Date: Sunday, October 7, 2018
Session Title: Phenomenology and Clinical Assessment Of Movement Disorders
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: To define a consensus-based and clinically applicable method for measuring the camptocormia angle.
Background: Camptocormia is characterized by a pathological forward bending of the trunk, which is reversible upon lying and worsened by standing or walking. So far there is no consensus on how to measure the camptocormia angle. This may contribute to the large differences in the reported prevalence of camptocormia. A consistent, validated and clinically applicable solution is needed.
Methods: Two raters independently measured photos of 39 patients with Parkinson’s disease and camptocormia using four methods of measuring the camptocormia angle. The perpendicular method (PM), the malleolus method (MM) and the fulcrum method (FM) evaluate camptocormia in total and the upper camptocormia method (UCM) focuses only on the bending in the upper parts of the spine.
Results: The four different methods yielded camptocormia angles for the same patients differed significantly by as much as 50%. The FM generated the highest angle values, followed by the MM and then the PM. The absolute difference between the two raters and the standard error were highest for the FM with lower and similar values for the PM, MM and UCM. The interrater-reliability measured with the intra-class correlation coefficient was 0.719 for the FM, 0.985 for the MM, 0.983 for the PM and 0.942 for the UCM. Test-retest reliability done in a subsample was high for all methods.
Conclusions: Camptocormia research needs a consistent and validated angle measurement. It should reflect the severity of camptocormia, be reliable and applicable in lightly dressed patients and distinguish between the total camptocormia angle and upper camptocormia. Consensus recommendation: Consensus was reached to propose the MM as a measure of total camptocormia and UCM for upper camptocormia (Fig. 1). MM is measured as the angle between the line from the malleolus lateralis to the spinous process L5 and the line from L5 to C7. The upper camptocormia angle is measured between the line from L5 to the spinal fulcrum and the line between the fulcrum and C7.
To cite this abstract in AMA style:N. Margraf, R. Wolke, O. Granert, A. Berardelli, D. Berg, B. Bloem, R. Djaldetti, A. Espay, A. Fasano, Y. Furusawa, N. Giladi, M. Hallett, J. Jankovic, M. Murata, M. Tinazzi, J. Volkmann, G. Deuschl. Consensus for the measurement of the camptocormia angle [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/consensus-for-the-measurement-of-the-camptocormia-angle/. Accessed December 1, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/consensus-for-the-measurement-of-the-camptocormia-angle/