Analysis of risk factors for the occurrence and aggravation of lower back pain in Parkinson's disease patients
Objective To explore the independent risk factors for the occurrence and aggravation of lower back pain(LBP)in patients with Parkinson's disease(PD),in order to provide reference for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on the case data of 309 PD patients who visited the Affiliated Yixing Hospital of Jiangsu University from June 2018 to May 2020.The KING Parkinson's Disease Pain Scale(KPPS)was used to quantitatively evaluate the LBP of PD patients,who were divided into LBP group and Non LBP group.The general clinical data,PD related data,and imaging data of the two groups were compared and analyzed.Binary logistic regression analysis was used to evaluate independent risk factors for LBP in PD patients.Pearson correlation analysis was conducted between KPPS scores and various factors,and linear regression analysis was used to identify the relevant risk factors that exacerbate LBP in PD patients.Results Compared with the Non LBP group,the LBP group had lower bone mineral density(BMD)and a lower proportion of patients who engaged in daily exercise.The difference between the two groups was statistically significant(all P<0.05).Compared with the Non LBP group,patients in the LBP group had a longer course of illness,higher stiffness scores,a higher proportion of patients with fluctuating symptoms,higher UPDRS-Ⅲ scores,and a higher proportion of patients with thoracolumbar fascial injury(TLFI)and lumbar sagittal imbalance.The differences between the two groups were statistically significant(all P<0.05).The results of binary logistic regression analysis showed that combined TLFI(OR=2.773,95%CI:1.219-6.309,P=0.015),combined lumbar sagittal imbalance(OR=4.835,95%CI:2.244-10.421,P<0.001),and lower BMD(OR=2.818,95%CI:1.767-4.493,P<0.001)were risk factors for LBP in PD patients.The KPPS score was correlated with BMD and TLFI(r=-0.146,0.294,all P<0.05).The linear regression results showed that the merged TLFI(B=2.271,β=0.285,P<0.001)was positively correlated with KPPS score,indicating a risk factor.Conclusions The combination of TLFI,lumbar sagittal imbalance,and lower BMD is closely related to the occurrence of LBP in PD patients,and the combination of TLFI is an independent risk factor for exacerbating LBP symptoms.Clinical attention should be paid to the prevention and treatment of TLFI in PD patients.
Parkinson's diseaseLow back painFascia injuryRisk factor