Law Karlen K P, Lau Kenney K L, Shea Graham K H, Cheung Kenneth M C
Department of Orthopaedic and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, China.
Eur Spine J. 2022 Dec;31(12):3347-3364. doi: 10.1007/s00586-022-07349-x. Epub 2022 Sep 7.
This review aimed to identify effective physical performance tests (PPT) as clinical outcome indicators for detecting and monitoring degenerative cervical myelopathy (DCM).
A comprehensive literature search was performed on seven electronic databases on the effectiveness in detection and monitoring of DCM by PPT. All included studies were reviewed and undergone quality assessments on the risk-of-bias by Newcastle-Ottawa Scale and were pooled by random-effect analysis with level of significance at 0.05. Homogeneity among studies was assessed by I-statistics and effect of PPT was confirmed by Cohen's d effect size and confidence intervals.
Totally, 3111 articles were retrieved, and 19 studies were included for review and meta-analysis. There were 13 studies investigating PPT regarding the upper limbs and 12 studies regarding the lower limbs. Performance in 10-second-Grip-and-Release Test (G&R) and 9-Hole-Peg Test (9HPT) was studied in 10 and 3 articles, respectively, while 10-second-Stepping Test (SST), 30-meter-Walking Test (30MWT) and Foot-Tapping Test (FTT) for lower limbs were studied in 5, 4, and 3 articles correspondingly. Only 1 study utilized the Triangle-Stepping Test. High-quality study with fair risk-of-bias was revealed from Newcastle-Ottawa scale. Large effect size facilitated detection and monitoring in DCM was unveiling for G&R, 9HPT, SST, and 30MWT. FTT, while also effective, was hindered by a high-degree heterogeneity in the meta-analysis.
Effective PPT including G&R, 9HPT, SST, 30MWT, and FTT was identified for disease detection and monitoring in DCM.
本综述旨在确定有效的身体机能测试（PPT）作为检测和监测退行性颈椎脊髓病（DCM）的临床结局指标。
在七个电子数据库上进行了全面的文献检索，以查找PPT在检测和监测DCM方面的有效性。对所有纳入研究进行了综述，并根据纽卡斯尔-渥太华量表对偏倚风险进行了质量评估，并通过随机效应分析进行汇总，显著性水平为0.05。通过I统计量评估研究之间的同质性，并通过Cohen's d效应量和置信区间确定PPT的效果。
共检索到3111篇文章，纳入19项研究进行综述和荟萃分析。有13项研究调查了上肢的PPT，12项研究调查了下肢的PPT。分别在10篇和3篇文章中研究了10秒握力与释放测试（G&R）和9孔插板测试（9HPT）的表现，而分别在5篇、4篇和3篇文章中研究了下肢的10秒踏步测试（SST）、30米步行测试（30MWT）和足部轻拍测试（FTT）。只有1项研究使用了三角踏步测试。纽卡斯尔-渥太华量表显示研究质量较高但存在一定偏倚风险。G&R、9HPT、SST和30MWT在DCM的检测和监测中显示出较大的效应量。FTT虽然也有效，但在荟萃分析中受到高度异质性的阻碍。
确定了包括G&R、9HPT、SST、30MWT和FTT在内的有效PPT，可用于DCM的疾病检测和监测。
