Cervical radiculopathy and myelopathy are common degenerative disorders, which can create a large amount of social and medical burden. The aims of this study are(1) to investigate the functional outcomes progression before and after surgery, (2) to evaluate the biomechanical change and compensatory patterns of patients with or without decompression surgery, and (3) to design innovation intervention for the patients with cervical myelopathy and radiculopathy.
Neck pain, which is common in population recently, is causing the huge burden in the global medical service system. Cervical myelopathy, that is induced by disc degeneration, is turning to be an alarming public health issue. The clinical manifestations of cervical myelopathy include neck/shoulder pain, numbness/weakness of four limbs, sensorimotor impairment, and sociopsychological dysfunction. However, most of the previous studies tend to justify patients, prognosis in a single dimension. The investigators realized that no standard protocol for management in patients with the variety of manifestation and severity of signs and symptoms.This study is purposed to integrate and analyze the finding in surgery selection, clinical manifestation, psychological consultation, compensatory patterns in the neuromusculoskeletal system, postural control, home exercise and biomechanical features. Then, the investigators will develop a complementary model in assessment and prediction of prognosis, and also an applicable standard guideline in the clinical setting. To achieve the expected target, the principal investigator will play the role as the main coordinator in the team. The 3-year plan is listed as below: 1. In the first year, the patients will be recruited for projects from different co-investigators. The recruited participants will be allocated to different study group after assessment to ensure the most suitable intervention are offered to the participants. 2. In the second year, the participants' recruitment will be continuing. The effectiveness previous treatment will be assessed. The study procedure will be adjusted based on pilot results. 2\. In the third year, the study finding of all co-investigators and results of the biomechanical analysis will be integrated to establish the model of prognosis prediction and clinical management guideline. This study will provide a complete clinical management guideline in cervical myelopathy, which is expected to be globally leading reference in the management of cervical myelopathy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
452
specific rehabilitation exercise for patients with cervical myelopathy
National Taiwan University Hospital
Taipei, Taiwan
Neck Disability Index (NDI)
Questionnaire
Time frame: 1 year
Japanese Orthopaedic Association Myelopathy Evaluation Questionnaire (JOACMEQ)
Questionnaire
Time frame: 1 year
Modified Japanese Orthopaedic Association Scale (Modified JOA scale)
Investigator-administered scale Sub-scale 1: Motor Dysfunction score of the upper extremity (maximum score-5, minimum score-0) Sub-scale 2: Motor Dysfunction score of the lower extremity (maximum score-7, minimum score-0) Sub-scale 3: Sensory dysfunction score of the upper extremities (maximum score-3, minimum score-0) Sub-scale 4: Sphincter dysfunction (maximum score-3, minimum score-0) Higher score shows better outcome
Time frame: 1 year
Nurick scale
Investigator-administered scale The total maximum score is 5: the total minimum score is 0. Higher score shows worse outcome
Time frame: 1 year
Grip and release test
Functional movement
Time frame: 1 year
Foot taping test
Functional movement
Time frame: 1 year
5 times sit to stand
Functional movement
Time frame: 1 year
10 second step test
Functional movement
Time frame: 1 year
Kinetic variables
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The ground reaction force, moment and center of pressure recorded by force platform during standing and ambulation.
Time frame: 1 year
Neuropathic Pain Symptom Inventory
Questionaire
Time frame: 1 year
Magnetic Resonance Imaging (MRI)
The cortical network of patients assessed by Diffusion Spectrum Imaging of the brain
Time frame: 1 year
SF-36
Questionnaire
Time frame: 1 year
WHOQOL_BREF
Questionnaire
Time frame: 1 year
Kinematic variables
Range of motion
Time frame: 1 year
Muscle activities in Electromyography (EMG)
Muscle activities in neck and lower limbs
Time frame: I year