Low Back Pain in Parkinson Disease

项目摘要 下背痛（LBP）是帕金森病（PD）中最常见的继发性疾病，影响高达74% 病人。在一般人群中，LBP引起显著的发病率，但LBP在患有 PD尚未得到很好的理解，缺乏治疗选择。非甾体抗炎药提供 疼痛缓解不足。阿片类止痛药是成瘾性的，可能会恶化PD表现，如认知功能障碍。 损伤和便秘。手术治疗PD的失败率和并发症发生率较高。因此，LBP是 往往不解决。物理治疗可以有效降低一般人群的LBP， PD患者LBP的有效治疗选择。然而，PD患者具有疾病特异性 在治疗开发中值得考虑的特征。因此，为LBP定制物理治疗 在PD中需要更好地理解LBP在该人群中的多因素性质。 这项横断面调查的总体目标是全面表征PD中的LBP。我们将 确定已知的因素是否以及如何促成LBP（例如，生物力学、感官和心理学 障碍）在PD患者和老年人之间存在差异。此外，我们将探讨这些损伤如何 导致PD患者的LBP相关残疾。我们的中心假设是PD中的LBP不同（即， 更严重的生物力学、感觉和心理损伤）。这 调查补充了NCMRR的使命，以提高残疾人的健康和生活质量， 开始了解PD中的LBP。这项研究将有助于制定有效的干预措施， 邓肯博士的职业目标是了解并最终防止或减少中学的负担 原发性神经系统疾病患者的肌肉骨骼疼痛状况。邓肯博士的职业发展 该计划将侧重于以下领域的教育：1）临床疼痛的多因素性质， 观点，2）疼痛和PD之间的相互作用，和3）高级统计（例如，多元回归 建模）。邓肯博士将接受乔尔·珀尔马特博士和琳达货车迪伦博士的指导，他们是 分别是PD和LBP领域的世界知名专家。这次调查将在华盛顿进行 圣路易斯大学医学院，一个国际知名的研究机构。运动 疾病中心，跟踪超过2,500人与PD，将提供足够的访问， 这次调查所需的样本从这项研究中获得的信息将奠定基础， 开发PD中LBP的治疗干预措施，这可能会减少残疾并改善生活质量。

Project Summary Low back pain (LBP) is the most prevalent secondary condition in Parkinson disease (PD), affecting up to 74% of patients. In the general population, LBP causes significant morbidity, but the effect of LBP in patients with PD is not well understood and treatment options are lacking. Non-steroidal anti-inflammatory drugs provide insufficient pain relief. Opioid pain medications are addictive and may worsen PD manifestations like cognitive impairment and constipation. Surgery has high failure and complication rates in PD. Consequently, LBP is often not addressed. Physical therapy effectively reduces LBP in the general population and may provide an effective treatment option for LBP in patients with PD. However, people with PD have disease-specific characteristics that warrant consideration in treatment development. As such, tailoring physical therapy for LBP in PD requires a better understanding of the multi-factorial nature of LBP in this population. The overall goal of this cross-sectional investigation is to comprehensively characterize LBP in PD. We will determine whether and how factors known to contribute to LBP (e.g., biomechanical, sensory, and psychologic impairments) differ between people with PD and older adults. Further, we will explore how these impairments contribute to LBP-related disability in people with PD. Our central hypothesis is that LBP in PD is different (i.e., greater severity of biomechanical, sensory, and psychologic impairments) from LBP in older adults. This investigation complements NCMRR’s mission to enhance health and quality of life in people with disabilities by beginning to understand LBP in PD. This study will help to inform the development of effective interventions to address it. Dr. Duncan’s career goal is to understand and ultimately prevent or reduce the burden of secondary musculoskeletal pain conditions in people with primary neurologic disease. Dr. Duncan’s career development plan will focus on education in the following areas: 1) the multi-factorial nature of pain from a clinical perspective, 2) the interaction between pain and PD, and 3) advanced statistics (e.g., multiple regression modeling). Dr. Duncan will receive mentorship from Dr. Joel Perlmutter and Dr. Linda Van Dillen, who are world-renowned experts in PD and LBP, respectively. This investigation will take place at Washington University in St. Louis School of Medicine, an internationally acclaimed research institution. The Movement Disorders Center, which follows more than 2,500 people with PD, will provide more than sufficient access to the sample required for this investigation. Information gained from this study will lay the foundation for development of therapeutic interventions for LBP in PD, which may reduce disability and improve quality of life.