Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy
Introduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the characteristics of gait analysis based on severity and det...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2023-11-01
|
| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/7/6/7_2023-0104/_pdf/-char/en |
| _version_ | 1827590116100538368 |
|---|---|
| author | Tatsuo Makino Kei Watanabe Tatsuki Mizouchi Takaaki Urakawa Masayuki Ohashi Hideki Tashi Keitaro Minato Yuki Tanaka Hiroyuki Kawashima |
| author_facet | Tatsuo Makino Kei Watanabe Tatsuki Mizouchi Takaaki Urakawa Masayuki Ohashi Hideki Tashi Keitaro Minato Yuki Tanaka Hiroyuki Kawashima |
| author_sort | Tatsuo Makino |
| collection | DOAJ |
| description | Introduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the characteristics of gait analysis based on severity and determined how gait disturbance progresses in compressive cervical myelopathy.
Methods: We enrolled 44 patients (32 men and 12 women; mean age, 65.0 years) out of 108 consecutive patients with compressive cervical myelopathy who underwent spinal cord decompression surgery in our hospital. The exclusion criteria were inability to gait and complications affecting gait. Twenty-two patients with Japanese Orthopaedic Association scores 1 or 2 for lower extremity motor functions were assigned to the severe group, and 22 patients who scored 3 or 4 were assigned to the moderate group. Gait analysis was performed preoperatively using a long thin-type sensor sheet, and 25 healthy volunteers were assigned to the control group.
Results: Stride length, swing phase, and gait speed decreased whereas step angle, stance phase, and double support duration increased as myelopathy progressed. Step width was significantly larger in the severe group than in the moderate and control groups. The cutoff values based on severe myelopathy with the inability to ascend or descend stairs without support were 60% for the stride length percentage of body height and 100 cm/s for gait speed.
Conclusions: Decreases in stride length, swing phase, and gait speed and increases in step angle, stance phase, and double support duration are compensatory changes as cervical myelopathy progresses. Step width is a compensatory change that is not significantly altered in moderate myelopathy but increases when gait becomes affected, such that the patient cannot ascend or descend stairs without support. |
| first_indexed | 2024-03-09T01:12:20Z |
| format | Article |
| id | doaj.art-151fc195670f40b3a95be3f5329b38aa |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-03-09T01:12:20Z |
| publishDate | 2023-11-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-151fc195670f40b3a95be3f5329b38aa2023-12-11T01:49:55ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2023-11-017648849510.22603/ssrr.2023-01042023-0104Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical MyelopathyTatsuo Makino0Kei Watanabe1Tatsuki Mizouchi2Takaaki Urakawa3Masayuki Ohashi4Hideki Tashi5Keitaro Minato6Yuki Tanaka7Hiroyuki Kawashima8Department of Orthopaedic Surgery, Niigata University Medical and Dental HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalSpine Centre, Department of Orthopaedic Surgery, Niigata Central HospitalDepartment of Orthopaedic Surgery, Nagaoka Chuo General HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalDepartment of Orthopaedic Surgery, Niigata University Medical and Dental HospitalIntroduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the characteristics of gait analysis based on severity and determined how gait disturbance progresses in compressive cervical myelopathy. Methods: We enrolled 44 patients (32 men and 12 women; mean age, 65.0 years) out of 108 consecutive patients with compressive cervical myelopathy who underwent spinal cord decompression surgery in our hospital. The exclusion criteria were inability to gait and complications affecting gait. Twenty-two patients with Japanese Orthopaedic Association scores 1 or 2 for lower extremity motor functions were assigned to the severe group, and 22 patients who scored 3 or 4 were assigned to the moderate group. Gait analysis was performed preoperatively using a long thin-type sensor sheet, and 25 healthy volunteers were assigned to the control group. Results: Stride length, swing phase, and gait speed decreased whereas step angle, stance phase, and double support duration increased as myelopathy progressed. Step width was significantly larger in the severe group than in the moderate and control groups. The cutoff values based on severe myelopathy with the inability to ascend or descend stairs without support were 60% for the stride length percentage of body height and 100 cm/s for gait speed. Conclusions: Decreases in stride length, swing phase, and gait speed and increases in step angle, stance phase, and double support duration are compensatory changes as cervical myelopathy progresses. Step width is a compensatory change that is not significantly altered in moderate myelopathy but increases when gait becomes affected, such that the patient cannot ascend or descend stairs without support.https://www.jstage.jst.go.jp/article/ssrr/7/6/7_2023-0104/_pdf/-char/encompressive cervical myelopathygait analysisjoa scoresurgery |
| spellingShingle | Tatsuo Makino Kei Watanabe Tatsuki Mizouchi Takaaki Urakawa Masayuki Ohashi Hideki Tashi Keitaro Minato Yuki Tanaka Hiroyuki Kawashima Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy Spine Surgery and Related Research compressive cervical myelopathy gait analysis joa score surgery |
| title | Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy |
| title_full | Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy |
| title_fullStr | Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy |
| title_full_unstemmed | Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy |
| title_short | Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy |
| title_sort | gait analysis by the severity of gait disturbance in patients with compressive cervical myelopathy |
| topic | compressive cervical myelopathy gait analysis joa score surgery |
| url | https://www.jstage.jst.go.jp/article/ssrr/7/6/7_2023-0104/_pdf/-char/en |
| work_keys_str_mv | AT tatsuomakino gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT keiwatanabe gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT tatsukimizouchi gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT takaakiurakawa gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT masayukiohashi gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT hidekitashi gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT keitarominato gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT yukitanaka gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy AT hiroyukikawashima gaitanalysisbytheseverityofgaitdisturbanceinpatientswithcompressivecervicalmyelopathy |