Impaired Postural Stability in Patients With Cervical Myelopathy

Yoshikawa, Masaho; Doita, Minoru; Okamoto, Koji; Manabe, Michihiko; Sha, Norihide; Kurosaka, Masahiro

doi:10.1097/brs.0b013e318178e666

Cited by 33 publications

(38 citation statements)

References 18 publications

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“…In this study, the patients were less accurate in force control (greater error) and showed prolonged release duration in both feet and hands. This extends previous findings showing that force control impairments may be present even in cervical spondylosis patients without neurological signs [35,36]. Anatomically, the CST represents the predominant tract in the lateral spinal cord and we have previously shown a correlation between FA in the lateral cervical spinal cord and accuracy of force control in the precision grip in a larger sample of healthy subjects (same task as in this study) [19].…”

Section: Discussionsupporting

confidence: 82%

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

et al. 2015

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Section: Discussionsupporting

confidence: 82%

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

et al. 2015

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“…The existence of poor balance and functional performance in individuals with DCM before surgical intervention has been reported by several studies (Nardone et al, 2008;Yoshikawa et al, 2008;Haddas et al, 2018b). Our study further demonstrated residual balance instability and functional impairments in postoperative individuals with DCM.…”

Section: Residual Balance Instability and Functional Impairment Aftersupporting

confidence: 83%

“…Several studies have reported balance instability in individuals with spinal disease (Boudreau and Falla, 2014;Hsu et al, 2014Hsu et al, , 2019Wong et al, 2019). Compared with healthy controls, a greater postural sway with increased muscle activation in the trunk and lower extremities was observed during quiet standing in individuals with DCM (Yoshikawa et al, 2008;Haddas et al, 2018b). In addition, delayed neuromuscular recruitment and postural unsteadiness under perturbation were reported in individuals with DCM (Nardone et al, 2008).…”

Section: Introductionmentioning

confidence: 95%

Perturbation-Based Balance Training in Postoperative Individuals With Degenerative Cervical Myelopathy

Cheng

Chien

Lai

et al. 2020

Front. Bioeng. Biotechnol.

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Degenerative cervical myelopathy (DCM) is a common aging condition caused by spinal cord compression. Individuals with DCM often presented with residual balance and functional impairments postoperatively. Perturbation-based balance training (PBT) has been shown to have positive effects on populations with neurological disorders but has yet to be investigated in DCM. The objective of this study was therefore to evaluate the effects of PBT on balance and functional performance in postoperative individuals with DCM. Fifteen postoperative individuals with DCM (DCM group) and 14 healthy adults (healthy control group) were recruited. The DCM group received a 4-weeks PBT using a perturbation treadmill. The outcome measures included mean velocity of center of pressure (COP) during quiet standing; center of mass (COM) variance and reaction time to balance perturbation during standing with forward and backward perturbation; gait speed during level ground walking; Timed Up and Go Test (TUG) and disability questionnaire scores including Visual Analog Scale, Neck Disability Index, and Lower Extremity Function of Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. The assessments were conducted preand post-training postoperatively for the DCM group but only once for the healthy control group. Significant improvements were observed in the mean velocity of COP, COM variance, reaction time, gait speed, and TUG in the DCM group. Disability questionnaire scores were not significantly different after training in DCM group. For between-group comparisons, significant differences that were observed pre-training were not observed post-training. The 4-weeks PBT is a potential rehabilitation strategy for addressing balance and functional impairment in postoperative individuals with DCM. In addition, the post-training performance in the DCM group exhibited trends comparable to those Frontiers in Bioengineering and Biotechnology | www.frontiersin.org 1 February 2020 | Volume 8 | Article 108Cheng et al.Perturbation Training in Cervical Myelopathy of age-matched healthy controls. Furthermore, the training regimens offer a practical reference for future studies on populations with balance disorders. Future studies complemented with neurophysiological assessments could reveal more information of the underlying mechanisms of PBT.

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“…Stabilometry evaluates a patient's postural control and is used to investigate body sway in several diseases [ 9 10 ]. Yoshikawa et al [ 11 ] used a stabilometer to investigate the postural stability of patients with cervical myelopathy and reported that a stabilometer can objectively evaluate postural stability, which may reflect the function of the dorsal spinal column.…”

Section: Introductionmentioning

confidence: 99%

Significance of Stabilometry for Assessing Postoperative Body Sway in Patients with Cervical Myelopathy

et al. 2017

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Study DesignProspective study.PurposeTo examine the changes in body sway using stabilometry in patients who underwent cervical laminoplasty for cervical myelopathy.Overview of LiteratureAlthough the patients of cervical myelopathy complain body sway there are few report to examine body sway objectively.MethodsPatients who received treatment for cervical myelopathy between October 2010 and February 2013 were included. Twenty-one patients underwent cervical laminoplasty (myelopathy group). Body sway was assessed using stabilometry, wherein patients stood on a stabilometer with their eyes closed for 30 seconds. The Romberg ratio, outer peripheral area (OPA) with eyes closed (cm2), and total locus length per unit area (L/A) with eyes closed (/cm) were examined. Examinations were performed preoperatively (at baseline) and at 8 weeks postoperatively. Examination results of patients in the myelopathy group were compared with those of 17 healthy individuals (control group). Clinical symptoms were evaluated using the Japanese Orthopaedic Association scale score (JOA score) and the timed up and go (TUG) test.ResultsIn the myelopathy and control groups, the mean baseline Romberg ratio, OPA, and L/A were 2.3±1.2, 8.9±5.5 cm2, and 14.2±5.3/cm and 1.4±1.0, 4.3±2.8 cm2, and 23.7±10.1/cm, respectively. Eight weeks after laminoplasty, only L/A showed significant improvement from baseline in the myelopathy group (23.2±10.1 to 16.8±7.9; p=0.03). The Romberg ratio and OPA showed improvement in the myelopathy group, but the changes were not statistically significant. JOA scores and TUG test results in this group significantly improved from baseline to 8 weeks after laminoplasty (12.7 to 13.4 and 10.8 to 8.0 seconds, respectively; both p<0.05).ConclusionsL/A is a useful parameter for measuring body sway to assess the recovery of body sway after laminoplasty.

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Impaired Postural Stability in Patients With Cervical Myelopathy

Cited by 33 publications

References 18 publications

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

Perturbation-Based Balance Training in Postoperative Individuals With Degenerative Cervical Myelopathy

Significance of Stabilometry for Assessing Postoperative Body Sway in Patients with Cervical Myelopathy

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