Quantitative physical performance tests can effectively detect Degenerative Cervical Myelopathy: A systematic review and meta-analysis

Lau, Kenney Ki-Lee; Shea, Graham Ka‐Hon; Cheung, Kenneth M.C.

doi:10.1007/s00586-022-07349-x

Cited by 4 publications

(8 citation statements)

References 69 publications

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“…While several tools are available for assessing hand function, counting G&R cycles within 10 seconds remains a straightforward and accessible method that does not require specialized equipment. 8 According to our findings, hand dexterity in DCM patients is classified as follows: normal hand function ( ≥ 20 cycles), mild impairment (17 to 19 cycles), moderate impairment (14 to 16 cycles), and severe impairment (0 to 13 cycles). Patients with mild impairment may not be cognizant of their diminished hand dexterity, whereas those with severe impairment experience significant disruptions in their daily lives and are strongly recommended for surgical intervention.…”

Section: Discussionmentioning

confidence: 76%

“…Various physical performance tests for DCM have been developed, including the Graded Redefined Assessment of Strength, Sensibility, and Prehension Version Myelopathy (GRASSP-M) and the 10-second grip and release (10s-G&R) test. [6][7][8] The GRASSP-M assesses strength, sensibility, and prehension, while the 10s-G&R test focuses on evaluating hand dexterity through the capture of grip and release motion. However, the GRASSP-M test requires trained experts and specialized tools for its complicated evaluation.…”

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confidence: 99%

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Classifying Hand Dexterity Impairment in Degenerative Cervical Myelopathy With 10-Second Grip and Release Test

Liang,

Ye,

Zheng

et al. 2023

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Study design. Diagnostic accuracy study with prospectively collected data. Objective. This study aimed to establish optimal cutoff values for the 10-second Grip and Release (10s-G&R) Test to distinguish between mild, moderate, and severe levels of hand dexterity impairment in patients with Degenerative Cervical Myelopathy (DCM). Background. The 10s-G&R test is widely utilized to assess hand function in DCM patients. However, whether this test can effectively distinguish between varying severities of hand dexterity impairment, along with the relevant cut-off values, remains unknown. Methods. We analyzed hand motion data from 551 consecutively enrolled DCM patients using an AI system. Additionally, we conducted evaluations of functional status, quality of life, and outcome measures. Receiver operating curve analysis was performed to determine cutoff values that differentiate mild, moderate, and severe hand dexterity impairments based on the ability to fasten buttons, as assessed by the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) Q2-1. The validity of these cutoffs was assessed by comparing G&R parameters, upper limb disability, overall disease severity, and quality of life among patients in different severity groups. Results. We identified 16 G&R cycles as the cutoff for moderate hand dexterity impairment and 13 G&R cycles as the cutoff for severe impairment. Patients with severe impairment exhibited significantly worse G&R parameters, more severe upper limb symptoms, greater overall disease severity, and reduced quality of life. Patients completing fewer than 13 G&R cycles within 10 seconds were more likely to have moderate-to-severe DCM, indicating the need for potential surgical intervention. Conclusion. We propose classifying mild hand dexterity impairment as 17-20 cycles on the 10s-G&R test, moderate as 14-16 cycles, and severe as 13 cycles or less. Our study underscores that the 10s-G&R test can serve as an effective supplementary tool within the context of other currently available measurement tools.

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Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

Classifying Hand Dexterity Impairment in Degenerative Cervical Myelopathy With 10-Second Grip and Release Test

Liang,

Ye,

Zheng

et al. 2023

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“…The quality of case–control and cohort studies was measured for multiple aspects, including selection, comparability, exposure, and outcome 21 . A total rate equal or less than four highlights a low‐quality score; a range from four to six expresses an intermediate quality score; a score from seven to nine represents an high‐quality score 22 …”

Section: Methodsmentioning

confidence: 99%

“…21 A total rate equal or less than four highlights a low-quality score; a range from four to six expresses an intermediate quality score; a score from seven to nine represents an high-quality score. 22…”

Section: Quality Assessmentsmentioning

confidence: 99%

Neurite Orientation Dispersion and Density Imaging in Multiple Sclerosis: A Systematic Review

