Pilates method for low back pain in individuals with Parkinson's disease: A feasibility study.

BACKGROUND: Pain is one of the most common and troublesome non-motor symptoms in Parkinson's disease (PD), including low back pain (LBP). OBJECTIVE: This study aims to evaluate the feasibility, acceptability, and safety of using Pilates for individuals with PD and LBP, as well as the effect on pain intensity, disability, motor and nonmotor PD symptoms, and quality of life. METHODS: Participants received 24 sessions of supervised Pilates twice a week for 12 weeks, each session consisting of 60 min. The isometric contractions of the core muscles were emphasized. RESULTS: Fifteen (13%) of the screened patients were enrolled in the study and continued for the entire 2 months (100%). Participants completed the full training in 352 of 360 sessions (98%). Adverse effects were not reported. Pain and disability were significantly improved after intervention (Visual Analog Scale, p = 0.007; McGill Pain Questionnaire, p = 0.034; Roland-Morris Disability Questionnaire, p = 0.035). There were also significant improvements in depressive symptoms (Beck Depression Inventory, p = 0.028) and PD symptoms (Unified Parkinson's Disease Rating Scale - UPDRSI, UPDRSIII, UPDRS Total). However, there were no statistically significant changes in fatigue and quality of life. CONCLUSIONS: This study suggests that the 12-week Pilates program is feasible and well tolerated by people with PD in mild to moderate stages of the disease. It also appears to be a promising strategy to reduce pain intensity and LBP-related disability, as well as PD motor and non-motor symptoms, which can be associated with this painful symptom. This study provides a basis for future investigations, especially randomized clinical trials.

Low back pain prevalence in Parkinson's disease / Prevalência da dor lombar na doença de Parkinson

ABSTRACT BACKGROUND AND OBJECTIVES: Low back pain is a non-motor symptom commonly reported by individuals with Parkinson's disease. The aim of this study was to identify the prevalence of low back pain and its characteristics in individuals with Parkinson disease from a specialized treatment center. METHODS: Individuals with idiopathic Parkinson's disease answered a questionnaire for the assessment of clinical parameters and associated pain symptoms. Pain intensity was assessed using the visual analog scale. RESULTS: One hundred and twenty-three patients with mean age 68.1±11.8 years, and disease duration of 7.0±4.9 years, answered the questionnaire. Pain was reported by 102 (82.9%) patients: 71 (57.7%) had low back pain and 31 (25.2%) had pain in other body segments. There was no difference in age, education, time of Parkinson's disease symptoms and diagnosis when comparing individuals with and without pain, as well as individuals with pain in other segments and low back pain. The group with low back pain had pain in a greater number of body segments in addition to the lumbar region, with longer duration of this symptom and more frequent use of analgesic drugs. In the low back pain group, women had greater pain intensity. CONCLUSION: The results show the high prevalence of pain in individuals with Parkinson's disease, specifically low back pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar é um sintoma não motor comumente relatado por indivíduos com doença de Parkinson. O objetivo deste estudo foi identificar a prevalência de dor lombar e suas características em indivíduos com doença de Parkinson em um centro de tratamento especializado. MÉTODOS: Indivíduos com doença de Parkinson idiopática responderam a um questionário para a avaliação de parâmetros clínicos e sintomas de dor associados. A intensidade da dor foi avaliada utilizando a escala analógica visual. RESULTADOS: Cento e vinte e três pacientes com idade média de 68,1±11,8 anos e duração média da doença de 7,0±4,9 anos responderam o questionário. A dor foi relatada por 102 (82,9%) pacientes: 71 (57,7%) com dor lombar e 31 (25,2%) com dor em outros segmentos corporais. Não houve diferença quanto à idade, escolaridade, tempo de sintomas e de diagnóstico da doença de Parkinson ao comparar os indivíduos com e sem dor, assim como indivíduos com dor em outras regiões e dor lombar. O grupo com dor lombar queixava-se de dor em maior número de segmentos corporais além da região lombar, com maior tempo de duração desse sintoma e uso mais frequente de analgésicos. Dentre os indivíduos do grupo com dor lombar, as mulheres apresentavam maior intensidade da dor. CONCLUSÃO: Os resultados mostraram alta prevalência da dor em indivíduos com doença de Parkinson, especificamente da dor lombar.

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

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.