Duration of symptoms in the quantification of upper limb disability and impairment for individuals with mild degenerative cervical myelopathy (DCM)
Autoři:
Sukhvinder Kalsi-Ryan aff001; Jerri Clout aff003; Pouya Rostami aff003; Eric M. Massicotte aff003; Michael G. Fehlings aff003
Působiště autorů:
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
aff001; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
aff002; Spine Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
aff003; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
aff004
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222134
Souhrn
Objectives
Degenerative cervical myelopathy (DCM) involves spinal cord compression, which causes neurological decline. Neurological impairment in DCM is variable and can involve complex upper limb dysfunction including loss of manual dexterity, hyper-reflexia, focal weakness, and sensory impairment. DCM can cause progressive loss of manual dexterity, reduced upper limb (UL) function and disability. The purpose of this study was to define relationships between impairment and disability of the UL and determine the impact of duration of symptoms on disease severity.
Design
An observational cross-sectional study quantifying disease severity, UL impairment and disability at time of diagnosis was conducted. A second observational longitudinal cohort was studied at the time of diagnosis and 1 year later.
Setting
Toronto Western Hospital, Spine Program.
Subjects
The cross sectional study included 140 study subjects diagnosed with mild, moderate or severe DCM. For the longitudinal study, 61 study subjects with mild DCM were enrolled and split into two groups, one group with less than 12 months of symptom duration and more than 12 months.
Main measures
Modified Japanese Orthopaedic Assessment (mJOA); Graded Redefined Assessment of Sensation, Strength and Prehension (GRASSP); Quick Disability of the Arm, Shoulder and Hand (QuickDASH).
Results
Pearson correlation coefficients between GRASSP and QuickDASH revealed significant relationships between strength, sensation and dexterity for all patients to varying degrees. The covariate (mJOA) was significantly related to QuickDASH, indicating duration of symptoms has an important effect on UL disability in the mild severity group.
Conclusions
Strength, sensation and dexterity play a defining role in disability of the UL across all severities of DCM and are discriminant measures. Duration of symptoms has a significant impact on self-perceived disability, where a longer duration in mild patients results in diminished disability, suggesting adaptation. Duration of symptoms is an important factor to consider in the treatment plan for patients with mild disease.
Klíčová slova:
Biology and life sciences – Neuroscience – Psychology – Social sciences – Anatomy – Medicine and health sciences – Health care – Patients – Public and occupational health – Disabilities – Nervous system – Musculoskeletal system – Body limbs – Arms – Neuroanatomy – Surgical and invasive medical procedures – Sensory perception – Biomechanics – Hand strength
Zdroje
1. Brian WR, Northfield D., Wilkinson M. The Neurological Manifestations of Cervical Spondylosis. Brain. 1952;75(2):187–225. doi: 10.1093/brain/75.2.187 14934989
2. Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain. 1972;95(1):87–100. doi: 10.1093/brain/95.1.87 5023093
3. Wilson JR, Fehlings MG, Kalsi-Ryan S, Shamji MF, Tetreault LA, Rhee JM, et al. Diagnosis, heritability, and outcome assessment in cervical myelopathy: a consensus statement. Spine. 2013;38(22 Suppl 1):S76–7.
4. Kalsi-Ryan S, Karadimas SK, Fehlings MG. Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder. Neuroscientist. 2013;19(4):409–21. doi: 10.1177/1073858412467377 23204243
5. Fehlings MG, Wilson JR, Kopjar B, Yoon ST, Arnold PM, Massicotte EM, et al. Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. J Bone Joint Surg Am. 2013;95(18):1651–8. doi: 10.2106/JBJS.L.00589 24048552
6. Tetreault L, Kopjar B, Nouri A, Arnold P, Barbagallo G, Bartels R, et al. The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy. Eur Spine J. 2017;26(1):78–84. doi: 10.1007/s00586-016-4660-8 27342612
7. Bartels RH, Fehlings MG, Abumi K. Cervical spondylotic myelopathy: an update: editorial. Eur Spine J. 2015;24 Suppl 2:131.
