The goal of this clinical trial is to learn whether starting rehabilitation earlier after surgery can improve recovery and is feasible and acceptable for adults with degenerative cervical myelopathy (DCM) undergoing cervical spine surgery. The main question it aims to answer is: Does starting rehabilitation earlier improve walking, balance, physical activity, quality of life, and nervous system function after surgery? Researchers will compare participants who begin rehabilitation two weeks after surgery with participants who begin rehabilitation six weeks after surgery to see if earlier rehabilitation leads to better recovery outcomes and participation. Participants will: Be randomly assigned to begin rehabilitation either two weeks or six weeks after surgery. Attend physical therapy sessions twice per week for eight weeks focused on strength, balance, and walking. Complete assessments of walking ability, balance, physical activity, quality of life, and nervous system function over several months after surgery. Provide feedback about their experience with the rehabilitation program, including satisfaction and any side effects or challenges related to participation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
Active, task-specific physical therapy to enhance balance, walking, and strength
Change from Baseline in the Ten Metre Walk Test
Time to walk ten metres; lower times indicate faster walking speed
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in the Six Minute Walk Test
Distance walked in six minutes; longer distances indicate greater walking endurance
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in the Timed Up and Go
Time taken to stand, walk 3 metres and return to sitting position; longer time indicates balance and mobility impairments
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in the Berg Balance Scale
Standardized test that includes 14 balance tasks, with scores ranging from 0 to 56; lower scores indicate balance impairment
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline on the 36-item Short Form Survey
Survey measuring health-related quality of life, with scores ranging from 0 to 100; higher scores indicate better health status
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Admission to Study on the modified Japanese Orthopaedic Association Scale
Score to evaluate the severity of degenerative cervical myelopathy, with scores ranging from 0 to 18; higher scores indicate more mild myelopathy
Time frame: Study Admission and End of Study (12 weeks)
Change from Baseline in Motor-Evoked Potentials
Transcranial Magnetic Stimulation (TMS) will be used and electromyography (EMG) will be recorded in lower extremity muscles; size of motor-evoked potentials will be measured
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
Change from Baseline in Hoffman Reflexes
Hoffman reflexes will be elicited in the soleus muscle and electromyography (EMG) will be recorded; H:M ratios and rate-dependent depression will be measured.
Time frame: Baseline and End Rehabilitation (8 weeks following Baseline)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.