Avaliação do perfil de dor e qualidade de vida de pessoas com Parkinson em um estado Amazônico: um estudo analítico- descritivo

Abstract

Introduction: Parkinson’s Disease (PD) is one of the most prevalent neurodegenerative conditions worldwide, characterized by classical motor symptoms and non-motor symptoms, among which pain stands out. Assessing pain in people with Parkinson’s and understanding its profile is both challenging and necessary to improve healthcare and rehabilitation for this population, as pain is associated with disability and impacts quality of life. Objective: To describe the profile of the sensory-discriminative component of pain (threshold, intensity, location, duration, and interference) in people with Parkinson’s Disease from a community in an Amazonian state, and to analyze the association between these variables and clinical, sociodemographic data, and quality of life. Materials and Methods: This is a cross-sectional, analytical-descriptive, and exploratory study that assessed pain location, intensity, interference, and pain threshold in individuals with Parkinson’s Disease, as well as their quality of life and clinical and functional parameters. The study followed the ethical guidelines of Resolution CNS 580/18 and was approved by the Research Ethics Committee of the Health Sciences Institute of the Federal University of Pará (CAAE: 72924423.9.0000.0018). The assessment tools used were: the Brief Pain Inventory – Short Form to evaluate pain location, intensity, and interference; a pressure algometer to assess pain threshold; the Movement Disorder Society – Unified Parkinson's Disease Rating Scale part III and the modified Hoehn & Yahr Scale to determine disease severity and stage; the Mini-Mental State Examination for cognitive screening; and the Parkinson’s Disease Questionnaire – 39 to assess quality of life. Sociodemographic, anthropometric, and health history data were also collected. Descriptive statistics were used for data analysis and are presented as mean, standard deviation, median and interquartile range, and absolute and relative frequencies. Normality was tested using the Shapiro-Wilk test. Pearson’s or Spearman’s correlation test was used depending on the parametric or non-parametric distribution of the variables. Associations were analyzed between quality of life, pain intensity, and pain interference. A p-value < 0.05 was considered statistically significant. Results: A total of 42 individuals with Parkinson’s Disease participated in the study (73% men, 67.1 ± 9.2 years of age, 45.2% with 8 to 12 years of education, and 59.5% married). The average BMI was 26.14 ± 4.69 kg/m². Clinically, participants were in the early stage of the disease, as observed in the MDS-UPDRS III and H&Y. The frequency of pain in the sample was high (92.9%), with the lumbar region being the most affected (24.3%). Pain intensity was considered mild, but with severe interference in functionality (>2), especially in general activities, mood, mobility, and sleep. Regarding pain threshold, no significant 10 differences were found when stratified by sex, education, time since diagnosis, and disease stage. Quality of life was classified as low impact overall, with the greatest impairments in the domains of Emotional Well-being, Bodily Discomfort, Mobility, and Activities of Daily Living. Correlation analyses showed a significant association between lower quality of life and greater pain, with moderate positive correlations for worst reported pain (r = 0.41; p = 0.01), pain interference with general activity (r = 0.45; p < 0.01), and ability to enjoy life (r = 0.41; p = 0.01). Association analyses indicated that pain interference in functionality explained up to 23% of the variance in quality of life in the general model. For females, pain interference in general activity, mood, and ability to enjoy life explained 64% of the variance in quality of life, while for males, the association accounted for 15%. Conclusion: The findings of our study suggest potential assessment tools that can be integrated into routine clinical follow-up, offering important descriptive data on pain characteristics in individuals with PD. Moreover, we emphasize the importance of adequate pain management in PD to reduce interference in functionality and improve overall quality of life.