Telemedicine intervention in patients with chronic pain in PD

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Project Background/Rationale. Pain is one of the most disabling and common nonmotor symptoms in Parkinson’s disease (PD), with a prevalence of 40-85% (Broen et al., 2012). Research indicates that undertreatment of pain is particularly high in the PD population. Only about one-half of patients with PD who report pain receive regular pain medications (Broen et al., 2012; Negre-Pages et al., 2008; Beiske et al., 2009). There is increasing interest in nonpharmacological treatments for chronic pain in PD to supplement pharmacological approaches. While there is evidence to support the utility of physical exercise to improve chronic pain management, relatively less is known about the role of cognitive exercise. Project Objective. We propose to conduct a pilot randomized, controlled trial in patients with chronic pain in PD to assess the impact of physical and cognitive exercise interventions on pain outcomes. Project Methods. A total of 166 community-dwelling veterans, 40 years of age or older, with chronic pain in mild-to-moderate PD will be randomly assigned in a 2 x 2 factorial design to one of four groups (1 – combined cognitive and physical intervention, 2 – physical intervention only, 3 – cognitive intervention only, 4 – health education). We will test the effects of the interventions at 3 months for the outcomes pain severity and pain interference, both assessed with the use of the Brief Pain Inventory.