Avaliação da fadiga e dor em pacientes com doença de parkinson

Abstract

Parkinson's disease is a common disease in patients over 65 years old, affecting two in every 100 people, and it usually reaches more males, in a ratio of 3: 2, regardless of ethnicity. It has an incidence of 1 to issue 2% in the population over 65 years and 3 to 5% with more than 85 years worldwide. An estimated prevalence in Brazil is 3.3%, a growing issue in the cowntry. Objective: Because fatigue is a common and debilitating symptom in many neurological diseases and the presence of pain affects most patients with Parkinson's disease, this study aims to evaluate fatigue a wellas pain in patients with Parkinson's disease through scales and protocols. Casuistics and Method: After the approval, of the Ethics Committee on Research 60 adult patients with Parkinson's disease were evaluated. The fatigue, pain and depression in these individuals were analyzed and submitted to clinical evaluation. Variables considered included schooling, profession, work activity, number of children and time of diagnosis. Instruments for the evaluation of Parkinson's disease were applied, such as: Unified Parkinson's Disease Assessment Scale (UPDRS), Hoehn and Yahr Scale (HY), Fatigue Severity Scale, Brief Pain Inventory (BPI), Beck Depression Inventory (BDI) and Neuropathic Pain Diagnosis Questionnaire (DN4). Results: A correlation between fatigue and disease progression was found with r = 0.3639 and p = 0.0043; Brief Pain Inventory (BPI) with r = 0.544 and p = <0.0001; Unified Parkinson's Disease Assessment Scale (UPDRS II) with r = 0.5673 and p = <0.0001; and UPDRS III with r = 0.4478 and p = 0.0003. Correlation between Brief Inventory of Pain (BPI) and Questionnaire for Diagnosis of Neuropathic Pain (DN4) with r = 0.3876 and p = 0.0342; the Unified Parkinson's Disease Rating Scale (UPDRS I) at r = 0.3828 and p = 0.0025; UPDRS II with r = 0.3964 and p = 0.0017; UPDRS III with r = 0.2649 and p = 0.0408. Correlation between depression and the Neuropathic Pain Diagnostic Questionnaire (DN4) with r = 0.3002 and p = 0.0221; the Unified Parkinson's Disease Assessment Scale (UPDRS II) at r = 0.381 and p = 0.0032; UPDRS III with r = 0.2607 and p = 0.0481; and UPDRS IV with r = 0.2905 and p = 0.0269. Conclusion: We conclude that Parkinson's disease is a chronic disease that presents several aggravating factors during its evolution, clearly demonstrated in this study. Along with fatigue, disease progression, pain, daily life activity and motor examination show that they are closely related. It is also concluded that pain and depression are present and added to the time of diagnosis, interfering and damaging the activities of daily living, work activity and, also, affect and decline the emotional and mental state and behavior of the individuals.