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Gait Posture. 2018 Jan;59:152-156. doi: 10.1016/j.gaitpost.2017.10.013. Epub 2017 Oct 10.

Analysis of spastic gait in cervical myelopathy: Linking compression ratio to spatiotemporal and pedobarographic parameters.

Author information

1
Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
2
Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: yasuhito@tokyo-med.ac.jp.
3
Rehabilitation Center, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.

Abstract

BACKGROUND:

Gait dysfunction associated with spasticity and hyperreflexia is a primary symptom in patients with compression of cervical spinal cord. The objective of this study was to link maximum compression ratio (CR) to spatiotemporal/pedobarographic parameters.

METHODS:

Quantitative gait analysis was performed by using a pedobarograph in 75 elderly males with a wide range of cervical compression severity. CR values were characterized on T1-weighted magnetic resonance imaging (MRI). Statistical significances in gait analysis parameters (speed, cadence, stride length, step with, and toe-out angle) were evaluated among different CR groups by the non-parametric Kruskal-Wallis test followed by the Mann-Whitney U test using Bonferroni correction. The Spearman test was performed to verify correlations between CR and gait parameters.

RESULTS:

The Kruskal-Wallis test revealed significant decline in gait speed and stride length and significant increase in toe-out angle with progression of cervical compression myelopathy. The post-hoc Mann-Whitney U test showed significant differences in these parameters between the control group (0.45<CR) and the worst myelopathy group (CR≤0.25). Cadence and step width did not significantly change with CR. On the other hand, the Spearman test revealed that CR was significantly correlated with speed, cadence, stride length, and toe-out angle.

CONCLUSION:

Gait speed, stride length, and toe-out angle can serve as useful indexes for evaluating progressive gait abnormality in cervical myelopathy. Our findings suggest that CR≤0.25 is associated with significantly poorer gait performance. Nevertheless, future prospective studies are needed to determine a potential benefit from decompressive surgery in such severe compression patients.

KEYWORDS:

Cervical myelopathy; Compression ratio; Gait analysis; MRI; Spasticity

PMID:
29031141
DOI:
10.1016/j.gaitpost.2017.10.013
[Indexed for MEDLINE]

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