Kadanka Zdenek, Kadanka Zdenek, Skutil Tomas, Vlckova Eva, Bednarik Josef
Department of Neurology, University Hospital, 625 00 Brno, Czech Republic.
Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
J Clin Med. 2021 Mar 1;10(5):927. doi: 10.3390/jcm10050927.
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.
步态障碍是退行性颈椎脊髓病(DCM)的主要症状之一,且常常是其首发表现。因此,定量步态分析是一种很有前景的客观工具,可用于发现退行性颈椎受压患者早期的脊髓损伤。这项横断面观察性队列研究的目的是验证一项客观且易于实施的步行和跑步测试,能否在相当比例的非脊髓型退行性颈椎脊髓受压(NMDCC)患者中检测出早期步态障碍,并揭示其与DCM患者残疾严重程度的相关性。研究组包括45例DCM患者(中位年龄58岁)、126例NMDCC受试者(59岁)和100例健康对照者(HC)(55.5岁),所有受试者均进行了标准化的10米步行和跑步测试。记录步行/跑步时间/速度、步数以及步行/跑步的步频;分析发现66.7%的NMDCC受试者存在异常。与NMDCC组相比,DCM组在所有步行/跑步参数方面表现出明显更显著的异常。这些异常在84.4%的DCM组患者中明显存在,并且与改良日本骨科协会量表量化的残疾程度密切相关。标准化的10米步行/跑步测试有能力发现没有其他明显脊髓病体征的NMDCC受试者的运动异常,并且可能为根据DCM患者的残疾程度进行分类提供一种方法。