Hand Dexterity Impairment in Patients with Cervical Myelopathy: A New Quantitative Assessment Using a Natural Prehension Movement

Abstract

Cervical myelopathy (CM) caused by spinal cord compression can lead to reduced hand dexterity. However, except for the 10 sec grip-and-release test, there is no objective assessment system for hand dexterity in patients with CM. Therefore, we evaluated the hand dexterity impairment of patients with CM objectively by asking them to perform a natural prehension movement. Twenty-three patients with CM and 30 age-matched controls were asked to reach for and grasp a small object with their right thumb and index finger and to subsequently lift and hold it. To examine the effects of tactile afferents from the fingers, objects with surface materials of differing textures (silk, suede, and sandpaper) were used. All patients also underwent the Japanese Orthopedic Association (JOA) test. Preoperative patients showed significantly greater grip aperture during reach-to-grasp movements and weaker grip force than controls only while attempting to lift the most slippery object (silk). Patients, immediately after surgery, (n = 15) tended to show improvements in the JOA score and in reaction time and movement time with respect to reaching movements. Multiple regression analysis demonstrated that some parameters of the prehension task could successfully predict subjective evaluations of dexterous hand movements based on JOA scores. These results suggest that quantitative assessments using prehension movements could be useful to objectively evaluate hand dexterity impairment in patients with CM.

A Tablet-Based App for Carpal Tunnel Syndrome Screening: Diagnostic Case-Control Study

“…Some studies have attempted to quantify these movements by using sensors or cameras. Motion capture analysis of the finger in cervical spondylosis [20] and small three-axis gyroscope analysis of thumb movement in CTS [4] have been reported. These methods have advantages in allowing precise measurement of detailed motion; on the other hand, special and precise devices and techniques are needed to achieve this and they are difficult to apply in clinical practice or daily life.…”

Handgrip Strength Correlated with Falling Risk in Patients with Degenerative Cervical Myelopathy

“…Compared with lumbar stenosis, the lack of data on DCM patients and the related risk of falls therein makes it difficult to predict surgical outcomes and postoperative rates of improvement in preoperative neurologic deficits. Additionally, prior studies that have characterized grip strength in association with myelopathic symptoms have presented mixed evidence with postoperative improvement, or no difference [ 34 , 35 , 36 ].…”

Changes in reaching skill in patients with cervical spondylosis after cervical decompression surgery

“…The severity of physical disability was assessed using the JOA score. Although the JOA score includes functions of the lower extremity and bladder, some studies have employed pertinent sub scores or upper extremity function measures (motor function of finger + sensory function) from the JOA score in isolation15, 16 ) . Based on these studies, we selected the items related to upper extremity function: finger motor function (using chopsticks or a spoon, writing, and dressing), manual muscle testing of shoulder and elbow (the deltoid or biceps muscles), and upper extremity sensory function (touch and pain sensation and/or numbness), from the JOA score, and defined this grouping as JOA-UEF (6-point system) for the purpose of the present study.…”