[OES-1-5] Postoperative changes in reaching function and its relationship with upper extremity performance in cervical myelopathy
Introduction
Cervical myelopathy (CM) is a disorder caused by spinal cord compression associated with cervical spondylosis, disc herniation, and congenital stenosis. Although proximal arm dysfunction at the body function level (e.g., muscle strength and sensory disturbances) is well known, dysfunction at the mobility level has not been discussed adequately. The aim of this study was to investigate postoperative changes in reaching movement and its relationship with upper extremity performance in CM.
Method
Thirteen CM patients (9 males and 4 females, 67.7 ± 8.2 years) participated in the study. We monitored the reaching movement in 3-dimentional space during performing an electronic-mechanical whac-a-mole-type task (K3000, Work Joy, Japan) before and after surgery. Participants were required to reach for and touch 16 targets that appeared one by one on the screen. Two kinematic parameters, i.e., Movement time (MT) and movement distance in 3-dimentional space (MD) during the task were calculated. Upper extremity performance was evaluated by using three tests follows; 1) upper extremity function in the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ-UEF), 2) the Japanese Orthopedic Association (JOA) score and 3) three subtests time (number 8, 9, and 10) of the Simple Test for Evaluating Hand Function (STEF). The paired t-test was used to compare parameters between different two time points (before vs. after surgery). Moreover, associations between kinematic parameters and upper extremity performance scales were examined with Pearson’s correlation coefficient. The study was approved by ethic committee of the hospital and written informed consent was obtained from all patients.
Result
We found decreased the MT (p < 0.05), and increased JOACMEQ-UEF (p < 0.05) and JOA scores (p < 0.01), indicating significant improvements after surgery. Moreover, MT at post-surgery was significantly correlated with the STEF.
Conclusion
We evaluated proximal arm function at the mobility level in CM patients, and found the improvement after surgery. It is worth noting that the MT correlated with only the STEF, not with the JOACMEQ-UEF and JOA-scores. We assume that the JOACMEQ-UEF and JOA-scores reflect the ability of upper extremity performance in daily living; on the other hand, the STEF evaluates the maximum capacity of upper extremity performance.
Cervical myelopathy (CM) is a disorder caused by spinal cord compression associated with cervical spondylosis, disc herniation, and congenital stenosis. Although proximal arm dysfunction at the body function level (e.g., muscle strength and sensory disturbances) is well known, dysfunction at the mobility level has not been discussed adequately. The aim of this study was to investigate postoperative changes in reaching movement and its relationship with upper extremity performance in CM.
Method
Thirteen CM patients (9 males and 4 females, 67.7 ± 8.2 years) participated in the study. We monitored the reaching movement in 3-dimentional space during performing an electronic-mechanical whac-a-mole-type task (K3000, Work Joy, Japan) before and after surgery. Participants were required to reach for and touch 16 targets that appeared one by one on the screen. Two kinematic parameters, i.e., Movement time (MT) and movement distance in 3-dimentional space (MD) during the task were calculated. Upper extremity performance was evaluated by using three tests follows; 1) upper extremity function in the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ-UEF), 2) the Japanese Orthopedic Association (JOA) score and 3) three subtests time (number 8, 9, and 10) of the Simple Test for Evaluating Hand Function (STEF). The paired t-test was used to compare parameters between different two time points (before vs. after surgery). Moreover, associations between kinematic parameters and upper extremity performance scales were examined with Pearson’s correlation coefficient. The study was approved by ethic committee of the hospital and written informed consent was obtained from all patients.
Result
We found decreased the MT (p < 0.05), and increased JOACMEQ-UEF (p < 0.05) and JOA scores (p < 0.01), indicating significant improvements after surgery. Moreover, MT at post-surgery was significantly correlated with the STEF.
Conclusion
We evaluated proximal arm function at the mobility level in CM patients, and found the improvement after surgery. It is worth noting that the MT correlated with only the STEF, not with the JOACMEQ-UEF and JOA-scores. We assume that the JOACMEQ-UEF and JOA-scores reflect the ability of upper extremity performance in daily living; on the other hand, the STEF evaluates the maximum capacity of upper extremity performance.