8. Fehlings MG, Tetreault LA, Riew KD, Middleton JW, Aarabi B, Arnold PM, et al. A Clinical Practice Guideline for the Management of Patients With Degenerative Cervical Myelopathy: Recommendations for Patients With Mild, Moderate, and Severe Disease and Nonmyelopathic Patients With Evidence of Cord Compression. Global Spine J. 2017;7(3 Suppl):70S–83S. doi: 10.1177/2192568217701914 29164035
9. Martin AR, De Leener B, Cohen-Adad J, Aleksanderek I, Cadotte DW, Kalsi-Ryan S, et al. 163 Microstructural MRI Quantifies Tract-Specific Injury and Correlates With Global Disability and Focal Neurological Deficits in Degenerative Cervical Myelopathy. Neurosurgery. 2016;63 Suppl 1:165.
10. Tetreault LA, Kopjar B, Vaccaro A, Yoon ST, Arnold PM, Massicotte EM, Fehlings MG. A clinical prediction model to determine outcomes in patients with cervical spondylotic myelopathy undergoing surgical treatment: data from the prospective, multi-center AOSpine North America study. J Bone Joint Surg Am. 2013 Sep 18;95(18):1659–1666. doi: 10.2106/JBJS.L.01323 24048553
11. Beaton DE, Wright JG, Katz JN; Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005 May;87(5):1038–1046. doi: 10.2106/JBJS.D.02060 15866967
12. Kalsi-Ryan S, Singh A, Massicotte EM, et al. Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy. Spine 2013 Oct 15;38(22 Suppl 1):S111–122.
13. Bartels RH, Verbeek AL, Benzel EC, Fehlings MG, Guiot BH. Validation of a translated version of the modified Japanese orthopaedic association score to assess outcomes in cervical spondylotic myelopathy: an approach to globalize outcomes assessment tools. Neurosurgery 2010;66:1013–1016. doi: 10.1227/01.NEU.0000368391.79314.6F 20404709
14. Kalsi-Ryan S, Beaton D, Curt A, Duff S, Popovic MR, Rudhe C, et al. The Graded Redefined Assessment of Strength Sensibility and Prehension: reliability and validity. J Neurotrauma. 2012;29(5):905–14. doi: 10.1089/neu.2010.1504 21568688
15. Organization WH. International Classification of Functioning, Disability and Health:ICF. Geneva, Switzerland 2001.
16. Hirabayashi S, Tsuzuki N, Abe R, Saiki K, Takahashi K. The value of a new method for assessing the separate functions of the long tracts and involved segments in patients with cervical myelopathy. Int Orthop 2000; 24(2):75–9. doi: 10.1007/s002640000127 10894374
17. Tam S, Barry RL, Bartha R, Duggal N. Changes in functional magnetic resonance imaging cortical activation after decompression of cervical spondylosis: case report. Neurosurgery 2010 Sep;67(3):E863–864; discussion E864. doi: 10.1227/01.NEU.0000374848.86299.17 20657323
18. Holly LT, Dong Y, Albistegui-DuBois R, Marehbian J, Dobkin B. Cortical reorganization in patients with cervical spondylotic myelopathy. J Neurosurg Spine 2007; 6:544–551. doi: 10.3171/spi.2007.6.6.5 17561743
19. Kalsi-Ryan S, Beaton D, Curt A, Duff S, Jiang D, Popovic MR, Rudhe C, Fehlings MG, Verrier MC. Defining the Role of Sensation, Strength, and Prehension for Upper Limb Function in Cervical Spinal Cord Injury. Neurorehabil Neural Repair. 2013 Jun 18; [Epub ahead ofprint] doi: 10.1177/1545968313490998 23778700.
20. King JT, Jr., Roberts MS. Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy. J Neurosurg 2002; 97:180–185. 12296676
21. Martin AR, De Leener B, Cohen-Adad J, Kalsi-Ryan S, Cadotte DW, Wilson JR, Tetreault L, Nouri A, Crawley A, Mikulis DJ, Ginsberg H, Massicotte EM, Fehlings MG. Monitoring for myelopathic progression with multiparametric quantitative MRI. PLoS One 2018 Apr 17; 13(4):e0195733. doi: 10.1371/journal.pone.0195733 29664964
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PLOS One
2019 Číslo 9
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