Regional Pain is Associated with Functional Performance in People with Parkinson's Disease

Little is known about how pain influences physical function in people with mild Parkinson disease (PwPD). The purpose of this study was to investigate the association between physical function and pain presence, location, and intensity in PwPD who were evaluated in an early physical therapy program.

Retrospective cross-sectional analysis of electronic medical records from patients with PD evaluated at a single center (2016-2023). Pain presence, location, and intensity (0-10 scale) were recorded at the initial physical therapy evaluation. Functional outcomes included 5-time sit-to-stand, 10-meter walk test, 6-minute walk test, timed up and go, mini-BESTest, and Functional Gait Assessment. Multivariable linear and proportional-odds regression models assessed associations between pain (presence and intensity by location) and function, adjusting for age and sex, with significance set at P < 0.05.

Ninety-eight (28%) of the 355 patients with PD reported pain. The presence of pain was associated with worse performance on the 10-meter walk test, 6-minute walk test, and 5-time sit-to-stand test. Those with lower extremity pain had worse gait performance as pain intensity increased. There were no associations between pain intensity and functional performance for those with axial or upper extremity pain.

Even in individuals with early PD, pain was associated with worse gait, endurance, and sit-to-stand performance. Surprisingly, increasing axial pain intensity was not associated with poorer gait performance, but increasing lower extremity pain was. There are opportunities for future studies on integrated pain assessment and management within neurologic Parkinson's care.