A new method for the evaluation of cervical dystonia

Objectives: The study aimed to develop a measurement method that yielded objective data for the clinical assessment of cervical dystonia using a Kinect camera system. Patients and methods: This double-blind, parallel-group method development study included 22 patients with cervical dystonia (3 males, 19 females; mean age: 47 years; range, 34 to 60 years) and 20 healthy individuals (13 females, 7 males; mean age: 32 years; age range, 22 to 65). Using cameras and a computer software, the head-neck postures of 40 healthy participants were recorded in the virtual environment. Using the device, 22 patients with cervical dystonia were examined both at rest and while moving with different parts of the body. Two different experts evaluated and scored the cases using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the Tsui scale. Results: A three-way comparison revealed interclass correlations between the coefficients of 0.799 (79.9%) and 0.784 (78.4%) for at rest and with movement, respectively. The two-way comparison of the experts revealed correlation coefficients of 0.717 (71.7%) and 0.692 (69.2%) for at rest and with movement, respectively. A three-way comparison of the device and Expert 1 and Expert 2 TWSTRS scores revealed interrater agreement values of 0.6 and 0.8 (good) and 0.6 and 0.8 (good) while at rest and with movement, respectively. A three-way comparison of the device and Expert 1 and Expert 2 Tsui scores revealed interrater agreement values of 0.6 and 0.8 (good) and 0.4 and 0.6 (moderate) while at rest and with movement, respectively. Conclusion: The newly developed system was a sensitive tool for use in the kinematic evaluation of patients with cervical dystonia and could prove beneficial in diagnosis and treatment follow-up.