Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China.
School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China.
Spine J. 2023 Aug;23(8):1127-1136. doi: 10.1016/j.spinee.2023.03.004. Epub 2023 Mar 17.
Cervical spondylotic myelopathy (CSM) is a degenerative disease caused by cervical cord compression and can lead to the significant impairment of motor function including gait and balance disturbances and changes in lower extremity muscle activity.
This study aimed to characterize gait, balance and lower extremity muscle activity in patients with CSM compared to age-matched healthy controls (HCs) using wearable sensors in the clinical setting.
Nonrandomized, prospective cohort study.
Ten CSM patients and 10 age-matched HCs were recruited for this study.
Gait and balance function parameters contained spatial temporal parameters, step regularity (SR1), stride regularity (SR2) and harmonic ratio (HR). EMG muscle activity parameters included time to peak and peak value during loading, stance, and swing phase.
In this study, parameters of gait and balance function were extracted using triaxial accelerometer attached to the spinous processes of Lumbar 5 while participants performed an overground walking at a self-preferred speed. Moreover, muscular activity was simultaneously recorded via sEMG sensors attached to tibialis anterior (TA), rectus femoris (RF), bicep femoris (BF), and gastrocnemius lateral (GL). Independent sample t test was used to find the differences between CSM patients and HCs.
Gait analysis showed cadence, step length and walking speed were statistically significantly lower in CSM patients than HCs. Stride time was significantly higher for CSM patients in comparison to HCs. Lower root mean square ratio (RMSR) of acceleration in the mediolateral (ML) direction, HR in the anteroposterior (AP) direction, SR1 in the AP direction and SR2 in all three directions were observed in CSM patients. For muscle activity analysis, EMG RMS for TA and RF during loading phase and RMS for GL during midstance phase was significantly lower for CSM patients, while significantly higher value was observed for RF RMS during midstance phase and GL RMS during swing phase in CSM patients.
Our pilot study shows that wearable sensors are able to detect the changes of gait, balance and lower extremity muscle activities of CSM patients in the clinical setting. This pilot study sets the stage for future researches on the diagnosis and monitor progression of CSM disease using wearable technology.
颈椎脊髓病（CSM）是一种由颈脊髓受压引起的退行性疾病，可导致运动功能显著受损，包括步态和平衡障碍以及下肢肌肉活动的改变。
本研究旨在使用可穿戴传感器在临床环境中比较 CSM 患者与年龄匹配的健康对照者（HCs）的步态、平衡和下肢肌肉活动。
非随机、前瞻性队列研究。
本研究纳入了 10 名 CSM 患者和 10 名年龄匹配的 HCs。
步态和平衡功能参数包括时空参数、步长规则性（SR1）、步长规则性（SR2）和调和比（HR）。肌电图（EMG）肌肉活动参数包括加载、站立和摆动阶段的峰值时间和峰值。
在本研究中，通过将三轴加速度计附着在腰椎 5 的棘突上，当参与者以自我偏好的速度进行地面行走时，提取步态和平衡功能参数。此外，通过附着在前胫骨肌（TA）、股直肌（RF）、股二头肌（BF）和腓肠外侧肌（GL）的表面肌电图（sEMG）传感器同时记录肌肉活动。使用独立样本 t 检验比较 CSM 患者和 HCs 之间的差异。
步态分析显示，CSM 患者的步频、步长和行走速度明显低于 HCs。CSM 患者的步长时间明显高于 HCs。CSM 患者在横向（ML）方向的加速度均方根比（RMSR）、前-后（AP）方向的 HR、AP 方向的 SR1 和所有三个方向的 SR2 均较低。对于肌肉活动分析，CSM 患者在加载阶段的 TA 和 RF 的肌电图 RMS 和中间站立阶段的 GL 的 RMS 明显较低，而 CSM 患者在中间站立阶段的 RF RMS 和摆动阶段的 GL RMS 明显较高。
我们的初步研究表明，可穿戴传感器能够在临床环境中检测 CSM 患者的步态、平衡和下肢肌肉活动的变化。本初步研究为使用可穿戴技术诊断和监测 CSM 疾病的进展奠定了基础。
