Osteoarthritis Increases Paresthestic and Akathisic Pain, Anxiety Case-ness, and Depression Severity in Patients With Parkinson's Disease

Rana, Abdul Qayyum; Qureshi, Abdul Rehman; Akhter, Shakib; Ingar, Yameen; Ali, Ayub; Abdullah, Ismael Y.; Madhosh, Obaidullah; Sarfraz, Zainab; Rana, Muhammad B.; Rana, Ruqqiyah

doi:10.3389/fneur.2018.00409

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…We suggest that BWSTT might protect the joints by decreasing their loading and thus provide movement with less pain. This may be important in PD as subjects with moderate to advanced disease have higher rates of pain, which may be related to concomitant osteoarthritis [25,26]. Supporting our findings, in a previous study of knee osteoarthritis [27], pain reduction was achieved after 12 weeks of lower body positive pressure supported TT compared with full body weight TT.…”

Section: Discussionsupporting

confidence: 87%

Effects of different percentages of body weight-supported treadmill training in Parkinson’s disease: a double-blind randomized controlled trial

Atan¹,

Taşkıran²,

Tokçaer³

et al. 2019

Turk J Med Sci

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Introduction Parkinson's disease (PD) is a progressive and degenerative disorder characterized by an inadequate production of dopamine due to pathology in the substantia nigra. Rigidity, bradykinesia, and postural instability are the cardinal features that lead to gait impairment and functional limitations [1]. Gait and balance impairments are important determinants of disability and quality of life in PD [2]. Overall, fatigue is one of the most common and disabling nonmotor symptoms and can be seen at all stages of the disease [3]. Aerobic training with treadmill training (TT) is effective in improving the gait, balance, and quality of life and relieving fatigue in subjects with PD [4,5]. Body weight-supported treadmill training (BWSTT) allows safe walking practice by supporting a portion of the body weight mechanically and stimulates activity-dependent neural plasticity [6]. Furthermore, physical performance and aerobic activities can be performed at higher intensities when the body weight is partially supported during walking compared to conventional TT [7]. This is especially beneficial in the rehabilitation of neurologically Background/aim: Body weight-supported treadmill training (BWSTT) might have greater effects than conventional treadmill training (TT) in neurological diseases such as Parkinson's disease (PD). The aim of this study was to evaluate the effects of different percentages of BWSTT on gait, balance, quality of life, and fatigue in PD. Materials and methods: Thirty-five patients with moderate to advanced PD were randomized into three BWSTT groups according to the supported percentage of body weight: 0% BWSTT (control group; unsupported TT), 10% BWSTT, or 20% BWSTT. Five patients were excluded due to early discharge and 30 patients completed BWSTT sessions lasting 30 min, 5 days a week, for 6 weeks during their inpatient rehabilitation stay. The primary outcome was 6-min walk distance (6MWD). Secondary outcomes were Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale (BBS), Nottingham Health Profile (NHP), Fatigue Impact Scale, and Fatigue Severity Scale scores. Measurements were performed before and after the training. Results: The unsupported TT group demonstrated no significant improvement in the outcome measures after a 6-week training except for BBS and NHP emotional subscores. Moreover, the NHP pain subscore increased in the unsupported TT group after training. The 10% and 20% supported BWSTT groups demonstrated significant improvements in 6MWD (P = 0.004 and P < 0.001, respectively), UPDRS-motor score (P = 0.012 and P = 0.005, respectively), NHP pain subscore (P = 0.003 and P = 0.002, respectively), and fatigue (P = 0.005 for both) after training. The 20% BWSTT provided the highest improvement in balance among the three groups (P < 0.001) and greater relief of fatigue than 10% BWSTT (P = 0.002). Conclusion: Six weeks of BWSTT improved walking distance and balance ability, relieved fatigue, and additionally reduced pain in patients with moderate to advanced PD.

