Camptocormia: a biomechanical analysis. A case report

Abstract

Although camptocormia, a conversion disorder associated with the disability of severely forward-bent posture, has been reported in the literature, to date there has been no report of a detailed kinematic or biomechanical analysis of this disability. Presented is a 47-yr-old male engineer with severely forward-bent posture during walking. One year ago, after playing tennis, he developed low back pain followed by a sensation that to walk comfortably he had to assume a forward-bent posture. Two months later, although the low back pain had resolved, he maintained the same unusual walking pattern. Although he could walk a few steps in the upright position, he would spontaneously revert to the forward-bent posture. Physical examination was normal except for bilateral 10 degree hip flexion contractures. Gait laboratory analysis, including kinematics, kinetics, and dynamic electromyography, revealed exaggerated anterior pelvic tilt during terminal stance when he walked in an upright posture. In the forward-bent posture, however, this anterior pelvic tilt was significantly less. It is possible that his unusual forward-bent posture was a compensatory mechanism to reduce excessive pelvic tilt. Although this rare disability has been previously attributed to a conversion disorder, there may be, in some instances, a biomechanical component.