Article
Gait analysis as diagnostic tool in patients with cervical myelopathy
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Published: | June 13, 2005 |
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Outline
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Introduction
The management of patients with cervical spondylotic myelopathy (CSM) is still a matter of controversy. Clinical scores depend on subjective judgement, and CT or MRI show structural changes only. Electrophysiological methods have been shown to be sensitive, but not very specific. The purpose of the study was to investigate if gait disturbances due to CSM can be detected by gait analysis.
Methods
10 patients with cervical myelopathy were evaluated preoperative, 1 week and 1 year after operation. Gait analysis was performed using an optoelectronic-motion-analysis-system (VICON), two force plates (Kistler plates) and a ten-channel surface EMG. Data collection of joint motion, electromyographic activity and ground-reaction force (GFR) were obtained simultaneously in real time with 24 gait cycles for each individual. For further evaluation 58 parameters relative to time-distance, kinematic and kinetic variables were calculated and statistically analysed. Data were compared with a control group of healthy subjects.
Results
Significant gait abnormalities could be identified in patients with SCM. Kinematic changes were seen at the hip, knee and ankle. Kinetic variables showed significant differences with respect to the GRF and the joint moments. Early changes were seen one week after surgical decompression with no further improvement after one year.
Discussion
Gait disturbances due to SCM could be quantified by gait analysis. Decompression surgery led to early changes in gait patterns that did not further improve after 1 year. Future studies will investigate if the changes detected by gait analysis correlate with clinical improvement in patients with CSM.