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帕金森病运动障碍与疼痛之间的关联

The Association Between Parkinson's Disease Motor Impairments and Pain.

作者信息

Allen Natalie E, Wong Cassandra M, Canning Colleen G, Moloney Niamh

机构信息

*Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia

*Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.

出版信息

Pain Med. 2016 Mar;17(3):456-462. doi: 10.1111/pme.12898. Epub 2016 Feb 2.

Abstract

OBJECTIVE

This study aimed to: 1) examine the severity and frequency of pain and the extent to which pain interferes with work and 2) explore the contributions of motor impairments to pain in people with Parkinson's disease (PD).

METHOD

Pain severity, frequency and the impact of pain on work were determined using subscores from the SF-36, Parkinson's Disease Questionnaire and SF-12v2, respectively, in 231 people with Parkinson's disease. Motor impairments were measured using the Unified Parkinson's Disease Rating Scale. Freezing of gait was determined as its presence or absence in the last month. Associations between impairments and pain were examined using logistic regression.

RESULTS

Pain was reported by 187 (81%) participants, with 91 (39%) reporting pain of moderate severity or worse. Pain interfered with work to some extent in 158 (68%) participants. After adjusting for age and gender, increased rigidity was associated with higher pain frequency and more pain that interfered with work (for both models, Odds Ratio = 1.14, 95% confidence interval 1.0-1.3). Tremor was not associated with any measures of pain and motor impairments were not associated with pain severity.

CONCLUSIONS

Most people with PD experience pain at least monthly and pain interferes with daily activities. PD impairments are associated with more frequent pain and pain that interferes with work, with rigidity having the strongest association. Development of Parkinson's disease-specific pain assessments and further investigation into the association between PD impairments and pain is warranted.

摘要

目的

本研究旨在:1)检查疼痛的严重程度和频率以及疼痛对工作的干扰程度;2)探讨运动障碍对帕金森病(PD)患者疼痛的影响。

方法

分别使用SF-36、帕金森病问卷和SF-12v2的子评分,对231名帕金森病患者的疼痛严重程度、频率及疼痛对工作的影响进行测定。使用统一帕金森病评定量表测量运动障碍。根据过去一个月是否存在冻结步态来确定其情况。使用逻辑回归分析障碍与疼痛之间的关联。

结果

187名(81%)参与者报告有疼痛,其中91名(39%)报告疼痛程度为中度或更严重。158名(68%)参与者的疼痛在一定程度上干扰了工作。在对年龄和性别进行校正后,肌张力增高与更高的疼痛频率以及更多干扰工作的疼痛相关(两种模型的比值比均为1.14,95%置信区间为1.0-1.3)。震颤与任何疼痛指标均无关联,运动障碍与疼痛严重程度也无关联。

结论

大多数帕金森病患者至少每月经历一次疼痛,且疼痛会干扰日常活动。帕金森病相关障碍与更频繁的疼痛以及干扰工作的疼痛相关,其中肌张力增高的关联最为强烈。有必要开发针对帕金森病的疼痛评估方法,并进一步研究帕金森病相关障碍与疼痛之间的关联。

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