Task Force Consensus on Nosology and Cut-Off Values for Axial Postural Abnormalities in Parkinsonism

Abstract

Background:There is no consensus with regard to the nosology and cut-off values for posturalabnormalities in parkinsonism.ObjectiveObjective:To reach a consensus regarding the nosology and cut-off values.MethodsMethods:Using a modified Delphi panel method, multiple rounds of questionnaires were conducted bymovement disorder experts to define nosology and cut-offs of postural abnormalities.ResultsResults:After separating axial from appendicular postural deformities, a full agreement was found for thefollowing terms and cut-offs: camptocormia, with thoracic fulcrum (>45 ) or lumbar fulcrum (>30 ), Pisasyndrome (>10 ), and antecollis (>45 ).“Anterior trunkflexion,”with thoracic (≥25 to≤45 ) or lumbar fulcrum(>15 to≤30 ),“lateral trunkflexion”(≥5 to≤10 ), and“anterior neckflexion”(>35 to≤45 ) were chosen for milderpostural abnormalities.ConclusionsConclusions:For axial postural abnormalities, we recommend the use of proposed cut-offs and six unique terms,namely camptocormia, Pisa syndrome, antecollis, anterior trunkflexion, lateral trunkflexion, anterior neckflexion, to harmonize clinical practice and future research.