Department of Neurology, UKSH, Christian-Albrechts University Kiel, Germany.
Department of Human Neuroscience, Sapienza, University of Rome and IRCCS NEUROMED, Pozzilli, Italy.
Parkinsonism Relat Disord. 2018 Jul;52:1-5. doi: 10.1016/j.parkreldis.2018.06.013. Epub 2018 Jun 8.
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.
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.
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.
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).
躯体前倾是一种以病理性的躯干前屈为特征的疾病，这种前屈在平卧时可以得到缓解，而在站立和行走时则会加重。迄今为止，对于如何测量弯曲角度还没有达成共识，因此不同的研究给出了不同的结果。为了研究和临床实践的目的，需要进行协调。骨科测量方法对此目的并不适用。
两名专家评估者独立分析了 39 名患有躯体前倾的帕金森病患者站立时的照片。他们使用了四种不同的方法来确定躯体前倾角度。对结果进行了统计学比较。一个国际共识小组审查了结果并起草了建议。
在同一患者中，四种方法得出的躯体前倾角度相差可达 50%。评估者之间的可靠性和复测可靠性也有所不同，但均为满意到优秀。
该共识小组得出结论，根据临床计量学特性，其中两种方法可作为可靠的站立患者躯干角度测量方法。他们建议将“总躯体前倾角度”定义为从外踝到 L5 棘突的线与 L5 棘突和 C7 棘突之间的线之间的角度。他们还建议将“上躯体前倾角度”定义为分别从椎骨枢轴到 L5 和 C7 的棘突的线之间的角度。该测量方法的应用程序可在网络上获得（http://www.neurologie.uni-kiel.de/de/axial-posturale-stoerungen/camptoapp）。