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Section: Discussionsupporting

confidence: 87%

Effects of different percentages of body weight-supported treadmill training in Parkinson’s disease: a double-blind randomized controlled trial

Atan¹,

Taşkıran²,

Tokçaer³

et al. 2019

Turk J Med Sci

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“…Patients with PD that have co-morbid osteoarthritis reported specific pain characteristics. They were more likely to have paraesthesia- and akathisia-related pain, and less likely to have aching pain, compared to patients with PD without osteoarthritis [ 25 ]. Patients with PD might also display increased thoracic kyphosis and decreased truncal mobility, which can lead to humeral-acromial impingement syndrome and capsulitis.…”

Section: Classification Of Pain In Pdmentioning

confidence: 99%

An overview of pain in Parkinson's disease

Tai

Lin

2020

Clinical Parkinsonism & Related Disorders

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Pain is a common non-motor symptom of Parkinson's disease (PD) and the prevalence of pain among PD patients varies because of the disease stage, co-morbidities, and evaluating tools. Risk factors for pain in PD include an early age of onset, long disease duration, motor complications, concomitant depressive symptoms, female gender, and associated medical conditions. In patients with PD, pain can be classified as musculoskeletal pain, chronic body pain (central or visceral), fluctuation-related pain, nocturnal pain, orofacial pain, pain with discolouration/oedema/swelling, and radicular/neuropathic pain; musculoskeletal pain as the most common type. Potential underlying mechanisms include a disruption of peripheral nociception and alterations in central pain threshold/processing. Genetic polymorphisms in genes that confer pain susceptibility might also play a role in the occurrence of pain in PD. In advanced stage of patients with PD, polyneuropathy could occur in patients using high dosage of levodopa. Pain often correlates to other non-motor symptoms of PD, including depression, sleep, and autonomic symptoms. Dopaminergic drugs, non-dopaminergic medications, botulinum toxin, deep brain stimulation, and physiotherapy have shown some benefits for certain types of PD-related pain. An increased awareness of pain as a common non-motor symptom of PD provides further insights into sensory system dysregulation in this disease. In this review, we aim to summarizes the clinical features of pain in patients with PD and emphasize the latest evidence of pain related to levodopa treatment.

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“…As we know from the literature, osteoarthritis, traumatic arthritis, and other types of joint disorders can also be seen in PD [16]. There is limited data about the frequency of osteoarthritis in PD from Rana et al [19], and in this study. They reported 34 patients with osteoarthritis out of 68 patients with PD.…”

Section: Discussionmentioning

confidence: 56%

“…They reported 34 patients with osteoarthritis out of 68 patients with PD. Mean duration of PD was approximately 4 years which was shorter than the disease duration of our pwPD, and the patients had mild to moderate PD according to the UPDRS motor scores, and H & Y scores as well [19].…”

Section: Discussionmentioning

confidence: 64%

Frequency of Comorbid Musculoskeletal Problems in Patients with Parkinson’s Disease: What and When?

Değirmenci¹,

Değirmenci²

2019

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Background: Musculoskeletal problems, deteriorating posture and pain are common complaints/comorbidities in Parkinson's disease (PD). The aim of this study was to investigate the frequency of comorbid musculoskeletal problems in PD, and their relationship with disease stage and severity. Methods: The study was approved by the local ethical committee of Duzce University numbered with 2018/52 on date 26.03.2018. Patients with PD (pwPD) underwent a detailed examination to investigate the possible comorbidity of musculoskeletal findings in the orthopedics and traumatology clinic. Socio-demographic features, disease characteristics, motor and non-motor scores were recorded. Results: Thirty-seven pwPD were enrolled in the study. Mean age was 68.75 ± 10.75 years. Comorbid musculoskeletal problems were rotator cuff syndrome (27%), knee osteoarthritis (24.3%), meniscus (13.5%), lumber disc herniation (10.8%), kyphosis (8.1%), myotendinous diseases (16.3%). Rotator-cuff disease and knee osteoarthritis were most common comorbidities, especially in the "mild" and "moderate" stages of pwPD. Conclusion: Since most of the pwPD, especially the ones that have musculoskeletal complaints prior to the diagnosis of PD, present to the orthopedics and traumatology clinics or physiotherapists, it is mandatory to enhance the awareness of the orthopedic surgeons, and physiotherapy specialist in order to keep PD in mind.

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Osteoarthritis Increases Paresthestic and Akathisic Pain, Anxiety Case-ness, and Depression Severity in Patients With Parkinson's Disease

Cited by 9 publications

References 34 publications

Effects of different percentages of body weight-supported treadmill training in Parkinson’s disease: a double-blind randomized controlled trial

Effects of different percentages of body weight-supported treadmill training in Parkinson’s disease: a double-blind randomized controlled trial

An overview of pain in Parkinson's disease

Frequency of Comorbid Musculoskeletal Problems in Patients with Parkinson’s Disease: What and When?

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