1324 - A Cross-sectional Analysis of Regional Pain and Functional Assessment of Patients in an Early-stage Parkinson’s Disease Program

Objectives: Physical activity may reduce motor symptom burden and increase quality of life in individuals with Parkinson’s Disease (PD). A frequently reported barrier to physical activity is pain, a common PD symptom with prevalence estimates ranging from 40 to 85%. Even prior to the onset of major motor symptoms, as many as 43% of PD patients report pain. Understanding the associations between regional pain and functional outcomes in physical therapy can help providers better tailor therapies that promote program adherence and support improved early PD outcomes.

Design: We extracted data from 355 patients evaluated in a proactive physical therapy program for early-stage PD patients (Hoehn and Yahr stage 1 or 2) between January 2016 and May 2023. Self-reported pain was categorized as axial, lower extremity, or upper extremity. The Six Minute Walk Test (6MWT) and Functional Gait Assessment (FGA) were used as metrics for walking capacity and dynamic balance, respectively. We evaluated whether functional performance was different between those with and without pain using an unpaired t-test.

Results: Among the 355 early-stage PD participants (mean age: 68.6 years; 33% female), roughly one-third (n=123) reported pain (axial: n=63; lower extremity: n=48, upper extremity: n=36). 314 participants completed the 6MWT, 104 of whom reported pain. 300 completed the FGA, 97 of whom reported pain. Walking capacity was lower in individuals who reported axial (1625±373 m), lower extremity (1589±439 m), or upper extremity (1638±424 m) pain compared to no pain (1779±342 m, p< 0.05). Dynamic balance was lower in those who reported axial (24.5±4.8) or lower extremity (25.5±3.7) pain compared to no pain (26.7±3.0, p< 0.05).

Conclusions:
Self-reported pain is associated with reduced walking capacity and dynamic balance in patients with early PD. Providers should consider the relationship between pain and functional capacity to optimize movement and physical therapy outcomes in individuals with early PD.