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Quantitative assessment of posture in healthy controls and patients with Parkinson's disease.
Parkinsonism & Related Disorders ( IF 4.1 ) Pub Date : 2020-01-28 , DOI: 10.1016/j.parkreldis.2020.01.012
Christian Schlenstedt 1 , Kathrin Boße 1 , Olga Gavriliuc 2 , Robin Wolke 1 , Oliver Granert 1 , Günther Deuschl 1 , Nils G Margraf 1
Affiliation  

INTRODUCTION A stooped posture is a main clinical feature of Parkinson's disease (PD). The assessment of posture is important to measure treatment effects. The aim of this study was to investigate the reliability of a standardized postural rating tool, to calculate minimal detectable change scores and to assess the role of gender and age. METHODS Two independent raters assessed total camptocormia (TCC), upper camptocormia (UCC) and Pisa angles of 192 PD patients and 78 healthy controls (HC) with the free NeuroPostureApp©(http://www.neuroimaging.uni-kiel.de/NeuroPostureApp). Reliabilities and linear models were calculated for different effects. Three subgroups were defined based on two thresholds (mean+2SD of HC and PD): A) normal, B) presumed stooped/lateral bended posture and C) postural disorder. RESULTS Intraclass correlation coefficients ranged between 0.71 and 0.95 for the interrater and test-retest reliability of the three angles. The minimal detectable change values in the PD patients were 3.7°, 6.7° and 2.1° for the TCC, UCC and Pisa angles, respectively. Men had a more stooped posture than women (p < 0.05). Patients with PD had a worse posture than HC (p < 0.001) in all three angles. For the TCC angle, 39.1% of the patients had a normal posture (<17.4°), 47.9% a presumed stooped posture (>17.4°, <30.2°) and 6.3° had camptocormia (>30.2°). CONCLUSIONS The NeuroPostureApp© is reliable. Our results confirmed gender differences and the progression of postural deviation in PD patients with age and empirically support the ≥30° TCC angle as a defining criterium for camptocormia. Diagnostic criteria for UCC and Pisa syndrome should be further explored in future studies.

中文翻译:

健康对照者和帕金森病患者姿势的定量评估。

引言 弯腰姿势是帕金森病 (PD) 的主要临床特征。姿势的评估对于衡量治疗效果很重要。本研究的目的是调查标准化姿势评级工具的可靠性,计算最小可检测变化分数并评估性别和年龄的作用。方法 两名独立评估者使用免费的 NeuroPostureApp©(http://www.neuroimaging.uni-kiel.de/) 评估了 192 名 PD 患者和 78 名健康对照 (HC) 的总弯曲度 (TCC)、上弯曲度 (UCC) 和 Pisa 角。 NeuroPostureApp)。计算不同效果的可靠性和线性模型。基于两个阈值(HC 和 PD 的平均值 + 2SD)定义了三个亚组:A) 正常,B) 假定的弯腰/侧弯姿势和 C) 姿势障碍。结果 三个角度的评分者间和重测信度的组内相关系数介于 0.71 和 0.95 之间。对于 PD 患者,TCC、UCC 和 Pisa 角的最小可检测变化值分别为 3.7°、6.7° 和 2.1°。男性比女性有更多的弯腰姿势(p < 0.05)。在所有三个角度,PD 患者的姿势都比 HC 差(p < 0.001)。对于 TCC 角,39.1% 的患者姿势正常(<17.4°),47.9% 的患者假定弯腰姿势(>17.4°,<30.2°)和 6.3° 的患者有斜角(>30.2°)。结论 NeuroPostureApp© 是可靠的。我们的结果证实了 PD 患者的性别差异和随年龄增长的姿势偏差的进展,并从经验上支持 ≥ 30° TCC 角作为弯曲皮质的定义标准。
更新日期:2020-01-28
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