Validity of the wall goniometer as a screening tool to detect postural abnormalities in Parkinson's disease. (December 2019)

• Record Type: Journal Article
• Authors: Tinazzi, Michele; Gandolfi, Marialuisa; Artusi, Carlo Alberto; Lanzafame, Ruggero; Zanolin, Elisabetta; Ceravolo, Roberto; Capecci, Marianna; Andrenelli, Elisa; Ceravolo, Maria Gabriella; Bonanni, Laura; Onofrj, Marco; Telese, Roberta; Bertolotti, Claudio; Polverino, Paola; Manganotti, Paolo; Mazzucchi, Sonia; Giannoni, Sara; Vacca, Laura; Stocchi, Fabrizio; Casali, Miriam; Zibetti, Maurizio; Lopiano, Leonardo; Fasano, Alfonso; Geroin, Christian
• Is Part Of: Parkinsonism & related disorders. Volume 69(2019)
• Page Start: 159
• Page End: 165
• Publication Date: 2019-12
• Subjects: Movement disorders -- Parkinsonism -- Bent spine syndrome -- Angle measurement -- Posture; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2019.10.024
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Software-based measurements of postural abnormalities in Parkinson's disease (PD) are the gold standard but may be time-consuming and not always feasible in clinical practice. Wall goniometer (WG) is an easier, quicker, and inexpensive instrument for screening patients with postural abnormalities, but no studies have investigated its validity so far. The aim of this study was to investigate the validity of the WG to measure postural abnormalities. Methods: A total of 283 consecutive PD outpatients with ≥5° forward trunk, lateral trunk or forward neck bending (FTB, LTB, FNB, respectively) were recruited from seven centers for movement disorders. Postural abnormalities were measured in lateral and posterior view using a freeware program (gold standard) and the WG. Both angles were expressed in degrees (°). Sensitivity and specificity for the diagnosis of camptocormia, Pisa syndrome, and anterocollis were assessed. Results: WG showed good to excellent agreement (intraclass correlation coefficient from 0.80 to 0.98) compared to the gold standard. Bland-Altman plots showed a mean difference between the methods from −7.4° to 0.4° with limits of agreements from −17.7° to 9.5°. Sensitivity was 100% for the diagnosis of Pisa syndrome, 95.74% for anterocollis, 76.67% for upper camptocormia, and 63.64% for lower camptocormia. Specificity was 59.57% for Pisa syndrome, 71.43% for anterocollis, 89.80% for upper camptocormia, and 100% for lower camptocormia. Overall, the WG underestimated measurements, especially in lower camptocormia with an average of −8.7° (90% of cases). Conclusion: WG is a valid tool for screening Pisa syndrome and anterocollis, but approximately 10° more should be added for camptocormia. Highlights: WG showed good to excellent agreement as compared with the gold standard. WG has an excellent sensitivity for screening of Pisa syndrome and anterocollis. WG underestimated the measures of upper camptocormia by −6.1° on average. WG underestimated the measures of lower camptocormia by −8.7°on average. Approximately 10° more should be added when measuring camptocormia.