Abstract

Impaired gait is one of the cardinal symptoms of degenerative cervical myelopathy (DCM) and frequently its initial presentation. Quantitative gait analysis is therefore a promising objective tool in the disclosure of early cervical cord impairment in patients with degenerative cervical compression. The aim of this cross-sectional observational cohort study was to verify whether an objective and easily-used walk and run test is capable of detecting early gait impairment in a practical proportion of non-myelopathic degenerative cervical cord compression (NMDCC) patients and of revealing any correlation with severity of disability in DCM. The study group consisted of 45 DCM patients (median age 58 years), 126 NMDCC subjects (59 years), and 100 healthy controls (HC) (55.5 years), all of whom performed a standardized 10-m walk and run test. Walking/running time/velocity, number of steps and cadence of walking/running were recorded; analysis disclosed abnormalities in 66.7% of NMDCC subjects. The DCM group exhibited significantly more pronounced abnormalities in all walk/run parameters when compared with the NMDCC group. These were apparent in 84.4% of the DCM group and correlated closely with disability as quantified by the modified Japanese Orthopaedic Association scale. A standardized 10-m walk/run test has the capacity to disclose locomotion abnormalities in NMDCC subjects who lack other clear myelopathic signs and may provide a means of classifying DCM patients according to their degree of disability.

Highlights

  • Degenerative cervical myelopathy (DCM) is a neurological condition resulting from spinal cord compression arising out of degenerative narrowing of the cervical spinal canal

  • The aim of this study was, to verify whether an objective and easy-to-use gait analysis employing a standardized 10-m walk and run test is capable of detecting early gait impairment in a practical proportion of non-myelopathic degenerative cervical cord compression (NMDCC) subjects and reflecting the severity of disability in degenerative cervical myelopathy (DCM) patients

  • 13 NMDCC subjects we found no clear myelopathic signs during routine clinical evaluation including those with subjective gait problems

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Summary

Introduction

Degenerative cervical myelopathy (DCM) is a neurological condition resulting from spinal cord compression arising out of degenerative narrowing of the cervical spinal canal. It constitutes the leading cause of spinal cord dysfunction in adults worldwide [1,2]. Objective physical signs of myelopathy include upper motor neuron signs in the upper and/or lower limbs (for example, hyper-reflexia/clonus, pyramidal Hoffmann’s, Trömner’s or Babinski’s signs, spasticity or spastic paresis of any of the extremities—most frequently spastic lower paraparesis), flaccid paresis of one or both upper extremities, atrophy of intrinsic hand muscles, sensory involvement in various distributions in upper or lower extremities, and gait ataxia with positive Romberg sign [5,6,7,8,9]

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