Telemedicine intervention in patients with chronic pain in PD

项目背景/理由。疼痛是一种最致残和常见的非运动症状， 帕金森病（PD），患病率为40-85%（Broen et al.，2012年）。研究表明 疼痛治疗不足在PD人群中尤其高。只有大约一半的PD患者 报告疼痛接受定期止痛药（Broen等人，2012; Negre-Pages等人，2008; Beiske等人，2009年）。 人们越来越关注PD慢性疼痛的非药物治疗， 药理学方法。虽然有证据支持体育锻炼可以改善 慢性疼痛管理，认知运动的作用知之甚少。 项目目标。我们建议在PD慢性疼痛患者中进行一项先导性随机对照试验 评估身体和认知运动干预对疼痛结局的影响。 项目方法。共有166名社区居住的退伍军人，40岁或以上，患有慢性疼痛， 将轻度至中度PD以2 × 2析因设计随机分配至4组之一（1 -组合 认知和身体干预，2 -仅身体干预，3 -仅认知干预，4 -健康 教育）。我们将在3个月时测试干预措施对疼痛严重程度和疼痛结局的影响。 干扰，均使用简明疼痛量表进行评估。

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.