Seyedmirzaei

Nabizadeh

Aarabi

et al. 2023

Magnetic Resonance Imaging

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Diffusion‐weighted imaging has been applied to investigate alterations in multiple sclerosis (MS). In the last years, advanced diffusion models were used to identify subtle changes and early lesions in MS. Among these models, neurite orientation dispersion and density imaging (NODDI) is an emerging approach, quantifying specific neurite morphology in both grey (GM) and white matter (WM) tissue and increasing the specificity of diffusion imaging. In this systematic review, we summarized the NODDI findings in MS. A search was conducted on PubMed, Scopus, and Embase, which yielded a total number of 24 eligible studies. Compared to healthy tissue, these studies identified consistent alterations in NODDI metrics involving WM (neurite density index), and GM lesions (neurite density index), or normal‐appearing WM tissue (isotropic volume fraction and neurite density index). Despite some limitations, we pointed out the potential of NODDI in MS to unravel microstructural alterations. These results might pave the way to a deeper understanding of the pathophysiological mechanism of MS.Evidence Level2.Technical EfficacyStage 3.

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“…[1][2][3][4] Clumsy finger movement, also termed myelopathy hand, [5][6][7][8] often occurs as a symptom of DCM. 3,[9][10][11][12] The clinical significance of myelopathy hand 13,14 is that it can be used as an indicator of neurological status and indicate the severity of myelopathy. 15,16 Impaired flexion and extension of the ulnar two or three fingers and inability to grip and release (G&R) the hands rapidly are frequently encountered in DCM patients.…”

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confidence: 99%

A Pilot Study of a Finger Kinematic Parameter-Based Tool for Evaluating Degenerative Cervical Myelopathy

Li,

Wang,

et al. 2023

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Study Design. This is a cross-sectional study. Objective. To evaluate the effectiveness of a novel finger Kinematic Parameter-Based Tool in grip-and-release (G&R) test for assessing degenerative cervical myelopathy (DCM). Summary of Background Data. The development and progression of DCM symptoms are gradual and obscure. Although previous studies have objectively evaluated hand movements specific to myelopathy using the G&R test, virtual reality, or wearable sensors, these methods have limitations, such as limited discrimination or inconvenience for simple screening. Consequently, there is a need to develop effective screening methods. Methods. 297 asymptomatic volunteers and 258 DCM patients were enrolled. This system comprises a wearable acceleration/gyro (A/G) sensor. The A/G sensor was placed on the little finger of the participants to perform 40 cycles of full-range G&R as quickly as possible. The collected data were then transformed into kinematic parameters using sensor-based software and R studio. Gender, age, and BMI subgroups (classified as BMI<18.5—below normal weight; 18.5≤BMI<25—normal weight group; BMI≥25—overweight group) were matched as predictor variables, and 201 pairs were matched. Non-parametric analysis using the Mann-Whitney U test was used for diagnosing the differences between the two groups, and the Kruskal-Wallis’s test followed by the Mann-Whitney U test was used for analyzing the differences among three different age groups (<40 yrs., 41-60 yrs. and >60 yrs. group). The cut-off value of 10s G&R cycles and a combined parameter were determined using receiver operating characteristics (ROC) curve analysis, area under the curve (AUC) and Youden index. Results. We found that little finger kinematic parameters were significantly lower in DCM patients than in asymptomatic participants. The optimal diagnostic indicator appeared to be the average top 10 linear accelerations with an AUC of 0.923. Conclusion. The Finger Kinematic Test System is an objective, practical and quantitative utility that appears to have the capacity to diagnose and evaluate the severity of DCM. Level of Evidence. 3

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Quantitative physical performance tests can effectively detect Degenerative Cervical Myelopathy: A systematic review and meta-analysis

Cited by 4 publications

References 69 publications

Classifying Hand Dexterity Impairment in Degenerative Cervical Myelopathy With 10-Second Grip and Release Test

Classifying Hand Dexterity Impairment in Degenerative Cervical Myelopathy With 10-Second Grip and Release Test

Neurite Orientation Dispersion and Density Imaging in Multiple Sclerosis: A Systematic Review

A Pilot Study of a Finger Kinematic Parameter-Based Tool for Evaluating Degenerative Cervical Myelopathy

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