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帕金森病患者的腰痛:一项横断面研究其患病率及其对功能能力和生活质量的影响。

Low back pain in Parkinson's disease: A cross-sectional study of its prevalence, and implications on functional capacity and quality of life.

机构信息

Program in Neuroscience, Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Clin Neurol Neurosurg. 2020 Jul;194:105787. doi: 10.1016/j.clineuro.2020.105787. Epub 2020 Mar 16.

Abstract

OBJECTIVE

The aim of this study was to estimate the prevalence of low back pain (LBP) in patients with Parkinson's disease (PD) and its impact on functional capacity and quality of life.

METHODS

Patients with idiopathic PD answered a questionnaire and were submitted to a clinical and functional assessment. Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale, Beck Depression Inventory (BDI), McGill Pain Questionnaire (McGill), Roland Morris Disability Questionnaire (RMDQ), 39-item Parkinson's Disease Questionnaire (PDQ-39) were used. In addition, the ability to contract transversus abdominis (TrA) was assessed.

RESULTS

One hundred and fifteen patients answered the questionnaire, and 95 (82.6 %) reported painful symptoms. Of these, 67 (58.3 %) had chronic LBP, and approximately 40 % patients reported its onset before diagnosis of PD. Higher scores in pain intensity, depressive symptoms and UPDRS II and III, more advanced stages of PD, and absence of TrA contraction determined poor functional limitation induced by LBP. However, pain intensity (McGill), severity of PD symptoms (UPDRS III) and absence of TrA contraction were identified as predictive factors for functional limitation and explained 66.1 % of the variance in the RMDQ. Pain intensity and LBP-related disability caused negative impact on the quality of life.

CONCLUSION

LBP is common in patients with PD and it causes disability and poor quality of life. Pain intensity, UPDRS III and absence of TrA contraction were the most significant predictive factors for disability assessed by the RMDQ.

摘要

目的

本研究旨在评估帕金森病(PD)患者腰痛(LBP)的患病率及其对功能能力和生活质量的影响。

方法

特发性 PD 患者回答问卷并接受临床和功能评估。使用统一帕金森病评定量表(UPDRS)、Hoehn 和 Yahr 量表、贝克抑郁量表(BDI)、麦吉尔疼痛问卷(McGill)、罗伦兹·莫里斯残疾问卷(RMDQ)、39 项帕金森病问卷(PDQ-39)。此外,还评估了横腹肌(TrA)的收缩能力。

结果

115 名患者回答了问卷,其中 95 名(82.6%)报告有疼痛症状。其中,67 名(58.3%)患有慢性 LBP,约 40%的患者报告在 PD 诊断前出现 LBP。疼痛强度、抑郁症状和 UPDRS II 和 III 评分较高、PD 分期较晚、TrA 收缩缺失均导致 LBP 引起的功能受限较差。然而,疼痛强度(麦吉尔)、PD 症状严重程度(UPDRS III)和 TrA 收缩缺失被确定为功能受限的预测因素,解释了 RMDQ 中 66.1%的变异性。疼痛强度和与 LBP 相关的残疾对生活质量产生负面影响。

结论

LBP 在 PD 患者中很常见,会导致残疾和生活质量下降。疼痛强度、UPDRS III 和 TrA 收缩缺失是 RMDQ 评估残疾的最显著预测因素。

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