Consensus for the measurement of the camptocormia angle in the standing patient

Nils G. Margraf, Robin Wolke, Oliver Granert, Alfredo Berardelli, Bastian R. Bloem, Ruth Djaldetti, Alberto J. Espay, Alfonso Fasano, Yoshihiko Furusawa, Nir Giladi, Mark Hallett, Joseph Jankovic, Miho Murata, Michele Tinazzi, Jens Volkmann, Daniela Berg, Günther Deuschl*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Introduction: Camptocormia is characterized by a pathological forward flexion of the trunk, which is reversible when lying and worsened by standing and walking. So far there is no consensus on how to measure the angle of flexion, and studies therefore give differing results. Harmonization is needed for both research and clinical practice. Orthopedic measures are not useful for this purpose. Methods: Two expert raters independently analyzed the photographs of 39 Parkinson patients with camptocormia while standing. They used four different methods to determine the camptocormia angle. The results were compared statistically. An international Consensus Group reviewed the results and drafted recommendations. Results: The four methods yielded camptocormia angles that differed by up to 50% in the same patient. Inter-rater reliability and test-retest reliability also differed, but were satisfactory to excellent. Conclusion: This Consensus Group concluded that two of the methods qualified as reliable measures of the trunk angles in standing patients based on their clinimetric properties. They propose that the ‘total camptocomia angle’ be the angle between the line from the lateral malleolus to the L5 spinous process and the line between the L5 spinous process and the spinous process of C7. They also propose that the ‘upper camptocormia angle’ be the angle of the lines between the vertebral fulcrum to the spinous processes of L5 and C7, respectively. An app is provided on the web for these measurements (http://www.neurologie.uni-kiel.de/de/axial-posturale-stoerungen/camptoapp).

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalParkinsonism and Related Disorders
Volume52
DOIs
StatePublished - Jul 2018

Funding

FundersFunder number
Janssen Pharmaceutica N.V.
McLaughlin Centre
Parkinson Fonds Deutschland gGmbH
Parkinson’s Foundation
Topsector Life Sciences and Health
USWorldMeds
National Institutes of Health
National Institute of Neurological Disorders and StrokeZIANS003031
Michael J. Fox Foundation for Parkinson's Research
Dystonia Medical Research Foundation
Pfizer
Bayer
Novartis
Roche
Medtronic
American Academy of Neurology
CHDI Foundation
Teva Pharmaceutical Industries
AbbVie
F. Hoffmann-La Roche
Chiesi Farmaceutici
Allergan
International Parkinson and Movement Disorder Society
Boston Scientific Corporation
Novartis Pharma
Acadia University
Japan Agency for Medical Research and Development
Sunovion
Ucb
ACADIA Pharmaceuticals
Neurocrine Biosciences
UCB Pharma
European Parkinson’s Disease Association
Great Lakes Neurotechnologies
Verily Life Sciences
Deutsche Forschungsgemeinschaft
Ministry of Education, Culture, Sports, Science and Technology
Bundesministerium für Bildung und Forschung
Bundesministerium für Wirtschaft und Technologie
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Ministry of Health, Labour and Welfare
University of Toronto
Eisai
Kyowa Hakko Kirin
Bundesministerium für Wirtschaft und Energie
Bundesministerium für Bildung und Frauen
Università degli Studi di Verona
Otsuka Pharmaceutical
Oxford University Press
Hersenstichting
Stichting ParkinsonFonds
Pharmaceuticals Bayer
Erzincan Üniversitesi
Merz Pharmaceuticals
H. Lundbeck A/S
Damp Stiftung
Ipsen

    Keywords

    • Angle measurement
    • Bent spine syndrome
    • Camptocormia
    • Clinical studies

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