Objective: To present a case study using a novel protocol evaluating postural, pain, and respiratory outcome in PD-related camptocormia before and after treatment.

Background: Camptocormia is a painful postural disorder marked by forward trunk flexion during activity that resolves when lying down. Various pharmacological and non-pharmacological approaches can be utilized to alleviate camptocormia (1). Despite these options, a clinical protocol for evaluating effects of treatment remains needed.

Method: We evaluated a 69-year-old male, with a PD diagnosis of 6 years and camptocormia in the last 2 years. He reported bilateral lumbar arching pain when standing and walking. LED 760 mg/day. Postural deformity was assessed with the patient standing against the wall, measuring the distance from the wall to the tragus, C7, 15 cm below C7 and 10 cm above posterior superior iliac spines (PSIS). The patient was instructed to stretch maximally and then to stand in relaxed position (2). Forced Expiratory Volume in 1 second (FEV₁) and Peak Expiratory Flow (PEF) were measured in sitting and standing (3). Pain was rated as a Numerical Rating Scale (NRS) (4). The patient received incobotuliunum toxin type A (Xeomin) injections into the rectus abdominis bilaterally (2 sites of 50 IU per side; total dose 200 IU) and was given a standard home-training program. Assessments were performed pre-and 4 weeks post-treatment.

Results: Tragus -to-wall distance decreased from 21 cm to 15 cm (28%). C7-to-wall decreased from 14 cm to 9 cm (35%). The distance 15 cm below C7 decreased from 7 cm to 6 cm (14%). The distance 10 cm above the PSIS remained 0 cm. No improvement was seen in FEV₁ in sitting (2.53 L vs 2.54 L) or standing (2.28 L vs 2.24 L). PEF decreased slightly in sitting (453 L/min vs 432 L/min). In standing, PEF increased from 415 L/min to 454 L/min, but this change is below clinically significant value of 77,4 L/min (5). FEV₁ (3.25 L) and PEF (492 L/min) were below the reference values (6) both before and after treatment. Pain decreased from 8 to 7, however the minimal clinically important difference (-1,6) (5) was not achieved.

Conclusion: Monitoring segmental distances against a wall may provide a simple way to track camptocormia severity and treatment effects. Positive signals in pain and lung function warrant further research with more sensitive measures and larger, longer‑term cohorts to clarify these findings.

References: 1. Sajin V, Goodall M, Macerollo M. Camptocormia in Parkinson’s disease: state of the art and future directions. Journal of Neurology. 2025;272:638.
2. Bloch F, Hoeto JL, Tezenas du Montcel S, Bonneville F, Etchepare F, Welter ML, et al. Parkinson’s disease with camptocormia. J Neurol Neurosurg Psychiatry. 2006;77:1223–1228.
3. Marinelli P, et al. Effect of camptocormia on lung volumes in Parkinson´s disease. Respiratory Physiology & Neurobiology. 2013;187:164–166.
4. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24
5. Sobreira M, Almeida MP, Gomes A, Lucas m, Oliveira A, Marques A. Minimal Clinically Important Differences for Measures of Pain, Lung Function, Fatigue, and Functionality in Spinal Cord Injury. Physical Therapy, 2021;101:1–11.
6. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault J-C. Lung volume and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J 1993;6: Suppl.16:5–40.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-novel-clinical-protocol-for-monitoring-therapeutic-outcomes-in-camptocormia-in-parkinsons-disease/