak, the need for modern digital therapies and those that are delivered remotely as well as their intervention at home have proven to be effective in the rehabilitation of patients with PD and other neurodegenerative disease. This could decrease the effect of motor skills, gait pattern, neuropsychiatric impairments and classic symptoms, such as tremor, bradykinesia, postural instability and freezing of gait [11]. The aim of the paper is to carry out a literature analyses regarding how the lockdown and physical activity influence motor and cognitive function, based on evaluation of the impact of decreasing physical activity, and the affected emotional status of healthy adults and patients with neurodegenerative diseases and associated comorbidities, such as Myastenia and Vascular dementia, in conditions imposed by COVID-19. The aim of the literature analysis includes a review of how the new interventions, such as telemedicine and telerehabilitation, could improve or maintain a healthy status, based on multi-language online surveys, semi-structured interviews and interventions on smartphones delivered through online platforms, for instance, Google, WhatsApp, Twitter, Research Gate, Facebook and LinkedIn. In our paper, we highlight the state of the art about what is written to date on the COVID-19 pandemic impact through the lives of healthy people and neurodegenerative disease patients.

Three questions guided the literature review: which physical activity has been chosen; what is the impact of the lockdown and decrease of physical activity under motor and

cognitive aspects; and what is the impact of the interventions through telerehabilitation and telemedicine?
