Gait and Posture
Gait and Posture
5 years ago

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

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.

Publisher URL: www.sciencedirect.com/science

DOI: S0966636217309694

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